Sample records for chronic middle ear

  1. Middle Ear Infection (Chronic Otitis Media) and Hearing Loss (United States)

    ... You Middle Ear Infection (Chronic Otitis Media) and Hearing Loss Middle Ear Infection (Chronic Otitis Media) and Hearing ... learning important speech and language skills. Types of hearing loss Conductive hearing loss is a form of hearing ...

  2. Ear infection - chronic (United States)

    Middle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infection ... up. When this happens, infection can occur. A chronic ear infection develops when fluid or an infection ...

  3. Evaluation of bacteriology of middle ear in early quiescent stage of chronic otitis media

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    Ramesh Bhandari


    Full Text Available Objectives The objectives of this study were to determine whether any organism does exist in middle ear cavity during the early quiescent stage of chronic otitis media and to isolate their types. Materials and methods Forty-seven patients of age 13 years and above with diagnosis of chronic otitis media mucosal type in early quiescent stage were included. Swab was collected from middle ear cavity for culture and sensitivity in operation theatre prior to middle ear surgery and brought to microbiology laboratory within half an hour to inoculate in Blood agar, Chocolate agar and Mac Conkey agar. The isolates were identified with the use of standard bacteriological technique. Results Aerobic bacteria were isolated from 15 cases (31.9%. Staphylococcus aureus isolated in 12(80%, Pseudomonas aeruginosa in 2(13.3% and E. coli in 1(6.7%. Conclusion Aerobic bacteria were isolated from middle ear cavity in quiescent stage of chronic otitis media in 15(32% cases. Staphylococcus aureus was the most common organism. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-4, 22-26 DOI:

  4. Attenuated TLRs in middle ear mucosa contributes to susceptibility of chronic suppurative otitis media. (United States)

    Si, Yu; Zhang, Zhi Gang; Chen, Sui Jun; Zheng, Yi Qing; Chen, Yu Bin; Liu, Yi; Jiang, Huaili; Feng, Lian Qiang; Huang, Xi


    The variability in the recovery of otitis media (OM) is not well understood. Recent data have shown a critical role for toll-like receptors (TLRs) in inflammatory responses to bacteria. It remains unclear whether TLRs-mediated mucosal immunity plays a role in the OM recovery. The etiology, pathological profile, expression levels of TLR2, TLR4, TLR5, TLR9 and proinflammatory cytokines were measured in human middle-ear mucosae sampled from three subject groups: non-OM group, chronic otitis-media (COM) group, and chronic suppurative otitis-media (CSOM) group. Of the 72 ears, 86.11% CSOM patients were positive for bacteria. The cellular makeup of the middle ear mucosa differs among the three groups. Mucosae from the CSOM group presented chronic inflammation or suppurative inflammation in the rudimentary stroma, mainly with infiltration of monocytes and macrophages. The mRNA and protein levels of TLR2, TLR4, and TLR5 exhibited no difference between the non-OM and COM groups but were significantly lower in the CSOM group. Conversely, there was no significant difference in the TLR9 level among the three groups. Furthermore, proinflammatory cytokines TNF-α, IL-1β, IFN-γ, IL-6 were up-regulated in the CSOM group. This study provides evidence that the variability in clinical otitis media recovery might be associated with the variability in the expression of mucosal TLRs. Reduced TLR levels in the middle-ear mucosa might cause weak host response to bacteria, persistent inflammation and susceptibility to CSOM.

  5. Inner ear disturbances related to middle ear inflammation (United States)

    Sone, Michihiko


    ABSTRACT The inner and middle ear are connected mainly through round and oval windows, and inflammation in the middle ear cavity can spread into the inner ear, which might induce a disturbance. In cases with intractable otitis media, attention should also be paid to symptoms related to the inner ear. In this paper, middle ear inflammation and related inner ear disturbances are reviewed with a focus on representative middle ear diseases (such as acute otitis media, chronic otitis media, otitis media with anti-neutrophil cytoplasmic antibody-associated vasculitis, eosinophilic otitis media, cholesteatoma with labyrinthine fistula, and reflux-related otitis media). Their clinical concerns are then discussed with reference to experimental studies. In these diseases, early diagnosis and adequate treatment are required to manage not only middle ear but also inner ear conditions.

  6. Cochlear implantation in chronic otitis media and previous middle ear surgery: 20 years of experience. (United States)

    Vincenti, V; Pasanisi, E; Bacciu, A; Bacciu, S; Zini, C


    Cochlear implantation in the setting of chronic otitis media or previous middle ear surgery poses several problems for the surgeon: possible spread of infection to the cochlea and the subarachnoid spaces with consequent meningitis, risk of electrode array extrusion and possible recurrence of the original disease. Several surgical strategies have been proposed to overcome these problems. In the present study, clinical and functional results of cochlear implantation in 26 patients with chronic otitis media (8 cases) or previous middle ear surgery (18 cases) in the ear most suitable for implantation were retrospectively reviewed. Among the 8 patients with chronic otitis media, in 7 cases a subtotal petrosectomy associated with external auditory canal closure and mastoid and Eustachian tube obliteration was performed, while in the remaining patient cochlear implantation was done 6 months after a myringoplasty. The only complication observed was a reperforation of the tympanic membrane in this latter patient. Among the 18 patients with previous middle ear surgery, 2 had undergone intact canal wall tympanomastoidectomy and were implanted utilising the previous surgical approach. In the remaining 16 patients who had a radical cavity, an open technique was maintained in 3 cases; a cavity revision associated to external auditory canal closure, Eustachian tube and mastoid obliteration was performed in 12 patients, while in one case a middle cranial fossa approach was utilised. Two of the 3 patients in whom an open technique was maintained have experienced electrode array extrusion. The only complication observed in the remaining patients was the breakdown of the external auditory canal closure in one case. No problems were noted in patients who had undergone intact canal wall tympanomastoidectomy as well as in the subject implanted via the middle cranial fossa approach. All patients achieved and maintained good hearing performance over time. Subtotal petrosectomy associated

  7. Middle ear infection (otitis media) (image) (United States)

    Otitis media is an inflammation or infection of the middle ear. Acute otitis media (acute ear infection) occurs when there is ... which causes production of fluid or pus. Chronic otitis media occurs when the eustachian tube becomes blocked ...

  8. Multiple Osteomas in Middle Ear

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    Yongxin Li


    Full Text Available Since the first description of middle ear osteomas by Thomas in 1964, only few reports were published within the English literatures (Greinwalid et al., 1998; Shimizu et al., 2003; Cho et al., 2005; and Jang et al., 2009, and only one case of the multiple osteomas in middle ear was described by Kim et al., 2006, which arose from the promontory, lateral semicircular canal, and epitympanum. Here we describe a patient with multiple middle ear osteomas arising from the promontory, incus, Eustachian tube, and bony semicanal of tensor tympani muscle. This patient also contracted the chronic otitis media in the ipsilateral ear. The osteomas were successfully removed by performing type III tympanoplasty in one stage.

  9. Middle Ear Infections (For Parents) (United States)

    ... Old Feeding Your 8- to 12-Month-Old Feeding Your 1- to 2-Year-Old Middle Ear Infections KidsHealth > For Parents > Middle Ear Infections ... Look at the Ear The Eustachian Tube About Middle Ear Infections Causes Signs ... the common cold , ear infections are the most frequently diagnosed childhood illness in the United States. Most kids will ...

  10. Diagnostic Performance of Endoscopic and Microscopic Procedures for Identifying Different Middle Ear Structures and Remaining Disease in Patients with Chronic Otitis Media: A Prospective Cohort Study.

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    Farhad Farahani

    Full Text Available The diagnostic performance of endoscopic and microscopic procedures for detecting diseases of the middle ear in patients with chronic otitis media (COM has rarely been investigated. This study was conducted to compare the performance of these procedures for identifying middle ear structures and their associated diseases in COM patients.In this prospective cohort study, 58 patients with chronic COM, who were candidates for tympanoplasty with or without a mastoidectomy, were enrolled. Before the surgical intervention, the middle ear was examined via an operating microscope and then through an endoscope to identify the middle ear structures as well as diseases associated with the middle ear.The patients were 15 years of age or older. The anatomical parts of the middle ear - the epitympanic, posterior mesotympanic, and hypotympanic structures - were more visible through an endoscope than through a microscope. In addition, the various segments of the mesotympanum, oval window, round window, and Eustachian tube were more visible via endoscopy. The post-operative endoscopic reevaluation of the middle ear revealed that a cholesteatoma had remained in four of 13 patients after surgery.According to the results of this study, in cases in which there is poor visibility with the operating microscope or the surgeon suspects remaining disease within the middle ear, endoscopy could be utilized to improve the evaluation of more hidden middle ear pits and structures, particularly if there is a potentially recrudescent pathology.

  11. Imaging of the postoperative middle ear

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    Williams, Marc T. [Department of Medical Imaging, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75940, Paris (France); Ayache, Denis [Department of Otorhinolaryngology, Fondation Ophtalmologique Adolphe de Rothschild, Paris (France)


    The aim of this article is twofold: (a) to present the principles and the indications of surgical treatment of middle ear pathologies; and (b) to review the imaging findings after middle ear surgery, including the normal postoperative aspects and imaging findings in patients presenting with unsatisfactory surgical results or with suspicion of postoperative complications. This review is intentionally restricted to the most common diseases involving the middle ear: chronic otitis media and otosclerosis. In these specific fields of interest, CT and MR imaging play a very important role in the postoperative follow-up and in the work-up of surgical failures and complications. (orig.)

  12. Osteoma of the middle ear: case report

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    Ryu, Ji Hwa [College of Medicine, Inje University, Dongrae Paik Hospital, Busan (Korea, Republic of)


    Osteomas of the middle ear are exceedingly rare benign neoplasms. To date, only 21 cases have been reported in the literature. They arise from the promontory, the pyramidal process and the ossicles, and they are usually asymptomatic or cause some conductive hearing loss. We report here the CT and pathologic findings in a 38-year-old woman with a benign osteoma of the middle ear along with chronic otitis media.

  13. Efficacy of nasopharyngeal culture in identification of pathogens in middle ear fluid in chronic otitis media with effusion

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    Eser O


    Full Text Available Purpose: Chronic otitis media with effusion (OME is the leading cause of hearing loss during childhood. In bacterial etiology of OME, the most frequent pathogens responsible are Haemophilus influenzae followed by Streptococcus pneumoniae and Moraxella catarrhalis . This study aimed at evaluating the accuracy of nasopharyngeal (NP specimens in the identification of pathogens in the middle ear fluid (MEF in patients with OME. Materials and Methods: In this cross sectional, case-control study, 95 MEFs and 53 NP secretion specimens were obtained from 53 children. As a control group, 102 NP specimens were taken from children having an operation other than an otological disease. Conventional culture methods and multiplex-PCR method have been used to determine the etiology of OME; NP carriage between cases and control groups were compared using conventional culture methods. Pearson Chi-Square and Fisher′s Exact tests were used in statistical analysis. Results : Bacteria were isolated by culture in 37.9% of MEF specimens, 14.7% of which belonged to the group H. influenzae , S. pneumoniae and M. catarrhalis. PCR was positive in 30.5% specimens targeting the same pathogens. There was a two-fold increase in carriage rate of S. pneumoniae and H. influenzae in patients than controls for each pathogen. Conclusion: PCR is a more reliable method to detect middle ear pathogens in MEF in comparison with the conventional culture methods. The NP colonization wasn′t found to be an indicator of the pathogen in MEF although middle ear pathogens colonize more in nasopharynx of diseased children.

  14. [Bone Conduction and Active Middle Ear Implants]. (United States)

    Volkenstein, S; Thomas, J P; Dazert, S


    The majority of patients with moderate to severe hearing loss can be supplied with conventional hearing aids depending on severity and cause for hearing loss in a satisfying way. However, some patients either do not benefit enough from conventional hearing aids or cannot wear them due to inflammatory reactions and chronic infections of the external auditory canal or due to anatomical reasons. For these patients there are fully- and semi-implantable middle ear and bone conduction implants available. These devices either directly stimulate the skull (bone conduction devices), middle ear structures (active middle ear implants) or the cochlea itself (direct acoustic stimulation). Patients who failed surgical hearing rehabilitation or do not benefit from conventional hearing aids may achieve a significant better speech understanding and tremendous improvement in quality of life by implantable hearing devices with careful attention to the audiological and anatomical indication criteria.

  15. Passive and active middle ear implants

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    Beutner, Dirk


    Full Text Available Besides eradication of chronic middle ear disease, the reconstruction of the sound conduction apparatus is a major goal of modern ear microsurgery. The material of choice in cases of partial ossicular replacement prosthesis is the autogenous ossicle. In the event of more extensive destruction of the ossicular chain diverse alloplastic materials, e.g. metals, ceramics, plastics or composits are used for total reconstruction. Their specialised role in conducting sound energy within a half-open implant bed sets high demands on the biocompatibility as well as the acoustic-mechanic properties of the prosthesis. Recently, sophisticated titanium middle ear implants allowing individual adaptation to anatomical variations are widely used for this procedure. However, despite modern developments, hearing restoration with passive implants often faces its limitations due to tubal-middle-ear dysfunction. Here, implantable hearing aids, successfully used in cases of sensorineural hearing loss, offer a promising alternative. This article reviews the actual state of affairs of passive and active middle ear implants.

  16. Osteomas of the middle ear

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    Sente Marko


    Full Text Available INTRODUCTION Osteomas of the middle ear are small, single, usually unilateral, peduncular growths, off-white in color, with smooth or multilobular surface, asymptomatic or causing functional disorders (progressive hearing loss, pathological appearance of the eardrum, vertigo and otorrhea, of unclear or unknown etiology. Fleury described three types of osteomas: massive, diffuse atticoantral and localized type. The therapy is surgical. Small and asymptomatic ones are followed-up. Cremers suggests surgical intervention in cases of progressive growth and increased hearing loss. Case description Discharge and pain in the left ear started twelve years ago, accompanied by impaired hearing and tinnitus. Four months ago the symptoms aggravated and discharge and pain increased. Otomicroscopic findings revealed: perforation in the posterior attic and a prominent polypous, clustered bright red formation. Schüller X-ray showed total absence of pneumocyte cells, with distinct sclerotic changes. Retroauricular access showed a biventricular bony formation in the cavum and partly in the antrum. A cholesteatoma extended from the cavum into the antrum, above the osteatoma. The bony formation was separated transmeatally from the grip in the posterior attic using a chisel, partially removing the bone wall of the exterior aural tube, removing it completely through the mastoid antrum. The removed bony mass, sized 5 x 8 x 8 mm, included also the incus. DISCUSSION Osteoma was discovered accidentally. Regarding clinical features, it belonged to the second group, due to progressive hearing loss, recurrent episodes of otorrhea, pain, biventricular shape and association with cholesteatoma. It was removed using a combined method. It was not possible to establish when the osteoma exactly started generating. It is possible that the initial complaints twelve years ago were the first signs of illness, and chronic otitis may have occurred as a consequence of the tumor.

  17. Chronic otorrhea caused by myospherulosis in the middle ear after tympanoplasty

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    Honings, J.; Dammeijer, P.F.


    OBJECTIVES: Myospherulosis is a foreign body reaction induced by the application of oil-based ointments. Myospherulosis in the ear is extremely rare. Only 4 cases have been described, all of which occurred after (repeated) mastoid surgery. METHODS: We present a case of persistent otorrhea and conduc

  18. Accumulation of Regulatory T Cells and Chronic Inflammation in the Middle Ear in a Mouse Model of Chronic Otitis Media with Effusion Induced by Combined Eustachian Tube Blockage and Nontypeable Haemophilus influenzae Infection. (United States)

    Hirano, Takashi; Kodama, Satoru; Kawano, Toshiaki; Suzuki, Masashi


    Nontypeable Haemophilus influenzae (NTHi) is associated with chronic otitis media (COM). In this study, we generated a murine model of COM by using eustachian tube (ET) obstruction and NTHi (10(7) CFU) inoculation into the tympanic bulla, and we investigated the relationship between regulatory T cells (Treg) and chronic inflammation in the middle ear. Middle ear effusions (MEEs) and middle ear mucosae (MEM) were collected at days 3 and 14 and at 1 and 2 months after inoculation. Untreated mice served as controls. MEEs were used for bacterial counts and to measure the concentrations of cytokines. MEM were collected for histological evaluation and flow cytometric analysis. Inflammation of the MEM was prolonged throughout this study, and the incidence of NTHi culture-positive MEE was 38% at 2 months after inoculation. The levels of interleukin-1β (IL-β), tumor necrosis factor alpha, IL-10, and transforming growth factor β were increased in the middle ear for up to 2 months after inoculation. CD4(+) CD25(+) FoxP3(+) Treg accumulated in the middle ear, and the percentage of Treg in the MEM increased for up to 2 months after inoculation. Treg depletion induced a 99.9% reduction of bacterial counts in MEEs and also significantly reduced the ratio of NTHi culture-positive MEE. The levels of these cytokines were also reduced in MEEs. In summary, we developed a murine model of COM, and our findings indicate that Treg confer infectious tolerance to NTHi in the middle ear.

  19. [The tempestuous history of middle ear operation]. (United States)

    Betlejewski, Stanisław; Betlejewski, Andrzej


    The paper is a review of primary and secondary historical and scientific literature concerning the surgical treatment of the middle ear diseases. The development of mastoid surgery can be traced through the past 4 centuries. Once used as a means of evacuating a postauricular abscess, it has evolved to become a method for gaining entry into the middle ear to control acute and chronic ear diseases, or for treatment of otogenic complications. Earlier works led the way to the postauricular "Wilde incision", which gave rise to Schwartze mastoidectomy. Oscar Wilde's ultimate demise from an otogenic meningitis appears all the more ironic when one considers the role his father, Sir William Wilde, played as one of the founding fathers of modern otology. The death of baron von Berger after mastoidectomy performed for treatment of tinnitus and hypacusis, stopped the further development of surgical procedures for about hundred years. The Joseph Toynbee's "Diseases of the ear" was the first work about ear diseases on a pathologic anatomical base, and fundamental for otology of the German speaking countries in the nineteenth and early twentieth centuries. Otology was emerging as a specific specialty. Von Tröltsch was the first surgeon, who proposed the antral opening through the external ear canal. When Schwartze and his assistant, Eysell, published their paper: "On the Artificial Opening of the Mastoid Air Cells," a century or so had passed since the few previous attempts to remove the tegmen of the mastoid had been reported. One of the greatest otologists of the 19th century was Adam Politzer, His influence on the 50 years of otology has never been equaled. It is in his honor that the International Society of Otology bears his name.

  20. Carcinoid tumour of the middle ear

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    Baig, Salman


    A case of middle ear mass in a young female from Ireland is described, who presented with left ear hearing loss and intermittent bloody discharge from the same ear. Examination under microscope revealed occlusive polyp in the left ear and a biopsy had been taken under general anaesthesia. Histopathology report described an adenoma \\/ carcinoid tumour of the middle ear confirmed by positive immunohistochemical staining. CT temporal bones revealed the extension of the disease. The patient underwent left tympanotomy and excision of the tumour. In general, these tumours are regarded as benign but may be mistaken for adenocarcinomas because of their histological heterogenecity.

  1. Optical assessment of middle ear inflammation


    Jung, David S.


    This thesis describes the development of an optical device to assess the inflammatory state of the middle ear mucosa through the ear canal, after ventilation tube insertion in otitis media with effusion in children. An optical phantom of the middle ear was developed in order to allow repeatable experiments. The phantom consists of eardrum and mucosa while all other structures are neglected. The optical properties of the phantom were determined based on literature review and experiments on...

  2. 21 CFR 874.3430 - Middle ear mold. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Middle ear mold. 874.3430 Section 874.3430 Food... DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3430 Middle ear mold. (a) Identification. A middle ear mold is a preformed device that is intended to be implanted to reconstruct the middle...

  3. Chronic discharging ear in a child: are we missing something? (United States)

    Dutta, Mainak; Ghatak, Soumya; Biswas, Gautam


    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.

  4. 3D finite element model of the chinchilla ear for characterizing middle ear functions. (United States)

    Wang, Xuelin; Gan, Rong Z


    Chinchilla is a commonly used animal model for research of sound transmission through the ear. Experimental measurements of the middle ear transfer function in chinchillas have shown that the middle ear cavity greatly affects the tympanic membrane (TM) and stapes footplate (FP) displacements. However, there is no finite element (FE) model of the chinchilla ear available in the literature to characterize the middle ear functions with the anatomical features of the chinchilla ear. This paper reports a recently completed 3D FE model of the chinchilla ear based on X-ray micro-computed tomography images of a chinchilla bulla. The model consisted of the ear canal, TM, middle ear ossicles and suspensory ligaments, and the middle ear cavity. Two boundary conditions of the middle ear cavity wall were simulated in the model as the rigid structure and the partially flexible surface, and the acoustic-mechanical coupled analysis was conducted with these two conditions to characterize the middle ear function. The model results were compared with experimental measurements reported in the literature including the TM and FP displacements and the middle ear input admittance in chinchilla ear. An application of this model was presented to identify the acoustic role of the middle ear septa-a unique feature of chinchilla middle ear cavity. This study provides the first 3D FE model of the chinchilla ear for characterizing the middle ear functions through the acoustic-mechanical coupled FE analysis.

  5. Influence of middle ear mucosal condition on post-tympanoplasty audiologic outcome. (United States)

    Song, Chan Il; Hong, Hye Ran; Yoon, Tae Hyun


    In this study, the association between the middle ear mucosal condition and post-tympanoplasty audiologic outcome was investigated in patients with chronic otitis media without cholesteatoma. One hundred and forty-three patients with chronic otitis media were collected in the Department of Otorhinolaryngology-Head and Neck Surgery at Asan Medical Center between January, 2009 and December, 2011. In the course of tympanoplasty, the status of the middle ear mucosa was divided into normal or abnormal by one surgeon. Pure tone audiometry was performed preoperatively and postoperatively, and post-tympanoplasty tympanogram was also conducted to estimate the condition of middle ear cavity. Of the 143 patients, there were 73 patients with normal middle ear mucosa and 70 patients with abnormal middle ear mucosa around Eustachian tube opening. The mean ABG of subjects with normal middle ear mucosa was 20.1 dB preoperatively, and 9.7 dB postoperatively (p ear mucosa group (p = 0.137). Postoperative ABGs for 500 and 1000 Hz (7.1, 7.7 dB) in normal middle ear mucosa patients were significantly lower than those (17.2, 19.4 dB) in abnormal middle ear mucosa patients (p ear mucosa status and post-tympanoplasty audiologic outcomes. The better condition of middle ear ventilation, the better postoperative hearing thresholds revealed after tympanoplasty.

  6. Structure and function of the mammalian middle ear. I: Large middle ears in small desert mammals. (United States)

    Mason, Matthew J


    Many species of small desert mammals are known to have expanded auditory bullae. The ears of gerbils and heteromyids have been well described, but much less is known about the middle ear anatomy of other desert mammals. In this study, the middle ears of three gerbils (Meriones, Desmodillus and Gerbillurus), two jerboas (Jaculus) and two sengis (elephant-shrews: Macroscelides and Elephantulus) were examined and compared, using micro-computed tomography and light microscopy. Middle ear cavity expansion has occurred in members of all three groups, apparently in association with an essentially 'freely mobile' ossicular morphology and the development of bony tubes for the middle ear arteries. Cavity expansion can occur in different ways, resulting in different subcavity patterns even between different species of gerbils. Having enlarged middle ear cavities aids low-frequency audition, and several adaptive advantages of low-frequency hearing to small desert mammals have been proposed. However, while Macroscelides was found here to have middle ear cavities so large that together they exceed brain volume, the bullae of Elephantulus are considerably smaller. Why middle ear cavities are enlarged in some desert species but not others remains unclear, but it may relate to microhabitat.

  7. Prenatal evaluation of the middle ear and diagnosis of middle ear hypoplasia using MRI

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    Katorza, Eldad; Nahama-Allouche, Catherine; Ducou le Pointe, Hubert; Garel, Catherine [Hopital d' Enfants Armand-Trousseau, Service de Radiologie, Paris (France); Castaigne, Vanina [Hopital Saint-Antoine, Service de Gynecologie-Obstetrique, Paris (France); Gonzales, Marie; Marlin, Sandrine [Hopital d' Enfants Armand-Trousseau, Service de Genetique et Embryologie medicales, Paris (France); Galliani, Eva [Hopital d' Enfants Armand-Trousseau, Service de Chirurgie maxillo-faciale, Paris (France); Jouannic, Jean-Marie; Rosenblatt, Jonathan [Hopital d' Enfants Armand-Trousseau, Service de Gynecologie-Obstetrique, Centre pluridisciplinaire de diagnostic prenatal, Paris (France)


    Analysis of the middle ear with fetal MRI has not been previously reported. To show the contribution of fetal MRI to middle ear imaging. The tympanic cavity was evaluated in 108 fetal cerebral MRI examinations (facial and/or cerebral malformation excluded) and in two cases, one of Treacher Collins syndrome (case 1) and the other of oculo-auriculo-vertebral (OUV) spectrum (case 2) with middle ear hypoplasia identified by MRI at 27 and 36 weeks' gestation, respectively. In all 108 fetuses (mean gestational age 32.5 weeks), the tympanic cavity and T2 hypointensity related to the ossicles were well visualised on both sides. Case 1 had micro/retrognathia and bilateral external ear deformity and case 2 had retrognathism with a left low-set and deformed ear. MRI made it possible to recognize the marked hypoplasia of the tympanic cavity, which was bilateral in case 1 and unilateral in case 2. Both syndromes are characterized by craniofacial abnormalities including middle ear hypoplasia, which cannot be diagnosed with US. The middle ear cavity can be visualized with fetal MRI. We emphasize the use of this imaging modality in the diagnosis of middle ear hypoplasia. (orig.)

  8. Carcinoid tumor of the middle ear. (United States)

    Nikanne, Elina; Kantola, Olli; Parviainen, Tapani


    Although carcinoid tumors are labeled as neuroendocrine tumors they can also originate in tissue lacking neuroendocrine cells, such as that in the middle ear. Symptoms of a carcinoid tumor in the middle ear are common ear symptoms such as fullness, pain and hearing loss. Carcinoid tumors have also been considered to be slow-growing. Both these aspects can easily lead to a relatively late diagnosis of carcinoid tumor of the middle ear. The diagnosis is made histologically, and the tumor is primarily treated surgically. In the follow-up of patients, octreotide scanning has proved to be a sensitive method in cases of both recurrence and metastasis. Our patient was a 34-year-old, otherwise healthy female with left-sided acute otitis media and facial palsy in her left ear. She had also suffered from the same symptoms 4 years earlier. She was treated with an operation, and the histologic diagnosis was a carcinoid tumor. In the follow-up of the patient we used octreotide scanning.

  9. Change of guinea pig inner ear pressure by square wave middle ear cavity pressure variation

    NARCIS (Netherlands)

    Feijen, RA; Segenhout, JM; Albers, FWJ; Wit, HP


    The inner ear fluid pressure of guinea pigs was measured during square wave middle ear cavity pressure variation. Time constants were derived for the slopes of the inner ear pressure recovery curves after middle ear pressure change. A "single exponential" function did not fit well and therefore more

  10. The use of a SQUID magnetometer for middle ear research

    NARCIS (Netherlands)

    Rutten, W.L.C.; Peters, M.J.; Brenkman, C.J.; Mol, H.; Grote, J.J.; Marel, van der L.C.


    A new technique is described for the measurement of vibrations in the temporal bones of an isolated middle ear. The precise recording of vibrations in the middle ear is of importance for the construction and improvement of a middle ear prosthesis.1 The method of measurement is based on a transformat

  11. Asymptomatic mucormycosis of middle ear: An incidental finding during tympanoplasty

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    K Biniyam


    Full Text Available Mucormycosis is a fungal infection, commonly affecting the paranasal sinuses. An aggressive invasive form of infection is common in people with uncontrolled diabetes and in immunocompromised people. Mucormycosis affecting temporal bone is a rare entity, most of the reported cases are of invasive disease in diabetic people. We report a case of mucormycosis of middle ear cavity which was found incidentally in a healthy nondiabetic woman while performing revision tympanoplasty for chronic suppurative otitis media.

  12. Acoustics of the human middle-ear air space. (United States)

    Stepp, Cara E; Voss, Susan E


    The impedance of the middle-ear air space was measured on three human cadaver ears with complete mastoid air-cell systems. Below 500 Hz, the impedance is approximately compliance-like, and at higher frequencies (500-6000 Hz) the impedance magnitude has several (five to nine) extrema. Mechanisms for these extrema are identified and described through circuit models of the middle-ear air space. The measurements demonstrate that the middle-ear air space impedance can affect the middle-ear impedance at the tympanic membrane by as much as 10 dB at frequencies greater than 1000 Hz. Thus, variations in the middle-ear air space impedance that result from variations in anatomy of the middle-ear air space can contribute to inter-ear variations in both impedance measurements and otoacoustic emissions, when measured at the tympanic membrane.

  13. Persistent middle ear effusion presumably biofilm-related in a paediatric patient with common variable immunodeficiency

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    Sara Torretta


    Full Text Available Bacterial biofilms play a role in upper respiratory tract diseases, including acute and chronic middle ear diseases, and are involved in chronic infections and resistance to antibiotic treatment. In particular, the nasopharynx and the surrounding tissues act as important reservoirs of resistant bacterial biofilms, which have been detected in biopsies taken from adenoid and/or middle ear mucosa of children with chronic middle ear effusion. Here we describe the management of a child with congenital immunodeficiency and a chronic middle ear effusion, resistant to traditional medical treatment and presumably due to nasopharyngeal colonization by bacterial biofilms, which has been successfully treated by means of medicated nasal douches delivering antibiotic and a biofilm-destroying compound.

  14. Diseases of the middle ear in childhood

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    Minovi, Amir


    Full Text Available [english] Middle ear diseases in childhood play an important role in daily ENT practice due to their high incidence. Some of these like acute otitis media or otitis media with effusion have been studied extensively within the last decades. In this article, we present a selection of important childhood middle ear diseases and discuss the actual literature concerning their treatment, management of complications and outcome. Another main topic of this paper deals with the possibilities of surgical hearing rehabilitation in childhood. The bone-anchored hearing aid BAHA and the active partially implantable device Vibrant Soundbridge could successfully be applied for children. In this manuscript, we discuss the actual literature concerning clinical outcomes of these implantable hearing aids.

  15. Effect of the middle ear reflex on sound transmission to the inner ear of rat. (United States)

    Pilz, P K; Ostwald, J; Kreiter, A; Schnitzler, H U


    The effect of the acoustic middle ear reflex (MER) was quantified using electrodes chronically implanted in the middle ears of rats. Cochlear microphonics (CM) and middle ear muscle EMG were measured under light Ketamin anesthesia after stimulation with tone pulses of 5-20 kHz ranging between 75 and 120 dB SPL. With increasing intensity, the CM measured before the onset of the MER increased to a maximum amplitude and then decreased with higher SPLs. At 10 kHz this maximum was reached at 95 dB SPL, for other stimulus frequencies at higher SPLs. After a latency of 10-20 ms, CM to 10 kHz stimuli of 80-95 dB SPL were decreased by the attenuating action of the MER. The lowest threshold of the MER was also measured at 10 kHz (77 dB SPL in the mean). To stimuli greater than 100 dB SPL after a latency of 6-10 ms, the CM amplitude was increased. That this CM increase to intense stimuli is caused by the action of the MER was confirmed by control experiments such as cutting the tendons of the middle ear muscles. The CM decrease to stimuli below 100 dB SPL, as well as the increase to very intense stimuli, can be explained by sound attenuation caused by the MER, together with the nonlinear dependence of CM amplitude on stimulus level. The observed shift of the maxima of the CM input-output function by the MER to higher stimulus levels probably indicates an increase of the dynamic range of the ear.

  16. The Role of Immittance Audiometry in Detecting Middle Ear Disease


    Jacobson, John T.


    Immittance audiometry is an objective technique which evaluates middle ear function by three procedures: static immittance, tympanometry, and the measurement of acoustic reflex threshold sensitivity. This article discusses the technique's ability to identify middle ear effusion, the single leading ear disease in children.

  17. Alterations in the Contra lateral Ear in Chronic Otitis Media

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Damghani


    Full Text Available Introduction: Chronic otitis media (COM, a persistent and durable inflammation and infection of the middle ear, is a common disorder. Alterations in the contralateral ear in sufferers have been observed in recent years. Because only a few studies have been reported in this area, we performed this study in order to assess alterations in the contralateral ear of patients with COM.   Materials and Methods: Cross-sectional and descriptive methods were used in 100 patients with COM who were selected for surgical treatment and admitted to hospital. An information form was completed for all patients including demographic data, medical history of otoscopy and paraclinical examinations such as pure tone audiometry (PTA, tympanometry, Schuller radiography, and high resolution computed tomography (HRCT. All data were processed using SPSS (version 18 software and descriptive statistical tests.   Results: According to otoscopy, PTA, tympanometry and graphical analysis, 60% of patients experienced disorders of the contralateral ear. Otoscopy analysis showed 54% of patients had a disorder of the contralateral ear, with the most common disorder being perforation of the ear drum. PTA showed a 48% incidence of contralateral ear problems (85% conductive hearing impairment; 12.5% sensorineural hearing impairment; 1.2% mixed. A total of 73.2% of patients with conductive hearing loss had a problem across all frequencies, while half of the patients with sensorineural hearing impairment had problems at frequencies greater than 1000 Hz. According to tympanometry, 38% of patients had problem in the contralateral ear. HRCT and Schuller graphical analyses indicated 31.5% and 36% occurrence of contralateral ear disorders, respectively.   Conclusion:  More than 50% of patients with COM in one ear have a chance of also presenting with the disease in the other ear. Outcomes of this study and previous studies have shown that COM should not be perceived as a disease limited

  18. Chronic suppurative otitis media, middle ear pathology and corresponding hearing loss in a cohort of Greenlandic children

    DEFF Research Database (Denmark)

    Avnstorp, Magnus Balslev; Homøe, Preben; Bjerregaard, Peter


    BACKGROUND: Otitis media (OM) has been observed at elevated prevalence rates in Greenlandic children. OM associated hearing loss (HL) may compromise the children's linguistic skills, social development and educational achievements. OBJECTIVES: We investigated the prevalence of chronic suppurative...... otitis media (CSOM), otitis media with effusion (OME) and tympanic membrane sequelae of OM, and compared the corresponding hearing thresholds. METHODS: In 2010 we examined a cohort of 223 Greenlandic children aged 4-10 years by video otoscopy, tympanometry and tested hearing thresholds for the low...... amplification in classrooms and otosurgical capacity should be further promoted in Greenland....

  19. Mouse middle ear ion homeostasis channels and intercellular junctions.

    Directory of Open Access Journals (Sweden)

    Lisa M Morris

    Full Text Available HYPOTHESIS: The middle ear contains homeostatic mechanisms that control the movement of ions and fluids similar to those present in the inner ear, and are altered during inflammation. BACKGROUND: The normal middle ear cavity is fluid-free and air-filled to allow for effective sound transmission. Within the inner ear, the regulation of fluid and ion movement is essential for normal auditory and vestibular function. The same ion and fluid channels active in the inner ear may have similar roles with fluid regulation in the middle ear. METHODS: Middle and inner ears from BALB/c mice were processed for immunohistochemistry of 10 specific ion homeostasis factors to determine if similar transport and barrier mechanisms are present in the tympanic cavity. Examination also was made of BALB/c mice middle ears after transtympanic injection with heat-killed Haemophilus influenza to determine if these channels are impacted by inflammation. RESULTS: The most prominent ion channels in the middle ear included aquaporins 1, 4 and 5, claudin 3, ENaC and Na(+,K(+-ATPase. Moderate staining was found for GJB2, KCNJ10 and KCNQ1. The inflamed middle ear epithelium showed increased staining due to expected cellular hypertrophy. Localization of ion channels was preserved within the inflamed middle ear epithelium. CONCLUSIONS: The middle ear epithelium is a dynamic environment with intrinsic mechanisms for the control of ion and water transport to keep the middle ear clear of fluids. Compromise of these processes during middle ear disease may underlie the accumulation of effusions and suggests they may be a therapeutic target for effusion control.

  20. Drop weld thermal injuries to the middle ear.

    LENUS (Irish Health Repository)

    Keogh, I J


    Drop weld injuries to the tympanic membrane and middle ear caused by hot sparks or molten slag are a rare but significant injury. Steel workers and welders who are regularly exposed to flying sparks and molten metal slag are predisposed. This type of transtympanic thermal injury occurs when the slag literally drops into the external auditory canal and burns through the tympanic membrane. A spectrum of severity of injury occurs which includes chronic tympanic membrane perforation, chronic otorrhoea, facial nerve injury and deafness. Chronic tympanic membrane perforation is the most common sequelae and is perhaps one of the most challenging of all perforations to repair The combination of direct thermal injury and foreign body reaction results in continuing or recurrent suppuration. The foreign body reaction is due to the embedding of metal slag in the promontorial mucosa. We present a case of drop weld injury to the left tympanic membrane, resulting in chronic middle ear inflammation, otorrhoea and tympanic perforation. CAT scan clearly demonstrated a metallic promontorial foreign body with localised bone erosion. We emphasise the importance of removing these foreign bodies and recommend a cartilage reinforced underlay tympanoplasty technique to repair these perforations. Transtympanic thermal trauma is a preventable occupational injury, which is best, avoided by earplugs and increased awareness.

  1. LDV measurement of bird ear vibrations to determine inner ear impedance and middle ear power flow (United States)

    Muyshondt, Pieter G. G.; Pires, Felipe; Dirckx, Joris J. J.


    The mechanical behavior of the middle ear structures in birds and mammals is affected by the fluids in the inner ear (IE) that are present behind the oval window. In this study, the aim was to gather knowledge of the acoustic impedance of the IE in the ostrich, to be able to determine the effect on vibrations and power flow in the single-ossicle bird middle ear for future studies. To determine the IE impedance, vibrations of the ossicle were measured for both the quasi-static and acoustic stimulus frequencies. In the acoustic regime, vibrations were measured with a laser Doppler vibrometer and electromagnetic stimulation of the ossicle. The impedance of the inner ear could be determined by means of a simple RLC model in series, which resulted in a stiffness reactance of KIE = 0.20.1012 Pa/m3, an inertial impedance of MIE = 0.652.106 Pa s2/m3, and a resistance of RIE = 1.57.109 Pa s/m. The measured impedance is found to be considerably smaller than what is found for the human IE.

  2. Middle and inner ear malformations in two cases of velocardiofacial syndrome


    Tabith Junior,Alfredo; Haetinger, Rainer Guilherme; Silva,Fernando Leite de Carvalho e; Gudmon, Monica de Castro


    Objective: To describe audiometric characteristics and middle and inner ear malformations in two patients with velocardiofacial syndrome. Method: Audiometric evaluation, computerized tomography of the temporal bones and analysis of DNA for multiple markers of 22q11 region were performed in two patients with clinical signs of velocardiofacial syndrome. Results: Conductive hearing loss related to chronic otites media and middle and inner ear malformations were found, the latter with the use of ...

  3. Scanning laser Doppler vibrometry of the middle ear ossicles. (United States)

    Ball, G R; Huber, A; Goode, R L


    This paper describes measurements of the vibratory modes of the middle ear ossicles made with a scanning laser Doppler vibrometer. Previous studies of the middle ear ossicles with single-point laser Doppler measurements have raised questions regarding the vibrational modes of the ossicular chain. Single-point analysis methods do not have the ability to measure multiple points on the ossicles and, consequently, have limited ability to simultaneously record relative phase information at these points. Using a Polytec Model PSV-100, detailed measurements of the ossicular chain have been completed in the human temporal bone model. This model, when driven with a middle ear transducer, provides detailed three-dimensional data of the vibrational patterns of the middle ear ossicles. Implications for middle ear implantable devices are discussed.

  4. Aberrant internal carotid artery in the middle ear

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Keun Tak; Kang, Hyun Koo [Dept. of Radiology, Seoul Veterans Hospital, Seoul (Korea, Republic of)


    The knowledge about the aberrant internal carotid artery (ICA) in the middle ear is essential for clinicians, because a misdiagnosis of the aberrant ICA could have serious consequences such as excessive aural bleeding during a middle ear surgery. A 38-year-old woman presented with tinnitus and hearing difficulties of the left ear that had started 5 years ago. During otoscopy, an anteroinferior bluish mass was seen in the tympanic space. Computed tomography and magnetic resonance imaging demonstrated a left-side aberrant ICA with bony dehiscence of the carotid canal in the middle ear and a reduced diameter of the tympanic ICA. Herein we report a case of an aberrant ICA in the middle ear. We also review the literature regarding this important vascular anomaly of the temporal bone which may lead to disastrous surgical complications.

  5. Hearing results of the total middle ear reconstruction

    Institute of Scientific and Technical Information of China (English)

    DING Yuan-ping; XU An-ting; CHEN Ying


    Objective:To evaluate the success of hearing results in total middle ear reconstruction with cartilage ossiculoplasty for the patients with old open- mastoidectomy cavities. Method: A retrospective review of 69 patients who underwent total middle ear reconstruction with cartilage ossiculoplasty was performed. Results: In this series, the successful hearing results were obtained in 61 % of the patients after operation, but 93% of the ears were dry. For patients with stapes, the successful rate was 65%; for patients without stapes,it was 58 %. The mean hearing gain was 10.7dB. Conclusion: Total middle ear reconstruction offers an effective treatment algorithia of hearing reconstruction for patients with old mastoidectomy cavities. 1. Stapes is important for hearing improvement; 2. Staged operation is good for hearing restoration; 3. For a large number of patients with a problematic cavitites, hearing restoration is possible by total middle ear reconstruction.

  6. An in vitro model of murine middle ear epithelium

    Directory of Open Access Journals (Sweden)

    Apoorva Mulay


    Full Text Available Otitis media (OM, or middle ear inflammation, is the most common paediatric disease and leads to significant morbidity. Although understanding of underlying disease mechanisms is hampered by complex pathophysiology it is clear that epithelial abnormalities underpin the disease. There is currently a lack of a well-characterised in vitro model of the middle ear (ME epithelium that replicates the complex cellular composition of the middle ear. Here, we report the development of a novel in vitro model of mouse middle ear epithelial cells (mMECs at an air–liquid interface (ALI that recapitulates the characteristics of the native murine ME epithelium. We demonstrate that mMECs undergo differentiation into the varied cell populations seen within the native middle ear. Proteomic analysis confirmed that the cultures secrete a multitude of innate defence proteins from their apical surface. We showed that the mMECs supported the growth of the otopathogen, nontypeable Haemophilus influenzae (NTHi, suggesting that the model can be successfully utilised to study host–pathogen interactions in the middle ear. Overall, our mMEC culture system can help to better understand the cell biology of the middle ear and improve our understanding of the pathophysiology of OM. The model also has the potential to serve as a platform for validation of treatments designed to reverse aspects of epithelial remodelling that underpin OM development.

  7. 慢性中耳乳突炎性疾病不同手术方式的疗效分析%Curative Effects of Different Surgical Procedures for Chronic Middle Ear and Mastoid Inflammatory Lesions

    Institute of Scientific and Technical Information of China (English)

    阿依恒·曲库尔汗; 王远强; 木拉提·阿地力; 冯娟


    Objective To study the curative effects of microscopic surgery for inflammatory lesions in the middle ear and mastoid by using different surgical procedures . Methods There were 110 cases of inflammatory lesions in the middle ear and mastoid from January 2009 to October 2013, including middle ear cholesteatoma and chronic suppurative otitis media .According to the scope of the lesions , either canal wall up mastoidectomy with or without tympanoplasty or open mastoidotympanectomy was carried out . Postoperative ear recovery , complications , recurrence , and hearing improvement were observed . Results The canal wall up mastoidectomy was performed in 51 cases, 46 of which received tympanoplasty simultaneously and 6 of which underwent a secondary artificial prosthesis implantation .Two patients with middle ear cholesteatoma experienced recurrence 1 year after surgery , and were given a secondary open operation .Postoperatively, hearing improvement was achieved >25 dB in 27 cases, >15 dB in 16 cases, and hearing loss was seen in 1 case.There were 59 cases of open mastoidectomy , including 31 cases of small tympanic cavity plasty .After open surgery, dry ear was not achieved in 1 case, which was cured after 2 months of dressing changes .The dry ear was achieved in all the remaining cases, with hearing improvement >15 dB in 3 cases and hearing loss in 3 cases. Conclusion According to different lesions in the middle ear and mastoid , different operative methods can be used to obtain satisfactory clinical curative effects .%目的:探讨慢性中耳乳突炎性疾病的不同显微手术方式的疗效。方法2009年1月~2013年10对110例慢性中耳乳突炎性病变,包括中耳胆脂瘤和慢性化脓性中耳炎,根据病变范围显微镜下分别施行完壁式乳突根治或同时鼓室成形术和开放式乳突根治术,观察术后干耳恢复情况、并发症、复发以及术后听力改善程度等。结果完壁式乳突根治术51例,其中46

  8. Middle ear mucosal regeneration with three-dimensionally tissue-engineered autologous middle ear cell sheets in rabbit model. (United States)

    Yaguchi, Yuichiro; Murakami, Daisuke; Yamato, Masayuki; Hama, Takanori; Yamamoto, Kazuhisa; Kojima, Hiromi; Moriyama, Hiroshi; Okano, Teruo


    The likelihood of recurrent retraction and adhesion of newly formed tympanic membrane is high when middle ear mucosa is extensively lost during cholesteatoma and adhesive otitis media surgery. If rapid postoperative regeneration of the mucosa on the exposed bone surface can be achieved, prevention of recurrent eardrum adhesion and cholesteatoma formation, for which there has been no definitive treatment, can be expected. Suture-less transplantation of tissue-engineered mucosal cell sheets was examined immediately after the operation of otitis media surgery in order to quickly regenerate middle ear mucosa lost during surgery in a rabbit model. Transplantable middle ear mucosal cell sheets with a three-dimensional tissue architecture very similar to native middle ear mucosa were fabricated from middle ear mucosal tissue fragments obtained in an autologous manner from middle ear bulla on temperature-responsive culture surfaces. Immediately after the mucosa was resected from middle ear bone bulla inner cavity, mucosal cell sheets were grafted at the resected site. Both bone hyperplasia and granulation tissue formation were inhibited and early mucosal regeneration was observed in the cell sheet-grafted group, compared with the control group in which only mucosal removal was carried out and the bone surface exposed. This result indicates that tissue engineered mucosal cell sheets would be useful to minimize complications after the surgical operation on otitis media and future clinical application is expected.

  9. Laser vibrometer measurements and middle ear prostheses (United States)

    Flock, Stephen T.; Dornhoffer, John; Ferguson, Scott


    One of us has developed an improved partial ossicular replacement prosthesis that is easier to implant and, based on pilot clinical measurements, results in better high-frequency hearing as compared to patients receiving one of the alternative prostheses. It is hypothesized that the primary reason for this is because of the relatively light weight (about 25 mg) and low compliance of the prosthesis, which could conceivably result in better high frequency vibrational characteristics. The purpose of our initial work was to develop an instrument suitable for objectively testing the vibrational characteristics of prostheses. We have developed a laser based device suitable for measuring the vibrational characteristics of the oval window or other structures of the middle ear. We have tested this device using a piezoelectric transducer excited at audio frequencies, as well as on the oval window in human temporal bones harvested from cadavers. The results illustrate that it is possible to non-invasively monitor the vibrational characteristics of anatomic structures with a very inexpensive photonic device.

  10. Impedance matching, optimum velocity, and ideal middle ears. (United States)

    Peake, W T; Rosowski, J J


    One way to assess an ear's performance as a receiver of acoustic power is to consider impedance matching at the tympanic membrane. Assumptions about some of the impedances involved have lead to the idea of an optimum velocity magnitude (per unit pressure), which has been used as a test of middle-ear performance. We show that this approach is not a realistic way to assess effectiveness of power absorption at the tympanic membrane. More generally, we suggest that, if the performance of the combined external-and-middle ear in collecting acoustic power and delivering it to the inner ear is considered, the external- and middle-ear power-transfer efficiencies, as well as impedance matching, are involved in relating performance to an ideal.

  11. Gain and maximum output of two electromagnetic middle ear implants: are real ear measurements helpful?

    NARCIS (Netherlands)

    Snik, A.F.M.; Noten, J.F.P.; Cremers, C.W.R.J.


    We compared the output of two electronic middle ear implants: the Otologics MET device and the Vibrant Soundbridge device. Both devices were programmed in the linear amplification mode. Aided minus unaided sound pressure levels recorded in the ear canal (objective gain) were compared to unaided minu

  12. Major evolutionary transitions and innovations: the tympanic middle ear (United States)


    One of the most amazing transitions and innovations during the evolution of mammals was the formation of a novel jaw joint and the incorporation of the original jaw joint into the middle ear to create the unique mammalian three bone/ossicle ear. In this review, we look at the key steps that led to this change and other unusual features of the middle ear and how developmental biology has been providing an understanding of the mechanisms involved. This starts with an overview of the tympanic (air-filled) middle ear, and how the ear drum (tympanic membrane) and the cavity itself form during development in amniotes. This is followed by an investigation of how the ear is connected to the pharynx and the relationship of the ear to the bony bulla in which it sits. Finally, the novel mammalian jaw joint and versatile dentary bone will be discussed with respect to evolution of the mammalian middle ear. This article is part of the themed issue ‘Evo-devo in the genomics era, and the origins of morphological diversity’. PMID:27994124

  13. The middle ear immune defense changes with age

    DEFF Research Database (Denmark)

    Nielsen, Michelle Christine; Friis, Morten; Martin-Bertelsen, Tomas


    -chain T-cell receptor-associated protein kinase and linker of activated T-cells, were upregulated in the adult. This study concludes that the normal middle ear immune system changes with age. Genes related to the innate immune system are upregulated in young rats, whereas genes related to the adaptive...... of this study was to analyze the relationship between age and the mucosal immune system in the middle ear. It is hypothesized that genes involved in the middle ear immune system will change with age. A comprehensive assessment of these genetic differences using the techniques of complementary DNA has not been...... performed. Complementary DNA microarray technology was used to identify immune-related genes differentially expressed between the normal middle ear mucosa of young (10 days old) and adult rats (80 days old). Data were analyzed using tools of bioinformatics. A total of 260 age-related genes were identified...

  14. Fresh Clues about the Origin of Mammalian Middle Ear Revealed

    Institute of Scientific and Technical Information of China (English)

    Song Jianlan


    @@ CAS paleontologists have identified a rod-like bone from two early Cretaceous mammals as ossified Meckel's cartilage (OMC). This clears some doubts on the controversial topic of the origin of definitive mannalian middle ear (DMME).

  15. A 3-D analysis of the protympanum in human temporal bones with chronic ear disease. (United States)

    Pauna, Henrique F; Monsanto, Rafael C; Schachern, Patricia; Paparella, Michael M; Cureoglu, Sebahattin


    Eustachian tube dysfunction is believed to be an important factor to cholesteatoma development and recurrence of disease after surgical treatment. Although many studies have described prognostic factors, evaluation methods, or surgical techniques for Eustachian tube dysfunction, they relied on the soft tissues of its structure; little is known about its bony structure-the protympanum-which connects the Eustachian tube to the tympanic cavity, and can also be affected by several inflammatory conditions, both from the middle ear or from the nasopharynx. We studied temporal bones from patients with cholesteatoma, chronic otitis media (with and without retraction pockets), purulent otitis media, and non-diseased ears, looking for differences between the volume of the protympanum, the diameter of the Eustachian tube isthmus, and the distance between the anterior tympanic annulus and the promontory. Light microscopy and 3-D reconstruction software were used for the measurements. We observed a decrease of volume in the lumen of the four middle ear diseased ears compared to the control group. We observed a significant decrease in the volume of the protympanic space in the cholesteatoma group compared to the chronic otitis media group. We also observed a decrease in the bony space (protympanum space) in cholesteatoma, chronic otitis media with retraction pockets, and purulent otitis media compared to the control group. We found a correlation in middle ear diseases and a decrease in the middle ear space. Our findings may suggest that a smaller bony volume in the protympanic area may trigger middle ear dysventilation problems.

  16. Indications and candidacy for active middle ear implants. (United States)

    Wagner, F; Todt, I; Wagner, J; Ernst, A


    Currently, there are two active middle ear implants available commercially: the Vibrant Soundbridge system and the Carina system. A third active middle ear implant, the Esteem, is under clinical evaluation. All devices are indicated for patients with moderate-to-severe hearing loss. Because active middle ear implants are directly coupled to middle ear structures, many of the problems that patients with conventional hearing aids report, such as acoustic feedback, occlusion, and irritation of the outer ear canal, are avoided. In addition, AMEI patients perform well in background noise. However, indications for AMEIs are selective and candidates should be carefully evaluated before surgery. Before considering an AMEI, patients should be provided with conventional hearing aids. Only when benefit is insufficient and audiological selection criteria are met is further candidacy evaluation indicated. Since Colletti described coupling the Vibrant Soundbridge directly onto the round window membrane in 2006, the indications for the Vibrant Soundbridge have expanded and the VSB is implanted in patients with conductive and mixed hearing losses. Patients have often undergone middle ear surgery before. Especially mixed hearing loss cases with 30-60 dB HL sensorineural hearing impairment and 30-40 dB HL air-bone gaps may be helped by this new application.

  17. Prevalence of middle ear disorders in coal miners

    Energy Technology Data Exchange (ETDEWEB)

    Lempert, B.L.; Hopkinson, N.T.; Keith, R.W.; Motl, M.L.; Horine, J.


    Results are presented from a study of the prevalence of middle and external ear disorders in coal miners who work underground. The study followed from an earlier NIOSH report (1976) that indicated a possibly large number of otoscopic abnormalities in this population of workers. Otoscopic examinations, pure tone air- and bone-conduction audiometry tests, and impedance tests were administered to 350 underground miners and 150 industrial workers not associated with mining. The study was conducted completely within a hospital otolaryngology/audiology clinic setting. Results of the investigation showed a highly similar prevalence of middle ear and ear canal abnormalities in the miner group and the control group (19 percent). Middle ear abnormalities observed in the miners were judged by the examining otolaryngologists to have preceded their experience in the mines and were not related solely to underground noise exposure or coal dust. Nearly half of the subjects who had an air-bone gap had no middle ear abnormality observable by otoscopic examination. There was substantial agreement between the finding of abnormal otoscopy and abnormal tympanometry. By itself, acoustic reflex was not useful in identifying middle ear disorders, since this reflex may be absent for other reasons, including presence of severe sensorineural hearing loss.

  18. Squamous cell carcinoma of the middle ear arising from CSOM: A case report

    Directory of Open Access Journals (Sweden)

    S R Davanageri


    Full Text Available Squamous cell carcinoma occurring in a background of chronic suppurative otitis media (CSOM is a rare complication. It runs an aggressive course. Hence early identification is significant to prevent disease progression and to improve the survival rate. Subjecting granulation tissue from middle ear for histopathologic examination is of importance to rule out associated malignant change.

  19. High resolution computed tomography of the middle ear. Its effectiveness, limits of diagnosis and clinical application

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Katsuhisa; Sakurai, Tokio; Saijo, Shigeru; Kobayashi, Toshimitsu (Iwaki Kyoritsu General Hospital, Fukushima (Japan))


    High resolution computed tomography was performed in 57 cases with various middle ear diseases (chronic otitis media, otitis media with effusion, acute otitis media and atelectasis). Although further improvement in detectability is necessary in order to discriminate each type of the soft tissue lesions, CT is the most useful method currently available in detecting the small structures and soft tissue lesions of the middle ear. In particular, the lesions at the tympanic isthmus and tympanic fold could very clearly be detected only by CT. In acute otitis media, lesions usually started in the attic and spread to the mastoid air cells. In otitis media with effusion, the soft tissue shadow was observed in the attic and mastoid air cell. CT is valuable in diagnosis, evaluation of the treatment and prognosis, and analysis of pathophysiology in the middle ear diseases.

  20. A new model for non-typeable Haemophilus influenzae middle ear infection in the Junbo mutant mouse

    Directory of Open Access Journals (Sweden)

    Derek Hood


    Full Text Available Acute otitis media, inflammation of the middle ear, is the most common bacterial infection in children and, as a consequence, is the most common reason for antimicrobial prescription to this age group. There is currently no effective vaccine for the principal pathogen involved, non-typeable Haemophilus influenzae (NTHi. The most frequently used and widely accepted experimental animal model of middle ear infection is in chinchillas, but mice and gerbils have also been used. We have established a robust model of middle ear infection by NTHi in the Junbo mouse, a mutant mouse line that spontaneously develops chronic middle ear inflammation in specific pathogen-free conditions. The heterozygote Junbo mouse (Jbo/+ bears a mutation in a gene (Evi1, also known as Mecom that plays a role in host innate immune regulation; pre-existing middle ear inflammation promotes NTHi middle ear infection. A single intranasal inoculation with NTHi produces high rates (up to 90% of middle ear infection and bacterial titres (104-105 colony-forming units/µl in bulla fluids. Bacteria are cleared from the majority of middle ears between day 21 and 35 post-inoculation but remain in approximately 20% of middle ears at least up to day 56 post-infection. The expression of Toll-like receptor-dependent response cytokine genes is elevated in the middle ear of the Jbo/+ mouse following NTHi infection. The translational potential of the Junbo model for studying antimicrobial intervention regimens was shown using a 3 day course of azithromycin to clear NTHi infection, and its potential use in vaccine development studies was shown by demonstrating protection in mice immunized with killed homologous, but not heterologous, NTHi bacteria.

  1. A new model for non-typeable Haemophilus influenzae middle ear infection in the Junbo mutant mouse. (United States)

    Hood, Derek; Moxon, Richard; Purnell, Tom; Richter, Caroline; Williams, Debbie; Azar, Ali; Crompton, Michael; Wells, Sara; Fray, Martin; Brown, Steve D M; Cheeseman, Michael T


    Acute otitis media, inflammation of the middle ear, is the most common bacterial infection in children and, as a consequence, is the most common reason for antimicrobial prescription to this age group. There is currently no effective vaccine for the principal pathogen involved, non-typeable Haemophilus influenzae (NTHi). The most frequently used and widely accepted experimental animal model of middle ear infection is in chinchillas, but mice and gerbils have also been used. We have established a robust model of middle ear infection by NTHi in the Junbo mouse, a mutant mouse line that spontaneously develops chronic middle ear inflammation in specific pathogen-free conditions. The heterozygote Junbo mouse (Jbo/+) bears a mutation in a gene (Evi1, also known as Mecom) that plays a role in host innate immune regulation; pre-existing middle ear inflammation promotes NTHi middle ear infection. A single intranasal inoculation with NTHi produces high rates (up to 90%) of middle ear infection and bacterial titres (10(4)-10(5) colony-forming units/µl) in bulla fluids. Bacteria are cleared from the majority of middle ears between day 21 and 35 post-inoculation but remain in approximately 20% of middle ears at least up to day 56 post-infection. The expression of Toll-like receptor-dependent response cytokine genes is elevated in the middle ear of the Jbo/+ mouse following NTHi infection. The translational potential of the Junbo model for studying antimicrobial intervention regimens was shown using a 3 day course of azithromycin to clear NTHi infection, and its potential use in vaccine development studies was shown by demonstrating protection in mice immunized with killed homologous, but not heterologous, NTHi bacteria.

  2. A new model for non-typeable Haemophilus influenzae middle ear infection in the Junbo mutant mouse (United States)

    Hood, Derek; Moxon, Richard; Purnell, Tom; Richter, Caroline; Williams, Debbie; Azar, Ali; Crompton, Michael; Wells, Sara; Fray, Martin; Brown, Steve D. M.; Cheeseman, Michael T.


    ABSTRACT Acute otitis media, inflammation of the middle ear, is the most common bacterial infection in children and, as a consequence, is the most common reason for antimicrobial prescription to this age group. There is currently no effective vaccine for the principal pathogen involved, non-typeable Haemophilus influenzae (NTHi). The most frequently used and widely accepted experimental animal model of middle ear infection is in chinchillas, but mice and gerbils have also been used. We have established a robust model of middle ear infection by NTHi in the Junbo mouse, a mutant mouse line that spontaneously develops chronic middle ear inflammation in specific pathogen-free conditions. The heterozygote Junbo mouse (Jbo/+) bears a mutation in a gene (Evi1, also known as Mecom) that plays a role in host innate immune regulation; pre-existing middle ear inflammation promotes NTHi middle ear infection. A single intranasal inoculation with NTHi produces high rates (up to 90%) of middle ear infection and bacterial titres (104-105 colony-forming units/µl) in bulla fluids. Bacteria are cleared from the majority of middle ears between day 21 and 35 post-inoculation but remain in approximately 20% of middle ears at least up to day 56 post-infection. The expression of Toll-like receptor-dependent response cytokine genes is elevated in the middle ear of the Jbo/+ mouse following NTHi infection. The translational potential of the Junbo model for studying antimicrobial intervention regimens was shown using a 3 day course of azithromycin to clear NTHi infection, and its potential use in vaccine development studies was shown by demonstrating protection in mice immunized with killed homologous, but not heterologous, NTHi bacteria. PMID:26611891

  3. Modification of closed tympanoplasty in middle ear cholesteatoma

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhi-gang; LIU Xiang; CHEN Sui-jun; CHEN Bin; ZHENG Yi-qing


    Background Classic mastoidectomy and modified mastoidectomy are traditional surgical procedures for middle ear cholesteatoma with goals of eradicating diseases, creating dry ears and preventing severe complications. However, the drawback of these procedures is the lack of hearing improvement. Therefore, our study aimed to investigate the effects and safety of a modification of closed tympanoplasty for middle ear cholesteatoma.Methods Eighty-three patients were recruited in this study based on the following two criteria: each patient had middle ear cholesteatoma in one ear; the affected ears had a functional eustachian tube and had neither intracranial nor extracranial complications. All the patients received a modification of closed tympanoplasty which included ossicular reconstruction with total ossicular replacement prosthesis (TORP) or partial ossicular replacement prosthesis (PORP) and membrane repair with conchal cartilage-perichondral complex.Results All the 83 cases had dry ears with membranes healed within 4-6 postoperative weeks. After 6 postoperative months, there were 3 cases with re-perforation at the tympanic membrane center and after 1.5 postoperative years, there were 5 cases with cholesteatoma recurrence (6.02%). Function tests after one postoperative year exhibited an improvement of pure tone audiometry (PTA) in 27 cases that was more than 30 dB, in 33 cases between 20-29 dB, 14 cases with improvement between 10-19 dB, and in 9 cases there was no improvement.Conclusions The modified closed tympanoplasty procedure for middle ear cholesteatoma in the present study has all the advantages of both close-cavity and open-cavity procedures. It has low recurrence rate and good hearing improvement.

  4. Tympanoplasty without use of gelfoam in the middle ear

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    Samad Ghiasi


    Full Text Available Introduction:  In usual technique of tympanoplasty almost all of otologic surgeons use gelfoam in the middle ear for support of graft against margin of tympanic membrane perforation. In this study we use technique that we did not use gelfoam in the middle ear. We compared results of graft taking rate in two techniques. Materials and Methods: In a clinical trial study during 2 years 181 patients with COM underwent tympanoplasty with underlay grafting. In 83 patients used gelfoam in the middle ear for tympanoplasty or tympanomastoidectomy (CCTM, OCTM. In 98 patients we did not use gelfoam in the middle ear. Results: In 83 patients with use of gelfoam, graft taking rate in 59 (71.1% cases with tympanoplasty and CCTM was 54 (91% and in 24 (28.9% cases with OCTM was 20 (83%. In 98 patients without use of gelfoam, graft taking rate in 61 (62.2% cases with tympanoplasty and CCTM was 54 (89% and in 37 (37.8% cases with OCTM were 31 (84%. Conclusion: In this study, results of graft taking rate were similar in 2 groups. On the other hand, gelfoam entirely reabsorbed during 45 to 54 days in the middle ear and immune system react by a round cell response. This sponge encourages the formation of the fibrous tissue at a higher rate than naturally occurs in the ear. In our technique we had not these problems. Another advantage of this technique is rapid improvement of patient hearing after removing of the external ear canal rosebud. We think this technique could be used in tympanoplasty and tympanomastoidectoy routinely. ‍‍‍

  5. Carcinoid Tumors in the Middle Ear: a Case Report and Literature Review

    Institute of Scientific and Technical Information of China (English)

    WANG Entong; GONG Weixi; DA Jiping


    Middle ear carcinoid tumor (MEC T) is rare. Only 46 cases of MECT have been reported in the literature since the first case of MECT was described in 1980. We present here a case of primary MECT initially diagnosed as inflammatory aural polyp. The case was a 43-year-old women complaining of right ear chronic otorrhea and hearing loss over a period of five years, with a blockage sensation in the right ear for two years. Audiometry showed conductive hearing loss in the right ear. Physical examination and CT scans showed a mass in the right external auditory canal and middle ear, surrounding the ossicular chain. Pathologic study of surgically removed specimen revealed features of carcinoid tumor with positive staining to chromogranin A and synaptophysin in tumor cells. Local radiation of 60 Gy was applied. The patient has been followed up for more than one year. Postoperative histopathological examination showed no evidence of MECT recurrence one year after surgery, but inflammatory changes in the middle ear. Relevant literatures were reviewed. Clinical, histopathological, immunohistochemical and ultrastructural features of MECT, and strategies in MECT diagnosis and management are discussed.

  6. Vibrant soundbridge middle ear implant in otosclerosis: technique - indication. (United States)

    Dumon, Thibaud


    With our growing experience with the Vibrant Soundbridge (VSB) middle ear implant, the question emerged of its indication in mixed hearing loss due to advanced otosclerosis. We describe the VSB implantation technique in primary otosclerosis performed together with a stapedotomy piston procedure. Hearing results under headphone and free-field conditions show that the stapedotomy piston procedure closes the air-bone gap as expected and that the VSB provides comparable gain to that usually recorded for pure sensorineural hearing loss. The gains of the two procedures add up. These results open the field of mixed hearing loss to the VSB middle ear implant.

  7. Primary T-cell lymphoblastic lymphoma in the middle ear. (United States)

    Li, Bo; Liu, Shixi; Yang, Hui; Wang, Weiya


    T-cell lymphoblastic lymphoma (T-LBL) is a highly aggressive lymphoma characterized by precursor T-cell malignancy and lymphadenopathy or mediastinal involvement. We present the case of an 11-year-old boy with a diagnosis of middle ear T-LBL, which manifested as a headache, hearing loss and peripheral facial paralysis. The child was given intensive chemotherapy and had a complete response. To our knowledge, this is the first case reported in the literature of T-LBL originating in the middle ear. This case aims to help clinicians to be vigilant about the possibility of primary lesions at atypical sites in some special diseases.

  8. Analysis of chick (Gallus gallus middle ear columella formation

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    Mercer Kathryn J


    Full Text Available Abstract Background The chick middle ear bone, the columella, provides an accessible model in which to study the tissue and molecular interactions necessary for induction and patterning of the columella, as well as associated multiple aspects of endochondral ossification. These include mesenchymal condensation, chondrogenesis, ossification of the medial footplate and shaft, and joint formation between the persistent cartilage of the extracolumella and ossified columella. Middle and external ear defects are responsible for approximately 10% of congenital hearing defects. Thus, understanding the morphogenesis and the molecular mechanisms of the formation of the middle ear is important to understanding normal and abnormal development of this essential component of the hearing apparatus. Results The columella, which arises from proximal ectomesenchyme of the second pharyngeal arch, is induced and patterned in a dynamic multi-step process. From the footplate, which inserts into the inner ear oval window, the shaft spans the pneumatic middle ear cavity, and the extracolumella inserts into the tympanic membrane. Through marker gene and immunolabeling analysis, we have determined the onset of each stage in the columella's development, from condensation to ossification. Significantly, a single condensation with the putative shaft and extracolumella arms already distinguishable is observed shortly before initiation of five separate chondrogenic centers within these structures. Ossification begins later, with periosteum formation in the shaft and, unexpectedly, a separate periosteum in the footplate. Conclusions The data presented in this study document the spatiotemporal events leading to morphogenesis of the columella and middle ear structures and provide the first gene expression data for this region. These data identify candidate genes and facilitate future functional studies and elucidation of the molecular mechanisms of columella formation.

  9. Middle ear adenoma. A tumor displaying mucinous and neuroendocrine differentiation. (United States)

    Wassef, M; Kanavaros, P; Polivka, M; Nemeth, J; Monteil, J P; Frachet, B; Tran Ba Huy, P


    Middle ear adenoma (MEA) is a distinctive, rare entity that appears to be derived from the lining epithelium of the middle ear mucosa. We report four cases of MEA displaying the typical histologic growth pattern. Two distinct tumor cell immunophenotypes were identified in all cases; the first type exhibited positivity with anti-epithelial membrane antigen and anti-keratin antibodies, and the second type showed immunoreactivity with anti-keratin, anti-vimentin, and anti-neuron-specific enolase antibodies. Ultrastructural studies revealed bidirectional mucinous and neuroendocrine differentiation, demonstrated by the presence of two distinct cell types containing apically located mucous granules and basally concentrated neuroendocrine granules, respectively. The presence of neuroendocrine differentiation was supported by the immunohistochemical detection of vasoactive intestinal polypeptide in the tumor cells in one case and neuron-specific enolase in three cases. These findings suggest that the potential for mixed mucinous/neuroendocrine differentiation described in other endodermally derived tumors also exists in middle ear mucosa. We also believe that the rare lesions diagnosed as primary carcinoid tumors of the middle ear might in fact be MEA with predominant or only neuroendocrine differentiation. The clinical course of our four cases and our review of the pertinent literature confirm the benign nature of MEA and indicate that these tumors should be treated by complete local excision without additional therapy.

  10. A dog with squamous cell carcinoma in the middle ear. (United States)

    Yoshikawa, Hiroto; Mayer, Monique N; Linn, Kathleen A; Dickinson, Ryan M; Carr, Anthony P


    An 8-year-old, castrated male golden retriever was referred for lethargy and inappetance. Severe pain was elicited on palpation of the left temporomandibular joint region. Computed tomography revealed aggressive bone destruction of the left bulla. Squamous cell carcinoma was diagnosed. Malignant tumor in the canine middle ear is rare.

  11. A dog with squamous cell carcinoma in the middle ear


    YOSHIKAWA, Hiroto; Mayer, Monique N.; Linn, Kathleen A.; Dickinson, Ryan M.; Carr, Anthony P.


    An 8-year-old, castrated male golden retriever was referred for lethargy and inappetance. Severe pain was elicited on palpation of the left temporomandibular joint region. Computed tomography revealed aggressive bone destruction of the left bulla. Squamous cell carcinoma was diagnosed. Malignant tumor in the canine middle ear is rare.

  12. Imaging evaluation of middle ear cholesteatoma: iconographic essay

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    Avila, Ana Flavia Assis de; Aburjeli, Bruna de Oliveira Melim; Moreira, Wanderval; Motta, Emilia Guerra Pinto Coelho; Ribeiro, Marcelo Almeida; Diniz, Renata Lopes Furletti Caldeira, E-mail: [Hospital Mater Dei, Belo Horizonte, MG (Brazil)


    Middle ear cholesteatoma is a relevant and relatively common disease that may have severe consequences. In the present pictorial essay, the authors have selected illustrative examples of multislice computed tomography and magnetic resonance imaging depicting the main presentations of cholesteatomas, and describing their characteristics, locations, and major complications. (author)

  13. The middle ear immune defense changes with age. (United States)

    Nielsen, Michelle Christine; Friis, Morten; Martin-Bertelsen, Tomas; Winther, Ole; Friis-Hansen, Lennart; Cayé-Thomasen, Per


    Otitis media is a common disease in childhood. In adults, the disease is relatively rare, but more frequently associated with complications. Possible reasons for this discrepancy are age-related differences in pathogen exposure, anatomy of the Eustachian tube and immune system. The objective of this study was to analyze the relationship between age and the mucosal immune system in the middle ear. It is hypothesized that genes involved in the middle ear immune system will change with age. A comprehensive assessment of these genetic differences using the techniques of complementary DNA has not been performed. Complementary DNA microarray technology was used to identify immune-related genes differentially expressed between the normal middle ear mucosa of young (10 days old) and adult rats (80 days old). Data were analyzed using tools of bioinformatics. A total of 260 age-related genes were identified, of which 51 genes were involved in the middle ear mucosal immune system. Genes related to the innate immune system, including alpha-defensin, calcium-binding proteins S100A9 and S100A8, were upregulated in young rats, whereas genes related to the adaptive immune system, including CD3 molecules, zeta-chain T-cell receptor-associated protein kinase and linker of activated T-cells, were upregulated in the adult. This study concludes that the normal middle ear immune system changes with age. Genes related to the innate immune system are upregulated in young rats, whereas genes related to the adaptive immune system are upregulated in adults.

  14. Middle ear osteoma causing progressive facial nerve weakness: a case report


    Curtis, Kate; Bance, Manohar; Carter, Michael; Hong, Paul


    Introduction Facial nerve weakness is most commonly due to Bell’s palsy or cerebrovascular accidents. Rarely, middle ear tumor presents with facial nerve dysfunction. Case presentation We report a very unusual case of middle ear osteoma in a 49-year-old Caucasian woman causing progressive facial nerve deficit. A subtle middle ear lesion was observed on otoscopy and computed tomographic images demonstrated an osseous middle ear tumor. Complete surgical excision resulted in the partial recovery...

  15. Clinical investigation of flat panel CT following middle ear reconstruction: a study of 107 patients

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    Zaoui, K. [University Hospital Heidelberg, Ruprecht Karls University, Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg (Germany); Kromeier, J. [St. Josefs Hospital, RkK, Department of Radiology, Freiburg (Germany); Neudert, M.; Beleites, T.; Zahnert, T. [University Hospital Dresden, Technical University, Department of Otorhinolaryngology, Head and Neck Surgery, Dresden (Germany); Laszig, R.; Offergeld, C. [University Hospital Freiburg, Albert Ludwigs University, Department of Otorhinolaryngology, Head and Neck Surgery, Freiburg (Germany)


    After middle ear reconstruction using partial or total ossicular replacement prostheses (PORP/TORP), an air-bone gap (ABG) may persist because of prosthesis displacement or malposition. So far, CT of the temporal bone has played the main role in the diagnosis of reasons for postoperative insufficient ABG improvement. Recent experimental and clinical studies have evaluated flat panel CT (fpCT) as an alternative imaging technique that provides images with high isovolumetric resolution, fewer metal-induced artefacts and lower irradiation doses. One hundred and seven consecutive patients with chronic otitis media with or without cholesteatoma underwent reconstruction by PORP (n = 52) or TORP (n = 55). All subjects underwent preoperative and postoperative audiometric testing and postoperative fpCT. Statistical evaluation of all 107 patients as well as the sole sub-assembly groups (PORP or TORP) showed a highly significant correlation between hearing improvement and fpCT-determined prosthesis position. FpCT enables detailed postoperative information on patients with middle ear reconstruction. FpCT is a new imaging technique that provides immediate feedback on surgical results after reconstructive middle ear surgery. Specific parameters evaluated by fpCT may serve as a predictive tool for estimated postoperative hearing improvement. Therefore this imaging technique is suitable for postoperative quality control in reconstructive middle ear surgery. (orig.)

  16. Usefulness of CT in preoperative examinations for middle ear surgery

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    Kobayashi, Toshimitsu; Okitsu, Takuji; Sakurai, Tokio; Ikeda, Katsuhisa; Taniguchi, Kazuhiko; Takahashi, Kuniaki; Kusakari, Jun


    The usefulness of CT in preoperative examinations for middle ear surgery was evaluated on the basis of whether or not it can provide a surgon with useful information not available from the other preoperative examinations, such as microscopic examination, pure tone audiometry, impedance audiometry, equilibrium tests, conventional X-ray films, etc. The findings of CT were compared with those obatained during operations and the following conclusions were reached: CT is especially useful for the three purposes indicated below. (1) to determine the patency of the attic air route to the mastoid antrum. (2) to make differential diagnoses of middle ear diseases in the presence of obstructive pathology of the external auditory meatus. (3) to make a rough estimate of the extent of cholesteatoma growth in the middle ear cleft, and to diagnose labyrinthine fistulae. CT proved less effective or useless for the following three purposes. (1) to secure detailed information on the status of the ossicular chain. (2) to determine the precise extent of the growth of cholesteatoma. (3) to evaluate the postoperative status of the ear. (author).

  17. Poor oral hygiene and middle ear infections: any relationship? (United States)

    Esra, Eryaman; Banu, Oter Ilhan; Erdinc, Aydin


    The purpose of this study is to evaluate the relationship between poor oral hygiene and middle ear infections. 59 children between 3-12 age intervals were included in this study. The ears were examined by microscope. The findings were marked according to Kempthorne clinical scale and tympanograms were performed. For data analysis of dental caries, dft and DMFT indexes were used in accordance with WHO (World Health Organization) criteria for oral health surveys. The oral hygiene status was determined by using Simplified Oral Hygiene Index of Greene and Vermillion. The scores of 0-1 were classified as low, and of 2-3 as high oral hygiene index (OHI-S). The low OHI-S was taken as the control group (30 patients). The high OHI-S was taken as the study group (29 patients). The effusion scores, the compliance values and the middle ear pressure values in the two groups were compared. The difference between the effusion score values of the control and study groups was found to be statistically meaningful (p = 0.338, and the χ(2) = 2.167). The compliance values of the control and study groups did not differ meaningfully statistically (p = 0.671). However, there was a statistically meaningful low middle ear pressure (p = 0.044, χ(2) = 4.069) in the control group. Since this finding is expected in the study group, instead of the control group, we did not make an issue of this result. We conclude from these clinical results that there is no statistically meaningful relation between the oral hygiene index and the middle ear.

  18. SuperSILAC Quantitative Proteome Profiling of Murine Middle Ear Epithelial Cell Remodeling with NTHi.

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    Stéphanie Val

    Full Text Available Chronic Otitis Media with effusion (COME develops after sustained inflammation and is characterized by secretory middle ear epithelial metaplasia and effusion, most frequently mucoid. Non-typeable Haemophilus influenzae (NTHi, the most common acute Otitis Media (OM pathogen, is postulated to promote middle ear epithelial remodeling in the progression of OM from acute to chronic. The goals of this study were to examine histopathological and quantitative proteomic epithelial effects of NTHi challenge in a murine middle ear epithelial cell line.NTHi lysates were generated and used to stimulate murine epithelial cells (mMEEC cultured at air-liquid interface over 48 hours- 1 week. Conditional quantitative Stable Isotope Labeling with Amino Acids in Cell Culture (SILAC of cell lysates was performed to interrogate the global protein production in the cells, using the SuperSILAC technique. Histology of the epithelium over time was done to measure bacterial dependent remodeling.Mass spectrometry analysis identified 2,565 proteins across samples, of which 74 exhibited differential enrichment or depletion in cell lysates (+/-2.0 fold-change; p value<0.05. The key molecular functions regulated by NTHi lysates exposure were related to cell proliferation, death, migration, adhesion and inflammation. Finally, chronic exposure induced significant epithelial thickening of cells grown at air liquid interface.NTHi lysates drive pathways responsible of cell remodeling in murine middle ear epithelium which likely contributes to observed epithelial hyperplasia in vitro. Further elucidation of these mediators will be critical in understanding the progression of OM from acute to chronic at the molecular level.

  19. Correlative mRNA and protein expression of middle and inner ear inflammatory cytokines during mouse acute otitis media. (United States)

    Trune, Dennis R; Kempton, Beth; Hausman, Frances A; Larrain, Barbara E; MacArthur, Carol J


    Although the inner ear has long been reported to be susceptible to middle ear disease, little is known of the inflammatory mechanisms that might cause permanent sensorineural hearing loss. Recent studies have shown inner ear tissues are capable of expressing inflammatory cytokines during otitis media. However, little quantitative information is available concerning cytokine gene expression in the inner ear and the protein products that result. Therefore, this study was conducted of mouse middle and inner ear during acute otitis media to measure the relationship between inflammatory cytokine genes and their protein products with quantitative RT-PCR and ELISA, respectively. Balb/c mice were inoculated transtympanically with heat-killed Haemophilus influenzae and middle and inner ear tissues collected for either quantitative RT-PCR microarrays or ELISA multiplex arrays. mRNA for several cytokine genes was significantly increased in both the middle and inner ear at 6 h. In the inner ear, these included MIP-2 (448 fold), IL-6 (126 fold), IL-1β (7.8 fold), IL-10 (10.7 fold), TNFα (1.8 fold), and IL-1α (1.5 fold). The 24 h samples showed a similar pattern of gene expression, although generally at lower levels. In parallel, the ELISA showed the related cytokines were present in the inner ear at concentrations higher by 2-122 fold higher at 18 h, declining slightly from there at 24 h. Immunohistochemistry with antibodies to a number of these cytokines demonstrated they occurred in greater amounts in the inner ear tissues. These findings demonstrate considerable inflammatory gene expression and gene products in the inner ear following acute otitis media. These higher cytokine levels suggest one potential mechanism for the permanent hearing loss seen in some cases of acute and chronic otitis media.

  20. Rheologic studies on middle ear effusions and their mucus glycoproteins. (United States)

    FitzGerald, J E; Green, G G; Birchall, J P; Pearson, J P


    The properties of pooled thick and thin middle ear effusions, from children with otitis media with effusion, were studied by viscometry. Mucus glycoproteins were responsible for effusion viscosity. Their percentage by weight in thick and thin effusions was 25% and 8.2%, respectively. N-acetylcysteine and 0.2 mol/L of mercaptoethanol caused a 39% viscosity drop in a 5-mg/mL glycoprotein solution, whereas S-carboxymethylcysteine had no effect. Treatment of thick effusions with 0.2 mol/L of mercaptoethanol initially caused a viscosity decrease followed by a gradual increase. Higher reducing agent concentrations (0.5 mol/L) caused a more rapid decrease followed by a rapid increase, presumably by causing nonspecific aggregation of reduced protein molecules. These results suggest that the concentration of and the time that a mucolytic is in the middle ear would be of prime importance in achieving the desired decrease in viscosity.

  1. Radiation effect on the middle ear of the guinea pig

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    Harada, Hirofumi; Nishizawa, Shinji; Hiraide, Fumihisa; Inoue, Tetsuzo


    It is known that radiation therapy of the head and neck causes otitis media with effusion. Otitis media with effusion was induced in guinea pigs by cobalt-60 irradiation. Twenty guinea pigs with intact drum and normal Preyer reflex were used. The animals were irradiated with doses of 2,000 rad, 4,000 rad, and 6,000 rad. They were sacrificed seven days after the irradiation. Other animals were irradiated with doses of 4,000 rad and sacrificed one day, three days, seven days, and fourteen days after the irradiation. Vascular permeability of the middle ear mucosa was observed by Majno's vascular labelling technique. Pathological change of the middle ear was examined under the light microscope. Vascular permeability increased in three days after 4,000 rad irradiation and small vessels were labelled with carbon particles. Seven days after irradiation, carbon labelling of small vessels was more extensive and extravascular blackening was present in the adjacent tissues. Edematous change of the middle ear mucosa and metaplasia of the epithelial cells were also observed. New bone formation of the tympanic bulla was increased by repeated irradiations. (author).

  2. Age effects in the human middle ear: Wideband acoustical measures (United States)

    Feeney, M. Patrick; Sanford, Chris A.


    Studies that have examined age effects in the human middle ear using either admittance measures at 220 or 660 Hz or multifrequency tympanometry from 200 to 2000 Hz have had conflicting results. Several studies have suggested an increase in admittance with age, while several others have suggested a decrease in admittance with age. A third group of studies found no significant age effect. This study examined 226 Hz tympanometry and wideband energy reflectance and impedance at ambient pressure in a group of 40 young adults and a group of 30 adults with age >=60 years. The groups did not differ in admittance measures of the middle ear at 226 Hz. However, significant age effects were found in wideband energy reflectance and impedance. In particular, in older adults there was a comparative decrease in reflectance from 800 to 2000 Hz but an increase near 4000 Hz. The results suggest a decrease in middle-ear stiffness with age. The findings of this study hold relevance for understanding the aging process in the auditory system, for the establishment of normative data for wideband energy reflectance, for the possibility of a conductive component to presbycusis, and for the interpretation of otoacoustic emission measurements. .

  3. Middle and inner ear malformations in two cases of velocardiofacial syndrome

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    Tabith Junior, Alfredo


    Full Text Available Objective: To describe audiometric characteristics and middle and inner ear malformations in two patients with velocardiofacial syndrome. Method: Audiometric evaluation, computerized tomography of the temporal bones and analysis of DNA for multiple markers of 22q11 region were performed in two patients with clinical signs of velocardiofacial syndrome. Results: Conductive hearing loss related to chronic otites media and middle and inner ear malformations were found, the latter with the use of reformations based on multislice acquisitions on of the computerized tomography of the temporal bones. Conclusion: We consider it to be highly important to carry out a thorough evaluation and monitoring of the hearing evolution, as well as the occurrence of symptoms related to the vestibular function in patients with velocardiofacial syndrome. From the radiological point of view, attention should be given to the use of high quality techniques for the tomographic study of temporal bones.

  4. Imaging Finding of Malignant Melanoma of Eustachian Tube with Extension to Middle Ear Cavity: Case Report

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    Km Hong Chul [Dept. of Radiology, Yeungnam University College of Medicine, Daegu (Korea, Republic of); Jang, Han Won [Daekyung Radiologic Clinics, Daegu (Korea, Republic of); Lee, Hui Joong [Dept. of Radiology, Kyungpook National University Hospital, Daegu (Korea, Republic of)


    We report a case of malignant melanoma of Eustachian tube with extension to the middle ear cavity and nasopharynx in a 51-year-old woman who presented with right ear fullness. Computed tomography showed a soft tissue mass in the middle ear cavity and caused the widening and eroding of the bony eustachian tube. Magnetic resonance imaging showed well enhancing mass in eustachian tube extending nasopharynx to middle ear cavity. A biopsy of the middle ear cavity mass revealed a malignant amelanotic melanoma.

  5. Imaging Finding of Malignant Melanoma of Eustachian Tube with Extension to Middle Ear Cavity: Case Report (United States)

    Kim, Hong Chul; Jang, Han Won


    We report a case of malignant melanoma of Eustachian tube with extension to the middle ear cavity and nasopharynx in a 51-year-old woman who presented with right ear fullness. Computed tomography showed a soft tissue mass in the middle ear cavity and causedthe widening and eroding of the bony eustachian tube. Magnetic resonance imaging showed well enhancing mass in eustachian tube extending nasopharynx to middle ear cavity. A biopsy of the middle ear cavity mass revealed a malignant amelanotic melanoma. PMID:23118582

  6. Anatomic Considerations on the Middle Ear in Dog

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    Carmen Berghes


    Full Text Available Purpose of this study is to explain some aspects of middle ear anatomy in dog. The study was conducted on five dog skulls (different ages from common, large size dogs. The skulls were processed by maceration and submitted to a treatment of mechanical cleaning with perhydrol. The temporal bone was collected first; the external wall was opened carefully to study the tympanic cavity. The ossicles were collected separately and subsequently described. From research carried promontory appears as an elongated projection that separates the oval window and round window. Vestibular window is oval or slightly ovoid shape of a hole, located dorso-medially to the promontory, which communicates with the middle ear vestibule. Cochlearia window appears as a round or circular hole located caudo-lateral to the promontory . it is blocked by a membrane called the tympanum secondary, cavity separating the ramp of the snail. In the ventro-oral cavity openings ductus faringo tympanicum. The osicules sound represented by hammer, anvil and stirrup are articulated with each other and form a chain as a link between the eardrum and vestibular window. Bones are driven by two muscles: the tensor muscle and muscle stirrup eardrum is very thin. osicules ear are relatively large and resemble those of humans. Lenticular bone is the lenticular process of the long arm of anvile.

  7. Active middle ear implantation for patients with sensorineural hearing loss and external otitis: long-term outcome in patient satisfaction

    NARCIS (Netherlands)

    Zwartenkot, J.W.; Hashemi, J.; Cremers, C.W.R.J.; Mulder, J.J.S.; Snik, A.F.M.


    OBJECTIVE: To study long-term subjective benefit of patients with sensorineural hearing loss and chronic external otitis who use active middle ear implants. DESIGN: Single-subject repeated measures in a preintervention and postintervention design with multiple postintervention measurements (question

  8. Inflammatory responses to Hydroxyapatite implants in middle ear in rats

    Institute of Scientific and Technical Information of China (English)

    YE Qing; JIANG Yi; WANG Xiao-yan; ZHENG Ke-fei


    Objective To study local inflammatory response after implantation of hydroxyapatite synthetic ossicular prosthesis. Methods Hydroxyapatite gantries were implanted in the bulla in 32 rats. Sham surgical procedures were performed in 10 rats as the control. Animals were sacrificed at 1 to 300 days after surgery. Bulla sections, stained with HE and Mallory's azan, were examined for numbers and percentages of various inflammatory cell types. Results Slightly more inflammatory reaction was seen in animals with the implant than in the controls, mostly during the early stage following the implantation procedure. Few inflammatory cells were observed at later times. There were satisfactory fibrosis in both implanted and control ears. Conclusion The results indicate that hydroxyapatite synthetic prosthesis is a biocompatible implantation material in the middle ear. Nonetheless, the presence of inflammatory reaction immediately following implantation implies that control of infection is important in the early times after the implantation procedure.

  9. Modeling Analysis of Biomechanical Changes of Middle Ear and Cochlea in Otitis Media (United States)

    Gan, Rong Z.; Zhang, Xiangming; Guan, Xiying


    A comprehensive finite element (FE) model of the human ear including the ear canal, middle ear, and spiral cochlea was developed using histological sections of human temporal bone. The cochlea was modeled with three chambers separated by the basilar membrane and Reissner's membrane and filled with perilymphatic fluid. The viscoelastic material behavior was applied to middle ear soft tissues based on dynamic measurements of tissues in our lab. The model was validated using the experimental data obtained in human temporal bones and then used to simulate various stages of otitis media (OM) including the changes of morphology, mechanical properties, pressure, and fluid level in the middle ear. Function alterations of the middle ear and cochlea in OM were derived from the model and compared with the measurements from temporal bones. This study indicates that OM can be simulated in the FE model to predict the hearing loss induced by biomechanical changes of the middle ear and cochlea.


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    Full Text Available BACKGROUND : Chronic Suppurative Otitis Media (CSOM is a disease of multiple aetiology and well known for its persis tence and recurrence inspite of treatment and are the bearbug of otologist, paediatrician and general practitioner. One of the reason s for the refractoriness to treatment and chronicity is coexist ing fungal infection of the ear. OBJECTIVES: Are to find out the prevalence of fungal infections in chronic discharging ears and to identify and isolate the type of fungus prevalent in these ears . MATERIALS AND METHOD S: Tertiary care hospital level descrip tive study was conducted in 50 cases of CSOM with actively discharging ears for a period of one year starting from February 2013. For all the cases aural swabs were collected from the diseased ear and were used for direct microscopic examination in potassi um hydroxide wet mount. Ear swab was cultured on Sabouraud’s dextrose agar plate for fungal cultures. The patient characteristics were prospectively recorded and results were analysed. CONCLUSION : There is high prevalence of coexisting fungal infection in actively discharging ears of CSOM patients

  11. Indications and outcome of subtotal petrosectomy for active middle ear implants. (United States)

    Verhaert, Nicolas; Mojallal, Hamidreza; Schwab, Burkard


    The aim of this study was to describe the outcome and possible complications of subtotal petrosectomy (SP) for Vibrant Soundbridge (VSB) device surgery in a tertiary referral center. A secondary objective was the evaluation of hearing results in a subgroup of subjects who received the VSB device. Between 2009 and early 2011, 22 adult subjects with chronic otitis media (COM) underwent a SP, blind sac closure of the external auditory canal and abdominal fat obliteration to facilitate the application of an active middle ear implant (AMEI) in a staged procedure. Indications consisted of mixed hearing loss after previous tympanomastoplasty and failure of hearing rehabilitation with a hearing aid or bone conduction device in COM. Pre- and postoperative pure-tone audiograms were analyzed in respect to deterioration of inner ear function, unaided and aided (hearing aid, bone-anchored hearing aid and VSB) speech audiograms were compared to verify improvements in communications skills and functional gains. Incidence and type of complications were reviewed. No significant change was observed regarding mean bone conduction thresholds after the first stage procedure. Some minor wound healing problems were noted. Speech perception using the VSB (n = 16) showed a mean aided speech discrimination at 65-dB SPL of 75 % [standard deviation (SD) 28.7], at 80-dB SPL of 90 % (SD 25.1). Our results suggest that for selected patients with open mastoid cavities and chronic middle ear disease, SP with abdominal fat obliteration is an effective and safe technique to facilitate safe AMEI placement.

  12. Phonemic Awareness and Middle-Ear Disease among Bedouin Arabs in Israel. (United States)

    Abu-Rabia, Salim


    Investigates the effect of middle-ear infections on phonemic awareness on first-grade Bedouin Arab elementary school children in northern Israel. Divides 49 children who were screened according to their infant medical records into two groups: one with repeated middle-ear infection and one without. Indicates a nonsignificant effect of middle-ear…

  13. Middle ear and mastoid hemangioma treated by neurointerventional techniques

    Directory of Open Access Journals (Sweden)

    Sachin Kumbhar


    Full Text Available Temporal bone hemangiomas are rare, difficult to diagnose and may cause devastating permanent sequelae. We report a case of 10-year-old female with middle ear and mastoid hemangioma who presented with facial palsy and conductive hearing loss. Due to presence of associated scalp swelling, hemangioma was suspected and confirmed by angiography. Treatment was performed by embolization leading to arrest of progression and partial reversal of hearing loss. On extensive review of literature, we conclude that this is the first case of temporal bone hemangioma to be diagnosed pre-operatively and to be treated with embolization techniques.

  14. The clinical efficacy of 1 mm-slice CT of the middle ear

    Energy Technology Data Exchange (ETDEWEB)

    Noda, Kazuhiro; Noiri, Teruhisa [Kawanishi Municipal Hospital, Hyogo (Japan); Doi, Katsumi; Koizuka, Izumi; Tanaka, Hisashi; Mishiro, Yasuo; Okumura, Shin-ichi; Kubo, Takeshi


    The efficacy of the preoperative 1 mm-slice CT for evaluating the condition of the ossicular chain and the facial canal was assessed. CT findings were compared with the operative findings of middle ears in 120 cases of chronic otitis media or cholesteatoma that underwent tympanoplasty. The reliability of 1 mm-slice CT in detecting any defect of the ossicular chain was much superior to those of 2 mm-slice CT previously reported, and the difference between them is essential for preoperative information. On the other hand, thinner slice than 1 mm may be unnecessary, especially in routine use. (author)

  15. A short-wave infrared otoscope for middle ear disease diagnostics (Conference Presentation) (United States)

    Carr, Jessica A.; Valdez, Tulio; Bruns, Oliver; Bawendi, Moungi


    Otitis media, a range of inflammatory conditions of the middle ear, is the second most common illness diagnosed in children. However, the diagnosis can be challenging, particularly in pediatric patients. Otitis media is commonly over-diagnosed and over-treated and has been identified as one of the primary factors in increased antibiotic resistance. We describe the development of a short-wave infrared (SWIR) otoscope for objective middle ear effusion diagnosis. The SWIR otoscope can unambiguously detect the presence of middle ear fluid based on its strong light absorption in the SWIR. This absorption causes a stark, visual contrast between the presence and absence of fluid behind the tympanic membrane. Additionally, when there is no middle ear fluid, the deeper tissue penetration of SWIR light allows the SWIR otoscope to better visualize middle ear anatomy through the tympanic membrane than is possible with visible light. We demonstrate that in healthy, adult human ears, SWIR otoscopy can image a range of middle ear anatomy, including landmarks of the entire ossicular chain, the promontory, the round window niche, and the chorda tympani. We suggest that SWIR otoscopy can provide valuable diagnostic information complementary to that provided by visible pneumotoscopy in the diagnosis of middle ear effusions, otitis media, and other maladies of the middle ear.

  16. The chronically draining ear. Notes on management in the office. (United States)

    Sheehy, J L


    THERE ARE THREE FACTORS RESPONSIBLE FOR PERSISTENCE OF DISCHARGE FROM A CHRONICALLY DRAINING EAR: Moisture, opportunistic bacteria, and debris and diseased tissue. In most cases, the discharge may be temporarily controlled or eliminated by office treatment:* Instruction of the patient in aural hygiene and impressing upon him the importance of avoiding getting water in the ear.* Thorough cleaning of the ear, by the physician initially, and by the patient as frequently as necessary to keep the ear free of discharge.* Antibiotics, used locally rather than systemically, and usually in the form of a powder applied by the patient daily at home.* Culture and sensitivity tests when the problem does not respond to routine office treatment as outlined.

  17. Decreasing incidence rate for surgically treated middle ear cholesteatoma in Denmark 1977-2007

    DEFF Research Database (Denmark)

    Djurhuus, Bjarki Ditlev; Faber, Christian Emil; Skytthe, Axel


    The objective was to estimate the annual incidence rate of surgically treated middle ear cholesteatoma (STMEC) in Denmark from 1977 to 2007, taking age, gender and secular trends into consideration.......The objective was to estimate the annual incidence rate of surgically treated middle ear cholesteatoma (STMEC) in Denmark from 1977 to 2007, taking age, gender and secular trends into consideration....

  18. Bone Signaling in Middle Ear Development: A Genome‐Wide Differential Expression Analysis

    DEFF Research Database (Denmark)

    Nielsen, Michelle Christine; Bertelsen, Tomas Martin; Friis, Morten;


    Common middle ear diseases may affect bone behavior in the middle ear air cell system. To understand this pathologic pneumatization, the normal development of bone in the middle ear should be investigated. The objective of this study was to analyze gene expression of bone‐related signaling factors...... and gene sets in the developing middle ear. Microarray technology was used to identify bone‐related genes and gene sets, which were differentially expressed between the lining tissue of adult (quiescent) bulla and young (resorbing/forming) bulla. Data were analyzed using tools of bioinformatics...... and expression levels of selected genes were validated using quantitative polymerase chain reaction. The candidate gene products were compared with previously published data on middle ear bone metabolism. No differentially expressed genes were found on the outer surface of bulla. On the inner lining a total...

  19. Three-dimensional CT of the ossicles of the middle ear

    Energy Technology Data Exchange (ETDEWEB)

    Edamatsu, Hideo; Yamashita, Koichi [Kanazawa Medical Univ., Uchinada, Ishikawa (Japan)


    This study was performed to evaluate the usefulness and limitations of three-dimensional (3-D) imaging of the ossicular chain in the middle ear by high speed helical CT. One dissected human temporal bone, five normal ears, and twelve diseased ears (trauma, ossicular anomaly, cholesteatoma, chronic otitis media) were scanned in 1.0 mm slices and reconstructed at a thickness of 0.2-0.5 mm. All 3-D CT specimens can be observed in any plane and from any direction. Ossicular 3-D CT temporal bone images were reconstructed as if the malleus, incus and stapes were being observed under a microscope. No defect in the ossicles or their joints was seen in the images. The entire structure of the stapes could not be represented by conventional two-dimensional CT, but the 3-D CT in our study showed the head, crus and foot plate of the stapes in detail. Ossicular 3-D CT images of normal ears yielded the same findings as those recorded in the temporal bone. Preoperative diagnostic findings of ossicles in diseased ears were very useful. 3-D CT was diagnostic and its accuracy was confirmed by surgical observations, especially in ossicular anomalies. 3-D CT was also an important method of postoperative evaluation of ossicular reconstruction, i.e. TORP and PORP. It could represent the anatomical relation between prosthesis and the oval window. Postoperative hearing improvement can be compared with 3-D CT findings. High-speed helical CT can scan an object more quickly and clearly than conventional CT, and its biological damage in humans is less than that of other methods. 3-D CT allows obviously clearer reconstruction by helical CT than the other methods. (author).

  20. 中耳胆脂瘤研究进展%Research progress of cholesteatoma of the middle ear

    Institute of Scientific and Technical Information of China (English)

    董洁; 刘勇智


    中耳胆脂瘤是耳鼻咽喉科较为常见的一种慢性中耳疾病,长期外耳道流脓、鼓膜穿孔、听力下降为其主要特点,它对周围组织具有侵袭性,易引起中耳传音结构的破坏和骨质吸收,进而引起面瘫、迷路炎、耳后骨膜下脓肿及各种颅内外并发症。中耳胆脂瘤的病因及发病机制复杂,治疗方法的疗效争议较多。本文主要将近年来关于中耳胆脂瘤的病因、发病机制及治疗进展进行综述。%Otitis media is the most common middle ear disease,caused by a bacterial or viral infection. It can be divided into 4 types in the clinical: secretory otitis media, suppurative otitis media, middle ear cholesteatoma, and special type of otitis media. Middle ear cholesteatoma is a common chronic middle ear disease in otorhinolaryngology, long-term discharging ear canal and tympanic membrane perforation, hearing loss as its main characteristics. It is invasive to the surrounding tissue, which can cause middle ear acoustic structure destruction and bone absorption easily. It can also cause paralysis, labyrinthine inlfammation, retroauri cular subperiosteal abscess, a variety of extracranial and intracranial complications. The etiology and pathogenesis of cholesteatoma is very complex,and the curative effect for the treatment is controversial. In this paper, the etiology, pathogenesis and treatment of cholesteatoma in recent years will be reviewed.

  1. CT and MR imaging after middle ear surgery

    Energy Technology Data Exchange (ETDEWEB)

    Koesling, Sabrina E-mail:; Bootz, F


    This article describes the current value of imaging in patients after stapes surgery and surgery after chronic otitis media including cholesteatoma. Possibilities and limits of computed tomography (CT) and MRI are described and most important investigation parameters are mentioned. After otosclerosis surgery, CT is the method of first choice in detection of reasons for vertigo and/or recurrent hearing loss in the later postoperative phase. CT may show the position and condition of prosthesis, scarring around the prosthesis and otospongiotic foci. Sometimes, it gives indirect hints for perilymphatic fistulas and incus necrosis. MRI is able to document inner ear complications. CT has a high negative predictive value in cases with a free cavity after mastoidectomy. Localized opacities or total occlusion are difficult to distinguish by CT alone. MRI provides important additional information in the differentiation of cholesterol granuloma, cholesteatoma, effusion, granulation and scar tissue.

  2. Real ear unaided gain and its relation with the equivalent volume of the external and middle ear

    Directory of Open Access Journals (Sweden)

    Bastos, Bárbara Guimarães


    Full Text Available Introduction: Old age is associated with changes in the characteristics of the middle ear transmission system and in external ear resonance, and these carry implications for the hearing aid (HA verification process for which targets and measures of the real ear insertion gain (REIG are used. Aim: To compare the real ear unaided gain (REUG and the equivalent volumes of the external ear (VeqEE and the middle ear (VeqME between elderly and adult patients. Methods: This is a retrospective study in which the medical records of 28 elderly patients (aged between 61 and 102 years, average hearing thresholds between 38.75 and 85 dB HL and 23 adult patients (aged 20-59, mean hearing thresholds between 31.25 and 116.25 dB HL with bilateral sensorineural hearing loss and no history of middle ear abnormalities were analyzed. Immittance measurements (VeqEE, VeqME, and pressure of the peak of maximum compliance and the REUG (frequency and amplitude of the primary peak were recovered for a total of 40 ears. These data were compared between elderly and adults as well as between men and women, using Student's t test. Correlations (Pearson between immittance and REUG data were also verified. Results: No statistically significant differences (p < 0.01 were found for immittance and REUG data between elderly and adults, or between men and women. A negative and weak but significant correlation was observed between the REUG primary peak and VeqEE. Conclusion: Hearing aid verification can be performed with target and measures of the REIG in the elderly population.

  3. CT and magnetic resonance imaging features of middle ear adenoma of neuroendocrine differentiation: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Kwon; Choe, Mi Sun [Keimyung University School of Medicine, Daegu (Korea, Republic of)


    Middle ear adenoma is a rare benign epithelial tumor. We report the CT and magnetic resonance imaging findings of a case of middle ear adenoma of neuroendocrine differentiation in a 36-year-old man. On high-resolution CT, the mass was found to fill the middle ear, in which the ossicles were embedded, but not destroyed, with outward bulging of the intact tympanic membrane. On MRI, the mass, which was intensely enhanced on 3-dimensional (3D) gadolinium (Gd)-enhanced spoiled gradient-recalled (SPGR) sequence, involved the middle ear, aditus ad antrum and a portion of mastoid antrum. Histological and immunohistochemical findings of the specimen obtained by surgical excisions were consistent with middle ear adenoma of neuroendocrine differentiation. Middle ear adenoma of neuroendocrine differentiation should be included in the differential diagnosis of an intensely enhancing mass filling the middle ear/mastoid antrum without ossicular destructions. The extent of the mass can be excellently assessed with 3D Gd-enhanced SPGR sequence.

  4. Middle ear cavity morphology is consistent with an aquatic origin for testudines.

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    Katie L Willis

    Full Text Available The position of testudines in vertebrate phylogeny is being re-evaluated. At present, testudine morphological and molecular data conflict when reconstructing phylogenetic relationships. Complicating matters, the ecological niche of stem testudines is ambiguous. To understand how turtles have evolved to hear in different environments, we examined middle ear morphology and scaling in most extant families, as well as some extinct species, using 3-dimensional reconstructions from micro magnetic resonance (MR and submillimeter computed tomography (CT scans. All families of testudines exhibited a similar shape of the bony structure of the middle ear cavity, with the tympanic disk located on the rostrolateral edge of the cavity. Sea Turtles have additional soft tissue that fills the middle ear cavity to varying degrees. When the middle ear cavity is modeled as an air-filled sphere of the same volume resonating in an underwater sound field, the calculated resonances for the volumes of the middle ear cavities largely fell within testudine hearing ranges. Although there were some differences in morphology, there were no statistically significant differences in the scaling of the volume of the bony middle ear cavity with head size among groups when categorized by phylogeny and ecology. Because the cavity is predicted to resonate underwater within the testudine hearing range, the data support the hypothesis of an aquatic origin for testudines, and function of the middle ear cavity in underwater sound detection.

  5. Middle ear osteoma: a rare cause of conductive hearing loss with normal tympanic membrane. (United States)

    Vérillaud, B; Guilleré, L; Williams, M T; El Bakkouri, W; Ayache, D


    Osteomas of the temporal bone are benign osseous tumors usually located to the external auditory canal. Osteomas involving the middle ear are very rare. We report the case of a patient presenting with a progressive hearing loss caused by a middle ear osteoma involving the incus and contiguous to the tympanic segment of the facial nerve. This report highlights the value of CT scan in the work-up of conductive or mixed hearing loss with normal tympanic membrane. The management of middle ear osteoma is discussed.

  6. Oral Pseudoephedrine Decreases the Rate of Trans-mucosal Nitrous Oxide Exchange for the Middle Ear (United States)

    Teixeira, Miriam S.; Alper, Cuneyt M.; Martin, Brian S; Cullen Doyle, Brendan M.; Doyle, William J.


    Objective Determine if oral pretreatment with a vasoconstrictor decreases the blood to middle-ear exchange-rate of the perfusion-limited gas, Nitrous Oxide (N2O). Study Design Randomized, double-blind, crossover study. Methods Ten adult subjects with and 10 without past middle-ear disease completed paired experimental sessions, identical but for oral pretreatment with either pseudoephedrine HCL or lactose placebo. At each session, subjects were fitted with a non-rebreathing mask and breathed room air for 20 minutes (acclimation period), 50% N2O:50% O2 for 20 minutes (experimental period) and 100% O2 for 10 minutes (recovery period). Throughout, heart-rate, blood-pressure and O2 saturation were monitored and bilateral middle-ear pressures were recorded by tympanometry every minute. The primary outcome was the slope of the middle-ear pressure-time function for the experimental period which estimates the volume N2O exchange-rate. Using repeated measures ANOVA, the effects of Group (disease history), Treatment (active vs. placebo) and Period (1 vs. 2) on the recorded vital signs, and of Group, Treatment and Ear (left/right) on the middle-ear pressure-time slope were evaluated for statistical significance. Results Statistically significant effects of Period on O2 saturation (Period 2>Period 1) and of Treatment on heart-rate (Active>Placebo) were documented. Only Treatment was statistically significant for the middle-ear pressure-time slope with a shallower slope characterizing the active treatment session. Conclusion The volume exchange-rate across the middle-ear mucosa of perfusion-limited gases can be modulated pharmacologically. Theoretically, similar drugs can be used to reduce the requisite Eustachian tube opening efficiency for adequate middle-ear pressure regulation. PMID:26152838

  7. Microtomography of the human middle and inner ear (United States)

    Vogel, Uwe; Beckmann, Felix; Zahnert, Thomas; Bonse, Ulrich


    Synchrotron radiation and x-ray microtomography based on absorption contrast (performed at HASYLAB at DESY/Hamburg and BAM/Berlin) have been used for imaging of temporal bones and various internal components in situ at spatial resolution down to 7 micrometers with potential enhancement into the submicron range. Due to the volume imaging approach, several hidden structures (e.g., intra-ossicular channels) were revealed. Using several 3D-image processing techniques all data have been segmented into objects (e.g., bony ossicles, ligaments, fluids, air spaces) and subsequently transformed into vectorized data models. Because they are based on the original voxel resolution their content of vector primitives (e.g., polygons) is huge compared to recent models. Therefore they became polygon-reduced to fit into current computation limitations. So far individual data models of the entire hearing apparatus from tympanic membrane to cochlea out of intact specimen, including separate models of ossicles, ligaments and other components have been obtained, provided, in interchangeable data formats (e.g. vector-based: IGES, STL, VRML) and introduced into FEA for modeling of acousto-mechanic transfer characteristics of the middle ear. Their pseudo and real 3D- visualizations (rendering, autosteroscopic display, enlarged solid models) allow easy understanding of the anatomy and pathology of the human hearing organ and may support patient and student education in the field of otology and audiology.

  8. Effects of Consecutive Wideband Tympanometry Trials on Energy Absorbance Measures of the Middle Ear (United States)

    Burdiek, Laina M.; Sun, Xiao-Ming


    Purpose: Wideband acoustic immittance (WAI) is a new technique for assessing middle ear transfer function. It includes energy absorbance (EA) measures and can be acquired with the ear canal pressure varied, known as "wideband tympanometry" (WBTymp). The authors of this study aimed to investigate effects of consecutive WBTymp testing on…

  9. The malleable middle ear: an underappreciated player in the evolution of hearing in vertebrates

    DEFF Research Database (Denmark)

    Christensen-Dalsgaard, Jakob


    The middle ear of tetrapods (limbed vertebrates) originated from nonauditory structures, and has been modified by adaptations arising from the lifestyle of the tetrapods. These accessory structures for the inner ear increased the sensitivity to airborne sound, the frequency range of hearing...

  10. Ear barotrauma (United States)

    Barotitis media; Barotrauma; Ear popping - barotrauma; Pressure-related ear pain; Eustachian tube dysfunction - barotrauma ... The air pressure in the middle ear is most often the same as the air ... body. The Eustachian tube is a connection between the middle ...

  11. [Nasopharyngeal and middle ear flora in children with acute otitis media]. (United States)

    Zielnik-Jurkiewicz, Beata; Kolczyńska, Magdalena


    Nasopharyngeal flora can be a reservoir of bacteria caused acute otitis media in children. The aim of the study was to identify microorganisms and antimicrobial susceptibilities of pathogens from the nasopharynx and middle ear of children with acute otitis media. The study comprised 128 children ages 1 year to 14 years with diagnosed of acute otitis media with purulent discharge. The nasopharyngeal and middle ear samples were collected at the same time. Agar, chocolate, blood and Chapman plates were inoculated for isolation of bacteria. The plates were incubated at 37 degrees C and examined at 24 hours. The susceptibility of bacteria was determined by disk diffusion technique containing concentration gradients for following antibiotics: penicillin, amoxicillin/clavulanate, ampicillin/sulbactam, cefaclor, cefprozil, cefuroxime, erythromycin, azithromycin, clindamycin and trimethoprim/sulfamethoxazole. 196 organisms from nasopharynx and 325 organisms from middle ear were isolated. Most frequent cultured bacteria were: Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis--75.6% in nasopharynx and 77.8% in middle ear. We observed statistically significant (p bacteria from nasopharynx and 81.8% of bacteria from middle ear. Most organisms were resistant to trimethoprim/sulfamethoxazole--60.7% of bacteria from nasopharynx and 62.6% of bacteria from middle ear. Penicillin resistance was observed in 25.0% of bacteria from nasopharynx and 25.6% of bacteria from middle ear. The correlation in resistance of bacteria between trimethoprim/sulfamethoxazole and erythromycin (r = 0.4886) and between trimethoprim/sulfamethoxazole and penicillin (r = 0.5027) was observed. Nasopharyngeal and middle ear flora in children with acute otitis media is similar. In that case susceptibility of bacteria from the nasopharynx can be useful for empirical treatment of acute otitis media in children.

  12. Diagnosis of ossicular chain in the middle ear by high-resolution CT

    Energy Technology Data Exchange (ETDEWEB)

    Fuse, Takeo (Hanamaki-Kosei Hospital, Iwate (Japan)); Aoyagi, Masaru; Koike, Yoshio; Sugai, Yukio


    This study was conducted to assess the usefulness and limitation of high-resolution CT for evaluating the condition of ossicular chain in the middle ear. Preoperative CT findings of the ossicular chain were compared with the operative findings of ossicles in 26 patients with chronic otitis media or congenital ossicular anomaly who underwent tympanoplasty. Total defect of head of the malleus, body of the incus and long process of the incus were completely detected by high-resolution CT. But the reliability in detecting the defect of handle of the malleus and superstructure of the stapes were 33.3% and 60%, respectively. Defect of the I-S joint (1 case) and partial defect of stapes crus (2 cases) could not be diagnosed correctly in the preoperative estimation. Although these findings demonstrate the limitations of high-resolution CT in the diagnosis of ossicular chain, it will be diminished by the advanced space resolution of CT in the future. (author).

  13. Theoretic analysis of middle ear gas composition under conditions of nonphysiologic ventilation. (United States)

    Ostfeld, E J; Silberberg, A


    As gas flows in and out of the nasopharynx, the pressure in that region fluctuates. It drops below or rises above atmospheric pressure, which is itself not constant but is subject to changes in altitude and weather. Such pressure changes in the nasopharynx produce a pumping of gas into and out of the middle ear. The net amount of middle ear gas transferred from or to the nasopharynx will, component for component, in steady state exactly equal the amount of middle ear gas transferred to or from the microcirculation by means of diffusional absorption by (or release from) the mucosa. In the case of a permanently patulous eustachian tube, a single parameter, characteristic of the rate of ventilation through the open eustachian tube, is found to determine the gas composition in the middle ear, whereas in the case of a middle ear ventilated by tympanostomy, two rate-of-ventilation parameters, one for gas flow through the ventilation tube and one for flow through a periodically open eustachian tube, determine the steady state gas composition. A high rate of ventilation favors absorption of oxygen and venting of carbon dioxide from the middle ear in both cases.

  14. Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Chinh C Ngo

    Full Text Available Otitis media (OM is amongst the most common childhood diseases and is associated with multiple microbial pathogens within the middle ear. Global and temporal monitoring of predominant bacterial pathogens is important to inform new treatment strategies, vaccine development and to monitor the impact of vaccine implementation to improve progress toward global OM prevention.A systematic review of published reports of microbiology of acute otitis media (AOM and otitis media with effusion (OME from January, 1970 to August 2014, was performed using PubMed databases.This review confirmed that Streptococcus pneumoniae and Haemophilus influenzae, remain the predominant bacterial pathogens, with S. pneumoniae the predominant bacterium in the majority reports from AOM patients. In contrast, H. influenzae was the predominant bacterium for patients experiencing chronic OME, recurrent AOM and AOM with treatment failure. This result was consistent, even where improved detection sensitivity from the use of polymerase chain reaction (PCR rather than bacterial culture was conducted. On average, PCR analyses increased the frequency of detection of S. pneumoniae and H. influenzae 3.2 fold compared to culture, whilst Moraxella catarrhalis was 4.5 times more frequently identified by PCR. Molecular methods can also improve monitoring of regional changes in the serotypes and identification frequency of S. pneumoniae and H. influenzae over time or after vaccine implementation, such as after introduction of the 7-valent pneumococcal conjugate vaccine.Globally, S. pneumoniae and H. influenzae remain the predominant otopathogens associated with OM as identified through bacterial culture; however, molecular methods continue to improve the frequency and accuracy of detection of individual serotypes. Ongoing monitoring with appropriate detection methods for OM pathogens can support development of improved vaccines to provide protection from the complex combination of

  15. Malformations of the middle and inner ear on CT imaging in 22q11 deletion syndrome. (United States)

    Loos, Elke; Verhaert, Nicolas; Willaert, Annelore; Devriendt, Koenraad; Swillen, Ann; Hermans, Robert; Op de Beeck, Katya; Hens, Greet


    The 22q11 deletion syndrome (22q11DS), the most frequent microdeletion syndrome in humans, presents with a large variety of abnormalities. A common abnormality is hearing impairment. The exact pathophysiological explanation of the observed hearing loss remains largely unknown. The aim of this study was to analyze the middle and inner ear malformations as seen on computer tomographic imaging in patients with 22q11DS. We retrospectively reviewed the charts of 11 22q11DS patients who had undergone a CT of the temporal bone in the past. Of the 22 examined ears, two showed an abnormal malleus and incus, 10 presented with a dense stapes superstructure, and three ears had an abnormal orientation of the stapes. With regard to the inner ear, 12 ears showed an incomplete partition type II with a normal vestibular aqueduct. In four ears the vestibule and lateral semicircular canal were composed of a single cavity, in 14 ears the vestibule was too wide, and three ears had a broadened lateral semicircular canal. These findings suggest that malformations of the stapes, cochlea, vestibule, and lateral semicircular canal are frequent in 22q11DS. To our knowledge, the current study involves the largest case series describing middle and inner ear malformations in 22q11DS. © 2016 Wiley Periodicals, Inc.

  16. Assessment of middle ear function in patients with cleft palate treated under "Smile Train Project"

    Directory of Open Access Journals (Sweden)

    Prachi Gautam


    Full Text Available Objective: To evaluate the middle ear function in patients of cleft palate treated under "Smile Train Project". Materials and Methods: Sixty patients (120 ears; 32 male and 28 female of cleft palate with or without cleft lip were evaluated in pediatrics and ENT OPD in preoperative period. A general medical check up was performed in pediatrics OPD to evaluate the associated craniofacial anomalies. Middle ear function was evaluated in ENT OPD. Otoscopy was done in all patients. Cases under five years of age were evaluated for middle ear function by tympanometry and cases with more than five years of age were evaluated by tympanometry for middle ear function and pure tone audiometry to establish the type of hearing loss. The results are presented as number of ears. Results: A total of 50% of the patients in the study group were in zero- to two-year age group. Otoscopy findings in 120 ears showed that 66.66% of the patients had dull tympanic membrane suggesting a diagnosis of otitis media with effusion. Tympanometry was done in 110 ears, of which, 72.72% of ears had type B tympanogram suggesting otitis media with effusion. Pure tone audiometry in more than five years age group showed that 81.25% ears had conductive hearing loss. Conclusion: This study suggests the need of preoperative ENT check up and audiological assessment in patients of cleft palate undergoing palatal surgery under "Smile Train Project". The association of otitis media with effusion in patients with cleft palate appears strong and a high degree of suspicion for the disease should be kept in them. The anatomical defect and possible causative pathophysiology also supports the inference. Otitis media with effusion causing hearing loss in these patients causes speech delay and unfavorable outcome despite aggressive speech therapy in postoperative period. A co-ordinate team approach of concerned specialists involved in managing these patients would definitely improve their outcome.

  17. Evolution of the mammalian middle ear and jaw: adaptations and novel structures. (United States)

    Anthwal, Neal; Joshi, Leena; Tucker, Abigail S


    Having three ossicles in the middle ear is one of the defining features of mammals. All reptiles and birds have only one middle ear ossicle, the stapes or columella. How these two additional ossicles came to reside and function in the middle ear of mammals has been studied for the last 200 years and represents one of the classic example of how structures can change during evolution to function in new and novel ways. From fossil data, comparative anatomy and developmental biology it is now clear that the two new bones in the mammalian middle ear, the malleus and incus, are homologous to the quadrate and articular, which form the articulation for the upper and lower jaws in non-mammalian jawed vertebrates. The incorporation of the primary jaw joint into the mammalian middle ear was only possible due to the evolution of a new way to articulate the upper and lower jaws, with the formation of the dentary-squamosal joint, or TMJ in humans. The evolution of the three-ossicle ear in mammals is thus intricately connected with the evolution of a novel jaw joint, the two structures evolving together to create the distinctive mammalian skull.

  18. Highly biocompatible behaviour and slow degradation of a LDH (layered double hydroxide)-coating on implants in the middle ear of rabbits. (United States)

    Duda, Franziska; Kieke, Marc; Waltz, Florian; Schweinefuß, Maria E; Badar, Muhammad; Müller, Peter Paul; Esser, Karl-Heinz; Lenarz, Thomas; Behrens, Peter; Prenzler, Nils Kristian


    Chronic inflammation can irreversibly damage components of the ossicular chain which may lead to sound conduction deafness. The replacement of impaired ossicles with prostheses does not reduce the risk of bacterial infections which may lead to loss of function of the implant and consequently to additional damage of the connected structures such as inner ear, meninges and brain. Therefore, implants that could do both, reconstruct the sound conduction and in addition provide antibacterial protection are of high interest for ear surgery. Layered double hydroxides (LDHs) are promising novel biomaterials that have previously been used as an antibiotic-releasing implant coating to curb bacterial infections in the middle ear. However, animal studies of LDHs are scarce and there exist only few additional data on the biocompatibility and hardly any on the biodegradation of these compounds. In this study, middle ear prostheses were coated with an LDH compound, using suspensions of nanoparticles of an LDH containing Mg and Al as well as carbonate ions. These coatings were characterized and implanted into the middle ear of healthy rabbits for 10 days. Analysis of the explanted prostheses showed only little signs of degradation. A stable health constitution was observed throughout the whole experiment in every animal. The results show that LDH-based implant coatings are biocompatible and dissolve only slowly in the middle ear. They, therefore, appear as promising materials for the construction of controlled drug delivery vehicles.

  19. Clinical characteristics of patients with labyrinthine fistulae caused by middle ear cholesteatoma

    Institute of Scientific and Technical Information of China (English)

    YANG Juan-mei; CHI Fang-lu; HAN Zhao; HUANG Yi-bo; LI Yi-ke


    Background Labyrinthine fistula (LF) is a very common clinical complication mainly caused by middle ear cholesteatoma.Whether the presence of different degree LF caused by middle ear cholesteatoma aggravates neurosensory hearing loss (NSHL) and what is the degree of the hearing loss caused by LF were still under controversial.This study aimed to investigate whether the LF degree is correlative with the age distribution,disease duration and hearing loss degree for cholesteatomatous patients.Methods The files of 143 patients with middle ear cholesteatoma were selected and reviewed in a retrospective study.Seventy-eight patients with LF were divided into three types according to the degree of destruction of labyrinth.Sixty-five patients without LF were randomly chosen for control.Then,we compared the clinical characteristics of patients with or without labyrinthine fistulae caused by middle ear cholesteatoma.Results According to the study,cholesteatomatous patients with LF were older and suffered longer disease duration than those without LF.Hearing loss is severe with high frequencies both in patients with and without LF.Moreover,inner ear impairment is correlative with the degree of destruction in labyrinth,and more severe destruction in labyrinth follow the more severe symptoms correlative with inner ear impairment.Conclusion Surgical intervention should be performed as eady as possible for these cholesteatomatous patients.

  20. What middle ear parameters tell about impedance matching and high frequency hearing. (United States)

    Hemilä, S; Nummela, S; Reuter, T


    Acoustic energy enters the mammalian cochlea aided by an anatomical impedance matching performed by the middle ear. The purpose of this paper is to analyse the functional consequences of changes in scale of the middle ear when going from the smallest mammals to the largest. Our anatomical measurements in mammals of different sizes ranging from bats to elephants indicate that middle ear proportions are largely isometric. Thus the calculated transformer ratio is basically independent of animal size, a typical value lying between 30 and 80. Similarly, the calculated specific acoustic input impedance of the inner ear is independent of animal size, the average value being about 140 kPa s/m. We show that if the high frequency hearing limit of isometric ears is limited by ossicle inertia, it should be inversely proportional to the cubic root of the ossicular mass. This prediction is in reasonable agreement with published audiogram data. We then present a three-parameter model of the middle ear where some obvious deviations from perfect isometry are taken into account. The high frequency hearing limits of different species generally agree well with the predictions of this simple model. However, the hearing limits of small rodents clearly deviate from the model calculation. We interpret this observation as indicating that the hearing limit towards very high frequencies may be set by cochlear transduction mechanisms. Further we discuss the exceptional high frequency hearing of the cat and the amphibious hearing of seals.

  1. Laser interferometric vibration measurements of the middle ear in healthy humans (United States)

    Jorge, J. Rodriguez; Hemmert, Werner; Burkhardt, Claus; Zenner, Hans-Peter; Gummer, Anthony W.


    The use of spontaneous and evoked otacoustic emissions is now a standard clinical tool for diagnosis of the function of the inner ear. However, it is not possible to extract this information over the entire, functionally relevant frequency range because of imperfect coupling of: (1) stapedial to ear-drum vibrations through the ossicular chain of the middle ear and (2) ear-drum vibrations to air in the external auditory meatus. The problem could be circumvented if it were possible to measure the vibration of the stapes and ear drum. The ear drum can be visualized non-invasively, whereas the stapes is only accessible intra-operatively. Therefore, we designed a laser-interferometric system to non-invasively measure the vibration of the human ear drum. Vibrations were measured with a laser Doppler velocimeter (Polytec OFV-302) coupled into the side arm of an operating microscope (Zeiss OPMI MDM). The wavelength was 633 nm and emitted power was less than 1 mW. Direct coupling through the optics of the operating microscope, instead of through glass fibers, enabled a larger signal-to- noise ratio (20 - 30 dB) due to collection of more reflected light. This coupling scheme avoids the problems associated with having to place a reflecting material on the ear drum. The developed vibration measurement system allows non-invasive, fast and reproducible characterization of the dynamics of the human ear drum and as such can be used for clinical diagnostics.

  2. Outer- and middle-ear contributions to presbycusis in the Brown Norway rat. (United States)

    Gratton, Michael Anne; Bateman, Kristin; Cannuscio, Joseph F; Saunders, James C


    This paper examines the contribution of the outer and middle ears to the hearing loss associated with presbycusis in Brown Norway rats. Animals were formed into two groups; young adults (2-3 months old) and aged animals (approximately 34 months old). Auditory brainstem response (ABR) thresholds were obtained with the outer ear intact or surgically removed. Tympanic membrane (TM) velocity transfer functions were measured from the umbo with the outer ear removed. The length of the auditory meatus, TM surface area, and TM thickness were quantified. The ABR thresholds were 17-26 dB less sensitive in the aged animals between 8.0 and 40.0 kHz when the outer ear was intact. A significant and reliable reduction in the aged rat velocity transfer function of 5-8 dB occurred between 10.0 and 32.0 kHz, while the low frequency velocity response was only a few decibels greater in the younger animals. The ABR threshold differences between young adult and aged ears were compensated by removing the outer/middle ear effects of aging to reveal a purely sensorineural component of presbycusis. The outer and middle ear effects were calculated directly when the ABR and TM velocity data were obtained with the outer ear removed. The outer ear intact condition was modeled in order to compare the ABR data obtained with the outer ear intact with the TM velocity data obtained with the outer removed. With either procedure, removal of the age-related contributions of the outer and middle ear to the ABR threshold resulted in similar age-related ABR threshold shifts between the two age groups. The pure sensorineural threshold shift component of the ABR response was restricted to frequencies between 5.0 and 20.0 kHz and reached a maximum of approximately 15 dB. These results support the conclusion that there is an outer- and middle-ear contribution to the threshold loss defining presbycusis.

  3. HRCT常规重建与后处理对CSOM及中耳胆脂瘤诊断价值%The Diagnostic Value of HRCT Image Reconstruction and Post-processing Technology in Chronic Suppurative Otitis Media and Middle Ear Cholesteatoma

    Institute of Scientific and Technical Information of China (English)

    李必强; 王小铭; 黄显龙; 李朝军; 杨超; 唐茁月; 唐永存


    目的:探讨高分辨率CT扫描常规轴位、冠状位重建图像及图像后处理技术对慢性化脓性中耳炎及中耳胆脂瘤的诊断价值。方法对经手术病理证实并行64排螺旋CT容积扫描慢性化脓性中耳炎及中耳胆脂瘤共105例(107耳)进行回顾性分析。在常规轴位及冠状位重建图像基础上,综合运用图像后处理技术,根据主要CT表现:1、鼓室、鼓窦腔软组织密度影;2、听骨链骨质破坏情况;3、鼓室、鼓窦壁骨质破坏情况;进行术前分型,并将手术阳性结果与CT表现进行比较分析。结果慢性化脓性中耳炎59耳,其中单纯型8耳,肉芽型36耳,硬化灶肉芽型15耳;中耳胆脂瘤48耳,术前CT分型准确率为89%。对主要CT征象,常规轴位+冠状位显示率为88%,结合图像后处理技术,显示率为95%。对于所有可CT显示的术中阳性发现,均可以用多平面重组进行显示;容积再现及多平面容积再现对锤骨、砧骨破坏能较好显示,对镫骨破坏显示受到一定限制;曲面重组对面神经骨管破坏显示较满意,对听骨链骨质破坏也有一定的价值。结论 HRCT能对CSOM及中耳胆脂瘤进行较准确的术前分类、分型,常规轴位、冠状位重建图像能较全面、准确地对解剖和病变进行显示,各种图像后处理技术特别是MPR能提高CSOM及中耳胆脂瘤细微病变显示率和诊断准确率,具有很高的临床应用价值。%Objective To investigate the high resolution CT(HRCT) conventional axial scanning, coronal reconstruction images and image post-processing technology in the diagnosis of chronic suppurative otitis media(CSOM ) and middle ear choles⁃teatoma. Methods 107 ears(105 patients) were included who had been diagnosed CSOM or middle ear cholesteatoma by surgi⁃cal pathology, and been checked by 64 slices spiral CT volume scanning before surgery. The retrospectively analysis was applied to

  4. Presence of viral nucleic acids in the middle ear: acute otitis media pathogen or bystander? (United States)

    Chonmaitree, Tasnee; Ruohola, Aino; Hendley, J Owen


    Viruses play an important role in acute otitis media (AOM) pathogenesis, and live viruses may cause AOM in the absence of pathogenic bacteria. Detection of AOM pathogens generally relies on bacterial culture of middle ear fluid. When viral culture is used and live viruses are detected in the middle ear fluid of children with AOM, the viruses are generally accepted as AOM pathogens. Because viral culture is not sensitive and does not detect the comprehensive spectrum of respiratory viruses, polymerase chain reaction assays are commonly used to detect viral nucleic acids in the middle ear fluid. Although polymerase chain reaction assays have greatly increased the viral detection rate, new questions arise on the significance of viral nucleic acids detected in the middle ear because nucleic acids of multiple viruses are detected simultaneously, and nucleic acids of specific viruses are detected repeatedly and in a high proportion of asymptomatic children. This article first reviews the role of live viruses in AOM and presents the point-counterpoint arguments on whether viral nucleic acids in the middle ear represent an AOM pathogen or a bystander status. Although there is evidence to support both directions, helpful information for interpretation of the data and future research direction is outlined.

  5. First Branchial Cleft Fistula Associated with External Auditory Canal Stenosis and Middle Ear Cholesteatoma

    Directory of Open Access Journals (Sweden)

    shahin abdollahi fakhim


    Full Text Available Introduction: First branchial cleft anomalies manifest with duplication of the external auditory canal.   Case Report: This report features a rare case of microtia and congenital middle ear and canal cholesteatoma with first branchial fistula. External auditory canal stenosis was complicated by middle ear and external canal cholesteatoma, but branchial fistula, opening in the zygomatic root and a sinus in the helical root, may explain this feature. A canal wall down mastoidectomy with canaloplasty and wide meatoplasty was performed. The branchial cleft was excised through parotidectomy and facial nerve dissection.   Conclusion:  It should be considered that canal stenosis in such cases can induce cholesteatoma formation in the auditory canal and middle ear.

  6. Macroscopic description of the external and middle ear of paca (Cuniculus paca Linnaeus, 1766

    Directory of Open Access Journals (Sweden)

    Leandro L. Martins


    Full Text Available Abstract: Paca (Cuniculus paca, one of the largest rodents of the Brazilian fauna, has inherent characteristics of its species which can conribute as a new option for animal experimantation. As there is a growing demand for suitable experimental models in audiologic and otologic surgical research, the gross anatomy and ultrastructural ear of this rodent have been analyzed and described in detail. Fifteen adult pacas from the Wild Animals Sector herd of Faculdade de Ciências Agrárias e Veterinárias, Unesp-Jaboticabal, were used in this study. After anesthesia and euthanasia, we evaluated the entire composition of the external ear, registering and ddescribing the details; the temporal region was often dissected for a better view and detailing of the tympanic bulla which was removed and opened to expose the ear structures analyzed mascroscopically and ultrastructurally. The ear pinna has a triangular and concave shape with irregular ridges and sharp apex. The external auditory canal is winding in its path to the tympanic mebrane. The tympanic bulla is is on the back-bottom of the skull. The middle ear is formed by a cavity region filled with bone and membranous structures bounded by the tympanic membrane and the oval and round windows. The tympanic membrane is flat and seals the ear canal. The anatomy of the paca ear is similar to the guinea pig and from the viewpoint of experimental model has major advantages compared with the mouse ear.

  7. Effects of polylactic acid film on middle ear mucosa and cochlear function in Guinea pigs. (United States)

    Ensari, Nuray; Tutar, Hakan; Ekinci, Ozgur; Ugur, Mehmet Birol; Bayazıt, Yıldırım A; Gokdogan, Cagil; Goksu, Nebil


    Our aim was to assess the effects of polylactic acid (PLA) on middle ear mucosa and cochlea, to be used as a film barrier for postoperative adhesion prevention in the middle ear. Twenty-one albino Guinea pigs were included in the study. A window was opened on both tympanic bulla and on one side PLA material was placed in the middle ear and on the other side only fenestration was performed and used as a control. All Guinea pigs underwent evaluation of tympanic membranes microscopically; functional hearing was analyzed by auditory brainstem responses preoperatively, in the first and the sixth month. All Guinea pigs were killed on the sixth month for histopathologic evaluation of their temporal bones. There was no statistical difference between both groups regarding hearing thresholds, interpeak wave latencies preoperatively and on first and the sixth months postoperatively. Histopathological evaluation revealed no specific changes. There was a mild local inflammation both in the PLA implanted and control ears. PLA film barrier most likely has no toxic effects on Guinea pig middle ear and does not show any ototoxic side effects.

  8. Resistance to complement-mediated killing and IgM binding to non-typeable Haemophilus influenzae is not altered when ascending from the nasopharynx to the middle ears in children with otitis media. (United States)

    Langereis, Jeroen D; van Dongen, Thijs M A; Stol, Kim; Venekamp, Roderick P; Schilder, Anne G M; Hermans, Peter W M


    We have previously found that non-typeable Haemophilus influenzae (NTHi) collected from the middle ear of children with otitis media (OM) exhibit increased levels of complement resistance compared to NTHi collected from the nasopharynx. However, it is unknown whether bacteria develop complement resistance in the middle ear, or whether resistance is present when residing in the nasopharynx. The objective of this study was to investigate whether the levels of complement resistance of isolates collected from the middle ear were similar to those of isolates from the nasopharynx with an identical MLST type. We included 62 children with recurrent acute OM, chronic OM with effusion or acute tympanostomy tube otorrhea. NTHi was simultaneously isolated from the nasopharynx and middle ear fluid. MLST, resistance to complement-mediated killing, IgG binding, IgM binding and phosphorylcholine expression was determined. In 41 children, NTHi isolated from the middle ear and nasopharynx showed to have an identical MLST type. Isolates collected from the middle ear showed a highly similar level of complement resistance and IgM binding with isolates collected from the nasopharynx, whereas this was not the case for IgG binding and phosphorylcholine incorporation into lipooligosaccharide. Resistance to complement-mediated killing and IgM binding of NTHi isolates with an identical MLST type collected from the middle ear and nasopharynx of children with OM was highly similar.

  9. Middle ear impedance studies in elderly patients implications on age-related hearing loss

    Directory of Open Access Journals (Sweden)

    Olusola Ayodele Sogebi


    Full Text Available INTRODUCTION: Controversies arise with respect to functioning of the middle ear over time.OBJECTIVE: To assess changes in middle ear impedance that may be related to aging, and/or if there was an association of these changes with those of the inner ear in the elderly patients.METHODS: Cross-sectional, comparative study of elderly patients managed in ear, nose and throat clinics. A structured questionnaire was administered to obtain clinical information. Pure tone audiometry, tympanometry, and acoustic reflexes were performed. Comparative analyses were performed to detect intergroup differences between clinico-audiometric findings and middle ear measures, viz. tympanograms and acoustic reflexes.RESULTS: One hundred and three elderly patients participated in the study; 52.4% were male, averagely 70.0 ± 6.3 years old, age-related hearing loss in 59.2%, abnormal tympanograms in 39.3%, absent acoustic reflex in 37.9%. There was no association between age and gender in patients with abnormal tympanograms and absent acoustic reflex. Significantly more patients with different forms and grades of age-related hearing loss had abnormal tympanometry and absent acoustic reflex.CONCLUSION: Some abnormalities were observed in the impedance audiometric measures of elderly patients, which were significantly associated with parameters connected to age-related hearing loss.

  10. Antibodies mediate formation of neutrophil extracellular traps in the middle ear and facilitate secondary pneumococcal otitis media. (United States)

    Short, Kirsty R; von Köckritz-Blickwede, Maren; Langereis, Jeroen D; Chew, Keng Yih; Job, Emma R; Armitage, Charles W; Hatcher, Brandon; Fujihashi, Kohtaro; Reading, Patrick C; Hermans, Peter W; Wijburg, Odilia L; Diavatopoulos, Dimitri A


    Otitis media (OM) (a middle ear infection) is a common childhood illness that can leave some children with permanent hearing loss. OM can arise following infection with a variety of different pathogens, including a coinfection with influenza A virus (IAV) and Streptococcus pneumoniae (the pneumococcus). We and others have demonstrated that coinfection with IAV facilitates the replication of pneumococci in the middle ear. Specifically, we used a mouse model of OM to show that IAV facilitates the outgrowth of S. pneumoniae in the middle ear by inducing middle ear inflammation. Here, we seek to understand how the host inflammatory response facilitates bacterial outgrowth in the middle ear. Using B cell-deficient infant mice, we show that antibodies play a crucial role in facilitating pneumococcal replication. We subsequently show that this is due to antibody-dependent neutrophil extracellular trap (NET) formation in the middle ear, which, instead of clearing the infection, allows the bacteria to replicate. We further demonstrate the importance of these NETs as a potential therapeutic target through the transtympanic administration of a DNase, which effectively reduces the bacterial load in the middle ear. Taken together, these data provide novel insight into how pneumococci are able to replicate in the middle ear cavity and induce disease.

  11. Assessment of middle ear effusion and audiological characteristics in young children with adenoid hypertrophy

    Institute of Scientific and Technical Information of China (English)

    REN Dong-dong; WANG Wu-qing


    Background Otitis media with effusion is a highly concurrent disease in young children with adenoid hypertrophy.The aim of this study was to assess the middle ear effusion and audiological characteristics in children with adenoid hypertrophy and compare the various assessment methods.@@Methods Two hundred and seven candidates who were to undergo adenoidectomy were analyzed using otoscopy,tympanometry,air-conduction auditory steady-state responses (AC-ASSR),and computerized tomography (CT) before adenoidectomy.@@Results About 73.4% (304/414) of ears were confirmed to have middle ear effusion (MEE) by otoscopy; 75.4% (312/414) of ears revealed MEE by CT.CT scan correctly predicted all the myringotomy results,giving 100% accuracy on the diagnosis of MEE.Additionally,CT revealed two children with inner ear malformations.Type B tracing tympanogram provided a sensitivity of 91.7% and a specificity of 92.2%.Type C tympanogram with peak pressure <-200 daPa indicated effusion; type C tympanogram having acoustic stapedius reflex could exclude MEE.We excluded the AC-ASSR results of the 4 ears with malformation; 54.4% (223/410) of ears were confirmed of hearing loss.Furthermore,5.2%(16/310) of the ears with MEE suffered from severe to profound hearing loss.The average threshold level in the 0.25 kHz frequency of children was found to have poorer hearing thresholds than those in the 0.5,1,2,and 4 kHz (P <0.001) frequencies; 29.7% (92/310) of ears with MEE were regarded as normal hearing level.About 55.8% (173/310) of ears with MEE were classified as having slight-mild hearing loss.@@Conclusions The practitioners should pay much attention to the middle ear condition and be aware of a possible development of severe to profound hearing loss during the course of MEE in young children with adenoid hypertrophy.CT scan is good for the assessment of MEE before ventilation tube insertion.

  12. Femtosecond laser microstructuring of titanium surfaces for middle ear ossicular replacement prosthesis: results of preliminary studies (United States)

    Biedron, S.; Ilgner, J. F. R.; Fadeeva, E.; Chichkov, B.; Prescher, A.; Bovi, M.; Westhofen, M.


    The objective of this study was to optimize titanium surfaces by means of Ti:Sapphire femtosecond laser to improve the attachment of human cartilage cells on titanium prosthesis in middle ear surgery. The application of microstructures on titanium samples was evaluated and the influence of these microstructures on human auricular chondrocytes was studied in-vitro. After establishing the ear chondrocyte cell culture, cells were seeded on titanium platelets with selected microstructure patterns. Whereas the phenotype of cells seeded on unstructured titanium was similar to cells grown on standard tissue culture surfaces, the morphology of chondrocytes grown on structured titanium samples was influenced by the pattern. For future titanium middle ear prosthesis structural optimizations will be developed to promote chondrocyte growth and adhesion while impeding fibrocyte proliferation to avoid scarring on implant interfaces.

  13. Fenestration operation in middle ear bone with pulsed infrared lasers:an in-vivo study

    Institute of Scientific and Technical Information of China (English)

    Xianzeng Zhang; Xiaoyan Wang; Zhenlin Zhan; Qing Ye; Shusen Xie


    The feasibility of fenestration operation in middle ear bone with pulsed infrared laser is evaluated.Healthy male New Zealand rabbits in vivo are used in the experiment.Middle ear mastoid bone of animal model is complctely exposed with conventional methods,and then a pulsed CO2 laser(10.6 μm)and an Er:YAG laser(2.94 μm)are used to perform the fenestration operation.Diamond drill is also used as a control group.The total operation time and light irradiation time are recorded and the opening efficiency is assessed.The morphological changes and thermal damage around the opening window on the middle ear bone are examined.It is shown that both laser systems are suitable for the fenestration operation in middle ear bone,and this no-touch technique has a lot of benefits compared with traditional methods.The bleeding during operation has an important effect on operation time and thermal injury and needs to be controlled efficiently in further study.

  14. A surgical technique for implantation of the vibrant soundbridge middle ear implant in dogs

    NARCIS (Netherlands)

    Haar, G. Ter; Mulder, J.J.S.; Venker-van Haagen, A.J.; Sluijs, F.J. van; Smoorenburg, G.F.


    OBJECTIVE: To report a surgical implantation of the Vibrant Soundbridge (VSB) middle ear implant in dogs. STUDY DESIGN: Pilot study. ANIMALS: Dogs (n=3). METHODS: A lateral approach to the tympanic bulla was used to insert the floating mass transducer of the VSB into the tympanic bulla. Using micros

  15. Short term and long term subjective taste disorder after middle ear cleft surgery

    Directory of Open Access Journals (Sweden)

    Ayaz Rehman


    Full Text Available Aim: The present study is a prospective study that looks into the prevalence of chorda tympani nerve injury and related symptoms following varying degrees of trauma to the nerve during four common types of middle-ear operations; namely, Tympanomastoid operations, myringoplasty, Tympanoplasty and Exploratory tympanotomy. Materials and Methods: 178 patients who underwent middle ear cleft surgery were included in this prospective study. Childrens below 20 years and patients with other potential cause of taste disturbance were excluded. Patients were given a single questionnaire, so as to assess their post-operative taste disturbance. Patient name, Age, Sex, Type of middle ear surgery, side of surgery were recorded. Any change in sense of taste immediately (after 2-4 weeks or delayed (2-3 yearswere recorded. Results: The number of patients with Chorda tympani nerve-related symptoms varied widely between these four groups. Increased occurrence of the nerve related symptoms were observed in Tympanomastoid and Myringoplasty, and a prolonged recovery time were observed in the tympanomastoid group. Stretching of the nerve produced more symptomatic cases than thermal injury or drying. Conclusion: It is important to inform patients about the possibility of Chorda Tympani Nerve injury during middle-ear operations, and it should also be emphasized that symptoms related to Chorda Tympani Nerve injury can occur irrespective of the type of damage to the nerve.

  16. Influenza A virus alters pneumococcal nasal colonization and middle ear infection independently of phase variation. (United States)

    Wren, John T; Blevins, Lance K; Pang, Bing; King, Lauren B; Perez, Antonia C; Murrah, Kyle A; Reimche, Jennifer L; Alexander-Miller, Martha A; Swords, W Edward


    Streptococcus pneumoniae (pneumococcus) is both a widespread nasal colonizer and a leading cause of otitis media, one of the most common diseases of childhood. Pneumococcal phase variation influences both colonization and disease and thus has been linked to the bacteria's transition from colonizer to otopathogen. Further contributing to this transition, coinfection with influenza A virus has been strongly associated epidemiologically with the dissemination of pneumococci from the nasopharynx to the middle ear. Using a mouse infection model, we demonstrated that coinfection with influenza virus and pneumococci enhanced both colonization and inflammatory responses within the nasopharynx and middle ear chamber. Coinfection studies were also performed using pneumococcal populations enriched for opaque or transparent phase variants. As shown previously, opaque variants were less able to colonize the nasopharynx. In vitro, this phase also demonstrated diminished biofilm viability and epithelial adherence. However, coinfection with influenza virus ameliorated this colonization defect in vivo. Further, viral coinfection ultimately induced a similar magnitude of middle ear infection by both phase variants. These data indicate that despite inherent differences in colonization, the influenza A virus exacerbation of experimental middle ear infection is independent of the pneumococcal phase. These findings provide new insights into the synergistic link between pneumococcus and influenza virus in the context of otitis media.

  17. Jun N-Terminal Protein Kinase Enhances Middle Ear Mucosal Proliferation during Bacterial Otitis Media▿ (United States)

    Furukawa, Masayuki; Ebmeyer, Jörg; Pak, Kwang; Austin, Darrell A.; Melhus, Åsa; Webster, Nicholas J. G.; Ryan, Allen F.


    Mucosal hyperplasia is a characteristic component of otitis media. The present study investigated the participation of signaling via the Jun N-terminal protein kinase (JNK) mitogen-activated protein kinase in middle ear mucosal hyperplasia in animal models of bacterial otitis media. Otitis media was induced by the inoculation of nontypeable Haemophilus influenzae into the middle ear cavity. Western blotting revealed that phosphorylation of JNK isoforms in the middle ear mucosa preceded but paralleled mucosal hyperplasia in this in vivo rat model. Nuclear JNK phosphorylation was observed in many cells of both the mucosal epithelium and stroma by immunohistochemistry. In an in vitro model of primary rat middle ear mucosal explants, bacterially induced mucosal growth was blocked by the Rac/Cdc42 inhibitor Clostridium difficile toxin B, the mixed-lineage kinase inhibitor CEP11004, and the JNK inhibitor SP600125. Finally, the JNK inhibitor SP600125 significantly inhibited mucosal hyperplasia during in vivo bacterial otitis media in guinea pigs. Inhibition of JNK in vivo resulted in a diminished proliferative response, as shown by a local decrease in proliferating cell nuclear antigen protein expression by immunohistochemistry. We conclude that activation of JNK is a critical pathway for bacterially induced mucosal hyperplasia during otitis media, influencing tissue proliferation. PMID:17325051

  18. Application of active middle ear implants in patients with severe mixed hearing loss.

    NARCIS (Netherlands)

    Verhaegen, V.J.O.; Mulder, J.J.S.; Cremers, C.W.R.J.; Snik, A.F.M.


    OBJECTIVE: To determine the long-term benefit of the Vibrant Soundbridge (VSB) middle ear implant in patients with severe mixed hearing loss and to compare it with other hearing devices. DESIGN: A retrospective analysis. SETTING: University-affiliated medical center. PATIENTS: Six patients with seve

  19. Fetal development of the elastic-fiber-mediated enthesis in the human middle ear. (United States)

    Takanashi, Yoshitaka; Shibata, Shunichi; Katori, Yukio; Murakami, Gen; Abe, Shinichi; Rodríguez-Vázquez, Jose Francisco; Kawase, Tetsuaki


    In the human middle ear, the annular ligament of the incudostapedial joint and the insertions of the tensor tympani and stapedius muscles contain abundant elastic fibers; i.e., the elastic-fiber-mediated entheses. Hyaluronan also coexists with the elastic fibers. In the present study using immunohistochemistry, we demonstrated the distribution of elastin not only in the incudostapedial joint but also in the other two joints of the middle ear in adults and fetuses. In adults, the expression of elastin did not extend out of the annular ligament composed of mature elastic fibers but clearly overlapped with it. Electron microscopic observations of the annular ligament demonstrated a few microfibrils along the elastic fibers. Thus, in contrast to the vocal cord, the middle ear entheses seemed not to contain elaunin and oxytalan fibers. In mid-term fetuses (at approximately 15-16 weeks of gestation) before opening of the external acoustic meatus, the incudostapedial joint showed abundant elastic fibers, but the incudomalleolar and stapediovestibular joints did not. At this stage, hyaluronan was not colocalized, but distributed diffusely in loose mesenchymal tissues surrounding the ear ossicles. Therefore, fetal development of elastin and elastic fibers in the middle ear entheses is unlikely to require acoustic oscillation. In late-stage fetuses (25-30 weeks), whose ear ossicles were almost the same size as those in adults, we observed bundling and branching of elastic fibers. However, hyaluronan expression was not as strong as in adults. Colocalization between elastic fibers and hyaluronan appeared to be a result of postnatal maturation of the entheses.

  20. Middle ear adenoma is an amphicrine tumor: why call it adenoma? (United States)

    Ketabchi, S; Massi, D; Franchi, A; Vannucchi, P; Santucci, M


    Middle ear adenoma (MEA) is a rare tumor postulated to take origin from the lining epithelium of the middle ear cavity. The authors report on a case of MEA arising in a 53-year old woman suffering from a sensation of fullness in her left ear, otalgia, and light left-sided hearing loss. Histopathologically, the lesion was composed of cuboidal and polygonal cells displaying a trabecular, tubulo-glandular, and solid pattern of growth. Immunohistochemically, neoplastic cells diffusely stained with anti-vimentin antibodies and were focally positive for chromogranin A, neuron-specific enolase, lysozyme, and cytokeratins AE1/AE3. The majority of tumor cells showed weak and diffuse staining with both anti-PP and anti-ACTH antibodies and intense positivity with anti-glucagon and anti Leu-7 antibodies. Ultrastructural investigation revealed both mucinous-glandular and neuroendocrine differentiation. The authors suggest that the appropriate terminology would be adeno-carcinoid or amphicrine tumor of the middle ear rather than "adenoma," a term that does not reflect its dual nature.

  1. Middle Ear Pressure Regulation - Complementary Action of the Mastoid and Eustachian Tube

    DEFF Research Database (Denmark)

    Gaihede, Michael; Dirckx, Joris J J; Jacobsen, Henrik;


    HYPOTHESIS:: Middle ear pressure (MEP) is actively regulated by both the Eustachian tube and the mastoid air cell system. BACKGROUND:: MEP is a highly significant factor involved in many clinical conditions related to otitis media. Basic knowledge on its overall regulation remains insufficient...... of these distinct mechanisms were found. CONCLUSION:: The human mastoid as well as the Eustachian tube was capable of active counter-regulation of the MEP in short-term experimental pressure changes in healthy ears. Thus, these 2 systems seemed to function in a complementary way, where the mastoid was related...

  2. Connectivity analysis of suggestive brain areas involved in middle ear pressure regulation in humans

    DEFF Research Database (Denmark)

    SA, Sami; Gaihede, Michael


    HYPOTHESIS:: Middle ear pressure (MEP) is actively regulated by both the Eustachian tube and the mastoid air cell system. BACKGROUND:: MEP is a highly significant factor involved in many clinical conditions related to otitis media. Basic knowledge on its overall regulation remains insufficient...... of these distinct mechanisms were found. CONCLUSION:: The human mastoid as well as the Eustachian tube was capable of active counter-regulation of the MEP in short-term experimental pressure changes in healthy ears. Thus, these 2 systems seemed to function in a complementary way, where the mastoid was related...

  3. Tympanosclerosis of the middle ear: radiologic-surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Won Jin; Park, Dong Woo; Lee, Seung Ro; Seong, Jin Yong; Song, Soon Young; Hahm, Chang Kok; Kim, Yong Soo; Park, Choong Ki; Tae, Kyung [Hanyang Univ., Seoul (Korea, Republic of). Coll. of Medicine


    Tympanosclerosis is a common problem causing conductive hearing loss accompanied by chronic otitis media. The purpose of this study was to evaluate the CT findings of tympanosclerosis, and correlate them with the surgical findings. The CT scans of 17 patients with surgically-proven tympanosclerosis and those of a control group of 34 patients with nontympanosclerotic chronic otitis media were reviewed. According to their location, they were assigned to one of three groups; tympanic membrane, epitympanum, or ossicles. Tympanosclerosis usually appears on CT as ossicular thickening, narrowing of the epitympanum, calcification of the tympanic membrane and/or tympanic cavity. CT is very helpful in evaluating ossicular involvement and determining the appropriate surgical treatment of tympanosclerosis. (author). 13 refs., 4 figs.

  4. Design of Floating Mass Type Piezoelectric Actuator for Implantable Middle Ear Hearing Devices

    Institute of Scientific and Technical Information of China (English)

    LIU Houguang; TA Na; MING Xiaofeng; RAO Zhushi


    To overcome some of the problems inherent in conventional hearing aids such as low gain at high frequencies due to acoustic feedback, discomfort in occlusion of the external ear canal and so on, implantable middle ear hearing devices (IMEHDs) have been developed over the past two decades. For such kinds of IMEHDS, this paper presents the design of a floating mass piezoelectric actuator using a PMN-30%PT stack as a new type of vibrator. The proposed piezoelectric actuator consists of only three components of a piezoelectric stack, a metal case and a clamp. For the purpose of aiding the design of this actuator, a coupling biomechanics model of human middle ear and the piezoelectric actuator was constructed. This model was built based on a complete set of computerized tomography section images of a healthy volunteer's left ear by reverse engineering technology. The validity of this model was confirmed by comparing the motion of the tympanic membrane and stapes footplate obtained by this model with published experimental measurements on human temporal bones. It is shown that the designed actuator can be implanted on the incus long process by a simple surgical operation, and the stapes footplate displacement by its excitation at 10.5 V root-mean-square(RMS) voltage was equivalent to that from acoustic stimulation at 100 dB sound pressure level(SPL), which is adequate stimulation to the nssicular chain. The corresponding power consumption is 0.04 mW per volt of excitation at 1 kHz, which is low enough for the transducer to be used in an implantable middle ear device.

  5. Mobile, one stage, bilateral ear surgery for chronic otitis media patients in remote areas

    DEFF Research Database (Denmark)

    Homøe, P; Sørensen, H C Florian; Tos, M


    OBJECTIVES: We evaluated the results of mobile, one stage, bilateral ear surgery conducted in Greenland, where chronic otitis media with and without suppuration is prevalent. The study aimed to increase the number of operations conducted and to reduce the cost of ear surgery in remote areas...... was assessed using median air conduction pure tone average gain, and the 'take rate' (i.e. the percentage of total ears with a closed perforation) was evaluated. RESULTS: All patients attended for follow up. Eighty-two per cent had at least one perforation closed, and the overall take rate was 65 per cent...... of the 34 ears. The median air conduction pure tone average gain after two years was 18 dB and 13 dB for the right and left ears, respectively. Fourteen patients (82 per cent) obtained an air conduction pure tone average hearing level of ear. In total, 71 per cent of the patients...

  6. Conditioning the middle ear reflex at sensation levels below reflex threshold: air jet and electrical stimulation. (United States)

    McDaniel-Bacon, L; Fulton, R T; Laskowski, R P


    An ABAB functional analysis, conditioning and generalization, design was used in 3 experiments (2 were formal studies and 1 was empirical in nature) to investigate the conditionability of the middle ear reflex. The conditioned stimuli were subreflex threshold pure tones of various frequencies and intensities. The unconditioned stimulus (UCS) was an auricular air jet to the contralateral ear in the first experiment and cutaneous electrical stimulation to the ipsolateral, probe ear in the last 2 experiments. Reflexes were monitored by an otoadmittance meter, storage oscilloscope, and strip chart recorder. In the first experiment (air jet UCS), no subjects met the conditioning criterion within the maximum presentation of 400 paired trials, despite pilot evidence which indicated conditioning was feasible. In the second experiment (electrical stimulation UCS), 2 subjects met conditioning criterion; however, only one subject reconditioned and demonstrated partial generalization to other conditioned stimuli. In the third experiment (electrical stimulation UCS), one of 3 subjects who had previously been unconditionable with the air jet UCS met conditioning and reconditioning criterion and demonstrated partial generalization. Results indicate that the middle ear reflex can be conditioned to be elicited by subreflex threshold pure tones, however, results are limited.

  7. Spatial Motion in Natural and Reconstructed Middle Ears and the Impact on Sound Transfer (United States)

    Eiber, Albrecht; Heckeler, Christoph; Lauxmann, Michael; Maier, Hannes; Saffarini, Mohammed


    During sound transmission the elements of the middle ear carry out frequency dependent motions in all three spatial directions. Particularly the stapes exhibits a piston and rocking motion and recent studies show that rocking also has an impact on hearing. Here the spatial motions of natural and reconstructed ears are considered on the basis of experiments and numerical simulations based on Multibody System (MBS) approach and Finite Element Method (FEM). In case of a passive reconstruction with a PORP the stapes carries out pronounced rocking motions as well as the piston driven by the natural incus in classical stapedotomy. In the active, electromagnetic middle ear implant Phonak Ingenia, a piston prosthesis is driven by the actuator. Due to anatomical restrictions, the axes of the actuator and the prosthesis are not in line and thus a rocking motion of the prosthesis occurs. Compared to passive reconstructions and the natural ear, this rocking is about in the same range of magnitude. In particular, the coupling between actuator and prosthesis is important for the hearing sensation. Thus, a standardized coupling configuration between the Phonak Ingenia actuator and the piston prosthesis with predefined coupling stiffness and damping offers optimal sound transfer.

  8. Middle ear adenoma with neuroendocrine differentiation: relate of two cases and literature review (United States)

    Bittencourt, Aline Gomes; Tsuji, Robinson Koji; Cabral, Francisco; Pereira, Larissa Vilela; Fonseca, Anna Carolina de Oliveira; Alves, Venâncio; Bento, Ricardo Ferreira


    Summary Introduction: Adenomas with neuroendocrine differentiation are defined as neuroendocrine neoplasms, and they are rarely found in the head and neck. Objective: To describe two cases of a middle ear adenoma with neuroendocrine differentiation, with a literature review. Case Report: Patient 1 was a 41-year-old woman who presented with a 3-year history of left aural fullness associated with ipsilateral “hammer beating” tinnitus. Patient 2 was a 41-year-old male who presented with unilateral conductive hearing loss. Conclusion: Adenoma with neuroendocrine differentiation of the middle ear is a rare entity, but it should be considered in patients with tinnitus, aural fullness, and a retrotympanic mass and remembered as a diferential diagnosis of tympanic paraganglioma. PMID:25992031

  9. Effects of changes in dynamic characteristics of the middle ear on transient-evoked otoacoustic emissions

    Directory of Open Access Journals (Sweden)

    Špirić Sanja


    Full Text Available Transient-evoked otoacoustic emissions are transmitted through the middle ear. The purpose of this study was to investigate the effects of dynamic properties of the transmission system on the measurability of transient otoacoustic emissions. The authors analyzed the presence of transient otoacoustic emissions in 48 children with serous otitis media regarding the tympanogram, presence and type of effusion and pure tone average findings. The results obtained in this research show the predominant absence of transient otoacoustic emissions in patients with type B tympanogram (69.1% especially if the effusion is mucoid (77.5% with the hearing loss of 15 decibel hearing level. This research shows that disorders in dynamic characteristics of the middle ear in patients with serous otitis obstruct the transmission of acoustic energy and affect the measurability of transient otoacoustic emissions, especially if the effusion is mucoid and hearing loss of 15 decibel hearing level.

  10. Study Of The Effect Of Nasal- Septal Deviation On The Middle Ear Pressure

    Directory of Open Access Journals (Sweden)

    Motesaddi Zarandi M


    Full Text Available Eustachian tube connects middle ear space to the nasopharyngeal space. Upper airway obstruction, with any cause, can derange Eustachian tube function. Nasal septal deviation is one of the prevalent causes of upper airway obstruction which can affects the ventilation function of Eustachian tube."nMaterials and Methods: This study was conducted on the patients who underwent septoplasty due to severe septal deviation leading to unilateral nasal obstruction in Amiraalam hospital from summer of 1378 till the spring of 1379."nResults: There was 140 patients whose data were as: female patients 34 (24.3% male patients 106 (75.7%, mean age (22.7. Median age (20 years and mode of age (18 years of age. they were from 12 to 40 years of age."nConclusion: Comparison between preoperative and postoperative middle ear pressures shows no any significant statistical difference (p=0.798.

  11. Virus and bacteria enhance histamine production in middle ear fluids of children with acute otitis media. (United States)

    Chonmaitree, T; Patel, J A; Lett-Brown, M A; Uchida, T; Garofalo, R; Owen, M J; Howie, V M


    Histamine levels were measured in 677 middle ear fluid (MEF) samples from 248 children (aged 2 months to 7 years) with acute otitis media (AOM); of these, 116 (47%) had documented viral infection. Histamine content was higher in bacteria-positive than in bacteria-negative MEF samples (P = .007) and higher in samples from patients with viral infection than in those from patients with no viral infection (P = .002). Bacteria and viruses together had an additive effect on histamine content in MEF. Histamine concentration in the initial MEF sample tended to be higher in patients with persistent otitis than in those with good response to treatment (P = .14). Results suggest that viruses, bacteria, or both induce histamine production, which leads to increased inflammation in the middle ear. Antihistaminic drugs may be beneficial. Large, prospective, controlled trials of the effects of antihistamine as an adjunct therapy in bacterial and viral AOM are required before recommendations can be made.

  12. One third of middle ear effusions from children undergoing tympanostomy tube placement had multiple bacterial pathogens

    Directory of Open Access Journals (Sweden)

    Holder Robert C


    Full Text Available Abstract Background Because previous studies have indicated that otitis media may be a polymicrobial disease, we prospectively analyzed middle ear effusions of children undergoing tympanostomy tube placement with multiplex polymerase chain reaction for four otopathogens. Methods Middle ear effusions from 207 children undergoing routine tympanostomy tube placement were collected and were classified by the surgeon as acute otitis media (AOM for purulent effusions and as otitis media with effusion (OME for non-purulent effusions. DNA was isolated from these samples and analyzed with multiplex polymerase chain reaction for Haemophilus influenzae, Streptococcus pneumoniae, Alloiococcus otitidis, and Moraxella catarrhalis. Results 119 (57% of 207 patients were PCR positive for at least one of these four organisms. 36 (30% of the positive samples indicated the presence of more than one bacterial species. Patient samples were further separated into 2 groups based on clinical presentation at the time of surgery. Samples were categorized as acute otitis media (AOM if pus was observed behind the tympanic membrane. If no pus was present, samples were categorized as otitis media with effusion (OME. Bacteria were identified in most of the children with AOM (87% and half the children with OME (51%, p Haemophilus influenzae was the predominant single organism and caused 58% of all AOM in this study. Alloiococcus otitidis and Moraxella catarrhalis were more frequently identified in middle ear effusions than Streptococcus pneumoniae. Conclusions Haemophilus influenzae, Streptococcus pneumoniae, Alloiococcus otitidis, and Moraxella catarrhalis were identified in the middle ear effusions of some patients with otitis media. Overall, we found AOM is predominantly a single organism infection and most commonly from Haemophilus influenzae. In contrast, OME infections had a more equal distribution of single organisms, polymicrobial entities, and non-bacterial agents.

  13. Outcome of Vibrant Soundbridge Middle Ear Implant in Cantonese-Speaking Mixed Hearing Loss Adults


    Yu, Joannie Ka Yin; Tsang, Willis Sung Shan; Wong, Terence Ka Cheong; Tong, Michael Chi Fai


    Objectives To investigate the aided benefits, speech recognition in quiet and in noise, change in hearing and subjective report of satisfaction on mixed hearing loss adults implanted with Vibrant Soundbridge (VSB) middle ear implant. Methods Eight Cantonese speaking adult patients with mixed hearing loss were enrolled in a single-subject, repeated measures prospective study design. Audiometric testing, including air and bone conduction and word recognition under sound-field were conducted bef...

  14. Long-term patient satisfaction with different middle ear hearing implants in sensorineural hearing loss


    Rameh, Charbel; Meller, Renaud; Lavieille, Jean-Pierre; Deveze, Arnaud; Magnan, Jacques


    Introduction: Implantable hearing devices are a viable option for patients with moderate-to-severe sensorineural hearing loss who cannot benefit from the conventional hearing aids. In this study, we focus on the patients_ satisfaction with 3 different middle ear implants, the Vibrant Sound Bridge (VSB), the semi implantable Otologics MET implant, and the fully implantable Carina implant. Materials and Methods: Between 1998 and 2008, we have implanted 112 patients with these devices. Hereby, w...

  15. Superior semicircular canal dehiscence associated with external, middle, and inner ear abnormalities. (United States)

    Wang, Jenny R; Parnes, Lorne S


    We report a case of bilateral superior semicircular canal dehiscence (SSCD) in a 38-year-old man who presented with congenital hearing loss without vestibular symptoms. This case is unusual due to the association of SSCD with multiple congenital anomalies of the external, middle, and inner ears, but without any other craniofacial or systemic developmental anomalies. Findings of multiple malformations of temporal bone structures in this case lend support to the theory that SSCD may have an underlying developmental or congenital etiology.

  16. Osteoradionecrosis of the temporal bone with cancer of the middle ear. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Ishida, Katsunori; Sakai, Makoto [Chigasaki Central Hospital, Kanagawa (Japan); Shinkawa, Atsushi


    Osteoradionecrosis of the temporal bone may occur as a result of radiation therapy for head and neck carcinomas or brain tumors. A 64-year-old female received radiation therapy for squamous cell carcinoma of the middle ear 20 years ago, and then she developed osteoradionecrosis of the temporal bone. The patient underwent extensive debridement with removal of sequestrations in the temporal bone and adjacent areas, and abscess drainage. Her postoperative course was satisfactory and there was no progression of the disease. (author)

  17. Your Ears (United States)

    ... gross and useful. continue The Middle Ear: Good Vibrations After sound waves enter the outer ear, they travel through the ... ear's main job is to take those sound waves and turn them into vibrations that are delivered to the inner ear. To ...

  18. Ear Tubes (United States)

    ... of the ear drum or eustachian tube, Down Syndrome, cleft palate, and barotrauma (injury to the middle ear caused by a reduction of air pressure, ... specialist) may be warranted if you or your child has experienced repeated ... fluid in the middle ear, barotrauma, or have an anatomic abnormality that ...

  19. High-resolution computed tomography of the middle ear and mastoid. Part III. Surgically altered anatomy and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Swartz, J.D.; Goodman, R.S.; Russell, K.B.; Ladenheim, S.F.; Wolfson, R.J.


    High-resolution computed tomography (CT) provides an excellent method for examination of the surgically altered middle ear and mastoid. Closed-cavity and open-cavity types of mastoidectomy are illustrated. Recurrent cholesteatoma in the mastoid bowl is easily diagnosed. Different types of tympanoplasty are discussed and illustrated, as are tympanostomy tubes and various ossicular reconstructive procedures. Baseline high-resolution CT of the postoperative middle ear and mastoid is recommended at approximately 3 months following the surgical procedure.

  20. Ear Disorders (United States)

    ... You use all of them in hearing. Sound waves come in through your outer ear. They reach your middle ear, where they make your eardrum vibrate. The vibrations are transmitted through three tiny bones, called ossicles, ...

  1. Histological Changes of the Middle Ear Ossicles Harvested During Cholesteatoma Surgery

    Directory of Open Access Journals (Sweden)

    Lukáš Školoudík


    Full Text Available Background: In the cholesteatoma surgery ossicles can be replaced to reconstruct middle ear function. It is important that these ossicles are free of squamous epithelium, to prevent residual disease. This study focuses on the histological findings of the malleus and incus harvested during cholesteatoma surgery. Materials and Methods: Eighty middle ears ossicles were examined in vivo and histologically to consider the relationship of cholesteatoma to ossicles, grade of bone destruction and invasion of cholesteatoma to deeper layers of bone. Results: Serious ossicular destruction was observed more frequently in incus compared to malleus (p = 0.0065. Difference of ossicles destruction between children and adults was not significant (p = 0.3032. Deep invasion of cholesteatoma into the vascular spaces or inner core of the bone was not observed. Conclusions: Autograft ossicles from cholesteatomatous ears should not necessarily be rejected for reconstruction of the ossicular chain. Regarding the histological finding, the authors suggest mechanical cleaning of the ossicle surface to eliminate residual disease.

  2. [The active middle ear implant for the rehabilitation of sensorineural, mixed and conductive hearing losses]. (United States)

    Sprinzl, G M; Wolf-Magele, A; Schnabl, J; Koci, V


    Active middle ear implants, such as the Vibrant Soundbridge, are used as an important part in the rehabilitation of sensorineural, conductive hearing, or mixed hearing loss. The attachment of the Vibrant Soundbridge at the round window and the usage of the Vibroplasty couplers strongly expanded the application of the Vibrant Soundbridge.The Vibrant Soundbridge is developed for patients who have an intolerance to hearing aids and a moderate to profound sensorineural hearing loss. The VSB also provides an optimal solution for patients with failed middle ear reconstructions or patients with atresia. To capture the improvement with the VSB Implant with different hearing losses a literature analysis was conducted. The functional gain was analyzed for 107 patients with conductive hearing loss and for 214 patients with sensorineural hearing loss out of 14 studies.Patients with conductive and mixed hearing loss resulted in a functional gain from 30 to 58 dB with the VSB. Patients with a pure sensorineural hearing loss showed a functional gain of 23-30 dB. The VSB bone conduction threshold shift was analyzed for all studies conducted in the years between 2000 and 2009. In 11 of the 16 studies there was no significant (p=0.05) change found. In 5 studies, the pre- to post-surgical bone conduction threshold shift was less than 10 dB. None of these studies measured a threshold shift of more than 10 dB.The flexible attachment at either the long process of the incus with sensorineural hearing loss, with an conductive hearing loss at the round window or the use of Vibroplasty couplers at the oval window, head of the stapes or round window makes the VSB an extremely versatile instrument. If patients can't wear conventional hearing aids, had failed middle ear reconstructions or atresia the VSB presents, due to the significant hearing improvement in any type of hearing loss, an ideal solution.

  3. [The Vibrant Soundbridge as an active implant in middle ear surgery]. (United States)

    Beleites, T; Bornitz, M; Neudert, M; Zahnert, T


    Implantable hearing aids are not only gaining importance for the treatment of sensorineural hearing loss, but also for treatment of mixed hearing loss. The most frequently used active middle ear implant is the Vibrant Soundbridge (VSB) system (Fa. MED-EL, Innsbruck, Österrreich). Following widening of the spectrum of indications for the VBS, various new coupling systems have been established. Based on the literature, available petrosal bone investigations and finite element model (FEM) calculations, this article summarizes the current knowledge concerning mechanical excitation by the VSB. Important concomitant aspects related to coupling, transmission and measurement are also discussed.

  4. The paratympanic organ: a barometer and altimeter in the middle ear of birds? (United States)

    von Bartheld, Christopher S; Giannessi, Francesco


    A century has passed since the discovery of the paratympanic organ (PTO), a mechanoreceptive sense organ in the middle ear of birds and other tetrapods. This luminal organ contains a sensory epithelium with typical mechanosensory hair cells and may function as a barometer and altimeter. The organ is arguably the most neglected sense organ in living tetrapods. The PTO is believed to be homologous to a lateral line sense organ, the spiracular sense organ of nonteleostean fishes. Our review summarizes the current state of knowledge of the PTO and draws attention to the astounding lack of information about the unique and largely unexplored sensory modality of barometric perception.

  5. Simulations and Measurements of Human Middle Ear Vibrations Using Multi-Body Systems and Laser-Doppler Vibrometry with the Floating Mass Transducer


    Tobias Strenger; Stefan Lehner; Frank Böhnke; Theodor Bretan


    The transfer characteristic of the human middle ear with an applied middle ear implant (floating mass transducer) is examined computationally with a Multi-body System approach and compared with experimental results. For this purpose, the geometry of the middle ear was reconstructed from μ-computer tomography slice data and prepared for a Multi-body System simulation. The transfer function of the floating mass transducer, which is the ratio of the input voltage and the generated force, is deri...

  6. [Histological evaluation of the condition of the trepanation cavity coating after radical surgery on the middle ear]. (United States)

    Anikin, I A; Bykova, V P; Patiakina, O K; Portenko, E G


    Tissue samples obtained intraoperatively from different parts of the middle ear in the course of the radical operation (35 cases) or reconstructive operations in patients with the history of surgical intervention on the ear (67 cases) were examined histologically. Fibrous-atrophic changes in the trepanation cavity coating correlated with the duration of the disease and the time since the radical operation. Pathomorphological and topographic profile of the changes in the operated ear coating copies relevant picture of otitis media purulenta chronica. The tympanomastoid cavity coating was characterized by increasing fibrous-atrophic changes reflecting regeneratory-plastic insufficiency of the epithelium and persistent tympanofibrosis in conditions of open trepanation cavity with disturbed anatomic relations in the middle ear.

  7. Dosimetric analysis of the use of CBCT in diagnostic radiology: sinus and middle ear. (United States)

    Dierckx, D; Saldarriaga Vargas, C; Rogge, F; Lichtherte, S; Struelens, L


    The use of cone beam computed tomography (CBCT) in diagnostic radiology departments is increasing. Several discussions arise whether with the CBCT application, some multi-slice CT (MSCT) examinations can be replaced by it. High hopes are set regarding the dosimetric aspects of CBCT: are patient doses in between those of conventional X-rays and MSCT? In this study, effective dose and organ doses were evaluated for two non-dental CBCT examinations: sinus and middle ear. A comparison with the dose obtained with a MSCT protocol was performed. Moreover, the sinus examination was also compared with the dose obtained by projection radiography (RX). Effective doses were estimated from thermoluminescent detector dose measurements in an anthropomorphic phantom and were compared against Monte Carlo simulations. Results show that the effective dose for the sinus examination is more than three times higher with MSCT than with CBCT and about five times lower with RX compared with CBCT, whereas for the middle ear examination, the effective dose obtained with MSCT is almost six times higher than that of CBCT. Finally, a sensitivity study on the size and position of the CBCT field of view showed the influence of these two factors on the dose received by the patient.

  8. FGF23 deficiency leads to mixed hearing loss and middle ear malformation in mice.

    Directory of Open Access Journals (Sweden)

    Andrew C Lysaght

    Full Text Available Fibroblast growth factor 23 (FGF23 is a circulating hormone important in phosphate homeostasis. Abnormal serum levels of FGF23 result in systemic pathologies in humans and mice, including renal phosphate wasting diseases and hyperphosphatemia. We sought to uncover the role FGF23 plays in the auditory system due to shared molecular mechanisms and genetic pathways between ear and kidney development, the critical roles multiple FGFs play in auditory development and the known hearing phenotype in mice deficient in klotho (KL, a critical co-factor for FGF23 signaling. Using functional assessments of hearing, we demonstrate that Fgf[Formula: see text] mice are profoundly deaf. Fgf[Formula: see text] mice have moderate hearing loss above 20 kHz, consistent with mixed conductive and sensorineural pathology of both middle and inner ear origin. Histology and high-voltage X-ray computed tomography of Fgf[Formula: see text] mice demonstrate dysplastic bulla and ossicles; Fgf[Formula: see text] mice have near-normal morphology. The cochleae of mutant mice appear nearly normal on gross and microscopic inspection. In wild type mice, FGF23 is ubiquitously expressed throughout the cochlea. Measurements from Fgf[Formula: see text] mice do not match the auditory phenotype of Kl-/- mice, suggesting that loss of FGF23 activity impacts the auditory system via mechanisms at least partially independent of KL. Given the extensive middle ear malformations and the overlap of initiation of FGF23 activity and Eustachian tube development, this work suggests a possible role for FGF23 in otitis media.

  9. Wideband energy reflectance measurements: effects of negative middle ear pressure and application of a pressure compensation procedure. (United States)

    Shaver, Mark D; Sun, Xiao-Ming


    The wideband energy reflectance (ER) technique has become popular as a tool for evaluating middle ear function. Negative middle ear pressure (MEP) is a prevalent form of middle ear dysfunction, which may impact application of ER measurements in differential diagnosis. A negative MEP may be countervailed by application of an equivalent negative ear canal pressure. The present study examined ER in the same ears under normal and experimentally induced negative MEP conditions. Thirty-five subjects produced at least one negative MEP each (-40 to -225 daPa). Negative MEP significantly altered ER in a frequency-specific manner that varied with MEP magnitude. ER increased for low- to mid-frequencies with the largest change (~0.20 to 0.40) occurring between 1 and 1.5 kHz. ER decreased for frequencies above 3 kHz with the largest change (~-0.10 to -0.25) observed between 4.5 and 5.5 kHz. Magnitude of changes increased as MEP became more negative, as did the frequencies at which maximum changes occurred, and the frequency at which enhancement transitioned to reduction. Ear canal pressure compensation restored ER to near baseline values. This suggests that the compensation procedure adequately mitigates the effects of negative MEP on ER. Theoretical issues and clinical implications are discussed.

  10. Evaluation of concordance between the microorganisms detected in the nasopharynx and middle ear of children with otitis media. (United States)

    van Dongen, Thijs M A; van der Heijden, Geert J M G; van Zon, Alice; Bogaert, Debby; Sanders, Elisabeth A M; Schilder, Anne G M


    Studies of microorganisms involved in otitis media in children often use a nasopharyngeal sample as a proxy for the middle ear fluid to test for bacteria and viruses. The question is whether such studies provide an accurate estimate of the prevalence of microorganisms involved in otitis media. We performed a systematic review of the literature reporting on the concordance between test results of nasopharyngeal and middle ear fluid samples for the most prevalent microorganisms in children with otitis media. Our findings show that the concordances vary from 68% to 97% per microorganism. For the most prevalent microbes, positive predictive values are around 50%. Most negative predictive values are moderate to high, with a range from 68% up to 97%. These results indicate that test results from nasopharyngeal samples do not always provide an accurate proxy for those of the middle ear fluid. It is important to interpret and use results of such studies carefully.

  11. Comparison of advanced optical imaging techniques with current otolaryngology diagnostics for improved middle ear assessment (Conference Presentation) (United States)

    Nolan, Ryan M.; Shelton, Ryan L.; Monroy, Guillermo L.; Spillman, Darold R.; Novak, Michael A.; Boppart, Stephen A.


    Otolaryngologists utilize a variety of diagnostic techniques to assess middle ear health. Tympanometry, audiometry, and otoacoustic emissions examine the mobility of the tympanic membrane (eardrum) and ossicles using ear canal pressure and auditory tone delivery and detection. Laser Doppler vibrometry provides non-contact vibrational measurement, and acoustic reflectometry is used to assess middle ear effusion using sonar. These technologies and techniques have advanced the field beyond the use of the standard otoscope, a simple tissue magnifier, yet the need for direct visualization of middle ear disease for superior detection, assessment, and management remains. In this study, we evaluated the use of portable optical coherence tomography (OCT) and pneumatic low-coherence interferometry (LCI) systems with handheld probe delivery to standard tympanometry, audiometry, otoacoustic emissions, laser Doppler vibrometry, and acoustic reflectometry. Comparison of these advanced optical imaging techniques and current diagnostics was conducted with a case study subject with a history of unilateral eardrum trauma. OCT and pneumatic LCI provide novel dynamic spatiotemporal structural data of the middle ear, such as the thickness of the eardrum and quantitative detection of underlying disease pathology, which could allow for more accurate diagnosis and more appropriate management than currently possible.

  12. Strategies for Coping with Educational and Social Consequences of Chronic Ear Infections in Rural Communities. (United States)

    Pillai, Patrick


    Children with chronic ear infections experience a lag time in understanding speech, which inhibits classroom participation and the ability to make friends, and ultimately reduces self-esteem. Difficulty in hearing affects speech and vocabulary development, reading and writing proficiency, and academic performance, and could lead to placement in…

  13. Middle and inner ear malformations in two siblings exposed to valproic acid during pregnancy: a case report. (United States)

    Van Houtte, Evelyne; Casselman, Jan; Janssens, Sandra; De Kegel, Alexandra; Maes, Leen; Dhooge, Ingeborg


    Valproic acid (VPA) is a known teratogenic drug. Exposure to VPA during the pregnancy can lead to a distinct facial appearance, a cluster of major and minor anomalies and developmental delay. In this case report, two siblings with fetal valproate syndrome and a mild conductive hearing loss were investigated. Radiologic evaluation showed middle and inner ear malformations in both children. Audiologic, vestibular and motor examination was performed. This is the first case report to describe middle and inner ear malformations in children exposed to VPA.

  14. Amphiphilic γ-PGA nanoparticles administered on rat middle ear mucosa produce adjuvant-like immunostimulation in vivo

    DEFF Research Database (Denmark)

    Nilsson, Johan; Broos, Sissela; Akagi, Takami;


    CONCLUSION: Amphiphilic biodegradable nanoparticles (NPs) composed of poly(γ-glutamic acid) conjugated with L-phenylalanine ethylester (γ-PGA-Phe NPs) applied on the rat middle ear mucosa produce an inflammatory type 1 response. The observation is of relevance for the use of γ-PGA-Phe NPs...... as a concomitant antigen delivery system and adjuvant measure in the context of vaccinations. OBJECTIVES: To examine effects of topical mucosal administration of γ-PGA-Phe NPs as a potentially combined antigen delivery system and adjuvant. METHODS: γ-PGA-Phe NPs were administered on rat middle ear mucosa in a sham...

  15. Orpheus 0 G or ear In microgravity to establish symptoms concomitant of inner and middle ear and osteoporosis in microgravity (United States)

    Tomatis, Alfred; Talbi, Louisa; Vervoort, Jozef; Fromenteau, Joel; De Voigt, Martin; Van Deun, Jozef


    The goal of the proposed work is to collect data on the responses of the vestibular system to long-term conditions of weightlessness and to evaluate the benefits of a program of Electronic Ear(1) designed to act preventively to lessen symptoms due to weightlessness and to readapt the vestibular system after return to normal gravity.Data in the form of listening tests and brain maps tests(2) and observations(3) will be collected during pre- and post-flight simulation.We have to identify if the preservation process of astronauts against weightlessness effects is located in the ear. The long- term objective of the study is to create a blueprint of an Electronic Ear to be used on board should the outcome be positive.

  16. A new developmental mechanism for the separation of the mammalian middle ear ossicles from the jaw (United States)

    Urban, Daniel J.; Anthwal, Neal; Luo, Zhe-Xi; Maier, Jennifer A.; Sadier, Alexa


    Multiple mammalian lineages independently evolved a definitive mammalian middle ear (DMME) through breakdown of Meckel's cartilage (MC). However, the cellular and molecular drivers of this evolutionary transition remain unknown for most mammal groups. Here, we identify such drivers in the living marsupial opossum Monodelphis domestica, whose MC transformation during development anatomically mirrors the evolutionary transformation observed in fossils. Specifically, we link increases in cellular apoptosis and TGF-BR2 signalling to MC breakdown in opossums. We demonstrate that a simple change in TGF-β signalling is sufficient to inhibit MC breakdown during opossum development, indicating that changes in TGF-β signalling might be key during mammalian evolution. Furthermore, the apoptosis that we observe during opossum MC breakdown does not seemingly occur in mouse, consistent with homoplastic DMME evolution in the marsupial and placental lineages. PMID:28179517

  17. Intraoperative auditory steady state response measurements during Vibrant Soundbridge middle ear implantation in patients with mixed hearing loss: preliminary results.

    NARCIS (Netherlands)

    Verhaegen, V.J.O.; Mulder, J.J.S.; Noten, J.F.P.; Luijten, B.M.A.; Cremers, C.W.R.J.; Snik, A.F.M.


    OBJECTIVE: To optimize intraoperatively the coupling of the floating mass transducer (FMT) of the Vibrant Soundbridge middle ear implant to the round or oval cochlear window in patients with mixed hearing loss. STUDY DESIGN: Intraoperative measurement of objective hearing thresholds using auditory s

  18. Active Middle Ear Implantation: Long-term Medical and Technical Follow-up, Implant Survival, and Complications

    NARCIS (Netherlands)

    Zwartenkot, J.W.; Mulder, J.J.S.; Snik, A.F.M.; Cremers, C.W.R.J.; Mylanus, E.A.M.


    OBJECTIVE: To evaluate the long-term medical and technical results, implant survival, and complications of the semi-implantable vibrant soundbridge (VSB), otologics middle ear transducer (MET), and the otologics fully implantable ossicular stimulator (FIMOS). STUDY DESIGN: Retrospective cohort study

  19. Antibodies mediate formation of neutrophil extracellular traps in the middle ear and facilitate secondary pneumococcal otitis media

    NARCIS (Netherlands)

    Short, K.R.; Kockritz-Blickwede, M. von; Langereis, J.D.; Chew, K.Y.; Job, E.R.; Armitage, C.W.; Hatcher, B.; Fujihashi, K.; Reading, P.C.; Hermans, P.W.M.; Wijburg, O.L.; Diavatopoulos, D.A.


    Otitis media (OM) (a middle ear infection) is a common childhood illness that can leave some children with permanent hearing loss. OM can arise following infection with a variety of different pathogens, including a coinfection with influenza A virus (IAV) and Streptococcus pneumoniae (the pneumococc

  20. Antibodies mediate formation of neutrophil extracellular traps in the middle ear and facilitate secondary pneumococcal otitis media

    NARCIS (Netherlands)

    K.R. Short (Kirsty); M. von Köckritz-Blickwede (Maren); J.D. Langereis (Jeroen); K.Y. Chew (Keng Yih); E.R. Job (Emma); S. Armitage (Shane); P. Hatcher (Pascale); K. Fujihashi (Kohtaro); C.L. Reading (Chris ); P.W.M. Hermans (Peter); O.L. Wijburg (Odilia); D.A. Diavatopoulos (Dimitri)


    textabstractOtitis media (OM) (a middle ear infection) is a common childhood illness that can leave some children with permanent hearing loss.OMcan arise following infection with a variety of different pathogens, including a coinfection with influenza A virus (IAV) and Streptococcus pneumoniae (the

  1. Differential Gene Expression in the Otic Capsule and the Middle Ear-An Annotation of Bone-Related Signaling Genes

    DEFF Research Database (Denmark)

    Nielsen, Michelle C.; Martin-Bertelsen, Tomas; Friis, Morten;


    and stria vascularis) and the lining tissues from the middle ear of the rat. Data was analyzed with statistical bioinformatics tools. Gene expression levels of selected genes were validated using quantitative polymerase chain reaction. Results: A total of 413 genes were identified when young inner bulla...

  2. Visualisation of passive middle ear implants by cone beam and multi-detector computed tomography: a comparative in vitro study

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, T.D.; Koesling, S. [University of Halle-Wittenberg, Department of Radiology, Halle Saale (Germany); Mlynski, R. [Head and Neck Surgery ' ' Otto Koerner' ' , Department of Otorhinolaryngology, Rostock (Germany); Plontke, S.K. [University of Halle-Wittenberg, Department of Otorhinolaryngology, Head and Neck Surgery, Halle Saale (Germany)


    Modern passive middle ear titanium prostheses are filigree structures, resulting in poorer depiction on CT compared to prostheses used in the past. We compared the visibility of newer prostheses on cone beam CT (CBCT) to multi-detector CT (MDCT) with standard and lower dose in vitro, and analysed image noise and metal artefacts. Six different titanium middle ear prostheses (three partial and one total ossicular replacement prostheses, two stapes prostheses) were implanted twice in formalin-fixed head specimens - first correctly and then with displacement. Imaging was performed using standard CBCT and MDCT as well as MDCT with lower dose (36 single imaging investigations). Images were analysed with knowledge of the used types of middle ear prostheses, but blinded with respect to the positioning in the specific case. On all images the type of prostheses and their positions could be clearly recognized. Their identifiability including their details was rated as statistically significantly higher for all CBCT investigations than for MDCT. MDCT with lower dose showed the worst results. No statistical differences were found in image noise and metal artefacts. If available, CBCT should be preferred over MDCT in diagnostic evaluation of passive middle ear prostheses. (orig.)

  3. Middle ear influence on otoacoustic emissions. I : Noninvasive investigation of the human transmission apparatus and comparison with model results

    NARCIS (Netherlands)

    Avan, P; Buki, B; Maat, B; Dordain, M; Wit, HP


    Evoked otoacoustic emissions (EOAEs) are generated within the cochlea in response to external sounds, and they can be acoustically detected in the external auditory meatus after backward propagation through the middle ear. In addition to being used to probe the cochlear mechanisms, they are expected

  4. Neutrophil extracellular traps and bacterial biofilms in middle ear effusion of children with recurrent acute otitis media--a potential treatment target.

    Directory of Open Access Journals (Sweden)

    Ruth B Thornton

    Full Text Available BACKGROUND: Bacteria persist within biofilms on the middle ear mucosa of children with recurrent and chronic otitis media however the mechanisms by which these develop remain to be elucidated. Biopsies can be difficult to obtain from children and their small size limits analysis. METHODS: In this study we aimed to investigate biofilm presence in middle ear effusion (MEE from children with recurrent acute otitis media (rAOM and to determine if these may represent infectious reservoirs similarly to those on the mucosa. We examined this through culture, viability staining and fluorescent in situ hybridisation (FISH to determine bacterial species present. Most MEEs had live bacteria present using viability staining (32/36 and all effusions had bacteria present using the universal FISH probe (26/26. Of these, 70% contained 2 or more otopathogenic species. Extensive DNA stranding was also present. This DNA was largely host derived, representing neutrophil extracellular traps (NETs within which live bacteria in biofilm formations were present. When treated with the recombinant human deoxyribonuclease 1, Dornase alfa, these strands were observed to fragment. CONCLUSIONS: Bacterial biofilms, composed of multiple live otopathogenic species can be demonstrated in the MEEs of children with rAOM and that these contain extensive DNA stranding from NETs. The NETs contribute to the viscosity of the effusion, potentially contributing to its failure to clear as well as biofilm development. Our data indicates that Dornase alfa can fragment these strands and may play a role in future chronic OM treatment.

  5. Effect of low-intensity focused ultrasound on the middle ear in a mouse model of acute otitis media. (United States)

    Noda, Kanako; Hirano, Takashi; Noda, Kenji; Kodama, Satoru; Ichimiya, Issei; Suzuki, Masashi


    We hypothesized that low-intensity focused ultrasound (LIFU) increases vessel permeability and antibacterial drug activity in the mouse middle ear. We determined appropriate settings by applying LIFU to mouse ears with the external auditory canal filled with normal saline and performed histologic and immunohistologic examination. Acute otitis media was induced in mice with nontypable Haemophilus influenzae, and they were given ampicillin (50, 10, or 2 mg/kg) intraperitoneally once daily for 3 days with or without LIFU (1.0 W/cm(2), 20% duty cycle, 30 s). In the LIFU(+) groups receiving the 2- and 10-mg/kg doses, viable bacteria counts, number of inflammatory cells and IL-1β and TNF-α levels in middle ear effusion were significantly lower than in the LIFU(-) groups on the same doses. Severity of AOM also tended to be reduced more in the LIFU(+) groups than in the LIFU(-) groups. LIFU application with antibiotics may be effective for middle ear infection.

  6. Middle ear risk index as a prognostic factor in pediatric ossicular reconstruction

    Directory of Open Access Journals (Sweden)

    Khalid Almazrou


    Full Text Available Objectives: To study the hearing results in children following ossicular reconstruction and to determine if the middle ear risk index (MERI is a useful tool for predicting the outcome of surgery. Design: A retrospective case series. Setting: A tertiary academic center. Patients: Forty-four children underwent ossicular reconstruction using autologous or alloplastic prostheses from January 1995 to January 2005. Materials and Methods: Patients′ audiograms were evaluated preoperatively and postoperatively for pure-tone average (PTA and air-bone gap (ABG. Each ear was scored using the MERI and a total index was calculated. Results: 23 boys and 21 girls were included in the study. The mean preoperative ABG was 38 dB, and the mean postoperative ABG was 25.3 dB. The mean MERI was 3.40 for excellent results (0-10 dB postoperative ABG, 4.42 for good results (11-20 dB postoperative ABG, 4.45 for fair results (21-30 dB postoperative ABG, and 4.06 for poor results (ABG > 30 dB. The complications included perforation of tympanic membrane (13.6%, worsening of the conductive hearing loss (6.8%, retraction pockets (9.1%, recurrent or residual cholesteatoma (6.8%, high-frequency sensorineural hearing loss (4.45%, and prosthesis extrusion (2.3%. The mean follow-up period was 14 months. Conclusion: Children have poorer hearing outcome following ossicular reconstruction in comparison to the published adults′ results. The MERI was not a reliable tool for predicting the hearing results of ossicular reconstruction in children.

  7. Asthma in ear, nose, and throat primary care patients with chronic rhinosinusitis with nasal polyps

    DEFF Research Database (Denmark)

    Frendø, Martin; Håkansson, Kåre; Schwer, Susanne;


    BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory disorder associated with asthma. This association is well described in patients with CRSwNP undergoing endoscopic sinus surgery (ESS); however, some patients are never referred for surgery, and the frequency...... were prospectively recruited from nine PC ear, nose, and throat clinics in the Copenhagen area. CRSwNP was diagnosed according to the European Position Paper on Chronic Rhinosinusitis and Nasal Polyps; severity was assessed by using a visual analog scale. Allergy, lung function, and asthma tests...

  8. Ear problems in swimmers. (United States)

    Wang, Mao-Che; Liu, Chia-Yu; Shiao, An-Suey; Wang, Tyrone


    Acute diffuse otitis externa (swimmer's ear), otomycosis, exostoses, traumatic eardrum perforation, middle ear infection, and barotraumas of the inner ear are common problems in swimmers and people engaged in aqua activities. The most common ear problem in swimmers is acute diffuse otitis externa, with Pseudomonas aeruginosa being the most common pathogen. The symptoms are itching, otalgia, otorrhea, and conductive hearing loss. The treatment includes frequent cleansing of the ear canal, pain control, oral or topical medications, acidification of the ear canal, and control of predisposing factors. Swimming in polluted waters and ear-canal cleaning with cotton-tip applicators should be avoided. Exostoses are usually seen in people who swim in cold water and present with symptoms of accumulated debris, otorrhea and conductive hearing loss. The treatment for exostoses is transmeatal surgical removal of the tumors. Traumatic eardrum perforations may occur during water skiing or scuba diving and present with symptoms of hearing loss, otalgia, otorrhea, tinnitus and vertigo. Tympanoplasty might be needed if the perforations do not heal spontaneously. Patients with chronic otitis media with active drainage should avoid swimming, while patients who have undergone mastoidectomy and who have no cavity problems may swim. For children with ventilation tubes, surface swimming is safe in a clean, chlorinated swimming pool. Sudden sensorineural hearing loss and some degree of vertigo may occur after diving because of rupture of the round or oval window membrane.

  9. [Novel possibilities for the rehabilitation of patients presenting with congenital external and middle ear malformations]. (United States)

    Mileshina, N A; Osipenkov, S S; Bakhshinian, V V; Tavartkiladze, G A


    The objective of the present study was to estimate the advantages of cochlear Baha BIA 400 abutments in the intraoperative and early postoperative periods. A total of 10 implantations of the systems with the use of hydroxyapatite bone cement were performed in 9 patients of different age. Stability of the implants and intensity of skin reactions were evaluated. The data obtained indicate that the use of cochlear Baha BIA 400 abutments significantly simplifies and shortens the surgical stage of rehabilitation producing a good cosmetic result. The use of the Osstell instrument made it possible to estimate stability of the implants intraoperatively and evaluate the effectiveness of osteointegration during the follow-up period. Analysis of the results of the study provided a basis on which to improve the quality and shorten duration of the rehabilitative treatment of the patients presenting with congenital external and middle ear malformations. Moreover, the data obtained can be used to develop practical recommendations for the further work in this area.

  10. Hearing loss and potential hazards of metallic middle-ear implants in NMR-magnetic fields

    Energy Technology Data Exchange (ETDEWEB)

    Huettenbrink, K.B.


    Concurrent with the expanding clinical applications of nuclear magnetic resonance (NMR) imaging, patients with metallic middle-ear implants will certainly be exposed to this strong magnetic field in the future. To determine potential hazards, associated with movements of steel- or Platinium stapes-prostheses, several tests were performed in a 0.5 tesla NMR unit and the induced forces were calculated. Although the commonly used paramagnetic steel-wire or platinium-alloys will not dislodge in vivo, ferromagnetic prostheses may present a hazardous risk. Prior to exposure to the magnetic field, information about the implanted material should therefore be obtained. A side-effect of the induced current flow is the attenuation of the sound-vibrations of the stapes prosthesis. This, 5-10 dB impairment of transmission develops only at a certain position of the patient's head, when the prosthesis vibrates perpendicularly to the magnetic field's Z-axis. Patients with a metallic prosthesis should be informed about this purely physical, harmless phenomenon prior to entering the NMR-cylinder.

  11. Femtosecond laser microstructuring of titanium surfaces for middle ear ossicular replacement prosthesis (United States)

    Ilgner, Justus; Biedron, Slavomir; Fadeeva, Elena; Chichkov, Boris; Westhofen, Martin


    Introduction: While a variety of materials has been evaluated for replacement of human middle ear ossicles following inflammation, titanium and its alloys have shown excellent sound transmission properties and biocompatibility. However, cartilage thickness at the tympanic membrane interface deteriorates over time, while fibrous tissue formation may dislodge the titanium prosthesis. This study was performed to evaluate the effect of microstructures on titanium surfaces in contact with adjacent biological tissue. Materials and Methods: Titanium samples of 5mm diameter and 0,25mm thickness were structured by means of a Ti:Sapphire femtosecond laser operating at 970nm. The structures applied were lines of parabolic shape (cross-sectional) of 5µm (parallel), 5µm (cross-hatch) and 10µm width (parallel). The inter-groove distance between two maxima was exactly twice the line width. Results: Lines smaller than 5µm were not feasible due to the natural irregularity of the basic material with pits and level changes of up to 2µm. The process showed little debris and constant microstructure shape over the whole structured area (2x2mm). The resulting debris was examined for toxic by-products on human fibrobcytes and chondrocytes. Discussion: The results show that microstructures can be applied on titanium surfaces for human implantation with reproducible and constant shapes. Further studies will focus on cell culture which has suggested a relative selectivity for chondrocyte compared to fibrocyte growth in earlier studies with selected microstructures.

  12. 放疗后中耳胆固醇肉芽肿的治疗%Cholesterin Granuloma of the Middle Ear in Post-irradiated Patients

    Institute of Scientific and Technical Information of China (English)

    杨海弟; 许耀东; 张志钢; 陈穗俊; 郑亿庆


    (A-B gap) was 45.8 dB respectively versus 62.3 dB and 25.5 dB postoperation 6 months. [Conclusion] Most of post-irradiated NPC patients with cholesterin granuloma of the middle ear benefit from the surgery. Chronic otitis media caused by radiotherapy is not a contraindication to tympanoplasty.

  13. Original Solution for Middle Ear Implant and Anesthetic/Surgical Management in a Child with Severe Craniofacial Dysmorphism (United States)

    Bianchin, Giovanni; Tribi, Lorenzo; Reverzani, Aronne; Formigoni, Patrizia; Polizzi, Valeria


    We describe the novel solution adopted in positioning middle ear implant in a child with bilateral congenital aural atresia and craniofacial dysmorphism that have posed a significant challenge for the safe and correct management of deafness. A five-year-old child, affected by a rare congenital disease (Van Maldergem Syndrome), suffered from conductive hearing loss. Conventional skin-drive bone-conduction device, attached with a steel spring headband, has been applied but auditory restoration was not optimal. The decision made was to position Vibrant Soundbridge, a middle ear implant, with an original surgical application due to hypoplasia of the tympanic cavity. Intubation procedure was complicated due to child craniofacial deformities. Postoperative hearing rehabilitation involved a multidisciplinary team, showing improved social skills and language development. PMID:26491591

  14. Original Solution for Middle Ear Implant and Anesthetic/Surgical Management in a Child with Severe Craniofacial Dysmorphism

    Directory of Open Access Journals (Sweden)

    Giovanni Bianchin


    Full Text Available We describe the novel solution adopted in positioning middle ear implant in a child with bilateral congenital aural atresia and craniofacial dysmorphism that have posed a significant challenge for the safe and correct management of deafness. A five-year-old child, affected by a rare congenital disease (Van Maldergem Syndrome, suffered from conductive hearing loss. Conventional skin-drive bone-conduction device, attached with a steel spring headband, has been applied but auditory restoration was not optimal. The decision made was to position Vibrant Soundbridge, a middle ear implant, with an original surgical application due to hypoplasia of the tympanic cavity. Intubation procedure was complicated due to child craniofacial deformities. Postoperative hearing rehabilitation involved a multidisciplinary team, showing improved social skills and language development.

  15. Original Solution for Middle Ear Implant and Anesthetic/Surgical Management in a Child with Severe Craniofacial Dysmorphism


    Giovanni Bianchin; Lorenzo Tribi; Aronne Reverzani; Patrizia Formigoni; Valeria Polizzi


    We describe the novel solution adopted in positioning middle ear implant in a child with bilateral congenital aural atresia and craniofacial dysmorphism that have posed a significant challenge for the safe and correct management of deafness. A five-year-old child, affected by a rare congenital disease (Van Maldergem Syndrome), suffered from conductive hearing loss. Conventional skin-drive bone-conduction device, attached with a steel spring headband, has been applied but auditory restoration ...

  16. Dexmedetomidine infusion during middle ear surgery under general anaesthesia to provide oligaemic surgical field: A prospective study

    Directory of Open Access Journals (Sweden)

    Kumkum Gupta


    Full Text Available Background and Aims: Middle ear surgery requires bloodless surgical field for better operating conditions, deep level of anaesthesia and rapid emergence. Recent studies suggest that α2 agonists could provide desired surgical field, sedation and analgesia. The present study was aimed to evaluate the clinical effects of dexmedetomidine infusion as anaesthetic adjuvant during middle ear surgery using operating microscope. Methods: Sixty four adult patients aged 18-58 years, American Society of Anaesthesiologists Grades I and II, of both gender were randomised into two comparable equal groups of 32 patients each for middle ear surgery under general anaesthesia with standard anaesthetic technique. After induction of general anaesthesia, patients of Group I were given dexmedetomidine infusion of 0.5 μg/kg/h and patients of Group II were given placebo infusion of normal saline. Isoflurane concentration was titrated to achieve a systolic blood pressure 30% below the baseline value. All patients were assessed intra-operatively for bleeding at surgical field, haemodynamic changes, awakening time and post-operative recovery. Results: Statistically significant reduction was observed in the required percentage of isoflurane (0.8 ± 0.6% to maintain the systolic blood pressure 30% below the baseline values in patients receiving dexmedetomidine infusion when compared to those receiving placebo infusion (1.6 ± 0.7%. Patients receiving dexmedetomidine infusion had statistically significant lesser bleeding at surgical field (P < 0.05. The mean awakening time and recovery from anaesthesia did not show any significant difference between the groups. Conclusion: Dexmedetomidine infusion can be safely used to provide oligaemic surgical field for better visualization using operating microscope for middle ear surgery.

  17. Betahistine as an add-on: The magic bullet for postoperative nausea, vomiting and dizziness after middle ear surgery?

    Directory of Open Access Journals (Sweden)

    Sandip Mukhopadhyay


    Full Text Available Purpose: Patients undergoing middle ear surgery experience variable degrees of postoperative nausea and vomiting (PONV despite prophylaxis and treatment with ondansetron or other 5HT 3 receptor antagonists. Furthermore vertigo or dizziness are not well controlled perioperatively. Role of betahistine was tested as an add-on to ondansetron in control of PONV and vertigo in middle ear surgery cases. Materials and Methods: We conducted a prospective, randomized, double-blind, placebo controlled study, enrolling one hundred patients undergoing middle ear surgery under local anesthesia into two groups consisting of fifty (n = 50 patients each. Group A patients were given betahistine 16 mg plus ondansetron 8 mg and placebo plus ondansetron 8 mg were given to group B or placebo group, orally 3 hours before starting operation. The incidence of nausea, vomiting, and dizziness was noted during the intraoperative and postoperative 24 hours period. Chi-square test, unpaired ′t′ test, and Fisher′s exact tests were performed for statistical analysis using SPSS version 16 and Open Epi version 2.3.1 softwares. Results: Complete response was obtained in 90% patients in the betahistine group as compared to 66% in the placebo group. Vomiting in the intraoperative and postoperative period was noted in 4% and 8% cases, respectively, in the betahistine group as compared to 18% and 26%, respectively, in the placebo group. Overall, vertigo was 10% versus 32% in betahistine group and placebo group, respectively. Conclusion: Betahistine as an add-on to ondansetron can significantly attenuate PONV and perioperative vertigo, following middle ear surgeries.

  18. Mammalian development does not recapitulate suspected key transformations in the evolutionary detachment of the mammalian middle ear. (United States)

    Ramírez-Chaves, Héctor E; Wroe, Stephen W; Selwood, Lynne; Hinds, Lyn A; Leigh, Chris; Koyabu, Daisuke; Kardjilov, Nikolay; Weisbecker, Vera


    The ectotympanic, malleus and incus of the developing mammalian middle ear (ME) are initially attached to the dentary via Meckel's cartilage, betraying their origins from the primary jaw joint of land vertebrates. This recapitulation has prompted mostly unquantified suggestions that several suspected--but similarly unquantified--key evolutionary transformations leading to the mammalian ME are recapitulated in development, through negative allometry and posterior/medial displacement of ME bones relative to the jaw joint. Here we show, using µCT reconstructions, that neither allometric nor topological change is quantifiable in the pre-detachment ME development of six marsupials and two monotremes. Also, differential ME positioning in the two monotreme species is not recapitulated. This challenges the developmental prerequisites of widely cited evolutionary scenarios of definitive mammalian middle ear (DMME) evolution, highlighting the requirement for further fossil evidence to test these hypotheses. Possible association between rear molar eruption, full ME ossification and ME detachment in marsupials suggests functional divergence between dentary and ME as a trigger for developmental, and possibly also evolutionary, ME detachment. The stable positioning of the dentary and ME supports suggestions that a 'partial mammalian middle ear' as found in many mammaliaforms--probably with a cartilaginous Meckel's cartilage--represents the only developmentally plausible evolutionary DMME precursor.

  19. The value of single-shot turbo spin-echo diffusion-weighted MR imaging in the detection of middle ear cholesteatoma

    Energy Technology Data Exchange (ETDEWEB)

    De Foer, Bert; Bernaerts, Anja; Maes, Joachim; Deckers, Filip; Pouillon, Marc [A.Z. Sint-Augustinus Hospital, Department of Radiology, Antwerp (Belgium); Vercruysse, Jean-Philippe; Somers, Thomas; Offeciers, Erwin [A.Z. Sint-Augustinus Hospital, University Department of ENT, Antwerp (Belgium); Michiels, Johan [Siemens Medical Solutions, Anderlecht (Belgium); Casselman, Jan W. [A.Z. Sint-Augustinus Hospital, Department of Radiology, Antwerp (Belgium); A.Z. Sint-Jan AV, Department of Radiology, Bruges (Belgium)


    Single-shot (SS) turbo spin-echo (TSE) diffusion-weighted (DW) magnetic resonance imaging (MRI) is a non echo-planar imaging (EPI) technique recently reported for the evaluation of middle ear cholesteatoma. We prospectively evaluated a SS TSE DW sequence in detecting congenital or acquired middle ear cholesteatoma and evaluated the size of middle ear cholesteatoma detectable with this sequence. The aim of this study was not to differentiate between inflammatory tissue and cholesteatoma using SS TSE DW imaging. A group of 21 patients strongly suspected clinically and/or otoscopically of having a middle ear cholesteatoma without any history of prior surgery were evaluated with late post-gadolinium MRI including this SS TSE DW sequence. A total of 21 middle ear cholesteatomas (5 congenital and 16 acquired) were found at surgery with a size varying between 2 and 19 mm. Hyperintense signal on SS TSE DW imaging compatible with cholesteatoma was found in 19 patients. One patient showed no hyperintensity due to autoevacuation of the cholesteatoma sac into the external auditory canal. Another patient showed no hyperintensity because of motion artifacts. This study shows the high sensitivity of this SS TSE DW sequence in detecting small middle ear cholesteatomas, with a size limit as small as 2 mm. (orig.)

  20. Electromyographic monitoring of facial nerve under different levels of neuromuscular blockade during middle ear microsurgery

    Institute of Scientific and Technical Information of China (English)

    CAI Yi-rong; XU Jing; CHEN Lian-hua; CHI Fang-lu


    Background The evoked electromyography (EMG) is frequently used to identify facial nerve in order to prevent its damage during surgeries. Partial neuromuscular blockade (NMB) has been suggested to favor EMG activity and insure patients' safety. The aim of this study was to determine an adequate level of NMB correspondent to sensible facial nerve identification by evaluating the relationship between facial EMG responses and peripheral NMB levels during the middle ear surgeries.Methods Facial nerve evoked EMG and NMB monitoring were performed simultaneously in 40 patients who underwent tympanoplasty. Facial electromyographic responses were recorded by insertion of needle electrodes into the orbicularis oris and orbicularis oculi muscles after electrical stimulation on facial nerve. The NMB was observed objectively with the hypothenar muscle's twitching after electrical stimulation of ulnar nerve, and the intensity of blockade was adjusted at levels of 0, 25%, 50%, 75%, 90%, and 100% respectively with increased intravenous infusion of Rocuronium (muscle relaxant).Results All of the patients had detectable EMG responses at the levels of NMB ≤50%. Four out of forty patients had no EMG response at the levels of NMB ≥75%. A significant linear positive correlation was present between stimulation thresholds and NMB levels while a linear negative correlation was present between EMG amplitudes and NMB levels.Conclusions The facial nerve monitoring via facial electromyographic responses can be obtained when an intraoperative partial neuromuscular blockade is induced to provide an adequate immobilization of the patient. The 50% NMB should be considered as the choice of anesthetic management for facial nerve monitoring in otologic microsurgery based on the relationship of correlation.

  1. [Audiological evaluation of the middle ear implant--speech discrimination under noise circumstances]. (United States)

    Saiki, T; Gyo, K; Yanagihara, N


    Speech discrimination scores under noise circumstances were studied by use of the middle ear implant (MEI) and the conventional hearing aid (HA, HA-33, RION, Co, Ltd). The studies were performed in 10 patients implanted with the MEI and in 12 adult volunteers with normal hearing as a control. The tests were carried out using Japanese monosyllabic lists from 57S-speech discrimination test list as a test sound and multi-talker noise as a noise source. A speaker was placed in front of a subject in one meter apart. Sound characteristics of HA were adjusted as far as possible to those of the MEI by use of a sound equalizer. The intensity of speech sound pressure was adjusted at 65dB SPL, while that of the noise was changed to 65, 70 and 75dB SPL in the position of patients. Audiological evaluation of the MEI, the HA and control obtained by percentages of correct answers to 50 words in speech discrimination test with and without noise (65, 70, 75dB SPL). When the test was performed without noise, speech discrimination scores by the MEI and the HA were either 96.8 +/- 3.6% and 94.8 +/- 4.1%. However, under noise circumstances (65dB SPL) that by both devices were either 81.6 +/- 9.1% and 66.8 +/- 10.6% (P less than 0.001). When the intensity of the noise increased to 70 and 75dB SPL, speech discrimination scores by both devices deprecated together with consistent difference (P less than 0.01). Moreover speech discrimination scores by the MEI were almost same as control.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Ontogeny of the Middle-Ear Air-Sinus System in Alligator mississippiensis (Archosauria: Crocodylia.

    Directory of Open Access Journals (Sweden)

    David L Dufeau

    function of braincase volume, but instead support the hypothesis that these changes may be a function of the acoustic properties of the middle ear.

  3. Ontogeny of the Middle-Ear Air-Sinus System in Alligator mississippiensis (Archosauria: Crocodylia). (United States)

    Dufeau, David L; Witmer, Lawrence M


    volume, but instead support the hypothesis that these changes may be a function of the acoustic properties of the middle ear.

  4. In vivo areal modulus of elasticity estimation of the human tympanic membrane system: modelling of middle ear mechanical function in normal young and aged ears

    Energy Technology Data Exchange (ETDEWEB)

    Gaihede, Michael [Department of Otolaryngology, Head and Neck Surgery, Aalborg Hospital, Aarhus University Hospital, Aalborg (Denmark); Liao Donghua [Centre of Excellence in Visceral Biomechanics and Pain, Aalborg Hospital, Aarhus University Hospital, Aalborg (Denmark); Gregersen, Hans [Centre of Excellence in Visceral Biomechanics and Pain, Aalborg Hospital, Aarhus University Hospital, Aalborg (Denmark)


    The quasi-static elastic properties of the tympanic membrane system can be described by the areal modulus of elasticity determined by a middle ear model. The response of the tympanic membrane to quasi-static pressure changes is determined by its elastic properties. Several clinical problems are related to these, but studies are few and mostly not comparable. The elastic properties of membranes can be described by the areal modulus, and these may also be susceptible to age-related changes reflected by changes in the areal modulus. The areal modulus is determined by the relationship between membrane tension and change of the surface area relative to the undeformed surface area. A middle ear model determined the tension-strain relationship in vivo based on data from experimental pressure-volume deformations of the human tympanic membrane system. The areal modulus was determined in both a younger (n = 10) and an older (n = 10) group of normal subjects. The areal modulus for lateral and medial displacement of the tympanic membrane system was smaller in the older group (mean = 0.686 and 0.828 kN m{sup -1}, respectively) compared to the younger group (mean = 1.066 and 1.206 kN m{sup -1}, respectively), though not significantly (2p = 0.10 and 0.11, respectively). Based on the model the areal modulus was established describing the summated elastic properties of the tympanic membrane system. Future model improvements include exact determination of the tympanic membrane area accounting for its shape via 3D finite element analyses. In vivo estimates of Young's modulus in this study were a factor 2-3 smaller than previously found in vitro. No significant age-related differences were found in the elastic properties as expressed by the areal modulus.

  5. Dissection of the Auditory Bulla in Postnatal Mice: Isolation of the Middle Ear Bones and Histological Analysis. (United States)

    Sakamoto, Ayako; Kuroda, Yukiko; Kanzaki, Sho; Matsuo, Koichi


    In most mammals, auditory ossicles in the middle ear, including the malleus, incus and stapes, are the smallest bones. In mice, a bony structure called the auditory bulla houses the ossicles, whereas the auditory capsule encloses the inner ear, namely the cochlea and semicircular canals. Murine ossicles are essential for hearing and thus of great interest to researchers in the field of otolaryngology, but their metabolism, development, and evolution are highly relevant to other fields. Altered bone metabolism can affect hearing function in adult mice, and various gene-deficient mice show changes in morphogenesis of auditory ossicles in utero. Although murine auditory ossicles are tiny, their manipulation is feasible if one understands their anatomical orientation and 3D structure. Here, we describe how to dissect the auditory bulla and capsule of postnatal mice and then isolate individual ossicles by removing part of the bulla. We also discuss how to embed the bulla and capsule in different orientations to generate paraffin or frozen sections suitable for preparation of longitudinal, horizontal, or frontal sections of the malleus. Finally, we enumerate anatomical differences between mouse and human auditory ossicles. These methods would be useful in analyzing pathological, developmental and evolutionary aspects of auditory ossicles and the middle ear in mice.

  6. Otitis media with effusion: Accuracy of tympanometry in detecting fluid in the middle ears of children at myringotomies (United States)

    Anwar, Khurshid; Khan, Saeed; Rehman, Habib ur; Javaid, Mohammad; Shahabi, Isteraj


    Objective: (1) The diagnostic accuracy of tympanometry in detecting fluid in the middle ear space in children with otitis media with effusion by comparing its findings with those of myringotomies. (2) Identify the age group most commonly affected by OME. Methods: This prospective study was conducted at the Department of ENT& Head and Neck Surgery, Postgraduate Medical Institute Hayatabad Medical complex, Peshawar from July 1, 2012 to April 30, 2015. Patients with suspicion of OME underwent tympanometry and later myringotomies. Using Jerger’s classification, Type B tympanogram with normal canal volume was considered as conclusive evidence of fluid in the middle ear space. Its findings were compared with those of the respective myringotomies. From the data collected, the accuracy, sensitivity, specificity, positive predictive value and negative predictive values were calculated. Results: A total 117 ears of 63 patients were operated. The age range was 3 to 12 years. The commonest age group (58.7%) affected by OME was 6-8 years. Type B tympanogram with flat curve and normal canal volume was obtained in 71.4% of the ears. Comparison with myringotomy findings showed TP 85, TN 13, FP 5 and FN 14. The diagnostic value of tympanometry was; Sensitivity 85.85%, Specificity 72.22%, PPV 94.44%, NPV 48.14% and Accuracy of 83.76%. P value calculated using chi square test showed that there was significant difference between tympanometry and myringotomy findings in OME (p < 0.05). Conclusions: OME is common in age group 6-8 years. Tympanogram Type B with normal canal volume is fairly sensitive in diagnosing this condition. However for occurrence of false positive results, final decision regarding management should be made on clinical findings and other supportive audiological tests. PMID:27182263


    Directory of Open Access Journals (Sweden)

    Rama Chandra Rao


    Full Text Available INTRODUCTION: Chronic Suppurative otitis media (CSOM is the most common condition encountered by otolaryngologists in day to day practice. The importance of chronic otitis media lies in its dreaded complications and deafness. AIM: This study was under taken to identify the microbiological isolates of the ear discharge in CSOM cases and their sensitivity to antibiotics. SETTINGS AND DESIGN: Tertiary care hospital in north costal Andhra Pradesh. It was a Prospective study. MATERIALS & METHODS: About 100 patients having ear discharge who attended ENT outpatient department from July 2013 to Feb 2014 for a period of 8months were studied. Aural swabs were sent to microbiology lab for culture &sensitivity. RESULTS: Culture reports showed aerobic bacterial isolates in 85 cases, fungi in 7 cases and sterile in 8 cases. Of the 85 cases of aerobic bacteria, staphylococcus aureus was isolated in 34 cases (40% followed by Pseudomonas aeruginosa in 29 cases (34%, klebsiella in 16 cases (18.8%, E.coli in 4 cases (4.7% and proteus in 2 cases. Antibiotic sensitivity reports showed Staphylococcus was more susceptible to netilmycin (97%, amoxiclav (91.7% and least sensitive to ceftazidime (64.7%. Pseudomonas was more sensitive to amikacin (96.5%, gentamycin (93.1% and least sensitive to amoxyclav (79.3%, ampicillin + sulbactum (82.75%. CONCLUSION: Mono microbial etiology, especially Staphylococcus species was found to be the most common organism causing chronic otitis media. Knowledge of the prevailing flora and their susceptibility to antimicrobials will guide the clinicians for early and effective treatment thereby avoiding complications.

  8. Ribotyping of strains of Moraxella (Branhamella) catarrhalis cultured from the nasopharynx and middle ear of children with otitis media

    DEFF Research Database (Denmark)

    Brygge, K; Sørensen, C H; Colding, H;


    Moraxella (Branhaomella) catarrhalis is frequently present in the nasopharyngeal microflora of small children, especially during episodes of acute otitis media . By means of ribotyping (restriction endonuclease analysis of chromosomal DNA combined with rRNA probing), we studied the genetic....... The distribution of these types was found to be almost identical to the distribution among 16 M. catarrhalis strains cultured from middle ear exudates of 16 children with acute otitis media. Ribotype HAPA was found in two-thirds of all the cultures investigated, and 44% of the children harboured more than one...

  9. A Fully-Implantable Cochlear Implant SoC with Piezoelectric Middle-Ear Sensor and Arbitrary Waveform Neural Stimulation. (United States)

    Yip, Marcus; Jin, Rui; Nakajima, Hideko Heidi; Stankovic, Konstantina M; Chandrakasan, Anantha P


    A system-on-chip for an invisible, fully-implantable cochlear implant is presented. Implantable acoustic sensing is achieved by interfacing the SoC to a piezoelectric sensor that detects the sound-induced motion of the middle ear. Measurements from human cadaveric ears demonstrate that the sensor can detect sounds between 40 and 90 dB SPL over the speech bandwidth. A highly-reconfigurable digital sound processor enables system power scalability by reconfiguring the number of channels, and provides programmable features to enable a patient-specific fit. A mixed-signal arbitrary waveform neural stimulator enables energy-optimal stimulation pulses to be delivered to the auditory nerve. The energy-optimal waveform is validated with in-vivo measurements from four human subjects which show a 15% to 35% energy saving over the conventional rectangular waveform. Prototyped in a 0.18 μm high-voltage CMOS technology, the SoC in 8-channel mode consumes 572 μW of power including stimulation. The SoC integrates implantable acoustic sensing, sound processing, and neural stimulation on one chip to minimize the implant size, and proof-of-concept is demonstrated with measurements from a human cadaver ear.

  10. Pili play an important role in enhancing the bacterial clearance from the middle ear in a mouse model of acute otitis media with Moraxella catarrhalis. (United States)

    Kawano, Toshiaki; Hirano, Takashi; Kodama, Satoru; Mitsui, Marcelo Takahiro; Ahmed, Kamruddin; Nishizono, Akira; Suzuki, Masashi


    Moraxella catarrhalis is a Gram-negative aerobic diplococcus that is currently the third most frequent cause of bacterial acute otitis media (AOM) in children. In this study, we developed an experimental murine AOM model by inoculating M. catarrhalis in the middle ear bulla and studied the local response to this inoculation, and modulation of its course by the pili of M. catarrhalis. The pili-positive and pili-negative M. catarrhalis showed differences in bacterial clearance and infiltration of inflammatory cells in the middle ear. Pili-negative M. catarrhalis induced a more delayed and prolonged immune response in the middle ear than that of pili-positive M. catarrhalis. TLR2, -4, -5 and -9 mRNA expression was upregulated in neutrophils that infiltrated the middle ear cavity during AOM caused by both pili-positive and pili-negative bacteria. TLR5 mRNA expression and TLR5 protein in the neutrophils were induced more robustly by pili-positive M. catarrhalis. This immune response is likely to be related to neutrophil function such as toll-like 5-dependent phagocytosis. Our results show that mice may provide a useful AOM model for studying the role of M. catarrhalis. Furthermore, we show that pili play an important role in enhancing M. catarrhalis clearance from the middle ear that is probably mediated through neutrophil-dependent TLR5 signaling.

  11. Simulations and Measurements of Human Middle Ear Vibrations Using Multi-Body Systems and Laser-Doppler Vibrometry with the Floating Mass Transducer

    Directory of Open Access Journals (Sweden)

    Tobias Strenger


    Full Text Available The transfer characteristic of the human middle ear with an applied middle ear implant (floating mass transducer is examined computationally with a Multi-body System approach and compared with experimental results. For this purpose, the geometry of the middle ear was reconstructed from μ-computer tomography slice data and prepared for a Multi-body System simulation. The transfer function of the floating mass transducer, which is the ratio of the input voltage and the generated force, is derived based on a physical context. The numerical results obtained with the Multi-body System approach are compared with experimental results by Laser Doppler measurements of the stapes footplate velocities of five different specimens. Although slightly differing anatomical structures were used for the calculation and the measurement, a high correspondence with respect to the course of stapes footplate displacement along the frequency was found. Notably, a notch at frequencies just below 1 kHz occurred. Additionally, phase courses of stapes footplate displacements were determined computationally if possible and compared with experimental results. The examinations were undertaken to quantify stapes footplate displacements in the clinical practice of middle ear implants and, also, to develop fitting strategies on a physical basis for hearing impaired patients aided with middle ear implants.

  12. [Investigation of viral nucleic acids in middle-ear effusion specimens from children with acute otitis media]. (United States)

    Abu Sitteh, Muhammed H; Sener, Kenan; Yapar, Mehmet; Kiliç, Abdullah; Güney, Cakir; Kubar, Ayhan


    Acute otitis media with effusion (OME) is one of the major causes of antibiotic use, indication for operation and hearing loss in children. In two third of the cases the etiologic agents are bacteria. Nonetheless, increasing numbers of reports have implicated viruses as etiologic agents that may have some effect on prognosis of OME. The aim of this study was to investigate the presence of nucleic acids of respiratory syncytial virus (RSV) type A and B, influenza type A virus, adenovirus, cytomegalovirus (CMV), herpes simplex virus type-1 (HSV-1), and enteroviruses in the middle ear effusion specimens from children with otitis media by TaqMan real-time PCR. As a result, 18 of 30 (60%) OME samples were found positive in terms of viral nucleic acids by real-time PCR. RSV-A was detected in nine samples (30%), CMV in 3 (10%) samples and HSV-1 in 1 (3.3%) sample. In five of the samples two viruses were detected in the same sample (three were positive for adenovirus and RSV-A, and two were positive for CMV and RSV-A). Our data have supported the importance of viruses as etiologic agents of OME. Additionally, it was thought that TaqMan real-time PCR may be used as a reliable and rapid method for the detection of viruses in the middle ear effusion samples.

  13. Passive flooding of paranasal sinuses and middle ears as a method of equalisation in extreme breath-hold diving. (United States)

    Germonpré, Peter; Balestra, Costantino; Musimu, Patrick


    Breath-hold diving is both a recreational activity, performed by thousands of enthusiasts in Europe, and a high-performance competitive sport. Several 'disciplines' exist, of which the 'no-limits' category is the most spectacular: using a specially designed heavy 'sled,' divers descend to extreme depths on a cable, and then reascend using an inflatable balloon, on a single breath. The current world record for un-assisted descent stands at more than 200 m of depth. Equalising air pressure in the paranasal sinuses and middle-ear cavities is a necessity during descent to avoid barotraumas. However, this requires active insufflations of precious air, which is thus unavailable in the pulmonary system. The authors describe a diver who, by training, is capable of allowing passive flooding of the sinuses and middle ear with (sea) water during descent, by suppressing protective (parasympathetic) reflexes during this process. Using this technique, he performed a series of extreme-depth breath-hold dives in June 2005, descending to 209 m of sea water on one breath of air.

  14. Sing It, Hear It, Play It! Ear Training for Middle School Students. (United States)

    Huenink, Jeffrey S.


    Discusses how to increase student skills in ear training. Offers suggestions used with fifth through eighth grade band students, such as sing with your bands or teach the band solfege syllables. Includes a list of songs, research resources, and tonal patterns. (CMK)

  15. Selection for phase variation of LOS biosynthetic genes frequently occurs in progression of non-typeable Haemophilus influenzae infection from the nasopharynx to the middle ear of human patients.

    Directory of Open Access Journals (Sweden)

    Kate L Fox

    Full Text Available Surface structures in Haemophilus influenzae are subject to rapid ON/OFF switching of expression, a process termed phase variation. We analyse tetranucleotide repeats controlling phase variation in lipo-oligosaccharide (LOS genes of H. influenzae in paired isolates from both the nasopharynx and middle ears of paediatric patients with chronic or recurrent otitis media. A change in expression of at least one of the seven phase variable LOS biosynthesis genes was seen in 12 of the 21 strain pairs. Several strains showed switching of expression in multiple LOS genes, consistent with a key role for phase variable LOS biosynthetic genes in human infection.

  16. Vibrant SoundBridge application to middle ear windows versus conventional hearing aids: a comparative study based on international outcome inventory for hearing aids. (United States)

    Atas, Ahmet; Tutar, Hakan; Gunduz, Bulent; Bayazıt, Yıldırım A


    In this study, we aimed to compare the outcomes of satisfaction of the patients who used hearing aids preceding the vibrant sound bridge (VSB) application on middle ear windows (14 oval window and 5 round window). Nineteen adult patients with conductive or mixed hearing loss were included in the study. All patients used behind the ear hearing aids on the site which was selected for VSB application. The patients used hearing aids for at least 3 months before the VSB operation. The floating mass transducer (FMT) was placed on one of the middle ear windows (oval or round) in VSB operation. The patients were evaluated with International Outcome Inventory for Hearing Aids (IOI-HA) preoperatively after at least 3 months trial of conventional hearing aid and postoperatively after 3 months use of VSB. No perioperative problem was encountered. The total score of IOI-HA was significantly higher with VSB compared with conventional hearing aids (p 0.05). The IOI-HA scores were significantly higher with the middle ear implant than the conventional hearing aid regarding benefit and residual participation restrictions (p VSB and hearing aid use, there was a superiority of VSB in terms of benefit and residual participation restrictions as well as overall IOI-HA scores as the FMT was placed on one of the middle ear windows.

  17. 探讨中耳乳突根治手术的临床疗效%The Clinical Efficacy of Radical Operation of Middle Ear and Mastoid

    Institute of Scientific and Technical Information of China (English)



    目的:研究分析中耳乳突根治手术的临床治疗效果。方法2010~2012年我院共接收了180例慢性中耳炎患者,根据这些患者的临床手术治疗来进行疗效探讨分析。结果临床中完璧式乳突根治以及鼓室成形治疗的患者干耳率达到了94.7%,开放式乳突根治和鼓室成形患者有92.5%的干耳率。结论临床中需要结合慢性中耳炎患者的病情以及病变范围来进行手术方式的选择,后鼓室入路探查和清理可以有效的治疗病变范围较广的患者,对于手术炎症的预防起到了比较积极的帮助。%Objective To study the curative effect of radical operation for middle ear and mastoid. Methods From 2010 to 2012, our hospital received a total of 180 cases of chronic otitis media patients, according to the clinical operation treatment for these patients to explore the curative effects. Results Clinical superlative radical mastoidectomy and tympanoplasty in patients treated with dry ear rate reached to 94.7%, open radical mastoidectomy and tympanoplasty in patients with dry ear rate was 92.5%. Conclusion We need to choose the mode of operation in patients with chronic otitis media with the severity and scope of clinical lesions in conclusion, posterior tympanum approach for the exploration and cleaning range can be effective treatment of lesions in patients with wide operation, for the prevention of inlfammation plays a positive help.

  18. Middle and inner ear malformations in mutation-proven branchio-oculo-facial (BOF) syndrome: case series and review of the literature. (United States)

    Carter, Melissa T; Blaser, Susan; Papsin, Blake; Meschino, Wendy; Reardon, Willie; Klatt, Regan; Babul-Hirji, Riyana; Milunsky, Jeff; Chitayat, David


    Hearing impairment is common in individuals with branchio-oculo-facial (BOF) syndrome. The majority of described individuals have conductive hearing impairment due to malformed ossicles and/or external canal stenosis or atresia, although a sensorineural component to the hearing impairment in BOF syndrome is increasingly being reported. Sophisticated computed tomography (CT) of the temporal bone has revealed middle and inner ear malformations in three previous reports. We present middle and inner ear abnormalities in three additional individuals with mutation-proven BOF syndrome. We suggest that temporal bone CT imaging be included in the medical workup of a child with BOF syndrome, in order to guide management.

  19. Giant Cell Tumor of the Temporal Bone with Direct Invasion into the Middle Ear and Skull Base: A Case Report

    Directory of Open Access Journals (Sweden)

    Takashi Iizuka


    Full Text Available Giant cell tumor (GCT is classified as a benign bone tumor, and it is frequently identified at the epiphysis of long bones and relatively rare in the temporal bone. For orthopedists expert at recognizing bone and soft tissue tumors, the diagnosis of GCT is relatively easy; however, since head and neck surgeons experience few cases of GCT, it may be difficult to diagnose when it occurs in the temporal bone. A 32-year-old man complained of left hearing loss, aural fullness, and tinnitus. Examination of the ear revealed a bulging tumor. Audiologic examination demonstrated conductive hearing loss of the left ear. Computer tomograph of the temporal bone showed a soft-tissue-density specification indicating bone destruction at the left temporal bone. The tumor invaded the skull base. Imaging examinations using magnetic resonance imaging revealed a nonhomogenous isosignal intensity area on T1 at the left temporal bone. After intravenous gadolinium, the mass showed unequal enhancement. This patient subsequently underwent surgery to remove the lesion using transmastoid and middle fossa approach. Pathological examinations from specimens of the tumor revealed characteristic of GCT. No clinical or radiological evidence of tumor recurrence was detected for 4 years.

  20. Increasing rate of middle ear ventilation tube insertion in children in denmark

    DEFF Research Database (Denmark)

    Djurhuus, Bjarki Ditlev; Skytthe, Axel; Christensen, Kaare;


    ear ventilation tube insertion performed in Denmark in the period were identified. A possible change in incidence rate over time was examined using Poisson regression analysis, while the cumulative incidence proportion was estimated using life-tables. RESULTS: A total of 502,569 uni- or bilateral...... in incidence rate was found in 1-year-olds with an annual increase of 4.5% (95% confidence interval 4.4-4.6%). Age-specific incidence rates remained at maximum around the age of 14 months throughout the period. The cumulative incidence proportion for the 2010 birth cohort by the time they reach the age of 5...

  1. CT中耳仿真内窥镜成像对中耳结构空间解剖关系的显示价值%Computed tomography virtual endoscopy imaging for spacial anatomy of the middle ear

    Institute of Scientific and Technical Information of China (English)

    杨智云; 刘春玲; 周旭辉; 严超贵; 谢红波; 彭谦


    CT仿真内窥镜耗时不长,可以临床常规使用.%BACKGROUND: The middle ear is a little aerated cavity with a complex anatomy and a deep location. Computed tomagraphy virtual endoscopy (CTVE) can be used to reconstruct the stereoscopic images of internal surface of hollow organs using spiral CT volumetric data, providing findings similar to fiberendoscope.OBJECTIVE: To vedfy the ability to show the normal middle ear and the clinical application of virtual endoscopy based on 64-detector CT data.DESIGN, TIME AND SETTING: A confirmatory controlled observation was performed at Department of Radiology, First Affiliated Hospital of Sun Yat-sen University between October 2005 and March 2006.PARTICIPANTS: A total of 33 patients (66 ears) with suspected middle ear disease who underwent spiral CT examination were included in this study. Among included ears, 35 were normal, and 31 were impaired, including 24 ears presenting with chronic suppurative otitis media (10 simple otitis media, 5 granulomatous otitis media, and 9 middle ear cholesteatoma), 2 ears with post-operative recurred suppurative otitis media, 2 ears with carcinoma of middle ear, and 2 ears with temporal bone fracture, and lear with foreign body granuloma.METHODS: CT images of the temporal bone were obtained using 0.5 mm thick axis slices with a soft reconstruction kemel at 0.3 mm intervals. Virtual endoscopic images of middle ear on CT were generated from volumetric data using the Navigator software. CTVE images were observed from multiple directions using the Fly Through software, and compared with the axial and coronal images and surgery findings.MAIN OUTCOME MEASURES: The following structures were observed: auditory ossicle and joints, superior, middle, and inferior tympanum, sinus tympani, external acoustic meatus, tympanum, facial recess, tegmental wall, anterior and superior ligaments of malleus, posterior ligament of incus, and retrotympanum.RESULTS: A series of images were acquired as the virtual

  2. Treatment of Age-Related Hearing Loss in Dogs with the Vibrant Soundbridge Middle Ear Implant : Short-Term Results in 3 Dogs

    NARCIS (Netherlands)

    Ter Haar, G.; Mulder, J. J.; Venker-van Haagen, A. J.; van Sluijs, F. J.; Snik, A. F.; Smoorenburg, G. F.


    Background Age-related hearing loss (ARHL), or presbycusis, is the most common form of acquired hearing loss in dogs. Middle ear implants have been used successfully in people with ARHL who cannot benefit from conventional hearing aids. Hypothesis Audibility improves in dogs with ARHL after implanta

  3. Treatment of age-related hearing loss in dogs with the vibrant soundbridge middle ear implant: short-term results in 3 dogs.

    NARCIS (Netherlands)

    Haar, G. Ter; Mulder, J.J.S.; Venker-van Haagen, A.J.; Sluijs, F.J. van; Snik, A.F.M.; Smoorenburg, G.F.


    BACKGROUND: Age-related hearing loss (ARHL), or presbycusis, is the most common form of acquired hearing loss in dogs. Middle ear implants have been used successfully in people with ARHL who cannot benefit from conventional hearing aids. HYPOTHESIS: Audibility improves in dogs with ARHL after implan

  4. Iodine potassium iodide improves the contrast-to-noise ratio of micro-computed tomography images of the human middle ear. (United States)

    Rohani, S A; Ghomashchi, S; Umoh, J; Holdsworth, D W; Agrawal, S K; Ladak, H M


    High-resolution imaging of middle-ear geometry is necessary for finite-element modeling. Although micro-computed tomography (microCT) is widely used because of its ability to image bony structures of the middle ear, it is difficult to visualize soft tissues - including the tympanic membrane and the suspensory ligaments/tendons - because of lack of contrast. The objective of this research is to quantitatively evaluate the efficacy of iodine potassium iodide (IKI) solution as a contrast agent. Six human temporal bones were used in this experiment, which were obtained in right-left pairs, from three cadaveric heads. All bones were fixed using formaldehyde. Three bones (one from each pair) were stained in IKI solution for 2 days, whereas the other three were not stained. Samples were scanned using a microCT system at a resolution of 20 μm. Eight soft tissues in the middle ear were segmented: anterior mallear ligament, incudomallear joint, lateral mallear ligament, posterior incudal ligament, stapedial annular ligament, stapedius muscle, tympanic membrane and tensor tympani muscle. Contrast-to-noise ratios (CNRs) of each soft tissue were calculated for each temporal bone. Combined CNRs of the soft tissues in unstained samples were 6.1 ± 3.0, whereas they were 8.1 ± 2.7 in stained samples. Results from Welch's t-test indicate significant difference between the two groups at a 95% confidence interval. Results for paired t-tests for each of the individual soft tissues also indicated significant improvement of contrast in all tissues after staining. Relatively large soft tissues in the middle ear such as the tympanic membrane and the tensor tympani muscle were impacted by staining more than smaller tissues such as the stapedial annular ligament. The increase in contrast with IKI solution confirms its potential application in automatic segmentation of the middle-ear soft tissues.

  5. Can use of a cold light source in endoscopic middle ear surgery cause sensorineural hearing loss?

    Directory of Open Access Journals (Sweden)

    Suat Terzi


    Full Text Available Objectives: To investigate possible sensorineural hearing loss created by the use of a cold light source in patients undergoing endoscopic tympanoplasty surgery. Materials and Methods: The medical records of 203 patients, who underwent endoscopic Type 1 tympanoplasty surgery in our ear, nose, and throat clinic between 2012 and 2015, were checked retrospectively. Ninety-one patients were male and 112 were female, and their mean age was 34.4 ± 11.2 years. Results of audiometric measurements performed during the preoperative period and repeated 1 and 3 months postsurgery were compared to each other. Results: The mean duration of the operations was determined to be 52.4 ± 9.1 min. In addition, average preoperative bone-conduction was 11.4 ± 7.4 dB nHL. However, it was 9.57 ± 7.1 dB nHL and 9.51 ± 7.4 dB nHL, respectively, in the 1st and 3rd postoperative months. Levels of postoperative average bone-conduction at the 1st and 3rd month, as well as the thresholds of bone-conduction at 500, 1000, and 2000 Hz, were significantly lower than the preoperative results (P 0.05. Conclusion: Based on our findings, the increased heat generated by the use of a cold light source during an endoscopic tympanoplasty surgery is unlikely to cause the development of sensorineural hearing loss.

  6. A molecular epidemiologic study of methicillin-resistant Staphylococcus aureus infection in patients undergoing middle ear surgery. (United States)

    Suh, H K; Jeon, Y H; Song, J S; Hwang, S J; Cheong, H J


    The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections after middle ear surgery has recently increased at our hospital. Most of these infections were thought to be hospital-acquired when medical personnel in contact with an MRSA-infected patient may have inadvertently transmitted the pathogen to other patients. To prevent further transmission it is essential that such sources of MRSA infection and transmission routes be selected out and eradicated. Therefore, it is necessary to determine whether the strains of MRSA isolated from infected patients are identical to those obtained from medical personnel in order to prove a reciprocal transmission of organisms between medical personnel and patients. Surveillance bacterial cultures from the anterior nares and hands of medical personnel working in the Department of Otolaryngology, Korea University Guro Hospital, were performed at two different time points: 6 December 1994 and 17 June 1996. Ribotyping with Southern blot technique was used to compare 12 MRSA strains from medical carriers with 60 strains identified from the otorrhea of MRSA-infected patients undergoing middle ear surgery. As results, six different MRSA strains were identified (types I, II, III, IV, V and VI) from ribotyping with EcoR1. One distinct subtype, type I strain, was the most frequently identified strain in both medical carriers and patients. Results also showed that 6 MRSA isolates from 10 medical carriers and 20 from 30 patients contained type I ribotype at first culture. Two medical carriers' isolates and 13 isolates from 30 patients shared the same type I strain at the second surveillance culture. In all, 41 out of 72 MRSA strains (56.9%) shared an identical ribotype pattern. Postoperative MRSA infection rates after treatment of medical carriers and the application of rigorous preventive procedures decreased from 11.9 to 5.7% after first culture and 9.0 to 7.7% following second cultures. These findings confirm that MRSA

  7. Mucosal biofilm detection in chronic otitis media

    DEFF Research Database (Denmark)

    Wessman, Marcus; Bjarnsholt, Thomas; Eickhardt-Sørensen, Steffen Robert


    The objectives of this study were to examine middle ear biopsies from Greenlandic patients with chronic otitis media (COM) for the presence of mucosal biofilms and the bacteria within the biofilms. Thirty-five middle ear biopsies were obtained from 32 Greenlandic COM patients admitted to ear...... of the patients served as controls. PNA-FISH showed morphological signs of biofilms in 15 out of 35 (43 %) middle ear biopsies. In the control skin biopsies, there were signs of biofilms in eight out of 23 biopsies (30 %), probably representing skin flora. PCR and 16s sequencing detected bacteria in seven out...... of 20 (35 %) usable middle ear biopsies, and in two out of ten (20 %) usable control samples. There was no association between biofilm findings and PCR and 16s sequencing. Staphylococci were the most common bacteria in bacterial culture. We found evidence of bacterial biofilms in 43 % of middle ear...

  8. Cartilage graft or fascia in tympanoplasty in patients with low middle ear risk index (anatomical and audological results). (United States)

    Callioglu, Elif Ersoy; Ceylan, B Tijen; Kuran, Gokhan; Demirci, Sule; Tulaci, Kamil Gokce; Caylan, Refik


    The aim of this study was to compare anatomic and audiological results of cartilage graft with temporal fascia graft in type 1 tympanoplasty patients with low middle ear risk index (MERI). In this retrospective study, 63 patients that underwent type 1 tympanoplasty with chondroperichondrial island graft between July 2009 and November 2010 were compared with 45 patients in whom temporal muscle fascia was used. Patients in both groups had low MERI values varying between 1 and 3. Five and nine patients underwent masteidectomy in cartilage and fascia group, respectively. Mean duration of follow-up was 11.9 ± 3.7 (5-17) months. Mean value was calculated at pre-operative and post-operative hearing threshold 0.5, 1, 2, 4 kHz, and air bone gap (ABG) gain was compared in both cartilage and fascia groups. when pre-operative and post-operative ABG gain were compared, significant decrease was seen in ABG levels (p fascia group. In both groups, age, sex, and the addition of mastoidectomy procedure had no significant effect on ABG gain and success. Cartilage is a graft material that may be preferred without concern about the effects on hearing results, especially, in patients with low MERI values. The addition of mastoidectomy had no impact on the outcome of operation and audiological results. However, further studies with larger case series may be carried out to further clarify the issue.

  9. Electrophysiological aspects of the middle ear muscle reflex in the rat: latency, rise time and effect on sound transmission. (United States)

    van den Berge, H; Kingma, H; Kluge, C; Marres, E H


    The latency, the rise time and the influence of the acoustic reflex on sound transmission were investigated in the adult rat during ketamin anesthesia. This was done by recordings of the cochlear microphonics (CM) and electromyographic (EMG) recordings of the reflex responses of the tensor tympani muscle. The acoustic reflex was elicited by contralateral acoustic stimuli of which the intensity and frequency was varied. Ipsilaterally, the effect on sound transmission was determined by estimating the change in amplitude of the CM's of ipsilateral administered subliminal stimuli. It was shown that both the tensor tympani muscle and the stapedius muscle contribute in the reflex. The latency as well as the rise time of the reflex determined by CM recordings showed to be short (minimal values: 12 and 7 ms respectively). The mean latency of the tensor tympani muscle reflex, measured by EMG, was about 7 ms. The attenuation of 0.25-8 kHz tone bursts upto 115 dB SPL is limited to a mean maximum of 15 dB SPL. The maximal attenuation was shown to occur at 1 kHz. Frequencies above 2 kHz appeared to be the best elicitor of the middle ear muscle reflex.

  10. Influence of Pneumococcal Conjugate Vaccine on Acute Otitis Media with Severe Middle Ear Inflammation: A Retrospective Multicenter Study. (United States)

    Sugino, Hirotoshi; Tsumura, Shigeru; Kunimoto, Masaru; Noda, Masuhiro; Chikuie, Daisuke; Noda, Chieko; Yamashita, Mariko; Watanabe, Hiroshi; Ishii, Hidemasa; Tashiro, Toru; Iwata, Kazuhiro; Kono, Takashi; Tsumura, Kaoru; Sumiya, Takahiro; Takeno, Sachio; Hirakawa, Katsuhiro


    The Japanese guidelines for acute otitis media in children recommend classifying acute otitis media by age, manifestations and local findings, and also recommend myringotomy for moderate-grade cases with severe local findings, severe-grade cases, and treatment-resistant cases. The heptavalent pneumococcal conjugate vaccine was released in Japan in February 2010. In Hiroshima City, public funding allowing free inoculation with this vaccine was initiated from January 2011, and the number of vaccinated individuals has since increased dramatically. This study investigated changes in the number of myringotomies performed to treat acute otitis media during the 5-year period from January 2008 to December 2012 at two hospitals and five clinics in the Asa Area of Hiroshima City, Japan. A total of 3,165 myringotomies for acute otitis media were performed. The rate of procedures per child-year performed in media in 1-year-old infants decreased significantly in the 2 years after the introduction of public funding for heptavalent pneumococcal conjugate vaccine compared to all years before introduction (pmedia in reducing the financial burden of myringotomy. In addition, this vaccine may help prevent acute otitis media with severe middle ear inflammation in 1-year-old infants.

  11. Minimal biofilm eradication concentration of antimicrobial agents against nontypeable Haemophilus influenzae isolated from middle ear fluids of intractable acute otitis media. (United States)

    Takei, Shin; Hotomi, Muneki; Yamanaka, Noboru


    Nontypeable Haemophilus influenzae (NTHi) makes the clinical course of acute otitis media (AOM) intractable by forming a biofilm that may hamper the clearance of the bacteria from middle ear cavity. In this study, we evaluated the minimum biofilm eradication concentration (MBEC) of antimicrobial agents against biofilm-forming NTHi strains. Twelve NTHi strains isolated from middle ear fluids of Japanese children with intractable AOM before antimicrobial treatment were evaluated for MBEC of fluoroquinolones in comparison with those of β-lactams and macrolides. AMPC and CDTR required much higher concentration, i.e., high MBECs, to suppress the biofilm formation of NTHi. In contrast, fluoroquinolones followed by macrolides showed lower MBECs. MBEC would be a good parameter to infer the efficacies of antimicrobials against NTHi in biofilm.

  12. Synergistic effect of interleukin 1 alpha on nontypeable Haemophilus influenzae-induced up-regulation of human beta-defensin 2 in middle ear epithelial cells

    Directory of Open Access Journals (Sweden)

    Park Raekil


    Full Text Available Abstract Background We recently showed that beta-defensins have antimicrobial activity against nontypeable Haemophilus influenzae (NTHi and that interleukin 1 alpha (IL-1 alpha up-regulates the transcription of beta-defensin 2 (DEFB4 according to new nomenclature of the Human Genome Organization in human middle ear epithelial cells via a Src-dependent Raf-MEK1/2-ERK signaling pathway. Based on these observations, we investigated if human middle ear epithelial cells could release IL-1 alpha upon exposure to a lysate of NTHi and if this cytokine could have a synergistic effect on beta-defensin 2 up-regulation by the bacterial components. Methods The studies described herein were carried out using epithelial cell lines as well as a murine model of acute otitis media (OM. Human cytokine macroarray analysis was performed to detect the released cytokines in response to NTHi exposure. Real time quantitative PCR was done to compare the induction of IL-1 alpha or beta-defensin 2 mRNAs and to identify the signaling pathways involved. Direct activation of the beta-defensin 2 promoter was monitored using a beta-defensin 2 promoter-Luciferase construct. An IL-1 alpha blocking antibody was used to demonstrate the direct involvement of this cytokine on DEFB4 induction. Results Middle ear epithelial cells released IL-1 alpha when stimulated by NTHi components and this cytokine acted in an autocrine/paracrine synergistic manner with NTHi to up-regulate beta-defensin 2. This synergistic effect of IL-1 alpha on NTHi-induced beta-defensin 2 up-regulation appeared to be mediated by the p38 MAP kinase pathway. Conclusion We demonstrate that IL-1 alpha is secreted by middle ear epithelial cells upon exposure to NTHi components and that it can synergistically act with certain of these molecules to up-regulate beta-defensin 2 via the p38 MAP kinase pathway.

  13. A study of middle ear reconstruction, the degree of functional restoration and causes of graft failure following chronic ear disease

    Directory of Open Access Journals (Sweden)

    Vishnu Prasad


    Conclusion: Patients with normal Eustachian tube function, large and medium size mastoids, small and medium size perforations of the tympanic membrane would have a good rate of graft uptake with tympano-ossiculoplasties thereby returning to normal hearing postoperatively.

  14. Classification and diagnosis of ear malformations


    Bartel-Friedrich, Sylva; Wulke, Cornelia


    In the ENT region 50% of the malformations affect the ear. Malformations of the outer and middle ear are predominantly unilateral (ca. 70-90%) and mostly involve the right ear. Inner ear malformations can be unilateral or bilateral. The incidence of ear malformations is approximately 1 in 3800 newborns. Ear malformations may be genetic (associated with syndromes or not, with family history, spontaneous mutations) or acquired in nature. Malformations can affect the outer ear (pinna and externa...

  15. Perfusion and diffusion limitations in middle ear gas exchange: the exchange of CO2 as a test case. (United States)

    Marcusohn, Yael; Ar, Amos; Dirckx, Joris J J


    A long standing debate on perfusion/diffusion limitations in the context of middle ear (ME) gas exchange was revisited using data obtained from previous iso-pressure gas-exchange measurements in different mammals. We tried to determine whether the exchange of CO(2) in the ME is limited by perfusion or by diffusion by comparing the mass specific cardiac output (msQ) and the mass specific initial CO(2) flow rate into air-washed MEs (msV(i) CO(2)) of rabbits and rats. Based on previously published allometry at rest, the msQ was 0.154 mL/(min g) in rabbits (mean body weight: 2800 g) and 0.259 mL/(min g) in rats (mean body weight: 179.1 g); msV(i) CO(2) (Delta t=0) was 0.109+/-0.047 microL/(h g) in rabbits (n=16) and 0.170+/-0.094 microL/(h g) in rats (n=9). Similar ratios were found when an allometric comparison was made between the ratio of msV(i) CO(2) (Delta t=0) (approximately 0.64), and the ratio of msQs (approximately 0.59) in rabbits and rats. If the active mucosal surface areas of MEs of rabbits and rats are directly proportional to their masses as are the masses of their hearts and if their msQs are proportional to the rates of blood flows in the ME mucosa, these results support the assumption that the exchange of CO(2) in the ME of mammals is mainly perfusion (and not diffusion) dependent.

  16. Conscious sedation for middle ear surgeries: A comparison between fentanyl-propofol and fentanyl-midazolam infusion

    Directory of Open Access Journals (Sweden)

    Raghu S Thota


    Full Text Available Introduction and Aim: Middle ear surgeries can be performed under local anesthesia and sedation and can be well tolerated by the patient with minimal discomfort. This study was undertaken to compare two techniques of conscious sedation, intravenous midazolam, and propofol infusion for tympanoplasty. Materials and Methods: Forty patients scheduled for right or left tympanoplasty. American Society of Anesthesiologists I or II in age group 18-75 years were included in the study. The patients were randomly allocated into one of the two groups to receive either propofol (group I or midazolam (group II. Results: The mean duration of anesthesia was 116.00 ± 33.94 min in group I, while 97.50 ± 30.76 min in group II (P = 0.07. The modified Ramsay sedation scale was not statistically significant in both the groups. In group I, 70% of the patients and 95% of the patients in group II had amnesia during the surgery (P = 0.091. The mean visual analog scale (VAS score for surgeons and patients was not statistically significant in both the groups. In group I there was a positive correlation between the total dose of fentanyl and VAS score for surgeons (P = 0.02. There was also a positive correlation between the total dose of propofol and VAS score for surgeons (P = 0.034 and patients (P = 0.039 in group I. Conclusion: Though propofol had shown a faster recovery and less nausea vomiting, we need a larger sample size to conclude, which of the technique is better. Both the techniques are safe, simple and versatile and provide excellent sedation with rapid trouble free recovery.

  17. Primary investigations on the potential of a novel diode pumped Er:YAG laser system for middle ear surgery (United States)

    Stock, Karl; Wurm, Holger; Hausladen, Florian


    Flashlamp pumped Er:YAG lasers are successfully used clinically for both precise soft and hard tissue ablation. Since several years a novel diode pumped Er:YAG laser system (Pantec Engineering AG) is available, with mean laser power up to 40 W and pulse repetition rate up to 1 kHz. The aim of the study was to investigate the suitability of the laser system specifically for stapedotomy. Firstly an experimental setup was realized with a beam focusing unit and a computer controlled translation stage to move the samples (slices of porcine bone) with a defined velocity while irradiation with various laser parameters. A microphone was positioned in a defined distance to the ablation point and the resulting acoustic signal of the ablation process was recorded. For comparison, measurements were also performed with a flash lamp pumped Er:YAG laser system. After irradiation the resulting ablation quality and efficacy were determined using light microscopy. Using a high speed camera and "Töpler-Schlierentechnik" the cavitation bubble in water after perforation of a bone slice was investigated. The results show efficient bone ablation using the diode pumped Er:YAG laser system. Also a decrease of the sound level and of the cavitation bubble volume was observed with decreasing pulse duration. Higher repetition rates lead to a slightly increase of thermal side effects but have no influence on the ablation efficiency. In conclusion, these first experiments demonstrate the high potential of the diode pumped Er:YAG laser system for use in middle ear surgery.

  18. Ear infection and hearing loss amongst headphone users. (United States)

    Mazlan, R; Saim, L; Thomas, A; Said, R; Liyab, B


    The use of headphone has been thought to cause infection in the ear canal and contribute to hearing loss. In this study, we examined 136 Customer Service Representative from Celcom (Malaysia) Sdn. Bhd. who use headphone throughout their working hours. The purpose of this study was to determine the prevalence of ear canal infection and other related diseases of the ear, nose and throat. Their hearing thresholds were also determined using the Amplaid 309 Clinical Audiometer. We found no incidence of infection of the external ear canal amongst the subjects. There were 4 cases of chronic middle ear infection and 4 cases of impacted wax. Hearing impairment was found in 25 subjects (21.2%). However, there was no significant association between hearing loss and the exposure to sound from headphone usage because the high frequencies were not predominantly affected. There was also no association between hearing loss and duration of service.

  19. Middle Ear Infections (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  20. Treatment of chronic suppurative otitis media with ofloxacin in hydroxypropyl methylcellulose ear drops: a clinical/bacteriological study in a rural area of Malawi. (United States)

    van Hasselt, Piet; van Kregten, Eric


    Chronic suppurative otitis media in young children is a major problem in Africa, with socio-economic consequences at a later age. Common treatment regimens with antibiotics are expensive and often not practically feasible. Therefore, a project was started to develop a low-cost and effective treatment in a rural area of Malawi by studying the clinical efficacy of an inexpensive application regimen of ofloxacin (0.075%) in hydroxypropyl methylcellulose (1.5%) ear drops. In earlier studies with this treatment regimen, it was possible to cure approximately 70% of ears. The aim of this study was to find out whether the bacteriological spectrum cultured from wet ears before and after treatment, and patterns of resistance to antibiotics, played a role in the percentage of cures. Patients with long-standing chronic suppurative otitis media were clinically assessed and treated with suction cleaning and instillation of ear drops on days 1, 3, 7 and 10. Bacterial swabs were taken for culture and sensitivity tests for ofloxacin were on days 1 and 10 from the ears that were still discharging. After 21 weeks, the ears were assessed again clinically. Clinical cure was considered to be complete cessation of otorrhea. Ninety of 104 tested patients (124 ears) completed the study. About 73% of the ears had become dry by day 10. This dropped to 42% after 21 weeks. Before treatment, most ears (91%) harbored fecal bacteria, Proteus mirabilis (74%) and enterococci (60%) being the most frequently isolated microbes. The second group of frequently cultured bacteria were water bacteria e.g. Pseudomonas species and other non-fermenters (69%), whereas the classical otitis media pathogens were detected only in 15% of ears. Before treatment, 9.7% of strains were resistant to ofloxacin, most (30/35) of which were cultured from ears that were eventually cured. After treatment, fecal and water bacteria were still the most frequently found, with 36% new strains and an overall sensitivity to

  1. CT of temporal bone - IV. inner ear

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Jae Yoon; Sung, Kyu Bo; Youn, Eun Kyoung; Park, Youn Kyeung; Lee, Young Uk [Koryo general Hospital, Seoul (Korea, Republic of)


    Temporal bone CT was done in 697 patients from April 1985 to October 1989. The abnormal findings were seen in 453 patients, which were chronic otitis media in 355 patients, fracture in 49 patients and congenital anomaly in 44 patients, etc. The abnormal findings of inner ear were observed on 46 patients. The results were summarized as follows : 1. The incidence of inner ear involvement by chronic otitis media was 7.3% (26/355 : labyrinthine fistula in 17 patients, labyrinthitis ossificans in 9 patients). Labyrinthine fistula was most commonly located on lateral semicircular canal (15/17, 88.2%). 2. Fusion of vestibule with lateral semicircular canal and formation of common cavity was demonstrated incidentally in 5 patients (0.7% of total number of temporal bone CT), and bilateral in 3 patients. 3. The incidence of inner ear anomaly in congenital ear anomaly was 11.4% (5/44). All cases were bilateral and three patients showed associated middle ear anomaly. 4. The incidence of involvement of bony labyrinth in temporal bone fracture was 10.2% (5/49). Labyrinthine fracture was seen all patients of transverse(3) and mixed fracture(1). In longitudinal fracture, labyrinthine fracture was seen in 2.2% (1/45). 5. Others were traumatic labyrinthitis ossificans(1), intracanalicular acoustic neuroma(3) and facial nerve neuroma(1)

  2. [Cochlear implantation through the middle fossa approach]. (United States)

    Szyfter, W; Colletti, V; Pruszewicz, A; Kopeć, T; Szymiec, E; Kawczyński, M; Karlik, M


    The inner part of cochlear implant is inserted into inner ear during surgery through mastoid and middle ear. It is a classical method, used in the majority cochlear centers in the world. This is not a suitable method in case of chronic otitis media and middle ear malformation. In these cases Colletti proposed the middle fossa approach and cochlear implant insertion omitting middle ear structures. In patient with bilateral chronic otitis media underwent a few ears operations without obtaining dry postoperative cavity. Cochlear implantation through the middle fossa approach was performed in this patient. The bone fenster was cut, temporal lobe was bent and petrosus pyramid upper surface was exposed. When the superficial petrosal greater nerve, facial nerve and arcuate eminence were localised, the cochlear was open in the basal turn and electrode were inserted. The patient achieves good results in the postoperative speech rehabilitation. It confirmed Colletti tesis that deeper electrode insertion in the cochlear implantation through the middle fossa approach enable use of low and middle frequencies, which are very important in speech understanding.

  3. Swimmer's ear (United States)

    ... worse when you pull on the outer ear Hearing loss Itching of the ear or ear canal ... reduce itching and inflammation Pain medicine, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) Vinegar (acetic acid) ...

  4. Ear wax


    Browning, George GG


    Ear wax only becomes a problem if it causes a hearing impairment, or other ear-related symptoms. Ear wax is more likely to accumulate and cause a hearing impairment when normal extrusion is prevented — for example, by hearing aids, or by the use of cotton buds to clean the ears.Ear wax can visually obscure the ear drum, and may need to be removed for diagnostic purposes.

  5. Next-Generation Sequencing Combined with Specific PCR Assays To Determine the Bacterial 16S rRNA Gene Profiles of Middle Ear Fluid Collected from Children with Acute Otitis Media (United States)

    Kramna, Lenka; Oikarinen, Sami; Sipilä, Markku; Rautiainen, Markus; Aittoniemi, Janne; Laranne, Jussi; Hyöty, Heikki; Cinek, Ondrej


    ABSTRACT The aim of the study was to analyze the bacteriome of acute otitis media with a novel modification of next-generation sequencing techniques. Outpatient children with acute otitis media were enrolled in the study, and middle ear fluids were collected during 90 episodes from 79 subjects aged 5 to 42 months (median age, 19 months). The bacteriome profiles of middle ear fluid samples were determined by a nested-PCR amplification of the 16S rRNA gene (V4 region), followed by mass sequencing. The profiling results were compared to the results of specific PCR assays targeting selected prevalent pathogens. Bacteriome profiling using nested amplification of low-volume samples was aided by a bioinformatic subtraction of signal contaminants from the recombinant polymerase, achieving a sensitivity slightly lower than that of specific PCR detection. Streptococcus pneumoniae was detected in 28 (31%) samples, Haemophilus influenzae in 24 (27%), Moraxella catarrhalis in 18 (20%), Staphylococcus spp. in 21 (23%), Turicella otitidis in 5 (5.6%), Alloiococcus otitidis in 3 (3.3%), and other bacteria in 14 (16%) using bacteriome profiling. S. pneumoniae was the dominant pathogen in 14 (16%) samples, H. influenzae in 15 (17%), M. catarrhalis in 5 (5.6%), T. otitidis in 2, and Staphylococcus auricularis in 2. Weaker signals of Prevotella melaninogenica, Veillonella dispar, and Veillonella montpellierensis were noted in several samples. Fourteen samples (16%) were not explainable by bacterial pathogens; novel causative agents were not detected. In conclusion, unbiased bacteriome profiling helped in depicting the true mutual quantitative ratios of ear bacteria, but at present, its complicated protocol impedes its routine clinical use. IMPORTANCE Although S. pneumoniae, H. influenzae, and M. catarrhalis have been long established as the most important pathogens in acute otitis media using culture and specific PCR assays, the knowledge of their mutual quantitative relations

  6. A Study of Relationship between the Acoustic Sensitivity of Vestibular System and the Ability to Trigger Sound-Evoked Muscle Reflex of the Middle Ear in Adults with Normal Hearing

    Directory of Open Access Journals (Sweden)

    S.F. Emami


    Full Text Available Introduction & Objective: The vestibular system is sound sensitive and the sensitivity is related to the saccule. The vestibular afferents are projected to the middle ear muscles (such as the stapedius. The goal of this research was studying the relationship between the vestibular hearing and the sound-evoked muscle reflex of the middle ear to 500 HZ. Materials & Methods: This study was a cross sectional-comparison done in audiology department of Sheikholreis C‍‍linic (Hamadan, Iran. The study groups consisted of thirty healthy people and thirty patients with benign paroxysmal positional vertigo. Inclusion criteria of the present study were to have normal hearing on pure tone audiometry, acoustic reflex, and speech discrimination scores. Based on ipsilateral acoustic reflex test at 500HZ, they were divided to normal and abnormal groups. Then they were evaluated by cervical vestibular evoked myogenic potentials (cVEMPs and finally classified in three groups (N Normal ear , (CVUA Contra lateral vertiginous ear with unaffected saccular sensitivity to sound,(IVA Ipsilateral vertiginous ear with affected saccular sensitivity to sound. Results: Thirty affected ears (IVA with decreased vestibular excitability as detected by ab-normal cVEMPs, revealed abnormal findings of acoustic reflex at 500HZ. Whereas, both un-affected (CVUA and normal ears (N had normal results. Multiple comparisons of mean values of cVEMPs (p13,n23 and acoustic reflex at500HZ among the three groups were sig-nificant. The correlation between acoustic reflex at 500HZ and p13 latencies was significant. The n23 latencies showed significant correlation with acoustic reflex at 500HZ. Conclusion: The vestibular sensitivity to sound retains the ability to trigger sound-evoked re-flex of the middle ear at 500 HZ. (Sci J Hamadan Univ Med Sci 2014; 21 (2:99-104

  7. Effect on cochlea function of guinea pig after controlled release recombinant human bone morphogenetic protein 2 transplanted into the middle ear

    Institute of Scientific and Technical Information of China (English)

    LI Xue-sheng; SUN Jian-jun; JIANG Wei; LIU Xiao


    Background The recombinant human bone morphogenetic protein 2 (rhBMP-2) has been used to induce osteogenesis in animals' middle ear and this technique is possible to be used to reconstruct the defects of ossicles. The side effects of the rhBMP-2 in middle ear should be observed before using in clinic. Thus we prepared the controlled release rhBMP-2 and implanted it into the acoustic bulla of guinea pigs. The effect on the cochlea was observed. Methods We prepared the acellular cancellous bone, accompanied with rhBMP-2. The material accompanied with rhBMP-2 was implanted into one acoustic bulla of the animal and the opposite side of the acoustic bulla was implanted with acellular cancellous bone without rhBMP-2. Totally 20 guinea pigs were undergone this procedure. After the operation, the auditory brainstem response (ABR) of the animals was tested according to the time sequence. Three months after the operation, the animals were sacrificed. The osteogenesis induced by rhBMP-2, the acoustic bulla and cochlea affected by rhBMP-2 were observed. The structures of hair cells were observed after silver nitrate staining. Results The animals were recovered soon after surgery. The hearing thresholds of the animals were declined slightly just after the surgery and come back completely after 3 months. Also, the bulla and cochlea were normal in shape. The osteogenesis occurred in the pore of the acellular cancellous bone with rhBMP-2. There was not any abnormal hyperplasia of bone in the bulla and cochlea. The articulation between the stapes and oval window was not merged. The shapes of the hair cells were normal and there was no obvious deletion of the hair cells compared with control group. Conclusions The controlled release rhBMP-2 transplanted into the middle ear could induce osteogenesis in the bulla of the animals. It did not affect the shape of the bulla and the hearing threshold of the animal, and did not induce the abnormal hyperplasia of bone in the bulla and might

  8. Interconnections between the Ears in Nonmammalian Vertebrates

    DEFF Research Database (Denmark)

    Feng, Albert S.; Christensen-Dalsgaard, J.


    Many of the nonmammalian vertebrates (anurans, lizards, crocodiles, and some bird species) have large, continuous air spaces connecting the middle ears and acoustically coupling the eardrums. Acoustical coupling leads to strongly enhanced directionality of the ear at frequencies where diffraction...

  9. Ear Pieces (United States)

    DiJulio, Betsy


    In this article, the author describes an art project wherein students make fanciful connections between art and medicine. This project challenges students to interpret "ear idioms" (e.g. "blow it out your ear," "in one ear and out the other") by relying almost entirely on realistic ear drawings, the placement of them, marks, and values. In that…

  10. Ear trauma. (United States)

    Eagles, Kylee; Fralich, Laura; Stevenson, J Herbert


    Understanding basic ear anatomy and function allows an examiner to quickly and accurately identify at-risk structures in patients with head and ear trauma. External ear trauma (ie, hematoma or laceration) should be promptly treated with appropriate injury-specific techniques. Tympanic membrane injuries have multiple mechanisms and can often be conservatively treated. Temporal bone fractures are a common cause of ear trauma and can be life threatening. Facial nerve injuries and hearing loss can occur in ear trauma.

  11. Adapting chronic care models for diabetes care delivery inlow-and-middle-income countries: A review

    Institute of Scientific and Technical Information of China (English)


    A contextual review of models for chronic care was doneto develop a context-adapted chronic care model-basedservice delivery model for chronic conditions includingdiabetes. The Philippines was used as the setting ofa low-to-middle-income country. A context-basednarrative review of existing models for chronic carewas conducted. A situational analysis was done at thegrassroots level, involving the leaders and members ofthe community, the patients, the local health system andthe healthcare providers. A second analysis making useof certain organizational theories was done to explore onimproving feasibility and acceptability of organizing carefor chronic conditions. The analyses indicated that carefor chronic conditions may be introduced, consideringthe needs of people with diabetes in particular andthe community in general as recipients of care, andthe issues and factors that may affect the healthcareworkers and the health system as providers of thiscare. The context-adapted chronic care model-basedservice delivery model was constructed accordingly.Key features are incorporation of chronic care in thehealth system's services; assimilation of chronic caredelivery with the other responsibilities of the healthcareworkers but with redistribution of certain tasks; andensuring that the recipients of care experience thewhole spectrum of basic chronic care that includes educationand promotion in the general population, riskidentification, screening, counseling including self-caredevelopment, and clinical management of the chroniccondition and any co-morbidities, regardless of level ofcontrol of the condition. This way, low-to-middle incomecountries can introduce and improve care for chronicconditions without entailing much additional demand ontheir limited resources.

  12. Wavelet Frequency-division Based Signal Processing Design for a Piezoelectric Middle Ear Implant%基于小波分频的压电式人工中耳信号处理研究

    Institute of Scientific and Technical Information of China (English)

    闵小峰; 刘后广; 田佳彬; 饶柱石


    基于一新型压电式人工中耳,提出利用小波分频方法对其信号进行处理,使该植入装置能模拟正常中耳的传递特性.首先,基于Bark频谱理论,利用小波分频技术将输入信号分为17个频带;再参考中耳传递特性,对每个频带的信号赋以相应的增益系数;最终,通过实验验证该方法的可行性.结果表明,该法可使压电叠堆的输出能较好地反应正常中耳的传递特性.%To make an actuator of a new middle ear implant vibrate simulating middle ear transfer property,wavelet frequency division based signal processing method is proposed. Firstly, the wavelet transform separates the input signals into seventeen frequency bands based on Bark frequency scale. Then, each frequency band is multiplied with the wavelet coefficients by the gain corresponding to the transfer property of the human middle ear system. At last, the validity of this method is confirmed by an experiment. The results show this algorithm can make the output of the piezoelectric stack have a good performance of simulating the normal human middle ear transfer property.

  13. Association of smoking or tobacco use with ear diseases among men: a retrospective study

    Directory of Open Access Journals (Sweden)

    Gaur Kiran


    Full Text Available Abstract Background Health related behaviour specially smoking and tobacco in any form are major determinants of health and lead to health inequities. Tobacco leads to various health problems including ear, nose and throat diseases. Objective To determine the influence of smoking or tobacco use on ear diseases we performed a retrospective study among men. Method Of 11454 subjects of different age-groups there were 4143 men aged 20-60 years who were evaluated for demographic variables, smoking/tobacco use and middle and internal ear diseases. Descriptive statistics and age adjusted logistic regression analyses were performed. Results Among the 4143 men, 1739 (42.0% were smokers or used tobacco. In smokers/tobacco users compared to non-users the age adjusted odds ratios and 95% confidence intervals (CI for chronic suppurative otitis media were 1.13 (CI 0.96-1.34, acute otitis media 1.16 (CI 0.82-1.64, suppurative otitis media 1.21 (CI 0.79-1.84, otosclerosis 0.97 (CI 0.52-1.33 (p > 0.05 and for overall middle ear diseases was 1.15 (CI 0.99-1.33, p = 0.05. For internal ear diseases the age adjusted odds ratios were for sensorineural hearing loss 1.12 (CI 0.92-1.58, 0.12 (CI 0.42-0.93 for vertigo and tinnitus and overall internal ear diseases were 0.97 (CI 0.77-1.22, p = 0.81. Among men 40-60 years there was a significantly greater risk for both middle ear (OR 1.73, CI 1.29-2.30 and internal ear diseases (OR 1.94, CI 1.24-3.04 (p Conclusion Smoking/tobacco use is significantly associated with greater prevalence of middle and internal ear diseases among middle-aged men in India.

  14. Classification and diagnosis of ear malformations

    Directory of Open Access Journals (Sweden)

    Bartel-Friedrich, Sylva


    Full Text Available In the ENT region 50% of the malformations affect the ear. Malformations of the outer and middle ear are predominantly unilateral (ca. 70-90% and mostly involve the right ear. Inner ear malformations can be unilateral or bilateral. The incidence of ear malformations is approximately 1 in 3800 newborns. Ear malformations may be genetic (associated with syndromes or not, with family history, spontaneous mutations or acquired in nature. Malformations can affect the outer ear (pinna and external auditory canal, EAC, middle ear and inner ear, not infrequently in combination. Formal classification is advisable in order to be able to predict the prognosis and compare treatment schedules. Various classifications have been proposed: pinna and EAC malformations according to Weerda [1], middle ear malformations according to Kösling [2], and inner ear malformations according to Jackler [3], [4], to Marangos [5] and to Sennaroglu [6]. Additionally, we describe Altmann’s classification of atresia auris congenita [7] and the Siegert-Mayer-Weerda score [8] for EAC and middle ear malformations, systems of great practicability that are in widespread clinical use. The diagnostic steps include clinical examination, audiological testing, genetic analysis and, especially, CT and MRI. These imaging methods are most usefully employed in combination. Precise description of the malformations by means of CT and MRI is indispensable for the planning and successful outcome of operative ear reconstruction and rehabilitation procedures, including cochlear implantation.

  15. Ear Tumors (United States)

    ... Japanese Espaniol Find information on medical topics, symptoms, drugs, procedures, news and more, written in everyday language. * This is ... the Ears, Nose, and Throat Additional Content Medical News Ear Tumors ... NOTE: This is the Consumer Version. DOCTORS: Click ...

  16. High-resolution computerized tomography appearances of congenital malformations of the external and middle ear%先天性外中耳畸形的高分辨率CT表现

    Institute of Scientific and Technical Information of China (English)

    刘广保; 聂玉霞; 谭子琨


    Objective To evaluate the value of clinical application of high-resolution computerized tomography (HRCT) in the diagnose of congenital malformations of the external and middle ear.Methods The imaging data of 40 congenital malformations of the external and middle ear patients with HRCT were collected and analyzed retrospectively.All the temporal bones were scanned with HRCT.All images were targeted using high-bone-detail algorithms.Results 13 cases of external ear abnormalities were found,including 1 case of accessory auricle,1 case of accessory with stenosis of external acoustic meatus,3 cases of stenosis of external acoustic meatus,5 cases of externai auditory canal bony atresia and 3 cases of external auditoer canal atresia film,8 cases of middle ear abnormalities,17 cases of external and middle ear malformation,2 cases of external,middle and inner ear malformation.Conclusion External ear malformation and middle ear malformation are usually unilateral,while enlargement of vestibular aqueduct is bilateral.Congenital atresia of external acoustic meatus is the most common type in the external ear malformation.HRCT can provide clear images of temporal bone and auditory ossicles,which help us diagnose the malformations of external ear,middle ear and osseous labyrinth.%目的 探讨不同类型的先天性外中耳畸形的高分辨率CT(HRCT)的诊断价值.方法 收集诊断为先天性外中耳畸形患者40例的影像学资料进行回顾性研究,所有患者均行HRCT扫描,骨算法成像.结果 在本研究的40例先天性外中耳畸形患者中,单纯外耳畸形13例,其中副耳1例,副耳合并外耳道狭窄1例,外耳道狭窄3例,外耳道骨性闭锁5例,外耳道膜性闭锁3例,单纯中耳畸形8例,外耳并中耳畸形17例,外耳、中耳及内耳混合畸形2例.结论 外耳畸形及中耳畸形单侧发病常见,外耳、中耳畸形常同时发生.外耳畸形中先天性外耳道闭锁常见,中耳畸形以听骨链异常常见.HRCT对

  17. Elephant ear (United States)

    ... Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Elephant ear URL of this page: // Elephant ear To use the sharing features on this page, please enable JavaScript. Elephant ear plants are indoor or outdoor plants with very large, ...

  18. 听骨链CT扫描并三维重建的临床应用%On the clinical application of spiral CT three-dimensional reconstructin of middle ear ossicles

    Institute of Scientific and Technical Information of China (English)

    孙捷; 刘志连; 张华; 巩若箴; 王海波


    目的:探讨CT仿真内镜(CTVE)显示中耳正常结构的显示方法,评价中耳病变特别是听骨链连接状态的价值及意义,确立显示听骨链及其他中耳结构的位点和方法。方法:选择40例无耳科疾病的志愿者(正常组)和30例疑有中耳疾病的患者(病例组),分别采用德国西门子(Siemens SOMATOM Sensation 16)螺旋CT机Inner Ear扫描程序对患者进行轴位扫描,重建原始图像,用Fly-through软件经选择的A、B、C点入路进行CTVE成像研究。重点显示听骨链连接状态,并对慢性中耳炎的显示结果与手术中探查图像进行对照。结果:正常组CTVE中锤骨、砧骨、鼓岬、面神经管水平段、外半规管隆凸显示率均为100%;而镫骨头、两足弓的显示率在3个显示层面则分别为57.5%、70.0%,97.5%;圆窗、卵圆窗为90.0%、93.0%、97.5%.在中耳炎、外伤、颞骨畸形等情况下可显示听小骨损伤、移位、中断、缺失和畸形。结论:CTVE在显示3个听小骨之间的链接关系(如中断等方面)有一定优势。通过选择恰当的入路,CTVE在显示听小骨及其链接关系以及病理状态方面有相当优势。通过比较CTVE在3个不同显示层面观察镫骨的能力,明确CTVE是断层影像的有利补充。%Objective:To investigate the CT virtual endoscopy(CTVE) shows the display method of the normal structure of the middle ear, and evaluation of middle ear disease, particularly in the value and significance of the connection status of the ossicular chain, established display ossicular chain and middle ear structure methods. Method: Volume scanning with a spiral CT unit was performed in forty normal cases and thirty patients with suspected lesions of middle ear. Respectively, with Germany s Siemens (Siemens SOMATOM Sensation 16) spiral CT the Inner Ear scanner patients with axial scanning, reconstruction of the original image, the software selected Fly-through A, B, C the point approach

  19. Listening to the ear (United States)

    Shera, Christopher A.

    Otoacoustic emissions demonstrate that the ear creates sound while listening to sound, offering a promising acoustic window on the mechanics of hearing in awake, listening human beings. That window is clouded, however, by an incomplete knowledge of wave reflection and transmission, both forth and back within the cochlea and through the middle ear. This thesis "does windows," addressing wave propagation and scattering on both sides of the middle ear. A summary of highlights follows. Measurements of the cochlear input impedance in cat are used to identify a new symmetry in cochlear mechanics-termed "tapering symmetry" after its geometric interpretation in simple models-that guarantees that the wavelength of the traveling wave changes slowly with position near the stapes. Waves therefore propagate without reflection through the basal turns of the cochlea. Analytic methods for solving the cochlear wave equations using a perturbative scattering series are given and used to demonstrate that, contrary to common belief, conventional cochlear models exhibit negligible internal reflection whether or not they accurately represent the tapering symmetries of the inner ear. Frameworks for the systematic "deconstruction" of eardrum and middle-ear transduction characteristics are developed and applied to the analysis of noninvasive measurements of middle-ear and cochlear mechanics. A simple phenomenological model of inner-ear compressibility that correctly predicts hearing thresholds in patients with missing or disarticulated middle-ear ossicles is developed and used to establish an upper bound on cochlear compressibility several orders of magnitude smaller than that provided by direct measurements. Accurate measurements of stimulus frequency evoked otoacoustic emissions are performed and used to determine the form and frequency variation of the cochlear traveling-wave ratio noninvasively. Those measurements are inverted to obtain the spatial distribution of mechanical

  20. Prótese implantável do ouvido médio: ganho funcional em perda auditiva mista Middle ear implants: functional gain in mixed hearing loss

    Directory of Open Access Journals (Sweden)

    Mario Emilio Zernotti


    Full Text Available Atresia óssea e otite média crônica são os principais grupos de beneficiários com implantes do ouvido médio. Cirurgia de atresia é tecnicamente complexo, tem muitas complicações e resultados funcionais pobres. Os aparelhos auditivos osseointegrados são uma alternativa. Eles fornecem um ganho funcional muito bom, mas tem muitos problemas de pele e osseointegração. Na otite média crônica, ossiculoplastias resolveram parcialmente o problema de audição. Infelizmente, em alguns casos de otites média e cavidades abertas, equipamentos com aparelhos auditivos convencionais são difíceis e muitas vezes insatisfatórios. OBJETIVO: Determinar a utilidade de um implante do ouvido médio. Desenho de estudo longitudinal. MÉTODOS: Vibrant-Soundbrigde foi implantado em oito pacientes com perda auditiva mista grave. Quatro apresentavam otite média crônica e quatro apresentavam atresia unilateral. A colocação do estimulador (FMT ou Floating Mass Transducer foi em cinco pacientes na janela redonda, dois no estribo e um na janela oval. RESULTADOS: Ganho funcional foi de 35 dB, 40 dB, 48,7 dB e 50 dB para as frequências de 500, 1000, 2000 e 4000 Hz, respectivamente. CONCLUSÃO: Vibrant-Soundbrigde é uma excelente opção no restabelecimento da audição em perda auditiva mista grave e profunda. Ele fornece um excelente ganho funcional em doenças de difícil tratamento com equipamentos convencionais.Osseous atresia and chronic otitis media are diseases benefit with middle ear implants. Surgery for atresia is technically complicated, has significant number of complications and functional results are often poor. The osseointegrated hearing aids are an alternative. They provide a very good functional gain, but have many problems with the skin and osseointegration. In chronic otitis media, the ossiculoplasty solved partially the hearing problem. Unfortunately in some cases of otitis media and in open cavities fitted with conventional hearing

  1. Detection of respiratory pathogens in pediatric acute otitis media by PCR and comparison of findings in the middle ear and nasopharynx. (United States)

    Yatsyshina, Svetlana; Mayanskiy, Nikolay; Shipulina, Olga; Kulichenko, Tatiana; Alyabieva, Natalia; Katosova, Lyubovj; Lazareva, Anna; Skachkova, Tatyana; Elkina, Maria; Matosova, Svetlana; Shipulin, German


    We conducted a series of polymerase chain reactions (PCRs) in order to detect bacteria (7 species) and viruses (17 species) in middle ear fluid (MEF) and nasopharynx (Nph) of children with acute otitis media (AOM; n=179). Bacterial and viral nucleic acids were detected in MEF of 78.8% and 14.5% patients, respectively. The prevalence was as follows: Streptococcus pneumoniae, 70.4%; Haemophilus influenzae, 17.9%; Staphylococcus aureus, 16.8%; Streptococcus pyogenes, 12.3%; Moraxella catarrhalis, 9.5%; rhinovirus, 9.5%; and adenovirus, 3.4%. The overall rate of PCR-positive specimens for bacterial pathogens was 2.6 times higher, compared to culture results. The rate of PCR-positive results and the distribution of pathogens in the Nph were similar to those in the MEF. Nph PCR results had variable positive predictive values and high negative predictive values in predicting MEF findings. Our results indicate that Nph PCR could be a practical tool for examining respiratory pathogens in children with acute infections.

  2. Pneumococcal neuraminidase A (NanA) promotes biofilm formation and synergizes with influenza A virus in nasal colonization and middle ear infection. (United States)

    Wren, John T; Blevins, Lance K; Pang, Bing; Basu Roy, Ankita; Oliver, Melissa B; Reimche, Jennifer L; Wozniak, Jessie E; Alexander-Miller, Martha A; Swords, W Edward


    Even in the vaccine era, Streptococcus pneumoniae (pneumococcus) remains a leading cause of otitis media, a significant public health burden, in large because of its high prevalence of nasal colonization in children. The primary pneumococcal neuraminidase NanA, which is a sialidase that catalyzes the cleavage of terminal sialic acids from host glycoconjugates, is involved in both of these processes. Coinfection with influenza A virus, which also expresses a neuraminidase, exacerbates nasal colonization and disease by S. pneumoniae, in part via the synergistic contributions of the viral neuraminidase. The specific role of its pneumococcal counterpart NanA in this interaction, however, is less well-understood. We demonstrate in a mouse model that NanA-deficient pneumococci are impaired in both nasal colonization and middle ear infection. Coinfection with neuraminidase-expressing influenza virus potentiates both but not to wild-type levels, suggesting an intrinsic role of NanA. Using in vitro models, we show that while NanA contributes to both epithelial adherence and biofilm viability, its effect on the latter is actually independent of its sialidase activity. These data indicate that NanA contributes both enzymatically and non-enzymatically to pneumococcal pathogenesis and, as such, suggest that it is not a redundant bystander during coinfection with influenza A virus. Rather, that its expression is required for the full synergism between these two pathogens.

  3. 基于CT图像构建听骨链三维有限元模型%The establishment of finite element model of the middle ear based on CT images

    Institute of Scientific and Technical Information of China (English)

    史长征; 吕长生; 李恒国


    Aim :To investigate the mechanical characteristics of the ossicular chain in the middle ear.Methods: The finite element model of the middle ear was established based on CT images of one normal hearing person. For the mechanical analysis, the principal strain, principal stress and displacement changes of ossicular chain of the middle ear at different frequencies were observed. Results: The principal strain, principal stress and the displacement changes in the low and intermediate frequency states were larger than those in the high-frequency state, especially in 200 Hz and 1000 Hz to 2 000 Hz stage,the change were most obvious. The principal stress and principal strain changed simultaneously, the ossicular chain was almost no displacement when the stimulus frequency greater than 2 000 Hz. Conclusion:The finite element model of the middle ear is a non-invasive way to study ossicular sound transmission mechanism, which is conducive to clinical assessment in the middle ear preoperative and postoperative stages.%目的:初步探讨中耳听骨链传声机制的力学特点.方法:采用1例听力正常者CT图像,建立中耳的三维有限元模型,进行中耳力学分析,观察不同频率下中耳主应变、主应力和位移的变化.结果:低频和中频中耳主应变、主应力变化较大,而在高频阶段变化并不明显,其中200 Hz和在1 000~2 000 Hz阶段变化最为明显,中耳主应力与主应变变化趋势相一致.当刺激音高于2 000 Hz时,中耳听骨链没有位移产生.结论:通过中耳有限元模型可以无创性地研究听骨链传声机制,有利于术前及术后对听骨链进行临床评估.

  4. 中耳畸形10例临床特点及治疗%Clinical characteristics and treatment of 10 patients with malformation of middle ear

    Institute of Scientific and Technical Information of China (English)

    王凯; 张建; 俞杰; 沈志森


    目的:分析中耳畸形的临床和听力学特征,手术探查明确中耳畸形具体形式,观察重建听骨链改善听力的效果。方法10例中耳畸形患者均行鼓室探查术。8例同时行听骨链重建(2例放弃),其中5例采用植入部分人工听骨( PORP)的鼓室成形术,2例采用植入全人工听骨( TORP)的鼓室成形术,1例采用镫骨足板开窗+人工镫骨植入术,1例行鼓岬开窗+人工听骨植入。结果术中发现砧骨畸形最多见,共9例,表现为砧骨长脚发育不全、豆状突缺失;其次是镫骨结构畸形并固定1例,镫骨仅存底板但可正常活动2例,镫骨畸形伴面神经畸形2例,另有1例前庭窗及面神经不能辨认。听力重建后患者听力满意,言语频率气导平均提高27.79 dB。结论中耳畸形的明确诊断依靠鼓室探查术,一定条件下植入PORP的手术效果最为理想。(中国眼耳鼻喉科杂志,2015,15:25-27)%Objective To analyze the diagnosis and treatment of malformation of middle ear .Methods Ten patients were involved in the study .Exploratory tympanotomy was undergone in all patients and 8 patients of which accepted the reconstruction of ossicular chain .Partial replacement prosthesis ( PORP) was used in 5 patients, total replacement prosthesis(TORP) was used in 2 patients, fenestration of stapes footplate with stapes prosthesis in 1 patient and fenestration of promontory of tympanum with prosthesis in 1 patient.Results Exploratory tympanotomy showed a variety of abnormalities of the middle ear which were difficult to identify preoperatively , despite of the modern imaging techniques.Hearing thresholds were obtained without severe complication occurrence . Conclusions Exploratory tympanotomy is essential to identify congenital conductive hearing loss and PORP implantation provides the optimal way for reconstruction of ossicular chain .

  5. Monitored anaesthesia care – Comparison of nalbuphine/dexmedetomidine versus nalbuphine/propofol for middle ear surgeries: A double-blind randomised trial

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao Nallam


    Full Text Available Background and Aims: Middle ear surgeries (MESs are usually performed under sedation with local anaesthesia and can be well tolerated by the patient with minimal discomfort. In the present study, we compare the effect of nalbuphine/dexmedetomidine combination with nalbuphine/propofol on sedation and analgesia in monitored anaesthesia care. Methods: One hundred adult patients undergoing MESs under monitored anaesthesia care (MAC were randomly allocated into two groups. All patients in both groups received injection nalbuphine 50 μg/kg intravenously (IV. Group D received a bolus dose of injection dexmedetomidine 1 μg/kg IV over 10 min followed by an infusion started at 0.4 μg/kg/h IV. Group P received a bolus dose of injection propofol 0.75 mg/kg followed by an infusion started at 0.025 mg/kg/min IV. Sedation was titrated to Ramsay Sedation Score (RSS of 3. Patient's mean arterial pressure, heart rate, saturation peripheral pulse and need for intraoperative rescue sedation/analgesia were recorded and compared. The data analysis was carried out with Z test and Chi-square test. Results: Mean RSS was significantly more in Group D (4.24 ± 1.54 as compared to Group P (2.58 ± 0.95. Overall VAS score was also significantly less in Group D (3.5 ± 1.7 than in Group P (5.4 ± 1.8. In total, 16 patients (32% in Group D had hypotension whereas 7 patients (14% only in Group P had hypotension. Conclusion: Nalbuphine/dexmedetomidine combination is superior to nalbuphine/propofol in producing sedation and decreasing VAS in patients undergoing MESs under MAC. Better surgeon and patient satisfaction were observed with nalbuphine/dexmedetomidine. Haemodynamics need to be closely monitored.

  6. The Efficacy of Mirodenafil for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Middle-Aged Males (United States)

    Kong, Do Hoon; Yun, Chang Jin; Park, Nam Cheol


    Purpose The aim of this study was to investigate the efficacy of mirodenafil in middle-aged male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Materials and Methods Eighty-eight males with CP/CPPS were randomized to receive either levofloxacin (500 mg/d) (group L, 40 patients) or levofloxacin (500 mg/d) and mirodenafil (50 mg/d) (group ML, 48 patients) for six weeks. The International Prostate Symptom Score (IPSS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and erectile function (EF) domain scores of the International Index of Erectile Function (IIEF) questionnaire were used to grade symptoms at baseline and 6 weeks after treatment. Results The mean change in total IPSS from baseline was higher in group ML than that in group L (group L, -1.1 vs. group ML, -4.3; p<0.05). Significant improvements were also seen in the IPSS voiding subscore (group L, -0.7 vs. group ML, -3.0; p<0.05). Changes observed in the NIH-CPSI of group ML at six weeks were greater than those at baseline (group L, -3.2 vs. group ML, -7.2; p<0.05). Significant improvements were seen in the NIH-CPSI voiding (group L, -0.5 vs. group ML, -1.7; p<0.05) and quality of life domains (group L, -1.0 vs. group ML, -1.8; p<0.05). Group ML showed a significantly greater increase in the IIEF-EF score than did group ML (group L, +0.2 vs. group ML, +7.8; p<0.05). Conclusions Mirodenafil (50 mg once daily) was well tolerated and resulted in significant symptomatic improvement in middle-aged males with CP/CPPS. PMID:25606563

  7. Detection of bacterial biofilms in different types of chronic otitis media. (United States)

    Gu, Xingzhi; Keyoumu, Youlidusi; Long, Li; Zhang, Hua


    Biofilms are organized bacterial communities that may be homogeneous or heterogeneous. They play a significant role in the pathogenesis of chronic nasal sinusitis, chronic tonsillitis, cholesteatomas, and device-related infections. Despite this, few studies have been done that examine the presence of bacterial biofilms in tissues from patients with different types of COM or middle ear cholesteatomas. In the current study, we examined the presence of biofilms in surgical tissue specimens from humans with chronic ear infections using scanning electron microscopy (SEM). We hypothesize that bacterial biofilms present differently in patients with different types of chronic otitis media. Our results provide new insights regarding treatment of chronic otitis media. A prospective study was conducted in which middle ear tissues were obtained from 38 patients who underwent tympanoplasty and/or tympanomastoid surgery due to chronic ear infections. A total of 50 middle and mastoid tissue samples were processed for SEM analysis. In addition, 38 middle ear secretion specimens were obtained for routine bacterial culture analysis. Bacterial biofilms were present in 85 % (11 of 13) of patients with middle ear cholesteatoma, 92 % (12/13) of patients with chronic otitis suppurative media (CSOM), and 16 % of patients (2/12) with tympanic membrane perforation (TMP). Fungal biofilms were found in two cases of cholesteatoma. The positive coincidence rate between bacterial biofilms visualized by SEM and bacteria detected by culture was 82 %. Our findings suggest that bacterial biofilms are very common in CSOM and middle ear cholesteatomas. Positive bacterial cultures imply the presence of biofilm formation in CSOM and cholesteatomas. As such, our results provide new insights regarding treatment of chronic otitis media.

  8. 38 CFR 4.87 - Schedule of ratings-ear. (United States)


    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Schedule of ratings-ear...—ear. Diseases of the Ear Rating 6200Chronic suppurative otitis media, mastoiditis, or cholesteatoma... of the substance 10 6208Malignant neoplasm of the ear (other than skin only) 100 Note: A rating...

  9. 螺旋CT多平面重建在先天性小耳畸形外耳道及中耳成形术中的应用%Application of spiral CT and multi-plane reconstruction in ear canal and middle ear reconstruction in congenital microtia

    Institute of Scientific and Technical Information of China (English)

    王鸿南; 吴玮; 费军; 韩浩伦; 李保卫; 孙喆结; 薄少军; 孟令照; 丁瑞英


    目的 探讨螺旋CT多平面重建(multi-plane reconstruction,MPR)在对先天性小耳畸形进行外耳道及中耳成形术时的应用价值.方法 回顾分析32耳先天性小耳畸形外耳道闭锁患者(均为Schuknecht分型之C型)的资料.采用螺旋CT行HRCT(High resolution CT,高分辨率CT)容积扫描,获取标准横断位及冠状位图像,并利用扫描原始数据作斜横断位、斜矢状位重建,使重建平面同时包含筛区和听小骨,通过横断位及冠状位CT图像确定面神经走行和听小骨形态,通过MPR确定外耳道成形的角度和深度.术中参照上述检查结果进行手术操作.将上述32耳与另外41耳(也为Schuknecht分型之C型)未行MPR者就以下两点进行比较:(1)寻找中耳的成功率;(2)两组病例中术式相同者(均为Ⅰ期外耳道及中耳成形加耳廓重建)的手术时间.结果 (1)行MPR检查的32耳中,29耳顺利找到中耳(90.6%),由于乳突气化不良、面神经畸形等因素,未能寻找到中耳者3耳(9.4%);而在未行MPR者41耳中,28耳顺利找到中耳(68.3%),未能找到中耳者13耳(31.7%).经卡方检验两组差异具有显著性.(2)采用MPR者平均手术时间为(342.75±41.70) min (n=28),未采用MPR者平均手术时间为(398.48±61.02) min (n=23),经t检验二者差异具有显著性.结论 应用螺旋CT多平面重建技术,可以在一次采取数据后,在任意平面重建真实影像,为外耳道和中耳成术形提供正确的角度和深度参考数据,对提高手术成功率,缩短手术时间具有重要价值.%Objective To investigate the value of spiral CT and multi-plane reconstruction (MPR) in guiding ear canal and middle ear reconstruction for patients with congenital microtia. Methods Patients with Schuknecht type C congenital microtia (32 ears) were examined with spiral CT, using continues volume scanning. Axial and coronal images were acquired to determine the route of facial nerve. Images of inclined axial and

  10. Mitochondrial DNA deletions in patients with chronic suppurative otitis media. (United States)

    Tatar, Arzu; Tasdemir, Sener; Sahin, Ibrahim; Bozoglu, Ceyda; Erdem, Haktan Bagis; Yoruk, Ozgur; Tatar, Abdulgani


    The aim of this study was to investigate the 4977 and 7400 bp deletions of mitochondrial DNA in patients with chronic suppurative otitis media and to indicate the possible association of mitochondrial DNA deletions with chronic suppurative otitis media. Thirty-six patients with chronic suppurative otitis media were randomly selected to assess the mitochondrial DNA deletions. Tympanomastoidectomy was applied for the treatment of chronic suppurative otitis media, and the curettage materials including middle ear tissues were collected. The 4977 and 7400 bp deletion regions and two control regions of mitochondrial DNA were assessed by using the four pair primers. DNA was extracted from middle ear tissues and peripheral blood samples of the patients, and then polymerase chain reactions (PCRs) were performed. PCR products were separated in 2 % agarose gel. Seventeen of 36 patients had the heterozygote 4977 bp deletion in the middle ear tissue but not in peripheral blood. There wasn't any patient who had the 7400 bp deletion in mtDNA of their middle ear tissue or peripheral blood tissue. The patients with the 4977 bp deletion had a longer duration of chronic suppurative otitis media and a higher level of hearing loss than the others (p media and the reactive oxygen species can cause the mitochondrial DNA deletions and this may be a predisposing factor to sensorineural hearing loss in chronic suppurative otitis media. An antioxidant drug as a scavenger agent may be used in long-term chronic suppurative otitis media.

  11. Comparison of the cuff pressure of a TaperGuard endotracheal tube and a cylindrical endotracheal tube after lateral rotation of head during middle ear surgery (United States)

    Choi, Eunkyung; Park, Yongmin; Jeon, Younghoon


    Abstract Background: Positional change affects the cuff pressure of an endotracheal tube (ETT) in treacheally intubated patients. We compared the cuff pressure of a TaperGuard ETT and a cylindrical ETT after lateral rotation of head during middle ear surgery. Methods: Fifty-two patients aged 18–70 years underwent a tympanomastoidectomy under general anesthesia were randomly allocated to receive endotracheal intubation with cylindrical (group C, n = 26) or TaperGuard ETTs (group T, n = 26). After endotracheal intubation, the ETT cuff pressure was set at 22 cmH2O in the neutral position of head. After lateral rotation of head, the cuff pressure was measured again and readjusted to 22 cmH2O. In addition, the change of distance from the carina to the tip of the ETT was measured before and after the positional change. The incidence of cough, sore throat, and hoarseness was assessed at 30 minutes, 6 hours, and 24 hours after surgery. Results: There was no difference in demographic data between groups. After lateral rotation of head, the cuff pressure significantly increased in group T (11.9 ± 2.3 cmH2O) compared with group C (6.0 ± 1.9 cmH2O) (P 30 cmH2O was higher in group T (96.2%) than in group C (30.8%) (P < 0.001). In addition, the degree of displacement of an ETT was greater in group T (11.0 ± 1.7 mm) than in group C (7.2 ± 2.6 mm) (P < 0.001). The overall incidences of postoperative sore throat, hoarseness, and cough at 30 minutes, 6 hours, and 24 hours after surgery were comparable between two groups. Conclusion: The cuff pressure was higher in the TaperGuard ETT than in the cylindrical ETT after positional change of head from neutral to lateral rotation. In addition, after a positional change, the extent of displacement of ETT was greater in the TaperGuard ETT than in the cylindrical ETT. PMID:28272230

  12. Comparison of Serotype Prevalence of Pneumococci Isolated from Middle Ear, Lower Respiratory Tract and Invasive Disease Prior to Vaccination in Iceland (United States)

    Haraldsson, Gunnsteinn; Erlendsdóttir, Helga; Haraldsson, Ásgeir; Kristinsson, Karl G.


    Background Information on pneumococcal serotype distribution before vaccination is a prerequisite for evaluation of vaccine effect. The aim was to investigate the prevalence of pneumococcal serotypes isolated from middle ear (ME), lower respiratory tract (LRT) and from invasive disease (IPD) in Iceland prior to implementation of ten-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV-10) into the infant vaccination program (April 2011). Methods and findings All isolates cultured 2007–2011 from ME, LRT and IPD identified as pneumococci were serotyped and tested for susceptibility at the Clinical Microbiology Department, Landspitali University Hospital that serves approximately 85% of the Icelandic population. Pneumococcal isolates were 1711 and 1616 (94.4%) were available for serotyping and included. Isolates belonging to PHiD-CV10 serotypes (VTs) were 1052 (65.1%). Isolates from ME were 879 (54.4%), with 639 (72.7%) from 0–1 year old patients and 651 of VTs (74%). Isolates from LRT were 564 (34.9%), with 292 (51.8%) from ≥65 years old patients, and 300 (53.2%) of VTs. IPD isolates were 173 (10.7%), although more evenly distributed according to age than isolates from the other sites most were from adults and the youngest age group,101 (58.4%) isolates were of VTs. The most common serotype was 19F, 583 (36.1%). Its prevalence was highest in ME, 400 (45.5%), 172 (30.5%) in LRT and 11 isolates (6.4%), in IPD. Penicillin non-susceptible isolates were 651 (40.3%), mainly belonging to VTs, 611 (93.9%), including 535 (82.2%) of 19F. Conclusions Multiresistant isolates of serotype 19F were highly prevalent, especially from ME of young children but also from LRT of adults. Serotype 14 was the most common serotype in IPD. The rate of VTs was high and almost all PNSP were of VTs. There was great difference in vaccine coverage between sampling sites, also reflecting difference in vaccine coverage by age groups. PMID:28125588

  13. Management of Chronic Hyperplastic Pulpitis in Mandibular Molars of Middle Aged Adults- A Multidisciplinary Approach (United States)

    Lingeswaran, Somiya; Ari, Geetha; Thyagarajan, Ramakrishnan; Logaranjani, Anitha


    The molar tooth of children and young adults is a common site for chronic hyperplastic pulpitis (pulp polyp). It rarely occurs in middle aged adults. This condition is usually characterized by extensive involvement of the pulp, dictating the extraction of involved tooth. Extraction of permanent molars can lead to transient or permanent malocclusion, aesthetic, phonetic and functional problems. Here we report a case of pulp polyp in mandibular first molar of a 33-year-old woman that grew into the carious cavity. The aim of this case report is to describe the diagnosis of a chronic hyperplastic pulpitis involving the permanent molar as well as to describe its management in order to preserve them as a functional unit of the dentition. PMID:26894192

  14. High detection rates of nucleic acids of a wide range of respiratory viruses in the nasopharynx and the middle ear of children with a history of recurrent acute otitis media. (United States)

    Wiertsema, Selma P; Chidlow, Glenys R; Kirkham, Lea-Ann S; Corscadden, Karli J; Mowe, Eva N; Vijayasekaran, Shyan; Coates, Harvey L; Harnett, Gerald B; Richmond, Peter C


    Both bacteria and viruses play a role in the development of acute otitis media, however, the importance of specific viruses is unclear. In this study molecular methods were used to determine the presence of nucleic acids of human rhinoviruses (HRV; types A, B, and C), respiratory syncytial viruses (RSV; types A and B), bocavirus (HBoV), adenovirus, enterovirus, coronaviruses (229E, HKU1, NL63, and OC43), influenza viruses (types A, B, and C), parainfluenza viruses (types 1, 2, 3, 4A, and 4B), human metapneumovirus, and polyomaviruses (KI and WU) in the nasopharynx of children between 6 and 36 months of age either with (n = 180) or without (n = 66) a history of recurrent acute otitis media and in 238 middle ear effusion samples collected from 143 children with recurrent acute otitis media. The co-detection of these viruses with Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis was analyzed. HRV (58.3% vs. 42.4%), HBoV (52.2% vs. 19.7%), polyomaviruses (36.1% vs. 15.2%), parainfluenza viruses (29.4% vs. 9.1%), adenovirus (25.0% vs. 6.1%), and RSV (27.8% vs. 9.1%) were detected significantly more often in the nasopharynx of children with a history of recurrent acute otitis media compared to healthy children. HRV was predominant in the middle ear and detected in middle ear effusion of 46% of children. Since respiratory viruses were detected frequently in the nasopharynx of both children with and without a history of recurrent acute otitis media, the etiological role of specific viruses in recurrent acute otitis media remains uncertain, however, anti-viral therapies may be beneficial in future treatment and prevention strategies for acute otitis media.

  15. Numerical analysis of ossicular chain lesion of human ear

    Institute of Scientific and Technical Information of China (English)

    Yingxi Liu; Sheng Li; Xiuzhen Sun


    Lesion of ossicular chain is a common ear disease impairing the sense of hearing. A comprehensive numerical model of human ear can provide better understanding of sound transmission. In this study, we propose a three-dimensional finite element model of human ear that incorporates the canal, tympanic membrane, ossicular bones,middle ear suspensory ligaments/muscles, middle ear cavity and inner ear fluid. Numerical analysis is conducted and employed to predict the effects of middle ear cavity, malleus handle defect, hypoplasia of the long process of incus,and stapedial crus defect on sound transmission. The present finite element model is shown to be reasonable in predicting the ossicular mechanics of human ear.

  16. Stent-assisted mechanical recanalization for symptomatic subacute or chronic middle cerebral artery occlusion (United States)

    Guo, Dong; Ma, Ji; Li, Teng-Fei; Zhu, Ming; Han, Xin-Wei; Shui, Shao-Feng


    To assess the feasibility and short-term effects of treating patients with subacute or chronic middle cerebral artery (M1) occlusion by stent-assisted mechanical recanalization. Six patients with cerebral arteries occlusion underwent surgery. Six cerebral arteries occlusion in 5 patients were successfully recanalized. On postoperative day 1, four patients’ symptoms were relieved and two patients’ symptoms were exacerbated, of which one was significantly improved after 3 days, the other one’s symptoms were recovered to preoperative levels in 2 weeks. No patients died after surgery. No stroke or transient ischemic attack occurred. The average follow-up of was 4.2 months, no worsening of condition, recurrence or death occurred. The results indicate that for patients with subacute or chronic middle cerebral artery (M1) occlusion, mechanical recanalization was technically feasible under the premise of strict case screening. Mechanical recanalization is able to improve ischemic symptoms and promote dysfunction restoration. But its long-term effect remains to be evaluated by further large samples, long-term follow-up studies. PMID:26885148

  17. Inflammation in the middle ear of children with recurrent or chronic otitis media is associated with bacterial load

    NARCIS (Netherlands)

    Stol, K.; Diavatopoulos, D.A.; Graamans, K.; Engel, J.A.; Melchers, W.J.G.; Savelkoul, H.F.J.; Hays, J.P.; Warris, A.; Hermans, P.W.M.


    Background: Viral upper respiratory tract infections have been described as an important factor in the development of otitis media (OM), although it is unclear whether they facilitate bacterial OM or can directly cause OM. To clarify the role of viral infections in OM, we compared the relative contr

  18. Development and Integration of the Ear. (United States)

    Fuchs, Jennifer C; Tucker, Abigail S


    The perception of our environment via sensory organs plays a crucial role in survival and evolution. Hearing, one of our most developed senses, depends on the proper function of the auditory system and plays a key role in social communication, integration, and learning ability. The ear is a composite structure, comprised of the external, middle, and inner ear. During development, the ear is formed from the integration of a number of tissues of different embryonic origin, which initiate in distinct areas of the embryo at different time points. Functional connections between the components of the hearing apparatus have to be established and maintained during development and adulthood to allow proper sound submission from the outer to the middle and inner ear. This highly organized and intimate connectivity depends on intricate spatiotemporal signaling between the various tissues that give rise to the structures of the ear. Any alterations in this chain of events can lead to the loss of integration, which can subsequently lead to conductive hearing loss, in case of outer and middle ear defects or sensorineural hearing loss, if inner ear structures are defective. This chapter aims to review the current knowledge concerning the development of the three ear compartments as well as mechanisms and signaling pathways that have been implicated in the coordination and integration process of the ear.

  19. The visible ear simulator

    DEFF Research Database (Denmark)

    Sorensen, Mads Solvsten; Mosegaard, Jesper; Mikkelsen, Peter Trier


    BACKGROUND: Existing virtual simulators for middle ear surgery are based on 3-dimensional (3D) models from computed tomographic or magnetic resonance imaging data in which image quality is limited by the lack of detail (maximum, approximately 50 voxels/mm3), natural color, and texture of the source...... material.Virtual training often requires the purchase of a program, a customized computer, and expensive peripherals dedicated exclusively to this purpose. MATERIALS AND METHODS: The Visible Ear freeware library of digital images from a fresh-frozen human temporal bone was segmented, and real-time volume...... is published for download (approximately 120 MB) as freeware at increasing personal computer performance, future versions may include enhanced resolution (up to 8,000 voxels/mm3) and realistic interaction with deformable soft tissue components such as skin, tympanic...

  20. Cosmetic ear surgery (United States)

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under ...

  1. Travel Inside the Ear

    Medline Plus

    Full Text Available ... Info » Hearing, Ear Infections, and Deafness Travel Inside the Ear Video When sound waves reach your ear, ... heard a soft sound or a loud sound. The sound passes through the outer ear and is ...

  2. TNF-R2 expression in acquired middle ear cholesteatoma Expressão do TNF-R2 no colesteatoma adquirido da orelha média

    Directory of Open Access Journals (Sweden)

    Rodrigo Faller Vitale


    Full Text Available Acquired middle ear cholesteatoma is a disease which promotes bone erosion resulting in potentially serious complications. The tumor necrosis factor alpha (TNF-α is present in cholesteatoma and it is related to bone erosion, as shown by different authors. To understand the aggressiveness characteristics of cholesteatoma is necessary, however, to better address the presence and distribution of their receptors. OBJECTIVE: To evaluate the expression of type 2 TNF-α receptor (TNF-R2 in fragments of cholesteatoma and correlate it to the degree of inflammation present. MATERIAL AND METHODS: observational cross-sectional study, which analyzed 33 fragments of cholesteatomas through histological analysis and immunohistochemistry (using as primary antibody to TNF-R2 LabVision® brand. The evaluation was performed by means of a qualitative and semi-quantitative agreement with the observed intensity. For statistical analysis we used the Fisher exact test and Spearman´s correlation coefficient (considered statistically significant when p O colesteatoma adquirido da orelha média promove erosão óssea, ocasionando complicações potencialmente graves. O fator de necrose tumoral alfa (TNF-α está presente no colesteatoma adquirido da orelha média e relaciona-se com a erosão óssea, como demonstraram diferentes autores. Para que se compreenda as características de agressividade do colesteatoma, é necessário que se estude a presença e a distribuição seus receptores. OBJETIVO: Avaliar a expressão do receptor tipo dois do TNF-α (TNF-R2 em fragmentos de colesteatoma e relacioná-lo com o grau de inflamação. MATERIAL E MÉTODOS: Estudo observacional do tipo transversal. Foram analisados 33 fragmentos de colesteatomas, submetidos à análise histológica e imunoistoquímica (utilizando o TNF-R2 da marca Labvision®. A avaliação foi realizada de forma qualitativa e semiquantitativa, de acordo com a intensidade observada. Para a análise estat

  3. A Randomized, Controlled Trial of Cognitive Behavioral Social Skills Training for Middle-Aged and Older Outpatients With Chronic Schizophrenia



    The number of older patients with chronic schizophrenia is increasing. There is a need for empirically validated psychotherapy interventions for these older patients. A randomized controlled trial compared treatment as usual (TAU) with TAU plus cognitive-behavioral social skills training (TAU+CBSST) in 76 middle-aged and older patients with chronic schizophrenia. CBSST teaches cognitive-behavioral coping techniques, social functioning skills, problem solving and compensatory aids for neurocog...

  4. Clinical Congenital Middle Ear Malformation and Its Relationship with Hearing Loss%先天性中耳畸形的临床分型及其与耳聋的相关性研究

    Institute of Scientific and Technical Information of China (English)



    目的:探讨先天性中耳畸形的临床分型及其与耳聋的相关性。方法将我院入院治疗的42例(62耳)先天性中耳畸形患者纳入本研究,对本组患者均进行详细的手术检查,分析患者中耳畸形状态。结果经过记性检查,可能有听骨链畸形表现,还有面神经骨管暴露与面神经异常的表现。本组听力学检查结果显示本组患者主要为锤砧骨畸形(31例),11例未蜗窗畸形与前庭窗畸形,11例患者畸形程度相对复杂,伴随走形异常与面神经结构异常。结论先天性中耳畸形根据其组织的来源,可以分为不同的类型,在临床研究中需要分析高频与听阈问题,结合CT检查结果与骨导变化结果进行分析,这能够为合理手术提供合理的临床依据,提升治疗的安全性。%Objective To investigate the correlation between the clinical classification of congenital malformation of the middle ear and hearing loss.Methods In our hospital, 42 cases of hospitalized patients (62 ears) were included in the study of patients with congenital malformation of the middle ear, for this group of patients were examined with the operation, analysis of patients with middle ear malformation state.Results after a check, there may be the ossicular chain deformity, and facial nerve canal and facial nerve exposed to abnormal performance. Results Showed that the group of audiological examination were mainly for the hammer incus deformity (31 cases), 11 cases without cochlear window deformity and vestibular window deformity, 11 cases of patients with deformity complicated with abnormal shape, facial nerve and abnormal structure.Conclusion Congenital middle ear malformation according to the source of its organization, can be divided into different types, in clinical research needs analysis of high frequency and threshold problem, combined with the results of CT and bone changes were analyzed, which can provide the basis for

  5. Effect of tympanostomy tube insertion on middle ear function in children with secretory otitis media%鼓室置管对儿童分泌性中耳炎中耳功能影响的研究

    Institute of Scientific and Technical Information of China (English)

    毛承刚; 万俐佳; 周小淳; 吴燕; 鲁海涛


    目的 探讨鼓室置管治疗儿童分泌性中耳炎对中耳功能的影响.方法 选取47例(58耳)临床诊断为分泌性中耳炎的患儿,分别在鼓室置管术前及术后1个月、6个月进行纯音测听、声导抗、畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)检查和耳镜检查,以评估鼓室置管手术前后中耳功能的变化及术后的并发症.结果 鼓室置管术后1个月、6个月分别行耳镜和声导抗检查,均较术前听力明显提高.术后6个月与术后1个月检查结果比较,听力改变差异无统计学意义.与鼓室置管术前比较,DPOAE引出率及部分频率幅值提高,差异具有统计学意义.鼓室置管术后的并发症主要是中耳感染、分泌性中耳炎复发、鼓膜穿孔和鼓膜内陷.结论 鼓室置管治疗儿童分泌性中耳炎,应用检测纯音测听、声导抗、DPOAE和耳镜检查,了解鼓室置管术后的并发症情况,综合评价对中耳功能的影响,具有临床指导意义.%Objective To investigate the effect of tympanostomy tube insertion on the middle ear function in children with secretory otitis media ( SOM). Methods Pure tone audiometry, acoustic impedance , distortion product otoacoustic emission ( DPOAE) examination and otoscopy were carried out in 47 children (58 ears) with SOM before tube insertion, one month and 6 months after tube insertion respectively to evaluate the changes of middle ear function and surgical complications. Results One month and 6 months after tube insertion, hearing of children with catheter patency was significantly improved. In addition, the detection rate and amplitude of DPOAE were significantly increased. The difference of hearing 1 month and 6 months after tube insertion was statistically insignificant. Surgical and postoperative complications included middle ear infection, recurrent SOM, tympanic perforation and tympanic membrane retraction. Conclusion Pure tone audiometry, acoustic impedance

  6. Optimal design of a floating mass type piezoelectric actuator for implantable middle ear hearing devices%人工中耳悬浮式压电振子的优化设计

    Institute of Scientific and Technical Information of China (English)

    田佳彬; 饶柱石; 塔娜; 许立富


    To optimize the implant performance of a floating mass type piezoelectric actuator for implantable hearing devices,a displacement amplifier was designed to improve the output characteristics of the actuator.A finite element model of human ear consisting of the external ear canal,middle ear and simplified cochlea was constructed via micro-computer tomography imaging and the technique of reverse engineering.The validity of the model was verified by comparing the model-derived results with experimental data from reference.Then an ear-actuator coupled mechanical model was developed,and the multi-field coupling was considered to study the implant performance of the actuator before and after the displacement amplifier was added.The results showed that the adoption of displacement amplifier can increase the equivalent sound pressure level of the actuator in the middle and high frequency ranges,and the power consumption can effectively be reduced at the same time.%为了优化人工中耳悬浮式压电振子的植入效果,设计了一种位移放大结构用于改善振子的输出特性。首先采用微 CT 扫描和逆向成型技术建立了包括外耳道、中耳和简化耳蜗的人耳有限元模型,通过与文献的实验数据比对验证模型的有效性。然后建立人耳与悬浮振子的耦合力学模型,通过有限元的耦合场分析研究加入位移放大结构前后的人工中耳植入效果。研究结果表明,采用位移放大结构后,振子于中高频段的等效声压级得到明显提升,可以有效降低压电振子的功耗。

  7. Benign ear cyst or tumor (United States)

    Osteomas; Exostoses; Tumor - ear; Cysts - ear; Ear cysts; Ear tumors; Bony tumor of the ear canal ... bony tumors of the ear canal (exostoses and osteomas) are caused by excess growth of bone. Repeated ...

  8. Expression and the Significance of MCP-1 and FN in Middle Ear Cholesteatoma Epithelium%M CP -1和 FN 在中耳胆脂瘤上皮中的表达和意义

    Institute of Scientific and Technical Information of China (English)

    高燕; 杨一兵; 丛林海; 汤勇; 张帆


    目的探讨单核细胞趋化因子(monocyte chemotactic factor ,MCP -1)和纤维连接蛋白(fibronectin , FN)在继发性中耳胆脂瘤上皮中的表达及其对胆脂瘤上皮侵袭能力的影响。方法应用免疫组织化学MaxVi-sionTM法检测MCP-1和FN在30例中耳胆脂瘤上皮、20例胆脂瘤患者耳后正常皮肤、16例非胆脂瘤患者耳后正常皮肤中的表达,应用计算机图像分析系统对其阳性表达灰度值情况及分析,比较三组之间 MCP -1和 FN表达的差异。结果 MCP-1阳性细胞表达主要分布于胆脂瘤上皮全层,其中棘层呈高表达,MCP-1在中耳胆脂瘤上皮中阳性表达率为70%,灰度值为147.2±20.1,强于胆脂瘤患者耳后正常皮肤中的阳性表达(35%,200.8±18.4)和非胆脂瘤患者耳后正常皮肤中的阳性表达(37.5%,193.3±15.5)( P<0.05)。FN阳性细胞主要分布于胆脂瘤上皮全层,基底层、棘层和基质呈高表达,FN在中耳胆脂瘤上皮中阳性表达率为76.7%,灰度值为139.2±18.5,强于胆脂瘤患者耳后正常皮肤中的阳性表达(30%,195.0±12.9)和非胆脂瘤患者耳后正常皮肤中的阳性表达(31.3%,191.6±13.5)(P<0.05)。在30例中耳胆脂瘤上皮组织中,MCP-1和FN的灰度值与胆脂瘤的侵袭能力负相关(rmcp-1=-0.682,rfn =-0.531,P<0.01),MCP-1和FN蛋白的表达不存在线性相关。结论 MCP-1和FN均在成人中耳胆脂瘤中高表达,且与中耳胆脂瘤的侵袭能力呈负相关。%Objective To study the expression of monocyte chemotactic factor -1(MCP-1) and fibronectin (FN ) in secondary acquired middle ear cholesteatoma epithelium ,and to investigate the ability of cholesteatoma of e-rosion .Methods MaxVisionTM immunohistochemical method was used to detect the expression of MCP -1 and FN in the secondary acquired middle ear cholesteatoma tissues from 30 patients

  9. Embolization of the Middle Meningeal Artery Effectively Treats Refractory Chronic Subdural Hematoma: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Gobran Alfotih


    Full Text Available Chronic subdural hematoma (CSDH formation mechanism is very complex, and has not entirely understood. It represents a frequent type of intracranial hemorrhage, and is very common disease in Neurosurgery practice, especially in older patients. Various surgical treatments have been proposed for the treatment of CSDH. The rate of recurrence in CSDH after surgery ranges from 5% to 30%, repeated surgery must be considered. But in some cases subdural collections are still persistent. Endovascular embolization of the middle meningeal artery (MMA is an option for treatment of refractory CSDH. We review all cases that were treated with embolization to assess the effect of this intervention. Our review revealed 6 papers with a total enrollment of 14 patients were treated with MMA embolization for refractory chronic subdural hematoma without any postoperative complication or recurrence. In this study we suggest MMA embolization as an alternative for treatment of non-curable CSDH, especially for old people with systematic diseases, who cannot tolerate repeat surgery.

  10. Fatal Lemierre’s syndrome as a complication of chronic otitis media with cholesteatoma

    Directory of Open Access Journals (Sweden)

    Tashneem Harris


    Full Text Available Background. Lemierre’s syndrome is septic thrombophlebitis of the internal jugular vein, initiated by an infection of the head and neck region. This septic thrombophlebitis gives rise to septic microemboli that can disseminate throughout the body to form septic infarctions and abscesses, with the most frequent site being pulmonary. Methods. We discuss the case of a 14-year-old male with Lemierre’s syndrome as a complication of chronic middle ear infection. Results. The patient developed septic shock and microemboli, and subsequently died. Conclusion. This case report illustrates that untreated chronic middle ear infection can lead to potentially fatal complications such as Lemierre’s syndrome, and emphasises the importance of timeous treatment of chronic middle ear pathology.

  11. Cochlear aqueduct flow resistance is not constant during evoked inner ear pressure change in the guinea pig

    NARCIS (Netherlands)

    Wit, HP; Feijen, RA; Albers, FWJ


    Inner ear fluid pressure was measured during 6.25 mHz square wave middle ear pressure manipulation, with a perforated tympanic membrane. After a negative-going middle ear pressure change the calculated flow resistance of the inner ear pressure release routes (mainly the cochlear aqueduct) was approx

  12. Prevalence of menopause, chronic illnesses and life style of middle aged women in Karachi, Pakistan

    Directory of Open Access Journals (Sweden)

    Sarah Saleem


    Full Text Available : Objectives: To determine the prevalence of menopause, chronic illnesses and lifestyle of middle aged women in Karachi, Pakistan. Design: A Cross Sectional survey was conducted among women of 40-60 years living in socio-economically different areas of Karachi. Information was gathered on their current menstrual status, age at menopause, body mass index, exercise habits, weekly recall of food consumed and chronic illnesses. These variables were also examined according to the socio economic status of the area where women reside. Results: A total of 1764 women in age group 40-60 years were interviewed. The prevalence of menopausal women in this age group was 39.3 percent (%. The mean age at menopause was 45.2 (±3.8 years. Only seven percent of women were doing some kind of exercise and approximately eighty percent had their Body Mass Index ≥ 23 kg/m2 according to Asian Standard. Approximately 31 percent (% of women reported eating any type of meat at least four times a week, of these most were from higher income area. Majority consumed meat less than three times a week. Similar pattern was observed for consumption of fruits and milk. Approximately 36 percent (% of women reported diabetes mellitus, hypertension, cardio vascular heart disease and arthritis. Conclusion: The sedentary life style, obesity and chronic illnesses are highly prevalent and are serious emerging public health problem for 40-60 years old women of Karachi. We recommend that awareness about balanced diet, exercise and healthy eating habits should be inculcated in women early in life, where possible through schools and media. Health policies and public health messages should be formulated according to the various stages of life cycle of women, so that women can prepare themselves for the next stage of life.

  13. 大鼠中耳上皮细胞形态学变化与杀菌-通透性增强蛋白的关系%Relation between the morphologic change of rat middle ear epithelium and bactericidal/permeability-increasing protein

    Institute of Scientific and Technical Information of China (English)

    祝威; 汪欣; 崔香艳; 杜宝东


    BACKGROUND: The recovery of middle ear morphology is an important index of improvement of chronic secretory otitis media. Looking for effective medicine to neutralize lipopolysaccharide and relieving the virulence of lipopolysaccharide to middle ear mucosa have drawn more attention.OBJECTIVE: To study the effect that bactericidal/permeability-increasing protein(BPI) neutralizing lipopolysaccharide to inhibit morphologic changes of the middle ear epithelium due to lipopolysaccharide.DESIGN: A nonrandomized controlled experimental study.SETTING and PARTICIPANTS: The setting is in Jilin University. Participants were 10 purebred Wistar rats in clean grade, weighing 200 -250 g, purchased from Center for Experimental Animals, Jilin University, and feeding condition was at 20 - 25℃, humidity of 60% - 70%.INTERVENTIONS: The middle ear epithelial cells were obtained from 10Wistar rats and distributed into 24-well tissue culture plate coated with poly-lysine. These epithelial cells were cultured for 7 days, and then divided into 3 groups: Untreated group was cultured without lipopolysaccharide and BPI in the culture medium; Lipopolysaccharide group was cultured with 1 μg/L lipopolysaccharide in the culture medium; BPI group was cultured with 1 μg/L lipopolysaccharide for 7 days, and then with added 1 mg/L BPI in the culture medium.MAIN OUTCOME MEASURES: The morphologic changes of the middle ear epithelial cells were observed under light microscope after 4 weeks.RESULTS: Compared to untreated group, lipopolysaccharide group showed that many cells became greater and swollen, and the number of them was increasing, the phenomena of cell breakage were observed in few areas 1week later. At 2 weeks, cells became much greater and swollen, and the number of broken and dead cells was obviously increased. Moreover, an increase in secretory cells and a decrease in ciliated cells were observed. After 4 weeks, the broken and dead cells distinctly were increased. However, at 2weeks of

  14. Coping with chronic pain among younger, middle-aged, and older adults living with neurological injury and disease. (United States)

    Molton, Ivan; Jensen, Mark P; Ehde, Dawn M; Carter, Gregory T; Kraft, George; Cardemas, Diana D


    Objective. This article compares use of pain coping strategies among older, middle-aged, and younger adults living with chronic pain and seeks to determine whether the relationship between pain severity and coping is moderated by age. Method. Participants were 464 adults reporting chronic pain secondary to multiple sclerosis, spinal cord injury, or neuromuscular disease. Participants completed a survey including measures of pain severity and the Chronic Pain Coping Inventory. Results. After controlling for clinical and demographic variables, older adults (older than 60) reported a wider range of frequently used strategies and significantly more frequent engagement in activity pacing, seeking social support, and use of coping self-statements than did younger or middle-aged adults. Moderation analyses suggest that, for younger adults, efforts at coping generally increased with greater pain severity, whereas this relationship did not exist for older adults. Discussion. These data suggest differences in the quantity and quality of pain coping among age groups.

  15. Application of autologous cartilage and Tos modified combined approach tympanoplasty in middle ear surgery%自体软骨和Tos改良联合进路鼓室成形术在中耳手术中的应用

    Institute of Scientific and Technical Information of China (English)

    张志钢; 陈穗俊; 郑亿庆; 杨海弟; 陈斌; 郭焕萍; 陈洽鑫


    Objective To explore the clinical application of autologous cartilage and Tos modified combined approach tympanoplaty in middle ear surgery. Methods Twenty-three patients with chronic otitis media with cholesteatoma received tympanoplasty with Tos modified combined approach. The lateral walls of epitympanum and posterior tympanum were removed and reconstructed with tragal cartilages. Type Ⅲ ossicular reconstruction was performed either with partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP), depending on the stapes situation. All the patients were followed up for 3-5 years. Results Four to six weeks after surgery, all the 23 patients experienced dry ear and wellhealed tympanic membranes with normal appearance. Depression of lateral walls of epitympanum and posterior tympanum after cartilage reconstruction was not seen in any case. One year after surgery, pure tone audiometry one showed that speech frequency (500, 1000, 2000, 3000, 4000 Hz), air conduction hearing threshold increased by at least 30 dB in 8 patients (34.78%), by 20-29 dB in 9 (39.13%), 10-19 dB in 4 (17.39%) and no improvement in 2 (8.69%). According to the first 3 years of follow-up, patients were with stable audition, and no cholesteatoma relapsed during follow-up of 5 years. Conclusions The tympanoplasty with Tos modified combined approach can be a good solution for surgical treatment of chronic otitis media with cholesteatoma since it can not only remove the lesions completely, but also keep the posterior wall of external tympanic meatus intact, with a satisfying postoperative hearing level obtained. The cartilage reconstruction of the lateral walls of epitympanum and posterior tympanum removed during surgery is effective to prevent depression of new tympanic membrane and formation of secondary cholesteatoma.%目的 探讨自体软骨和Tos改良联合进路鼓室成形术在中耳手术中的临床应用.方法 对23例胆脂瘤型中耳炎用Tos

  16. Travel Inside the Ear (United States)

    ... Home » Health Info » Hearing, Ear Infections, and Deafness Travel Inside the Ear Video When sound waves reach ... are smaller than an orange seed. It then travels into the inner ear, which is filled with ...

  17. Monitoring inner ear pressure changes in normal guinea pigs induced by the Meniett (R) 20

    NARCIS (Netherlands)

    Feijen, RA; Segenhout, JM; Wit, HP; Albers, FWJ


    The inner ear fluid pressure of guinea pigs was measured during a series of complex escalating middle ear pressure changes induced by the Meniett(R)20 (Pascal Medical, Sweden), a possible therapeutic pressure generator to be used by patients with Meniere's disease. Middle ear pressure changes were t

  18. Multi-frequency tympanometry as a diagnostic test of middle ear function in infants%0-12月龄婴幼儿不同频率声导抗测试研究

    Institute of Scientific and Technical Information of China (English)

    孙婧; 赵正言; 付勇; 吴磊


    Objective To report tympanometry results at 226, 678 and 1000 Hz in infants aged from 0 month to 12 months, and to evaluate the value of multiple frequency tympanometry in diagnosing middle ear function in infants. Methods A sample of 200 infants with normal hearing were divided into four groups by age:i.e. Groups 1 (0– 28 days), 2 (1–3 months, ± 3 days), 3 (4–6 months, ± 7 days) and 4 (7–12 months, ±7 days) (n=50 in each group). Tympanograms from different age groups including their frequency characteristics were obtained using a GSI TympStar 2 Middle-Ear analyzer. Results 1) At 226 Hz, tympanom-etry equivalent ear canal volume (Ecv) increased with age, while tympanometric peak pressure (TPP) and peak compensated static acoustic admittance (Ymt) decreased. 2) TPP and Ymt at 678 and 1000 Hz increased with age, although the lowest TPP and Ymt was seen in infants in Group 2. Within each age group, TPP and Ymt at 1000 Hz were greater than those at 678 Hz. Probe tone frequency and age showed a remarkable im-pact on TPP and Ymt. 4) The middle ear resonance frequency was 284 ± 48 Hz for Group1, 293 ± 51 Hz for Group 2, 450±152 Hz for Group 3 and 650±205 Hz for Group 4. Conclusion In evaluating middle ear func-tion in infants younger than 6 months, the 1000 Hz probe tone should be used, while the 678 Hz tone can be a supplementary option in cases when 1000 Hz tympanograms indicate an occlusion effect. For infants between 7 and 12 months, the 226 Hz tone should be used for tympanogram, while the 1000 Hz tone should be used for impedance tests. Probe tones of different frequencies and different reference values should be used for different ages for accurate evaluation of middle ear functions.%目的:分析0~12月龄听力正常婴幼儿226Hz、678Hz和1000Hz探测音声导抗测试的结果,探讨不同频率探测音声导抗鼓室图在评价该年龄段婴幼儿中耳功能中的作用。方法200例0~12月听力正常婴幼儿分成4组,每组50

  19. Evidence on access to medicines for chronic diseases from household surveys in five low- and middle-income countries. (United States)

    Vialle-Valentin, Catherine E; Serumaga, Brian; Wagner, Anita K; Ross-Degnan, Dennis


    The 2011 United Nations (UN) General Assembly Political Declaration on Prevention and Control of Non-Communicable Diseases (NCDs) brought NCDs to the global health agenda. Essential medicines are central to treating chronic diseases such as hypertension and diabetes. Our study aimed to quantify access to essential medicines for people with chronic conditions in five low- and middle-income countries and to evaluate how household socioeconomic status and perceptions about medicines availability and affordability influence access. We analysed data for 1867 individuals with chronic diseases from national surveys (Ghana, Jordan, Kenya, Philippines and Uganda) conducted in 2007-10 using a standard World Health Organization (WHO) methodology to measure medicines access and use. We defined individuals as having access to medicines if they reported regularly taking medicine for a diagnosed chronic disease and data collectors found a medicine indicated for that disease in their homes. We used logistic regression models accounting for the clustered survey design to investigate determinants of keeping medicines at home and predictors of access to medicines for chronic diseases. Less than half of individuals previously diagnosed with a chronic disease had access to medicines for their condition in every country, from 16% in Uganda to 49% in Jordan. Other than reporting a chronic disease, higher household socioeconomic level was the most significant predictor of having any medicines available at home. The likelihood of having access to medicines for chronic diseases was higher for those with medicines insurance coverage [highest adjusted odds ratio (OR) 3.12 (95% confidence intervals (CI): 1.38, 7.07)] and lower for those with past history of borrowing money to pay for medicines [lowest adjusted OR 0.56 (95% CI: 0.34, 0.92)]. Our study documents poor access to essential medicines for chronic conditions in five resource-constrained settings. It highlights the importance of

  20. 中耳细菌感染诱导的急性期HSP-70相关反应的免疫组织化学研究%Immunocytochemical research of HSP-70 correlative response in acute stage induced by bacterial infected middle ear

    Institute of Scientific and Technical Information of China (English)

    周永清; 邹静; 毕爱芳; 尚耀东


    探讨中耳细菌感染急性期时,哺乳动物中、内耳热休克反应的部位,以及中耳细菌感染诱生的热休克蛋白是否可能引发内耳自身免疫损伤。运用中耳注射肺炎克雷伯杆菌制成豚鼠中耳急性感染动物模型,分别于接种后第1、3、5、7天处死动物取材。应用免疫组化技术,研究了中耳粘膜和耳蜗表达热休克蛋白70(HSP-70)的部位。结果表明:正常状态下,中耳粘膜表层的上皮细胞和内耳膜迷路血管纹、螺旋韧带、Corti氏器均有弱的阳性反应,感染应激后,上述同样部位均有强的阳性显色。不同取材时段显示的阳性位置无差异。说明在中耳急性细菌感染期,中耳粘膜和内耳组织均表达了同源HSP-70蛋白分子,这些同源HSP-70为引发内耳自身免疫损伤提供了物质基础。%To illustrate the location of HSP-70 (heat\\|shock protein\\|70)correlative response in acute stage between middle and inner ear when mammalian middle ear infected by bacteria, and investigate the possibility to cause autoimmune inner ear injure by HSP-70 that induced by otitis media. An animal model of acute otitis media was established by inoculating Klebsiella pneumoniae (K.p) into middle ear of guinea pigs. Animals were sacrificed 1,3,5 and 7days after inoculation.Investigation of the locations of HSP-70 in middle ear mucosa and cochlea structures were detected by immunocytochemical technique .The results showed that light stain of HSP-70 existed in the superficial epithelium cells of normal mucosa and cochlea structures such as stria vascularis, spiral ligament and Corti′s organ.Heavy stain appeared in the same sites in the infected ears . No different positive sites was observed in all animals.Our findings suggested that HSP-70 were expressed in middle ear mucosa and inner ear structures during acute middle ear infective stage.The HSP-70 provide a material base for causing autoimmune inner ear injure

  1. Play it by Ear

    DEFF Research Database (Denmark)

    Kammersgaard, Nikolaj Peter Iversen; Kvist, Søren Helstrup; Thaysen, Jesper;


    The first antenna for ear-to-ear communication with a standard Bluetooth chip has the potential to improve hearing aid technology.......The first antenna for ear-to-ear communication with a standard Bluetooth chip has the potential to improve hearing aid technology....


    Directory of Open Access Journals (Sweden)

    Vijin Ravindran Nambiar


    Full Text Available Objective: To study microbiology of external auditory canal in patients with itchy ears and to also study susceptibility profiles of pathogenic organisms to aid in appropriate management. Materials & Methods: A total of hundred patients were selected. An external ear canal swab was taken. For recovery of bacteria, the samples were emulsified in a solution of BHI broth to study aerobic and anaerobic bacteria. Fungal microbiology was studied by KOH mount and fungal culture. Culture and sensitivity was done for the pathogenic organisms. Results: Of the total hundred patients, 48% patients had no growth. There were no anaerobes isolated. Of the remaining 52% cases, 33% of the growth was aerobic bacteria and 19% of the growth was fungi. Of the aerobic bacteria, coagulase negative staphylococcus was isolated from 22 patients, staphylococcus aureus from 9 patients and pseudomonas aeruginosa from 2 patients. Of the fungal species, candida was isolated from 11 patients and aspergillus niger from 8 patients. Conclusion: Our study concluded that there need not be an underlying bacterial or fungal infection to cause itching as evidenced by a condition called asteatosis. Hence, asteatosis should be considered as one of the differential diagnosis for chronic and persistent itching when all other causes have been ruled out. We also found that topical ciprofloxacin drops is equally effective against the common bacterial pathogens.

  3. Role of dynamic slow motion video endoscopy in etiological correlation between eustachian dysfunction and chronic otitis media: A case-control study

    Directory of Open Access Journals (Sweden)

    Minal Gupta


    Full Text Available Objective: To assess the role of dynamic slow motion video endoscopy (DSVE for diagnosing eustachian tube (ET dysfunction in the cases of middle ear disorders and to classify eustachian dysfunction into mechanical and functional for the purpose of systematic management of middle ear disorders. Materials and Methods: A prospective, case-control study was carried out on total 84 patients (168 ears of whom 64 patients with ear complaints (total 95 ears having middle ear disease was taken as cases. Remaining 20 patients without any ear and nasal complaints (40 ears and the normal ears among the case group (33 ears were taken as controls (total 73 ears. DSVE was performed in cases and controls to compare the incidence of eustachian dysfunction in the two groups. Tubal movements were classified into four grades depending on: (1 Appearance of tubal mucosa, (2 movements of medial and lateral cartilaginous lamina, (3 lateral excursion and dilatory waves of the lateral pharyngeal wall, (4 whether tubal lumen opened well or not and (5 presence of patulous tubes (concavity in the superior third of tube. Results: On correlating the DSVE findings of ET in both case and control group, 4 times higher incidence of abnormal ET dysfunction was obtained in cases of middle ear disorders as compared to controls (P = 0.001, odds ratio of 4.0852. We found that 29 tubes had mechanical type of dysfunction (Grades 2A and 3A, whereas 30 tubes had functional type of dysfunction (Grades 2B and 3B and patulous. Conclusion: There is a positive etiological correlation between eustachian dysfunction and chronic otitis media by DSVE. It provides valuable information regarding the structural and functional status of the pharyngeal end of the ET and in classifying the type of eustachian dysfunction into mechanical or functional, which has management implications.

  4. Otosclerosis associated with type B-1 inner ear malformation


    De Stefano, A.; DISPENZA, F.; Aggarwal, N.; Russo, A.


    Malformations of bony inner ear are rare anomalies occurring in approximately 20% of patients with congenital sensorineural hearing loss. Conductive hearing loss is usually associated with abnormalities of the external and middle ear. Recent reports of patients with lateral semicircular canal malformations indicate inner ear malformations to be associated with sensorineural or conductive hearing loss. Differential diagnosis of conductive hearing loss should include otosclerosis, isolated ossi...

  5. Application of Vibrant Soundbridge (VSB)in patients with congenital deformation of middle and outer ears%振动声桥在先天性中外耳畸形患者的应用

    Institute of Scientific and Technical Information of China (English)

    邹艺辉; 李佳楠; 陈爱婷; 戴朴; 韩东一; 刘会占; 杨仕明


    Objective To report application of the Vibrant Soundbridge (VSB) in patients with congenital deformation of the middle and outer ears and investigate its indications for this patient population. Method Four patients with congenital deformation of middle and outer ears underwent VSB implantation. All were male (aged 3-18 years, average 13.5 years) and operated on the left side., Malformation was bilateral in 3 patients and unilateral in 1 patient. Surgical techniques were modified to accommodate each patient' s unique conditions. The middle ear space was approached via the facial recess in 3 patients and through a post-facial nerve route in 1 patient. The VSB implant was connected to either the stapes (2 cases) or the round window (2 cases). Pure tone and speech audiometry results and daily communication before and after VSB activation were compared. Results The operations were successful in all patients, with no complications. The patient communication level improved significantly after VSB activation. Average air conduction pure tone threshold or conditioned reflex audiometry improved by 35dB in the 0.25-4 kHz range from 69 dB HL before VSB activation to 34 dB HL after. In quiet, the sentence recognition rate at 65 dB SPL went up to 86% from 0% without VSB for patients with bilateral deformation and remained at 100% for the patient with unilateral deformity. However, for the latter patient, the rate improved to 20% from 0% without VSB in noise (-8 dB SNR). Conclusion VSB is a good solution for improving hearing in patients with congenital deformation of middle and outer ears. Operation can be completed and good results can be achieved even in patients with unique conditions.%目的 报道振动声桥在先天性中外耳畸形患者(尤其有特殊情况者)的应用,探索其在该类患者的适应症.方法 对4例先天性中外耳畸形患者行振动声桥植入术,均为男性,年龄3-18岁(平均13.5岁),3例双耳畸形,1例单耳畸形,均为左侧植

  6. Epitympanoplasty with Cartilage Obliteration in the Canal Wall Up Technique to the Middle Ear Cholesteatoma%保留外耳道后壁上鼓室切开软骨重建术治疗中耳胆脂瘤

    Institute of Scientific and Technical Information of China (English)

    赵丹珩; 刘阳; 孙建军; 林勇生


    Objective To report the curative effect of the epitympanoplasty with cartilage obliteration in the treatment of middle ear cholesteatoma .Methods This study retrospectively analysed 123 cases ,with middle ear cholesteatoma treated in our department from November 2009 to July 2012 .The operation included mastoidectomy with posterior canal wall preserved ,lateral wall of attic resected ,facial recess opened to the epitympanum ,epitym-panum obliterated with cartilage and mastoid cavity blocked with bone dust .All cases were followed up on complica-tions and hearing improvement .Results All cases were followed up 6~38 months .In 123 cases ,there were 2 ca-ses had cholesteatoma recurrence in the middle ear cavity ,6 cases had infection of post auricular incision after opera-tion ,3 cases had residual marginal tympanic membrane perforation ,2 cases had ossicular replacement prosthesis ex-clusion ,and 6 cases had canal wall skin swelling or defect .The rest cases acquired full -recovery after 2 or 3 wound dressing changes .Out of 123 cases ,83 cases had the whole hearing document ,the average AB gap at 0 .5 ,1 ,2 kHz reduced from 32 .2 ± 11 .2 dB pre-operation to 20 .7 ± 12 .4 dB post -operation .The AB gap of pre - and post -operation had significant difference (P<0 .001) .Conclusion The mastoidectomy with posterior canal wall preserved greatly shortened the healing time .The resection of lateral wall of epitympanum can exposed operating field more completely and remove lesions thoroughly .The cartilage obliteration in the attic can prevent the retraction pocket formation effectively .This technique provides alternative in treating middle ear cholesteatoma .%目的探讨在保持外耳道后壁完整的情况下,切除上鼓室外侧壁并软骨封闭治疗中耳胆脂瘤的疗效。方法2009年11月~2012年7月对123例(123耳)中耳胆脂瘤患者行保留外耳道后壁的乳突切开、上鼓室盾板切除及面神经隐窝向上鼓室开放,清除病

  7. Ear Infection and Vaccines (United States)

    ... an ENT Doctor Near You Ear Infection and Vaccines Ear Infection and Vaccines Patient Health Information News ... or may need reinsertion over time. What about vaccines? A vaccine is a preparation administered to stimulate ...

  8. Ear Plastic Surgery (United States)

    ... receive light-weight earrings. Does Insurance Pay for Cosmetic Ear Surgery? Insurance usually does not cover surgery solely for ... republication strictly prohibited without prior written permission. Ears Cosmetic Surgery, Facelift, Rhinoplasty, Blepharoplasty ... Get Involved Professional Development Practice ...

  9. Ear Injuries (For Parents) (United States)

    ... head, sports injuries, and even listening to loud music can cause ear damage, which can affect hearing and balance. That's because the ear not ... Hearing Loss or Balance Problems Ear injuries can affect kids differently. ... sounds or music notes hearing only certain or muffled sounds ringing ...

  10. Current asthma contributes as much as smoking to chronic bronchitis in middle age: a prospective population-based study

    Directory of Open Access Journals (Sweden)

    Dharmage SC


    Full Text Available Shyamali C Dharmage,1 Jennifer L Perret,1,2, John A Burgess,1 Caroline J Lodge,1 David P Johns,3 Paul S Thomas,4 Graham G Giles,1,5 John L Hopper,1,6 Michael J Abramson,7,8 E Haydn Walters,3,9, Melanie C Matheson1 1Allergy and Lung Health Unit, Center for Epidemiology and Biostatistics, The University of Melbourne, 2Institute for Breathing and Sleep (IBAS, Melbourne, VIC, 3“Breathe Well” Center of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, TAS, 4Inflammation and Infection Research, Faculty of Medicine, University of New South Wales, Sydney, NSW, 5Cancer Epidemiology Center, Cancer Council Victoria, Melbourne, VIC, Australia; 6Department of Public Health, Seoul National University, Seoul, South Korea; 7Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, 8School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 9School of Medicine, University of Tasmania, Hobart, TAS, Australia Background and objective: Personal smoking is widely regarded to be the primary cause of chronic bronchitis (CB in adults, but with limited knowledge of contributions by other factors, including current asthma. We aimed to estimate the independent and relative contributions to adult CB from other potential influences spanning childhood to middle age.Methods: The population-based Tasmanian Longitudinal Health Study cohort, people born in 1961, completed respiratory questionnaires and spirometry in 1968 (n=8,583. Thirty-seven years later, in 2004, two-thirds responded to a detailed postal survey (n=5,729, from which the presence of CB was established in middle age. A subsample (n=1,389 underwent postbronchodilator spirometry between 2006 and 2008 for the assessment of chronic airflow limitation, from which nonobstructive and obstructive CB were defined. Multivariable and multinomial logistic regression models were used to estimate

  11. 不同方法修复先天性外中耳畸形新建耳道的皮肤缺损的临床研究%Clinical study of different methods to repair the skin defect of the new ear canal of the congenital external middle ear malformation

    Institute of Scientific and Technical Information of China (English)

    简洁君; 何超; 田磊; 李妮


    Objective To investigate the effect of repairing the skin defect of the new ear canal of the new ear canal with the acellular dermal matrix and the free thin layer of the skin.Methods 40 cases of January 2015 2013 to January 2009 in our hospital were congenital ear canal stenosis or deformity were included. All the patients underwent skeletal reconstruction of external auditory canal treatment. According to the random number table method is divided into two groups with 20 cases in each: in view of the new ear canal skin lesions, the observation group be dissimilar de cellular dermis matrix membrane repair treatment, control group was treated with autologous free thin skin graft treatment, comparative analysis the therapeutic effect of two groups.Results Patients were followed up for 6 months, patients in the two groups there were no graft rejection appeared and shedding phenomenon, the success rate of the two groups of patients transplanted reached 100%; were observed compared with control group, the group of complete epithelization time was significantly shortened (P<0.05); observation group transplantation 3 months and 6 months of Vancouver Scar score were lower than those in the control group decreased signiifcantly (P<0.05). The two groups had no serious abnormal reaction; observation group cosmetic satisfaction reached 95%, compared to the control group 85.00% increased significantly (P<0.05). ConclusionXenogenic deproteinization acellular dermal matrix membrane repair for congenital external and middle ear malformation new ear canal skin defect, as a dermal substitute, can effectively promote the skin defect of healing, reduce scar hyperplasia after the wound healing, good aesthetic effect, is worthy of clinical application.%目的:探讨异种脱细胞真皮基质修复膜与自体游离薄层皮片在先天性外中耳畸形新建耳道的皮肤缺损中的修复作用。方法:纳入2013年1月-2015年1月收治的先天性耳道狭窄或畸形患者40

  12. Surgical and Technical Modalities for Hearing Restoration in Ear Malformations. (United States)

    Dazert, Stefan; Thomas, Jan Peter; Volkenstein, Stefan


    Malformations of the external and middle ear often go along with an aesthetic and functional handicap. Independent of additional aesthetic procedures, a successful functional hearing restoration leads to a tremendous gain in quality of life for affected patients. The introduction of implantable hearing systems (bone conduction and middle ear devices) offers new therapeutic options in this field. We focus on functional rehabilitation of patients with malformations, either by surgical reconstruction or the use of different implantable hearing devices, depending on the disease itself and the severity of malformation as well as hearing impairment. Patients with an open ear canal and minor malformations are good candidates for surgical hearing restoration of middle ear structures with passive titanium or autologous implants. In cases with complete fibrous or bony atresia of the ear canal, the most promising functional outcome and gain in quality of life can be expected with an active middle ear implant or a bone conduction device combined with a surgical aesthetic rehabilitation in a single or multi-step procedure. Although the surgical procedure for bone conduction devices is straightforward and safe, more sophisticated operations for active middle ear implants (e.g., Vibrant Soundbridge, MED-EL, Innsbruck, Austria) provide an improved speech discrimination in noise and the ability of sound localization compared with bone conduction devices where the stimulation reaches both cochleae.

  13. A Model for the representation of Speech Signals in Normal and Impaired Ears

    DEFF Research Database (Denmark)

    Christiansen, Thomas Ulrich


    A model of human auditory periphery, ranging from the outer ear to the auditory nerve, was developed. The model consists of the following components: outer ear transfer function, middle ear transfer function, basilar membrane velocity, inner hair cell receptor potential, inner hair cell probabili...

  14. Evaluation of embryological sequences of ear anomalies and its radiological relevance

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    C Amarnath


    Full Text Available Aim: To correlate the sequence of embryological development of ear with radiological imaging. Materials and Methods: The study enrolled 23 patients of age group 11 months to 27 years with malformed external ear/microtia and hearing loss. The children with postoperative changes, acute hearing loss (such as infection, trauma were excluded from the study. We used high-resolution computed tomography, with axial and coronal sections to examine the temporal bones of patients. Results: Of the 23 cases, 12 cases had external ear anomaly and 11 cases had cochlear anomaly. In patients with the external ear anomaly, seven cases had associated middle ear malformations, one patient had associated middle and inner ear anomaly, one had anomalous course of facial nerve, and three cases had isolated external ear anomalies. In patients with inner ear anomalies, one patient had complete labyrinthine aplasia, one had cochlear dysplasia with incomplete cochlear turns, four had common cavity malformations, one had cystic featureless cochlea with dilated and cystic vestibule, two patients had small cochlea with the middle and apical turns coalescing to form a cystic apex, one patient had small rudimentary cochlea, and the other one had dilated vestibule and enlarged endolymphatic duct and sac with cochlear dysmorphism. Conclusion: Most of the children with malformed pinna had external auditory canal atresia with associated middle ear anomalies. Though the inner ear development is independent of external and middle ear development, we insist on the fact that insult during the 1 st month of embryogenesis can result in associated abnormalities involving external, middle, and inner ear. Developmental arrest at various stages of inner ear development results in various types of cochlear anomalies with associated vestibular, semicircular canal abnormalities, and rarely associated with middle and external ear anomalies. Hence, clear knowledge about embryology will help to

  15. High Intensity Pressure Noise Transmission in Human Ear: A Three Dimensional Simulation Study (United States)

    Hawa, Takumi; Gan, Rong; Leckness, Kegan


    High intensity pressure noise generated by explosions and jet engines causes auditory damage and hearing loss of the military service personals, which are the most common disabilities in the veterans. Authors have investigated the high intensity pressure noise transmission from the ear canal to middle ear cavity. A fluid-structure interaction with a viscoelastic model for the tympanic membrane (TM) as well as the ossicular chain has been considered in the study. For the high intensity pressure simulation the geometry of the ear was based on a 3D finite element (FE) model of the human ear reported by Gan et al. (Ann Biomed Eng 2004). The model consists of the ear canal, TM, ossicular chain, and the middle ear cavity. The numerical approach includes two steps: 1) FE based finite-volume method simulation to compute pressure distributions in the ear canal and the middle ear cavity using CFX; and 2) FE modeling of TM and middle ear ossicles in response to high intensity sound using multi-physics analysis in ANSYS. The simulations provide the displacement of the TM/ossicular chain and the pressure fields in the ear canal and the middle ear cavity. These results are compared with human temporal bone experimental data obtained in our group. This work was supported by DOD W81XWH-14-1-0228.

  16. Otosclerosis associated with type B-1 inner ear malformation. (United States)

    De Stefano, A; Dispenza, F; Aggarwal, N; Russo, A


    Malformations of bony inner ear are rare anomalies occurring in approximately 20% of patients with congenital sensorineural hearing loss. Conductive hearing loss is usually associated with abnormalities of the external and middle ear. Recent reports of patients with lateral semicircular canal malformations indicate inner ear malformations to be associated with sensorineural or conductive hearing loss. Differential diagnosis of conductive hearing loss should include otosclerosis, isolated ossicular deformities, inner ear anomalies or a combination of these. In this report, a case is described with right vestibule-lateral semicircular canal dysplasia presenting at our centre with bilateral otosclerosis.

  17. Secreção na orelha média em lactentes - ocorrência, recorrência e aspectos relacionados Secretion of middle ear in infants - occurrence, recurrence and related factors

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    Sandra de O. Saes


    Full Text Available OBJETIVO: O presente estudo objetivou avaliar a ocorrência e recorrência de secreção na orelha média e os possíveis fatores associados, em 190 recém-nascidos e lactentes observados nos 2 primeiros anos de vida, participantes de um programa de prevenção, detecção e intervenção interdisciplinar desenvolvido na Clínica de Educação para Saúde da Universidade do Sagrado Coração. MÉTODOS: Os recém-nascidos e lactentes foram submetidos mensalmente a anamnese, otoscopia, avaliação audiológica comportamental por meio de instrumentos sonoros e tons puros (audiometria pediátrica e timpanometria. RESULTADOS: Os resultados revelaram que 68,4% dos lactentes apresentaram um ou mais episódios de secreção na orelha média nos 2 primeiros anos, com maior recorrência para o sexo masculino. A idade de maior ocorrência foi entre 4 e 12 meses. Quanto mais cedo ocorreu o primeiro episódio, maior foi a probabilidade de recorrência. Os meses do ano de maior incidência foram de maio a agosto. Das variáveis estudadas, constatou-se que o período de aleitamento materno exclusivo atuou como um fator protetor. Quanto aos fatores de risco, verificou-se que a presença tabagismo passivo, refluxo gastroesofágico, alergia respiratória esteve relacionada à recorrência de efusão. CONCLUSÃO: Os achados revelaram a importância do acompanhamento auditivo periódico para lactentes nos 2 primeiros anos de vida, considerando ser o período crítico para o processo de maturação do sistema auditivo, no qual privações sensoriais auditivas podem ser responsáveis por seqüelas para o desenvolvimento de fala e linguagem.OBJECTIVE: The present study aimed at evaluating the occurrence and recurrence of middle ear secretion and possible associated factors in the first two years of life of 190 newborns and infants, participants in the interdisciplinary prevention, detection, and intervention program at the Clínica de Educação para Saúde of


    Directory of Open Access Journals (Sweden)



    Full Text Available Getting an object impact in the ear canal is a relatively common problem in children, the majority of items are lodged in the external auditory canal which is the small channel that ends at the ear drum. The children often place these items in their ears out of curiosity. Common objects found in ear include beads, toys, food material, insects and seeds etc. usually foreign body ear are removed by syringing or with Hartmann’s forceps, we are here presenting a case of foreign body in the middle ear removed by canaloplasty through post - aural approach.

  19. Assessment of Alveolar Bone Status in Middle Aged Chinese (40-59 Years with Chronic Periodontitis--Using CBCT.

    Directory of Open Access Journals (Sweden)

    Haijiao Zhao

    Full Text Available This study used con-beam computed tomography (CBCT to investigate the prevalence and severity of alveolar bone loss in middle-aged (40-59 years Chinese with chronic periodontitis.The study group comprised 145 dentate individuals aged 40 to 59 years residing in China who suffered from chronic periodontitis. CBCT and the application of NNT software were used to examine the level and location of alveolar bone loss.The study revealed that 40-59 year old patients with chronic periodontitis had severe bone loss. At 5,286 sites (34.7%, alveolar bone loss was mild; severe alveolar bone loss was found at 5,978 sites (39.2%. A comparison of bone loss in different jaws revealed that the area with the highest degree of bone loss was on the lingual side of the maxillary molar (56.3 ± 7.2%, and that the area with the lowest degree was primarily on the lingual side of the mandibular canine (27.5 ± 6.3%. There was a lower degree of alveolar bone loss in males than females. Differences were observed when comparing the incidence of bone loss between males and females (P < 0.05. Menopause in females and smoking in both genders may affect the level of bone loss. Male smokers experienced a greater degree of bone loss (41.67 ± 5.76% than male non-smokers (32.95 ± 4.31%. A 42.23 ± 6.34% bone loss was found in menopausal females versus 31.35 ± 3.62% in non-menopausal females.The study revealed that different sites and teeth exhibited a diverse degree of bone loss. In middle-aged patients with chronic periodontitis, the highest degrees of bone loss in the incisors, premolars, and molars were on the lingual side, mesial side and lingual side, respectively. Menopause in females and smoking may affect the level of bone loss.

  20. Efficacy in patients with outer and middle ear deformities of using bone-anchored hearing aids%双侧先天性外中耳畸形患者骨锚式助听器效果分析

    Institute of Scientific and Technical Information of China (English)

    樊悦; 陈晓巍; 杨华; 张志勇; 祝小莉; 曹克利; 高志强


    Objective To evaluate the efficacy and satisfaction of bone-anchored hearing aids (BAHA) in patients with outer and middle ear deformities.Methods Seven patients with bilateral microtia and aural atresia,and three patients with unilateral microtia and bilateral middle ear malformation were fitted with soft-band BAHA for a few months,followed by receiving unilateral BAHA implantation.Mean pure-tone thresholds and speech audiometry tests results were compared among patients without hearing aid,with softband BAHA, and with implanted BAHA. Scores from the BAHA users' questionnaires and Glasgow children's benefit inventory (GCBI) were used to measure patient satisfaction and subjective health benefit.Results The mean pure-tone thresholds of the patients were ( 64.8 ± 5.9 ) dBHL for those without hearing aid,(30.2 ± 3.7) dBHL for those with soft-band BAHA,and (20.3 ± 3.9 ) dBHL for those with implanted BAHA.The average decline in pure-tone threshold was (36.2 ± 8.0)dBHL for those with soft-band BAHA,and an additional decline of (12.2 ± 3.4)dBHL was achieved with implanted BAHA.The average gains in speech discrimination scores (SDS) were ( 3.00 ± 1.07 ) % for those without hearing aids and ( 89.39 ± 5.83) % for those with implanted BAHA in sound field of 45dBHL.SDS were(57.55 ± 10.30) % for those without hearing aids and (91.19 ± 4.16)% for those with implanted BAHA in sound field of 65 dBHL.The average gains in SDS were ( 88.21 ± 6.86) % and ( 38.04 ± 7.56) % tested with 45dBHL and 65dBHL respectively.Sound reception thresholds (SRT) without hearing aids were (63.1 ± 5.9 )dBHL and (24.7 ± 3.5 )dBHL for those with implanted BAHA.The average gains in SRT was(39.6 ± 6.2)dBHL.The BAHA application questionnaire demonstrated excellent patient satisfaction.The general benefit score was 35.59 ± 14.35.Conclusion BAHA remains one of the most reliable methods of auditory rehabilitation and improves quality of life for patients with ear deformities

  1. Sectional anatomical analysis of auricular and middle ear malformation in patients with microtia%先天性小耳外中耳畸形断面影像解剖学分析

    Institute of Scientific and Technical Information of China (English)

    韩娟; 卢九星; 邢宁; 林琳; 蒋海越; 庄洪兴


    Objective To analyze the sectional anatomical features of auricular and middle ear malformation in patients with microtia so as to improve the clinical classification and the instruction of surgery. Methods From Jun. to Dec. 2009,36 cases with microtia were selected in the center of auricular reconstruction in Plastic Surgery Hospital, including 22 cases of unilateral microtia and 14 cases of bilateral microtia. 22 patients with unilateral microtia were studied with the contralateral healthy ears as controls. Spiral CT was performed for high-resolution scan of the temporal bone. The coronal, sagittal and 3D reconstruction images were created with Mimic software. Several distances and degrees were measured. Results The patients were classified by Max classification. The anteroposterior diameter and the vertical diameter of tympanic cavity were (7. 75 ± 1. 92) mm and ( 14. 66 ± 4. 75 ) mm for type Ⅰ ; (6.17±2.56) mm and(14. 35 ±5. 12) mm for type Ⅱ ; (6. 31 ±3. 40) mm and (9.97 ±4.36) mm for type Ⅲ ( P = 0.001). The mastoid pneumatization degree for type Ⅰ , Ⅱ , Ⅲ were 13.33% , 13.64% ,30.77% in sclerotic type, 13. 33% , 18. 18 % , 7. 69% in diploetic type, 0, 9. 09% , 38. 46% in composite type,73. 33% ,59. 09% ,23. 08% in pneumatic type(x2 = 24. 11 ,P = 0. 002 ). The cover of fenestra vestibuli by facial nerve was 21. 43% ,47.62%, 54.55% (x2 =23.44, P = 0. 002 ) for type Ⅰ , Ⅱ , Ⅲ. There was a statistical difference between the microtia group and the control group. Conclusions According to the Max classification, the middle ear malformation changed along the auricular malformation. The anatomical variations was complicated in type Ⅱ microtia, which should be sub-classified.%目的 通过对先天性小耳患者外、中耳的畸形断面影像解剖学特征的系统研究,比较其与正常解剖之间的差异,总结重要解剖结构的变异规律及相互关系,以利于临床分型及手术治疗.方法 选取2009年6月至12月中

  2. 腭裂修复术对咽鼓管功能与中耳的影响%Study on the eustachian tube and on the problems of middle ears of the children with cleft palate

    Institute of Scientific and Technical Information of China (English)

    赖仁发; G.Schmidt; 等


    Aim: To study the prevalence of the dysfunction of eustachian tube and otitis media witheffusion in young children with cleft palate. Methods: 121 cleft palate cases, including 242 ears are di-vided, according to the time of surgical closure of soft cleft palate, into two groups: early operated groupand delay operated group. All children underwent rourine otoscopic, otomicroscopic examination of theears and they were also performed tympanotomy before and 1 year after veloplasty. Results: A significant-ly (P < 0,01 ) greater prevalence of otitis media with effusion was found among delay operated CP chil-dren than early operated CP children before veloplasty, and more mucotympanon and otitis media suppu-rativa were also found in delay operated CP children. No statistical significance was found 1 year after op-eration. Conclusion: Dysfunction of Eustachian tube and otitis media are commonly present among theCP children, tympanotomy and pressure equalization tube should be performed as early as possible so asto avoid complications of the middle ears, early veloplasty should be adopted for a better rehabilitation.%目的:探讨不同年龄组腭裂患儿施行腭裂修复术对咽鼓管功能障碍与中耳疾病的影响。方法:121例242耳腭裂患儿,分为早期腭帆修复组(手术时平均年龄为3.2个月)与延迟腭帆修复组(手术时平均年龄为15个月),在腭裂修复术前、术后一年进行耳镜、耳显微镜检查,鼓膜穿刺术和(或)鼓膜切开术。结果:2组腭裂患儿手术修复术前90%以上的中耳有病理性渗出,但延迟手术组腭裂患儿的中耳渗出向粘稠化、感染化转变,2组患儿中耳渗出情况在腭裂修复术后一年明显好转。结论:腭裂可导致中耳炎,应尽早作耳科相关检查,对病理性渗出的中耳,应置放鼓室平衡管,以消除负压和引流。早期实施的腭帆修复术,对咽鼓管及中耳功能的恢复有明显的改善。

  3. 21 CFR 524.1484d - Neomycin sulfate, hydrocortisone acetate, tetracaine hydrochloride ear ointment. (United States)


    ..., tetracaine hydrochloride ear ointment. 524.1484d Section 524.1484d Food and Drugs FOOD AND DRUG..., tetracaine hydrochloride ear ointment. (a) Specifications. The product contains 5 milligrams of neomycin... a lesser degree, chronic otitis externa in dogs and cats. In treatment of ear canker and...

  4. Effect of a single session of ear acupuncture on pain intensity and postural control in individuals with chronic low back pain: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Andrea Ushinohama


    Full Text Available ABSTRACT Background Ear Acupuncture (EA is a form of acupuncture in which needles are applied to the external ear and has been used in multiple painful conditions. Low back pain (LBP is highly prevalent in active individuals and causes high economic burden to health systems worldwide. LBP affects the person’s ability to keep balance, especially in challenging conditions. Objective The aim of the study was to examine the effects of a single session of EA on pain intensity and body sway during postural tasks. Method Eighty adults with LBP and pain intensity equal to or greater than 4 (0-10 scale were randomly allocated (1:1 to EA group (EAG or placebo group (PG. Initially, the level of pain intensity was assessed. Next, participants stood still on a force plate either with feet in parallel or in semi-tandem and with eyes open or closed. Then, the EAG was treated with EA for 20 min and the PG was treated with detuned ultrasound. After the treatment, pain intensity was assessed again and the postural test was repeated. Pain intensity was the primary outcome and center of pressure sway area and speed were the secondary outcomes measured. Results Results revealed that pain intensity decreased in both groups after treatment, but decreased more in the EAG. For postural control, no effect of treatment and no interaction between treatment and postural condition on body sway were found. Conclusion Those findings indicate that EA is better than placebo to reduce pain, but neither treatment has any effect on postural control.

  5. Facial Canal Dehiscence in Patients with Chronic Otitis Surgery

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    Ahmet Uluat


    Full Text Available Aim: To examine facial canal status in patients with chronic otitis media (COM surgery and to detect the relation between facial canals dehiscence (FCD with middle ear pathology in these patients. Material and Method: The surgery data of patients who were subjected to tympanoplasty with or without mastoidectomy and radical mastoidectomy due to COM were analyzed retrospectively from January 2006 to December 2012. In addition to demonstrative data of the patients, status of facial canal and preoperative diagnoses of patients, type of the operation performed, status of middle ear, number of surgeries, existence of cholesteatoma, existence of ossicular chain defect, lateral canal defect and dura defect were assessed and the relation thereof with facial canal dehiscence (FCD was analyzed statistically. Results: Seven hundred ninety six patients were included in the study. FCD was detected in 10.05% of the patients. FCD was most frequently observed in the tympanic segment. It was found out that there was a statistically significant relationship of middle ear pathology, cholesteatoma, revision surgery, lateral semicircular canal and ossicular chain defect with FCD. Discussion: COM diagnosed patients may have defect in facial canal according to their preoperative diagnoses, middle ear pathologies, number of operations and ossicular chain defects. These patients should be applied a more careful surgery and closely followed up in postoperative periods.

  6. Chronic caffeine prevents changes in inhibitory avoidance memory and hippocampal BDNF immunocontent in middle-aged rats. (United States)

    Sallaberry, Cássia; Nunes, Fernanda; Costa, Marcelo S; Fioreze, Gabriela T; Ardais, Ana Paula; Botton, Paulo Henrique S; Klaudat, Bruno; Forte, Thomás; Souza, Diogo O; Elisabetsky, Elaine; Porciúncula, Lisiane O


    Beneficial effects of caffeine on memory processes have been observed in animal models relevant to neurodegenerative diseases and aging, although the underlying mechanisms remain unknown. Because brain-derived neurotrophic factor (BDNF) is associated with memory formation and BDNF's actions are modulated by adenosine receptors, the molecular targets for the psychostimulant actions of caffeine, we here compare the effects of chronic caffeine (1 mg/mL drinking solution for 30 days) on short- and long term memory and on levels of hippocampal proBDNF, mature BDNF, TrkB and CREB in young (3 month old) and middle-aged (12 month old) rats. Caffeine treatment substantially reduced i) age-related impairments in the two types of memory in an inhibitory avoidance paradigm, and ii) parallel increases in hippocampal BDNF levels. In addition, chronic caffeine increased proBDNF and CREB concentrations, and decreased TrkB levels, in hippocampus regardless of age. These data provide new evidence in favor of the hypothesis that modifications in BDNF and related proteins in the hippocampus contribute to the pro-cognitive effects of caffeine on age-associated losses in memory encoding. This article is part of a Special Issue entitled 'Cognitive Enhancers'.

  7. How the Ear Works (United States)

    ... to the brain. Any source of sound sends vibrations or sound waves into the air. These funnel through the ear opening, down the external ear canal, and strike your eardrum, causing it to vibrate. The vibrations are passed to the three small bones of ...

  8. Autoimmune Inner Ear Disease (United States)

    ... to the brain. Any source of sound sends vibrations or sound waves into the air. These funnel through the ear opening, down the ear, canal, and strike your eardrum, causing it to vibrate. The vibrations are passed to the small bones of the ...

  9. Dynamics of Streptococcus pneumoniae serotypes causing acute otitis media isolated from children with spontaneous middle-ear drainage over a 12-year period (1999-2010 in a region of northern Spain.

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    Marta Alonso

    Full Text Available The aim of this study was to determine the serotype and clonal distribution of pneumococci causing acute otitis media (AOM and their relationship with recurrences and mixed infections with other microorganisms under the influence of the 7-valent pneumococcal conjugate vaccine (PCV7. To do this, all pneumococcal isolates collected from the spontaneous middle-ear drainage of children <5 years old diagnosed of AOM by their pediatrician or their general practitioner from 1999 to 2010 were phenotypically characterized and the most frequent serotypes were genotyped. In the 12-year study, 818 episodes of pneumococcal AOM were detected, mostly (70.5% in children younger than 2 years old. In 262 episodes (32%, the pneumococci were isolated with another bacterium, mainly (n=214 Haemophilus influenzae. Mixed infections were similar in children under or over 2 years old. The most frequent serotypes were 19A (n=227, 27.8%, 3 (n=92, 11.2% and 19F (n=74, 9%. Serotypes included in the PCV7 sharply decreased from 62.4% in the pre-vaccination (1999-2001 to 2.2% in the late post-vaccination period (2008-2010. Serotype diversity steadily increased after the introduction of the PCV7 but decreased from 2008-2010 due to the predominant role of serotype 19A isolates, mostly ST276 and ST320. The prevalence of serotype 3 doubled from 6.1% (20/326 in 1999-2004 to 14.6% (72/492 in 2005-2010. Relapses mainly occurred in male infants infected with isolates with diminished antimicrobial susceptibility. Reinfections caused by isolates with the same serotype but different genotype were frequent, highlighting the need for genetic studies to differentiate among similar strains. In conclusion, the main change in pneumococcal AOM observed after the introduction of the PCV7 was the sharp decrease in vaccine serotypes. Also notable was the high burden of serotype 19A in total pneumococcal AOM before and especially after the introduction of the PCV7, as well as in relapses and

  10. Comparison between Microscopic and Endoscopic Approaches for Evaluation of Anatomic Areas in Surgically Treated Chronic Otitis Media

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    M.T. Goodarzi


    Full Text Available Introduction & Objective: The diagnostic value of endoscopic and microscopic procedures for viewing different structures of middle ear has been widely assessed however, no published study is available for comparing the diagnostic value of them in chronic otitis media patients. The present study conducted to compare diagnostic value of these two procedures for as-sessment of middle ear normal structures and possible defects in these patients. Materials & Methods: In a prospective descriptive analytical study, fifty eight consecutive pa-tients older than 15 years who suffered from chronic otitis media and were candidates for tympanoplasty with or without mastoidectomy were included into the study and underwent operation. After entering the middle ear by post auricular incision and elevation of a tym-panomeatal flap, and prior to surgery , the middle ear was first examined by an operating mi-croscope in different bed and microscope positions and by performing gentle maneuvers on the head and then was reevaluated using a rigid 0 & 30 degree sinoscope. The visible areas of middle ear were separately noted. Results: Structures of epitympanum, posterior mesotympanum, and hypotympanum structures were more visible using endoscope compared with microscope(P0.05. Conclusion: Endoscopic and microscopic procedures had similar diagnostic values to view ossicular chain mobility and reflexes of round window as well as to detect ossicular chain erosions, but different anatomical parts and more hidden pits of the middle ear such as epitympanum, posterior mesotympanum, and hypotympanum are more visible by an endoscopic tool.In case of pathologic conditions, endoscopic approach is recommended for better observation and adequate evaluation of the location before and after the removal of the lesion. (Sci J Hamadan Univ Med Sci 2013; 20 (2:95-100

  11. Can balneotherapy improve the bowel motility in chronically constipated middle-aged and elderly patients? (United States)

    Dandinoglu, Taner; Dandin, Ozgur; Ergin, Tuncer; Tihan, Deniz; Akpak, Yasam Kemal; Aydın, Oguz Ugur; Teomete, Uygar


    Balneotherapy or spa therapy is usually known for different application forms of medicinal waters and its effects on the human body. Our purpose is to demonstrate the effect of balneotherapy on gastrointestinal motility. A total of 35 patients who were treated for osteoarthritis with balneotherapy from November 2013 through March 2015 at our hospital had a consultation at the general surgery for constipation and defecation disorders. Patients followed by constipation scores, short-form health survey (SF-12), and a colonic transit time (CTT) study before and after balneotherapy were included in this study, and the data of the patients were analyzed retrospectively. The constipation score, SF-12 score, and CTT were found statistically significant after balneotherapy (p < 0.05). The results of our study confirm the clinical finding that a 15-day course of balneotherapy with mineral water from a thermal spring (Bursa, Turkey) improves gastrointestinal motility and reduces laxative consumption in the management of constipation in middle-aged and elderly patients, and it is our belief that treatment with thermal mineral water could considerably improve the quality of life of these patients.

  12. Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries. (United States)

    Samb, Badara; Desai, Nina; Nishtar, Sania; Mendis, Shanti; Bekedam, Henk; Wright, Anna; Hsu, Justine; Martiniuk, Alexandra; Celletti, Francesca; Patel, Kiran; Adshead, Fiona; McKee, Martin; Evans, Tim; Alwan, Ala; Etienne, Carissa


    National health systems need strengthening if they are to meet the growing challenge of chronic diseases in low-income and middle-income countries. By application of an accepted health-systems framework to the evidence, we report that the factors that limit countries' capacity to implement proven strategies for chronic diseases relate to the way in which health systems are designed and function. Substantial constraints are apparent across each of the six key health-systems components of health financing, governance, health workforce, health information, medical products and technologies, and health-service delivery. These constraints have become more evident as development partners have accelerated efforts to respond to HIV, tuberculosis, malaria, and vaccine-preventable diseases. A new global agenda for health-systems strengthening is arising from the urgent need to scale up and sustain these priority interventions. Most chronic diseases are neglected in this dialogue about health systems, despite the fact that non-communicable diseases (most of which are chronic) will account for 69% of all global deaths by 2030 with 80% of these deaths in low-income and middle-income countries. At the same time, advocates for action against chronic diseases are not paying enough attention to health systems as part of an effective response. Efforts to scale up interventions for management of common chronic diseases in these countries tend to focus on one disease and its causes, and are often fragmented and vertical. Evidence is emerging that chronic disease interventions could contribute to strengthening the capacity of health systems to deliver a comprehensive range of services-provided that such investments are planned to include these broad objectives. Because effective chronic disease programmes are highly dependent on well-functioning national health systems, chronic diseases should be a litmus test for health-systems strengthening.

  13. Otoplasty (Cosmetic Ear Surgery) (United States)

    ... By Mayo Clinic Staff Otoplasty — also known as cosmetic ear surgery — is a procedure to change the shape, position ... age 5 — through adulthood. In some cases, the surgery is done as early as age 3. If ...

  14. Travel Inside the Ear

    Medline Plus

    Full Text Available ... stirrup. These are the smallest bones in your body. Together they are smaller than an orange seed. It then travels into the inner ear, which ... organizations Related Topics ...

  15. Travel Inside the Ear

    Medline Plus

    Full Text Available Skip to main content U.S. Department of Health & Human Services National Institutes of Health Search Search form Search A–Z Index Español Menu Home Health Info Hearing, Ear Infections, and Deafness ...

  16. External Otitis (Swimmer's Ear) (United States)

    ... otitis. Fungal external otitis (otomycosis), typically caused by Aspergillus niger or Candida albicans, is less common. Boils are ... of fullness in the ear. Otomycosis caused by Aspergillus niger usually causes grayish black or yellow dots (called ...

  17. Diving injuries to the inner ear. (United States)

    Farmer, J C


    Most of the previous literature concerning otologic problems in compressed gas environments has emphasized middle ear barotrauma. With recent increases in commercial, military, and sport diving to deeper depths, inner ear disturbances during these exposures have been noted more frequently. Studies of inner ear physiology and pathology during diving indicate that the causes and treatment of these problems differ depending upon the phase and type of diving. Humans exposed to simulated depths of up to 305 meters without barotrauma or decompression sickness develop transient, conductive hearing losses with no audiometric evidence of cochlear dysfunction. Transient vertigo and nystagmus during diving have been noted with caloric stimulation, resulting from the unequal entry of cold water into the external auditory canals, and with asymmetric middle ear pressure equilibration during ascent and descent (alternobaric vertigo). Equilibrium disturbances noted with nitrogen narcosis, oxygen toxicity, hypercarbia, or hypoxia appear primarily related to the effects of these conditions upon the central nervous system and not to specific vestibular end-organ dysfunction. Compression of humans in helium-oxygen at depths greater than 152.4 meters results in transient symptoms of tremor, dizziness, and nausea plus decrements in postural equilibrium and psychomotor performance, the high pressure nervous syndrome. Vestibular function studies during these conditions indicate that these problems are due to central dysfunction and not to vestibular end-organ dysfunction. Persistent inner ear injuries have been noted during several phases of diving: 1) Such injuries during compression (inner ear barotrauma) have been related to round window ruptures occurring with straining, or a Valsalva's maneuver during inadequate middle ear pressure equilibration. Divers who develop cochlear and/or vestibular symptoms during shallow diving in which decompression sickness is unlikely or during

  18. Sports injuries of the ear. (United States)

    Wagner, G A


    The author describes common sports injuries involving the ear. Such injuries include hematoma, lacerations, foreign bodies (tattoo), and thermal injuries. Ear canal injuries include swimmer's ear and penetrating injuries. Tympanum injuries include tympanic membrane perforations, ossicular discontinuity, eustachian tube dysfunction, temporal bone fractures and traumatic facial nerve palsy. Inner ear injuries include traumatic sensorineural deafness. The author emphasizes the management of these injuries.

  19. Chronic non-communicable disease and healthcare access in middle-aged and older women living in Soweto, South Africa.

    Directory of Open Access Journals (Sweden)

    Daniel Lopes Ibanez-Gonzalez

    Full Text Available The aim of the current study was to describe the healthcare access, beliefs, and practices of middle-aged and older women residing in Soweto. This is a cross-sectional study of the primary (female caregivers of the Birth to Twenty Cohort, based in Soweto, South Africa. The study instrument was administered to 1 102 caregivers as part of routine annual data collection. Over half the respondents (50.7% reported having at least one chronic non-communicable disease (CND, only a small portion (33.3% of whom reported accessing a healthcare service in the last 6 months. Reported availability of private medical practice and government clinics was high (75.1% and 61.5% respectively. The low utilisation of healthcare services by women with CND is a concern in terms of healthcare management. There is a need to further investigate how healthcare beliefs are formed, as well as the feasibility of programmes to support the ongoing management of CND in Soweto.

  20. Expression and Clinical Significance of Transforming Growth Factor β1 and Transforming Growth Factorβ2 in Middle Ear Effusions in Secretory Otitis Media%TGF -β1、TGF -β2在分泌性中耳炎患者中耳积液中的表达和临床意义

    Institute of Scientific and Technical Information of China (English)

    张帆; 袁琨; 肖伯奎; 胡姚; 蔡菁; 张晨星


    Objective To investigate the role of transforming growth factor β1( TGF - β1)and transforming growth factor β2(TGF - β2)in the pathogenesis of secretory otitis media(SOM). Methods The expression levels of TGF - β1 and TGF - β2 in middle ear effusions(MEEs)and blood plasma were measured in 56 patients(61 ears)with SOM as well as 32 normal volunteers using enzyme linked immunosorbent assay(ELISA). Results The positive rates of TGF - β1 and TGF - β2 in MEEs and plasma in SOM patients as well as normal plasma were all 100% . The con-centration of TGF - β1 in MEEs in patients with acute SOM was significantly lower than that in patients with chronic SOM(P ﹤ 0. 05). The concentration of TGF - β2 in MEEs in patients with acute SOM was significantly higher than that in patients with chronic SOM(P ﹤ 0. 05). There was no significant difference in the concentration of TGF - β1 in plasma between patients with acute SOM and normal volunteers(P ﹥ 0. 05). There was significant difference in the concentration of TGF - β2 in plasma between patients with acute SOM and normal volunteers(P ﹤ 0. 05). There was significant difference in the concentration of TGF - β1 in plasma between patients with chronic SOM and normal vol-unteers(P ﹤ 0. 05). There was no significant difference in the concentration of TGF - β2 in plasma between patients with acute SOM and normal volunteers(P ﹥ 0. 05). Conclusion TGF - β1 and TGF - β2 both participate in patho-genesis of SOM. TGF - β1 may play a role in the chronic course of SOM and TGF - β2 may be an important role in the early stage of SOM.%目的:探讨转化生长因子-β1(transforming growth factor β1,TGF -β1)和转化生长因子-β2(transforming growth factor β2,TGF -β2)在分泌性中耳炎(secretory otitis media,SOM)发病过程中的作用。方法采用双抗体夹心酶联免疫吸附试验法( enzyme linked immunosorbent assay ELISA)检测56例(61只耳) SOM 患者中

  1. Impact of Placement of In-the-Ear Antenna on Ear-to-Ear Path Gain

    DEFF Research Database (Denmark)

    Kammersgaard, Nikolaj Peter Iversen; Kvist, Søren H.; Thaysen, Jesper;


    An in-the-ear antenna is rotated in the concha. For the different placements the ear-to-ear path gain is simulated and measured. The simulations and measurements show that the ear-to-ear path gain varies with more than 15 dB even though it is the same antenna that occupies the same volume, which...... has only been rotated. This illustrates the importance of the correct placement of the antenna. The variation of the ear-to-ear path gain is compared with the far-field efficiency in order to explain part of the variation. The best and worst placements’ radiation patterns are analyzed....

  2. Risk factors analysis for non dry ear after radical mastoidectomy for chronic suppurative oti-tis media%慢性化脓性中耳炎患者乳突根治术后出现不干耳的危险因素分析

    Institute of Scientific and Technical Information of China (English)



    目的:探讨慢性化脓性中耳炎患者行乳突根治术后不干耳的危险因素。方法回顾性分析我院行乳突根治术的120例慢性中耳炎患者临床资料,应用Logistic回归模型分析年龄、性别、病程、吸烟史、药物过敏史、鼻咽部炎症状况、中耳炎类型以及致病菌等因素对术后不干耳的影响。结果干耳组与不干耳组患者年龄、性别、病程、药物过敏史、鼻咽部炎症状况等差异无统计学意义( P>0.05);不干耳组中吸烟者比例以及骨疡型中耳炎患者比例高于干耳组,胆脂瘤中耳炎比例低于干耳组,差异均有统计学意义( P<0.05);两组患者的常见致病菌构成差异亦有统计学意义( P<0.05)。 Logistic回归分析显示,吸烟史、中耳炎类型、致病菌与慢性化脓性中耳炎患者术后不干耳显著相关( OR值分别为8.201、10.801和7.273)。结论术前中耳炎类型、吸烟史以及真菌感染是慢性化脓性中耳炎患者行乳突根治术后不干耳的危险因素,针对这些因素,术前应积极做好充分准备。%Objective To investigate the risk factors of non dry ear after radical mastoidectomy for chronic suppurative otitis media.Methods Clinical data of 120 patients with chronic otitis media (COM),who were treated with radical mastoidectomy in our hospital,were retrospectively analyzed.The effects of age,gender,disease duration,smoking history,drug allergies history,nasopharynx inflammatory conditions ,otitis media types and pathogens in postoperative non dry ear were analyzed by using the Logistic regression a -nalysis.Results There was no significant difference in age ,gender,disease duration,drug allergies and nasopharynx inflammatory be-tween the dry ear and non dry ear groups .The proportions of smokers and COM with osteitis in the non dry ear groups were significantly higher than that in the dry ear group while the proportion of

  3. 开放式鼓室成形听力重建术不同频率效果分析%Frequency-specific hearing assessment after canal wall-down tympanoplasty for chronic ear diseases

    Institute of Scientific and Technical Information of China (English)

    陶朵朵; 陈兵


    Objectives To analyze frequency-specific hearing results after canal wall-down tympanoplasty for chronic ear diseases, in relation to various surgical factors. Methods Patients who underwent canal wall-down tympanoplasty for chronic ear diseases from June 2008 to January 2011 in the Department of Otolaryngology, Eye Ear Nose & Throat Hospital, Fudan University were reviewed retrospectively (n=87). Using pure tone audiometry, air-conductive threshold (AC), bone-conductive threshold (BC) ,and air-bone gap (ABG), and pre- and post-operative changes were analyzed for each of the following frequencies: 0.25 kHz, 0.5 kHz, 1 kHz, 2 kHz, 3 kHz, 4 kHz (AC and BC) and 6 kHz (AC). Frequency-specific results were investigated in relation to various surgical factors. Results Both AC and ABC results showed improvements at each frequency, primarily in the low and mid frequencies. The improvement decreased gradually from low to high frequencies. BC results showed significant improvement at every frequency except 4 kHz. In patients without ossiculoplasty, BC results improved significantly only at 1 kHz. Conclusion Canal wall-down tympanoplasty for chronic ear diseases can improve hearing primarily in low and mid frequencies.%目的 探讨慢性中耳炎患者开放式鼓室成形术后听力重建效果,并对不同频率听力重建效果进行对比分析.方法 回顾2008年6月至2011年1月在复旦大学附属眼耳鼻喉科医院耳鼻喉科行开放式鼓室成形术的920例患者,从中筛选具有完整随访资料患者87名,利用纯音测听对患者手术前后0.25 kHz、0.5 kHz、1 kHz、2kHz、3 kHz、4kHz、6 kHz频率处的纯音气导听阈、骨导听阈和气骨导差进行评估,比较各项指标手术前后差异,探讨各频率重建效果的可能影响因素.结果 术后气导听阈总体平均值在各个频率均有显著改善,听觉重建效果从低频到高频呈下降趋势,其中1 kHz以下频率明显优于2 kHz以上频率;术后气骨导


    Directory of Open Access Journals (Sweden)

    Mahesh V .


    Full Text Available Chronic Suppurative Otitis Media (CSOM is a condition of the middle ear that is characterized by persistent or recurrent discharge through a chronic perforation of the tympanic membrane from the middle ear cleft. Untreated cases of Chronic Suppurative Oti tis Media can result in a broad range of complications like mastoiditis, labyrinthitis, facial nerve paralysis and serious intracranial complications. In this study an attempt is made to know the aerobic bacteriology of Chronic Suppurative Otitis Media, wi th antimicrobial susceptibility testing of the bacterial isolates. The present prospective study was carried out on 50 patients presenting with Chronic Suppurative Otitis Media between January 2014 to December 2014 in the department of E.N.T, Basaveshwara Medical College Hospital and Research Centre, Chitradurga. The most common bacteria in Chronic Suppurative Otitis Media in this study was Pseudomonas aeruginosa (62% followed by Staphylococcus aureus (22%. Gentamicin was the most sensitive (100% antibio tic against Pseudomonas aeruginosa followed by Amikacin (96.77%. Ceftriaxone and Gentamicin were the most sensitive (100% antibiotic against Staphylococcus aureus followed by Amikacin (90.9%

  5. Comparison of Tympanoplasty Results in Dry and Wet Ears

    Directory of Open Access Journals (Sweden)

    Nikzad Shahidi


    Full Text Available Introduction: Tympanoplasty is the standard and well established procedure for closure of tympanic membrane perforations .This paper compares the results of tympanoplasty in terms of hearing improvement and graft incorporation in patients with chronic perforation of the tympanic membrane between two groups with and without active drainage at the time of surgery.  Materials and Methods: Sixty referring patients to specialty and subspecialty clinics between the age 15 to 60 years-old were selected. All patients suffered from Chronic Otitis Media and they were categorized into two groups: a those with wet ears and b those with dry ears. Tympanoplasty surgery was performed through the use of embedding technique of temporalis fascia graft and in medial position (Medial Graft Technique. Finally, the data about the level of hearing improvement and the repair of tympanic membrane were analyzed.  Results: Although there was hearing improvement in both groups - with wet or dry ear - no statistically significant difference was observed between two groups. Following the surgery, tympanic membrane in two patients with wet ear and one with dry ear was not repaired, however according to the statistical analysis this difference was not significant.  Conclusion:  The results of this study showed that in contrast to the common perception that tympanoplasty results in the patients with wet ear is poorer than those with dry ear, there was little difference in the results of the operations performed on two groups.

  6. Microbiologia do meato médio na rinossinusite crônica Microbiology of middle meatus in chronic rhinosinusitis

    Directory of Open Access Journals (Sweden)

    Elisabeth Araujo


    Full Text Available Este foi um estudo prospectivo que visou identificar a microbiologia do meato médio em pacientes com rinossinusite crônica (RSC e compará-la com a de indivíduos sadios. MATERIAL E MÉTODOS: Foram incluídos 134 pacientes RSC e 50 voluntários sadios, que constituíram o grupo controle. As amostras foram coletadas endoscopicamente e submetidas a exames pelo método de Gram com contagem leucocitária e culturas para aeróbios, anaeróbios e fungos. RESULTADOS: Nos pacientes com RSC foram cultivados 220 microorganismos, dentre os quais os mais freqüentes foram o Staphylococcus aureus, presente em 31% das amostras, e o Staphylococcus coagulase-negativo (SCN em 23%. Gram-negativos ou facultativos foram isolados em 37% das amostras, anaeróbios em 12%, e fungos em 14%. Ao exame bacterioscópico evidenciou-se alguns ou numerosos leucócitos em 74% das amostras com culturas positivas. Nos indivíduos sadios o SCN foi isolado em 40% das amostras e o Staphylococcus aureus em 18%. Em 12% dos indivíduos a cultura para fungos foi positiva, e o exame direto negativo. Todas as culturas anaeróbias foram estéreis. Quanto à contagem leucocitária todos apresentaram nenhum ou raros leucócitos. CONCLUSÃO: Os grupos apresentaram resultados semelhantes quanto à microbiologia, entretanto, diferiram em relação à contagem leucocitária, o que auxilia na diferenciação um microorganismo infectante de um colonizante.This was a prospective study which assessed endoscopically collected middle meatus secretions in patients with chronic rhinosinusitis (CRS and compared those findings with microbiological data of healthy individuals. METHODS: Middle meatus samples were collected from 134 CRS patients. In the laboratory, samples were Gram stained for microscopic examination with white blood cels (WBCs count and also send for aerobic, anaerobic and fungal cultures. Fifty volunteers served as control. RESULTS: In CRS patients a total of 220 microorganisms were

  7. [Inner Ear Hearing Loss]. (United States)

    Hesse, G


    Hearing loss is one of the most dominant handicaps in modern societies, which additionally very often is not realized or not admitted. About one quarter of the general population suffers from inner ear hearing loss and is therefore restricted in communicational skills. Demographic factors like increasing age play an important role as well as environmental influences and an increasing sound and noise exposure especially in leisure activities. Thus borders between a "classical" presbyacusis - if it ever existed - and envirionmentally induced hearing loss disappear. Today restrictions in hearing ability develop earlier in age but at the same time they are detected and diagnosed earlier. This paper can eventually enlighten the wide field of inner ear hearing loss only fragmentarily; therefore mainly new research, findings and developments are reviewed. The first part discusses new aspects of diagnostics of inner ear hearing loss and different etiologies.

  8. A simplified approach to assess variations in Eustachian tubal ventilatory function by Bortnick-Miller apparatus in chronic otitis media cases (dry before surgery

    Directory of Open Access Journals (Sweden)

    Apoorva Kumar Pandey


    Full Text Available Aim: The aim of this study is to see the different functional gradings of Eustachian tube ventilatory function as assessed by Bortnick-Miller (B-M apparatus in chronically diseased middle ears (dry cases planned to undergo tympanoplasty and to correlate the results with the past experiences. Materials and Methods: This study consisted of 29 cases of chronic suppurative otitis media, inactive stage having central perforation. Tubal function was evaluated by B-M apparatus based on ability of tube assimilating the applied positive and negative pressure. Tubal opening pressure was noted after applying positive pressure while residual intratympanic pressure after 10 swallows was recorded after applying negative pressure. Results: This study revealed that results of tubal manometry in diseased ears cover a wide spectrum of normal function to partial/non-function. 51.72% of cases were able to equalize applied negative pressure, 41.39% partially equalizing, while 6.89% of cases were completely unable to equalize applied negative pressure. Conclusion: Our results of aspiration method with the help of BM apparatus explicitly suggest that tubal function in chronically diseased ears deviates from that of normal ears. It perpetually reflects that varied results of middle ear reconstructive surgeries could be anticipated in accordance with different tubal function gradings.

  9. The ear in fetal MRI: what can we really see?

    Energy Technology Data Exchange (ETDEWEB)

    Moreira, Nuno Canto [Neuroradiology Section C., Campos Costa, Fragosela, Viseu (Portugal); Uppsala University, Department of Radiology, Uppsala (Sweden); Teixeira, Joao [Department of Neuroradiology, Porto (Portugal); Raininko, Raili; Wikstrom, Johan [Uppsala University, Department of Radiology, Uppsala (Sweden)


    The aim of this study was to investigate the ability to depict the components of the ear on brain-oriented fetal MRI studies. Retrospective evaluation of the ear in MRI studies was performed post-mortem in 16 fetuses ranging from 15 to 22 gestation weeks (GW), and in 122 examinations in vivo of fetuses ranging from 20 to 38 GW. The cochlea, vestibular apparatus, middle ear, and external auditory canal were separately graded according to the components that were delineated. The components of the inner and middle ear were fully delineated in 100% of the post-mortem examinations, but the external auditory canals were only seen in only 25%. In the in vivo group, the imaging detail was much lower. Cochlear turns could be identified in 75% of the fetuses, the vestibule and the lateral semicircular canals in 72% andossicles in 70%. Before 25 GW, the ability to identify these individual parts was 50%, 30%, and 33%, respectively, and above it was 89%, 93%, and 90%. In most cases, the external auditory canals could only be seen after 29 GW. In fetal MRI studies in vivo, it is possible to depict the components of the ear in the majority of the fetuses, in such a manner as to exclude major malformations. However, MRI might not provide enough detail to rule out pathology of the ear before 25 GW, this being a critical age for pregnancy management in many countries. (orig.)

  10. Lumped parametric model of the human ear for sound transmission. (United States)

    Feng, Bin; Gan, Rong Z


    A lumped parametric model of the human auditoria peripherals consisting of six masses suspended with six springs and ten dashpots was proposed. This model will provide the quantitative basis for the construction of a physical model of the human middle ear. The lumped model parameters were first identified using published anatomical data, and then determined through a parameter optimization process. The transfer function of the middle ear obtained from human temporal bone experiments with laser Doppler interferometers was used for creating the target function during the optimization process. It was found that, among 14 spring and dashpot parameters, there were five parameters which had pronounced effects on the dynamic behaviors of the model. The detailed discussion on the sensitivity of those parameters was provided with appropriate applications for sound transmission in the ear. We expect that the methods for characterizing the lumped model of the human ear and the model parameters will be useful for theoretical modeling of the ear function and construction of the ear physical model.

  11. The Influence of Nursing Intervention on Operation Effect of Middle Ear and Mastoid Operation for Secretory Otitis Media Patients%护理干预对分泌性中耳炎患者中耳乳突手术疗效的影响

    Institute of Scientific and Technical Information of China (English)



    Objective:To investigate the influence of nursing intervention on operation effect of middle ear and mastoid operation for secretory otitis media patients.Method:The clinical data of 150 cases with secretory otitis media treated with middle ear and mastoid operation from December 2011 to December 2013 in author’s hospital were selected,were randomly divided into two groups,each group had 75 cases.The control group was given operation related routine nursing, the observation group was given perioperative period nursing intervention on the basis of routine nursing.Result:The total effective rate of observation group was 94.7%,significantly higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion:The implementation of perioperative period nursing intervention on middle ear and mastoid operation of secretory otitis media patients,can significantly improve the operation effect,reduce complications,is worthy of clinical application.%目的:探讨护理干预对分泌性中耳炎患者中耳乳突手术疗效的影响。方法:选取2011年12月-2013年12月在笔者所在医院实施中耳乳突手术的150例分泌性中耳炎患者,随机分为两组,各75例。对照组实施手术相关的常规护理,观察组在常规护理基础上,实施围手术期护理干预。结果:观察组总有效率为94.7%,明显高于对照组,差异有统计学意义(P<0.05)。结论:对分泌性中耳炎中耳乳突手术患者,实施围手术期护理干预,可以明显提高手术疗效,减少并发症,值得临床推广应用。

  12. From Ear to Brain (United States)

    Kimura, Doreen


    In this paper Doreen Kimura gives a personal history of the "right-ear effect" in dichotic listening. The focus is on the early ground-breaking papers, describing how she did the first dichotic listening studies relating the effects to brain asymmetry. The paper also gives a description of the visual half-field technique for lateralized stimulus…

  13. Seeing With the Ears

    NARCIS (Netherlands)

    Koenderink, Jan


    In recent talks, I mentioned how my artist friends often complain that their clients see with their ears. It recently dawned on me that nobody understood what I said, or—worse—got the wrong idea. The audience thinks of bionic devices (Proulx, Stoerig, Ludowig, & Knoll, 2008) or bat echo location (Mo

  14. Low-set ears and pinna abnormalities (United States)

    Low-set ears; Microtia; "Lop" ear; Pinna abnormalities; Genetic defect-pinna; Congenital defect-pinna ... conditions: Abnormal folds or location of the pinna Low-set ears No opening to the ear canal ...

  15. Feature and significance of bacterial biofilm formation in middle-ear mucosa in the rat model of acute otitis media%细菌生物膜在急性中耳炎大鼠中耳腔的形成特点及意义

    Institute of Scientific and Technical Information of China (English)

    柯朝阳; 杨名保; 龚桃根; 刘明


    目的 通过观察细菌生物膜在急性中耳炎大鼠中耳腔的形成特点,分析其与急性中耳炎的关系,并探讨该中耳炎模型用于细菌生物膜研究的可行性.方法 30只健康雄性SD大鼠,采用随机数字表法分为实验组(24只)和对照组(6只).麻醉后将50μl肺炎链球菌悬液[1×108菌落形成单位(colony forming unit,CFU)/ml]经听泡穿刺注入到实验组大鼠双侧中耳腔,等量生理盐水注入到对照组大鼠双侧中耳腔.分别于注射后1、3、5、7、10、14 d各取3只实验组大鼠和1只对照组大鼠的双侧听泡行中耳黏膜扫描电镜观察;另取1只实验组大鼠,显微镜下刮取收集双侧中耳腔表面附着的膜状物,行异硫氰酸荧光素标记的刀豆球蛋白(FITC-ConA)及碘化丙啶(propidium iodide,PI)免疫荧光二重染色,激光扫描共聚焦显微镜观察和革兰染色观察.结果 实验组大鼠在炎性反应早期(1 d、3 d)可见中耳腔大量细菌黏附,定植于局部区域形成微菌落,有吞噬细胞混杂其中,形成初级细菌生物膜;炎性反应中期(5 d、7 d)可见成熟细菌生物膜散在于黏膜表面,形成特征性的"蘑菇状"、"塔状"三维立体结构;炎性反应后期(10 d、14 d)部分细菌生物膜呈现衰退迹象.中耳腔膜状物经FITC-ConA、PI二重荧光染色原位标记及革兰染色观察证实由细菌及多糖基质组成.结论 细菌生物膜在中耳急性感染的早期即已开始形成,并可能成为日后炎性反应反复发作或迁延不愈的原因;本研究建立的大鼠急性中耳炎模型是研究中耳细菌生物膜较为理想的动物模型.%Objective To investigate the relationship between bacterial biofilm and acute otitis media by observing the feature of bacterial biofilm formation in middle-ear mucosa in the rat model of acute otitis media and to study thc possibility of application this rat model in bacterial biofilm research. Methods A total of 30 healthy, male SD rats were


    Directory of Open Access Journals (Sweden)



    Full Text Available OBJECTIVE To compare hearing gain in dry and wet tympanoplasty. MATERIALS AND METHODS A total of 100 ears were included in the study. Two groups were created with 50 ears in each group. All patients had mucosal chronic otitis media. One group had dry ear, another had wet ear at the time of surgery. Type 1 tympanoplasty was done in all the cases by a single surgeon. Hearing gain was calculated 3 months after surgery for both groups and compared. RESULTS Hearing improvement seen in 35 (70% cases in dry ear group and 38 (76% cases in wet ear group. Statistically, both comparisons were insignificant. CONCLUSION The success of tympanoplasty was not adversely affected by the presence of discharge at time of surgery and outcomes were comparable to those of the operation done for dry ear.

  17. Chronic Conductive Hearing Loss Leads to Cochlear Degeneration.

    Directory of Open Access Journals (Sweden)

    M Charles Liberman

    Full Text Available Synapses between cochlear nerve terminals and hair cells are the most vulnerable elements in the inner ear in both noise-induced and age-related hearing loss, and this neuropathy is exacerbated in the absence of efferent feedback from the olivocochlear bundle. If age-related loss is dominated by a lifetime of exposure to environmental sounds, reduction of acoustic drive to the inner ear might improve cochlear preservation throughout life. To test this, we removed the tympanic membrane unilaterally in one group of young adult mice, removed the olivocochlear bundle in another group and compared their cochlear function and innervation to age-matched controls one year later. Results showed that tympanic membrane removal, and the associated threshold elevation, was counterproductive: cochlear efferent innervation was dramatically reduced, especially the lateral olivocochlear terminals to the inner hair cell area, and there was a corresponding reduction in the number of cochlear nerve synapses. This loss led to a decrease in the amplitude of the suprathreshold cochlear neural responses. Similar results were seen in two cases with conductive hearing loss due to chronic otitis media. Outer hair cell death was increased only in ears lacking medial olivocochlear innervation following olivocochlear bundle cuts. Results suggest the novel ideas that 1 the olivocochlear efferent pathway has a dramatic use-dependent plasticity even in the adult ear and 2 a component of the lingering auditory processing disorder seen in humans after persistent middle-ear infections is cochlear in origin.

  18. Effect of tympanic membrane thickness in fascia myringoplasty on the middle ear transfer function-a finite element ear model%颞肌筋膜重建鼓膜厚度对中耳传声的影响--有限元模型研究

    Institute of Scientific and Technical Information of China (English)

    王杰; Zhao Fei; 李永新


    目的研究颞肌筋膜重建鼓膜厚度对中耳传声的影响。方法依据1名成年男性颞骨标本的Micro-CT扫描数据,利用Mimics软件、ANSYS软件建立正常成人中耳有限元模型后,再依据该模型建立从0.05~2.00 mm共9种厚度鼓膜的有限元模型,分别计算不同厚度鼓膜对鼓膜及镫骨底板振动的影响,从而反应不同厚度重建鼓膜对中耳传声的影响。结果当90 dB SPL刺激鼓膜时,所建模型于鼓膜脐部、镫骨底板中央处振幅在文献报道颞骨实验测量结果的范围之内。依据该正常结构中耳有限元模型,建立9种厚度颞肌筋膜重建鼓膜的有限元模型。计算结果显示:当重建鼓膜厚度>0.4 mm时,鼓膜脐部振幅逐渐减低,尤其是当鼓膜厚度>1.0 mm时,影响最明显;当鼓膜厚度为0.05 mm和0.1 mm时,镫骨底板振幅在0.6 kHz以下轻度增强,提高镫骨底板振幅约2 dB,但0.6~8.0 kHz均降低约2.5 dB;当鼓膜厚度为0.2、0.4与0.6 mm时,于约3.0 kHz以下镫骨底板振幅水平下降,幅度约<5.0 dB;当鼓膜厚度为0.6、0.8与1.0 mm时,于3.0 kHz以下镫骨底板振幅减小明显,于0.8 kHz以下约达-10 dB;而当鼓膜厚度为1.5 mm与2.0 mm时,镫骨底板振幅于1.0 kHz以下降低最明显,于0.8、1.0 kHz处分别达-16 dB和-22 dB。另外,于共振峰约3.2 kHz处,9种厚度重建鼓膜对镫骨底板影响最大约-5 dB。共振峰3.2~8.0 kHz之间,镫骨底板均有明显降低,约于5.0 kHz处最大达约-10 dB。结论颞肌筋膜重建后的鼓膜厚度影响鼓膜本身及镫骨底板的振动,当重建鼓膜厚度超过1.0 mm时对中耳传声影响显著增加。%OBJECTIVE To study the effect of the thickness of tympanic membrane rebuilt from fascia myringoplasty on the acoustic transfer function of the middle ear. METHODS A finite element model(FEM) was developed with Mimics and Ansys based on the data from Micro-CT scanning of a

  19. nEar 05

    Institute of Scientific and Technical Information of China (English)

    S&C Labs


    Ego Systems简称ESI或Ego-Sys,这问韩国公司一向以制造低价格、高性能的专业音频产品闻名于专业音频制作领域。其产品涵盖了专业录音卡、监听音箱和USB声卡等。在大家的印象中,可能还记得MAYA录音卡、nEar 08监听音箱,以及MAYA EX系列USB声卡。其中,nEar08监听音箱曾在本刊2001年第18期报道过,那是它首次在国内媒体上亮相。经过四年多的市场检验,

  20. Nonlinear dynamics of the mammalian inner ear

    CERN Document Server

    Szalai, Robert; Homer, Martin


    A simple nonlinear transmission-line model of the cochlea with longitudinal coupling is introduced that can reproduce Basilar membrane response and neural tuning in the chinchilla. It is found that the middle ear has little effect on cochlear resonances, and hence conclude that the theory of coherent reflections is not applicable to the model. The model also provides an explanation of the emergence of spontaneous otoacoustic emissions (SOAEs). It is argued that SOAEs arise from Hopf bifurcations of the transmission-line model and not from localized instabilities. The paper shows that emissions can become chaotic, intermittent and fragile to perturbations.

  1. Reconstruction of External Auditory Meatus (Re-EAMs) and Tympanoplasty for、Patients with Congenital Deformation of the Middle and Outer Ears%先天性中外耳畸形外耳道再造与鼓室成形术

    Institute of Scientific and Technical Information of China (English)

    邹艺辉; 杨仕明; 戴朴; 韩维举; 韩东一


    Objective To explore the hearing improvement after reconstruction of external auditory meatus (Re-EAMs) and tympanoplasty for patients with congenital deformation of the middle and outer ears, and provide reference for later treat⁃ment to these kinds of patients. Methods a retrospective analysis of 41 cases (41 ears) with preoperative and postoperative hearing findings undergone Re-EAMs and tympanoplasty patients with congenital deformation of the middle and outer ears in General Hospital of PLA during 2006.7-2012.12. Results The methods for operations were Ossicular chain loosening 41.5%(17/41),Porp implantation 46.3%(19/41), Torp implantation 7.3%(3/41) and inner ear fenestration 4.9%(2/41),with average air conduction hearing threshold pre-and post-operation for 0.5k、1k、2k、4k (58 dB/53dB),(64 dB/52dB),(73 dB/73dB)and (62 dB/46dB)respectively. Conclusion Hearing improvement is not obvious after ossicular chain loosening and Torp implan⁃tation, while significant for Porp implantation and inner ear fenestration, but can’t reach the normal hearing threshold level.%目的:探索先天性中外耳畸形患者耳道再造与鼓室成形术后听力改善情况,为此类患者方案选择提供参考。方法回顾性分析2006年6月~2012年12月我们进行外耳道再造与鼓室成形患者中有术前术后听力的41例(41耳)的情况。结果手术采用听骨链松解41.5%(17/41),Porp植入46.3%(19/41),Torp植入7.3%(3/41),内耳开窗4.9%(2/41)。术前术后0.5k、1k、2k、4k平均气导听阈值分别为(58 dB/53dB),(64 dB/52dB),(73 dB/73dB),(62 dB/46dB).结论听骨链松解与Torp植入术后听力改善不明显,Porp植入和内耳开窗术后听力有明显改善,但未能达到正常听阈水平。

  2. The Topography and Differentiation of Facial Nerve in Middle Ear Surgery%中耳炎手术中面神经定位和辨认的临床研究

    Institute of Scientific and Technical Information of China (English)

    赵东; 郭龙梅; 徐平


    Objective To investigate the topography and differentiation of the facial nerves in the middle car surgery. Methods From January 2008 to December 2010, radical mastoidectomy or tympanoplasty was administered in 185 patients with chronic otitis media and choicstcatoma otitis media, and analyzed the exploration of the surgery. Results 58 cases of exposed facial nerves were identified and the topography of the tympanic segments in facial nerve was located as the cochlcariform, odontoid, and proccssus brcvis incudis. 33 cochlcariform process disappeared, 25 odontoid process damaged, and 19 proccssus brcvis damaged or displatcd. 12 cochlcariform process and 14 digastric ridge damaged; chorda tympani nerve also could locate the facial nerves and 33 variations were noted. The relationship between facial nerves and granulation tissues indicated that there were 78 cases of the granulation tissue covering the surface of the nerve, 47 cases of the granulation tissue enclosing the nerve and 24 cases of the granulation tissue came from the facial nerve itself. Conclusion We can reduce and prevent the occurrence of facial nerve injuries by being familiar with the practices and variations of facial nerves within the normal temporal bones, and become skilled in basic operations%目的 探讨中耳炎手术中面神经的定位和辨认.方法 回顾性分析2008年1月~2010年12月185例行开放式乳突根治术或加鼓室成形术的慢性化脓性中耳炎及胆脂瘤中耳炎患者的手术资料,对术中面神经探查定位及辨认方法进行分析总结.结果 ①185例中,面神经探查发现58例面神经裸露;②面神经鼓室段定位标志为匙突、齿突、砧骨短突,185例中33例匙突消失,25例齿突遭到破坏,19例砧骨短突破坏或移位;乳突段定位标志为水平半规管、二腹肌脊,185例中12例水平半规管遭破坏,14例二腹肌脊被破坏;33例鼓索神经变异;③面神经与肉芽组织的关系为肉

  3. Clinical Effects of the Method for Warming the Middle-jiao and Strengthening the Spleen on Gastric Mucosa Repair in Chronic Gastritis Patients

    Institute of Scientific and Technical Information of China (English)

    Hu Lingjing; Hu Xiaomei; Yang Min; Xie Huimin; Xiang Yanghong


    Objective:To observe clinical effects of the method for warming the middle-jiao and strengthening the spleen on gastric mucosa repair in chronic gastritis patients.Methods:The 42 cases of the treatment group were orally adiministered Yiweikang Capsule(益胃康胶囊);while the other 25 cases in the control group wore orally given Wenweishu Capsule(温胃舒胶囊).Both the groups wore observed for 2 months.Results:The total effective rate in the treatment group was obviously higher than that of the control group(P<0.05),with statistical significance shown by the TCM symptom score,gastroscopic examination and the HP test (p<0.05 or P<0.01).Conclusions:Yiweikang Capsule(益胃康胶囊)iS an effeetive medicine for chronic gastritis.

  4. Comparison of Three Methods Used in the Diagnosis of Extraesophageal Reflux in Children with Chronic Otitis Media with Effusion

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    Martin Formánek


    Full Text Available Objectives. Detection of extraesophageal reflux (EER in children with chronic otitis media with effusion (OME using three different diagnostic methods. Methods. Children between 1 and 7 years with OME who underwent adenoidectomy and myringotomy with insertion of a ventilation tube were included in this prospective study. EER was detected using three methods: oropharyngeal pH was monitored for 24 hours using the Restech system; detection of pepsin in middle ear fluid obtained during myringotomy was done using Peptest, and detection of pepsin in an adenoid specimen was done immunohistochemically. Results. Altogether 21 children were included in the study. Pathological oropharyngeal pH was confirmed in 13/21 (61.9% children. Pepsin in the middle ear fluid was present in 5/21 (23.8% children; these 5 patients were diagnosed with the most severe EER established through monitoring of oropharyngeal pH. No specimen of adenoids tested was positive for pepsin upon immunohistochemical examination. Conclusions. Diagnosis of EER in patients with OME using Restech is sensitive but less specific when compared to the detection of pepsin in middle ear fluid using Peptest. Pepsin in the middle ear was consistently present in patients with RYAN score above 200, and these patients in particular could potentially profit from antireflux therapy.

  5. Prevalence of ear disease in dogs undergoing multidetector thin-slice computed tomography of the head. (United States)

    Foster, Allison; Morandi, Federica; May, Elizabeth


    Previous reports describing the prevalence of ear diseases in dogs have primarily been based on dogs presenting with clinical signs of disease. The prevalence of subclinical ear disease remains unknown. The purpose of this cross-sectional retrospective study was to describe the prevalence of lesions consistent with middle and external ear disease in dogs presented for multidetector computed tomography (CT) of the head and/or cranial cervical spine at our hospital during the period of July 2011 and August 2013. For each included dog, data recorded were signalment, CT findings, diagnosis, and treatment. A total of 199 dogs met inclusion criteria. Nineteen dogs (9.5%) were referred for evaluation of suspected ear disease and 27 dogs (13.5%) had histories or physical examination findings consistent with otitis externa. A total of 163 dogs (81.9%) had CT lesions consistent with external ear disease (i.e. ear canal mineralization, external canal thickening, and/or narrowing of the external canal). Thirty-nine dogs (19.5%) had CT lesions consistent with middle ear disease (i.e. soft tissue attenuating/fluid material in the tympanic bullae, bulla wall thickening or lysis, and/or periosteal proliferation of the temporal bone). Findings from this study indicated that the prevalence of external and middle ear disease in dogs could be higher than that previously reported.

  6. The Engagement in Physical Activity for Middle-Aged and Older Adults with Multiple Chronic Conditions: Findings from a Community Health Assessment

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    Wei-Chen Lee


    Full Text Available The current aging trends accompanying the increasing prevalence of multiple chronic conditions (MCCs and decreasing participation in physical activity (PA have swept the United States. In light of the magnitude of this phenomenon, this study seeks to identify the most common MCC combinations and their relationships with PA level. A cross-sectional study, Brazos Valley Health Assessment, was conducted between October 2009 and July 2010. All data analyses were performed by STATA 12.0. The overall sample which met the inclusion criteria is 2,603. Among people older than 45 years, chronic conditions of cardiovascular, endocrine, and musculoskeletal systems were the most prevalent. Participants with three chronic conditions were less likely to meet the PA standard than those with only two chronic conditions. Younger age, women, rural residence, and unsafe environments were related to the lower PA level. After adjusting for seven covariates, all MCCs combinations adversely affect the level of PA (, . People with MCCs were among the least active subgroups despite the health benefits of doing exercise. Given the well-documented benefits of physical activity for delaying the onset or progression of MCCs, public health efforts to enhance regular PA in middle-aged and older adults are recommended.

  7. Ovine ear model for fully endoscopic stapedectomy training. (United States)

    Cordero, A; Benítez, S; Reyes, P; Vaca, M; Polo, R; Pérez, C; Alonso, A; Cobeta, I


    Endoscopic surgery of the middle ear is progressively gaining the interest of otologists, as technological advances have overcome some of its main drawbacks. The long learning curve required to master this technique, urges the search for models to practice it. After the validation of sheep's ear as a proper training model for microscopic stapedectomy, our objective is to demonstrate its adequacy for practicing stapes surgery but performed through a fully endoscopic approach. Endoscopic stapedectomy was performed by two surgeons in 40 sheep ears (20 specimens each). To analyze the effects of the learning curve on surgical success, complication rates and surgical time reduction, the sample was divided in two groups: group 1 being the first ten procedures of each surgeon, and group 2 the second set of stapedectomies. The impact of the operated side and the resection of the chordal spine were also studied. No statistically significant differences were found considering the operated side. A statistically significant improvement in some of the surgical steps was demonstrated comparing both groups and also after the resection of the chordal spine. Mean surgical time declined from 38 to 31.5 min (p sheep ear is an optimal model for endoscopic middle ear surgery, as it allows for the acquisition of the skills required to master this technique.

  8. Unusual pseudomyiasis with Musca domestica (housefly larvae in a child with chronic otitis media

    Directory of Open Access Journals (Sweden)

    Zafar Iqbal


    Full Text Available Myiasis is a disease caused by fly larvae and aural myiasis is a rare clinic condition often occurring in children or mentally retarded people. We report the case of an unusual presentation of a unilateral aural myiasis in a 3-year-old female child patient belonging to a slum with unilateral chronic otitis media caused by Musca domestica (housefly larvae. Eight larvae were removed from the external auditory canal while five more larvae were located in the middle ear cavity and were removed through perforation of the tympanic membrane. Management of ear myiasis is based on removal of the maggots and cleansing of the ear with ethanol, chloroform, or physiological saline. Physiological saline is preferred in patients who have tympanic membrane perforation. Myiasis is related to personal hygiene. Therefore, to decrease the incidence of these infestations, care, and hygiene standards should be carried out for those at risk through information, education, and communication.

  9. Ear Recognition Based on Gabor Features and KFDA



    We propose an ear recognition system based on 2D ear images which includes three stages: ear enrollment, feature extraction, and ear recognition. Ear enrollment includes ear detection and ear normalization. The ear detection approach based on improved Adaboost algorithm detects the ear part under complex background using two steps: offline cascaded classifier training and online ear detection. Then Active Shape Model is applied to segment the ear part and normalize all the ear images to the s...

  10. Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey (United States)

    Sousa, Renata M; Ferri, Cleusa P; Acosta, Daisy; Albanese, Emiliano; Guerra, Mariella; Huang, Yueqin; Jacob, KS; Jotheeswaran, AT; Rodriguez, Juan J Llibre; Pichardo, Guillermina Rodriguez; Rodriguez, Marina Calvo; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph; Zuniga, Tirso; Prince, Martin


    Summary Background Disability in elderly people in countries with low and middle incomes is little studied; according to Global Burden of Disease estimates, visual impairment is the leading contributor to years lived with disability in this population. We aimed to assess the contribution of physical, mental, and cognitive chronic diseases to disability, and the extent to which sociodemographic and health characteristics account for geographical variation in disability. Methods We undertook cross-sectional surveys of residents aged older than 65 years (n=15 022) in 11 sites in seven countries with low and middle incomes (China, India, Cuba, Dominican Republic, Venezuela, Mexico, and Peru). Disability was assessed with the 12-item WHO disability assessment schedule 2.0. Dementia, depression, hypertension, and chronic obstructive pulmonary disease were ascertained by clinical assessment; diabetes, stroke, and heart disease by self-reported diagnosis; and sensory, gastrointestinal, skin, limb, and arthritic disorders by self-reported impairment. Independent contributions to disability scores were assessed by zero-inflated negative binomial regression and Poisson regression to generate population-attributable prevalence fractions (PAPF). Findings In regions other than rural India and Venezuela, dementia made the largest contribution to disability (median PAPF 25·1% [IQR 19·2–43·6]). Other substantial contributors were stroke (11·4% [1·8–21·4]), limb impairment (10·5% [5·7–33·8]), arthritis (9·9% [3·2–34·8]), depression (8·3% [0·5–23·0]), eyesight problems (6·8% [1·7–17·6]), and gastrointestinal impairments (6·5% [0·3–23·1]). Associations with chronic diseases accounted for around two-thirds of prevalent disability. When zero inflation was taken into account, between-site differences in disability scores were largely attributable to compositional differences in health and sociodemographic characteristics. Interpretation On the basis

  11. 慢性化脓性中耳炎伴蛛网膜下腔出血病例分析%Chronic suppurative otitis media induced subarachnoid hemorrhage: case analysis

    Institute of Scientific and Technical Information of China (English)

    王冠楠; 杨文强; 张怡; 孙圣荣


    Summary We present a case of subarachnoid hemorrhage induced by chronic suppurative otitis media, and discuss the possible mechanism here. Chronic suppurnlive otitis media is a common suppurative inflammation of middle ear, which can cause sorts of extracranial and intracranial complications in the situation of lower resistance or higher virulence. However, the condition of subarachnoid heamorrhage casued by chronic suppurative otitis media is quite rare. According to this case and previously published articles, we consider that meningitis may be the main reason of subarachnoid hemorrhage induced by chronic suppurative otitis media.

  12. The ear: Diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Vignaud, J.; Jardin, C.; Rosen, L.


    This is an English translation of volume 17-1 of Traite de radiodiagnostic and represents a reasonably complete documentation of the diseases of the temporal bone that have imaging manifestations. The book begins with chapters on embryology, anatomy and radiography anatomy; it continues with blood supply and an overview of temporal bone pathology. Subsequent chapters cover malformations, trauma, infections, tumors, postoperative changes, glomus tumors, vertebasilar insufficiency, and facial nerve canal lesions. A final chapter demonstrates and discusses magnetic resonance images of the ear and cerebellopontine angle.

  13. Pressure difference receiving ears

    DEFF Research Database (Denmark)

    Michelsen, Axel; Larsen, Ole Næsbye


    of such pressure difference receiving ears have been hampered by lack of suitable experimental methods. In this review, we review the methods for collecting reliable data on the binaural directional cues at the eardrums, on how the eardrum vibrations depend on the direction of sound incidence, and on how sound...... waves behave in the air spaces leading to the interior surfaces of eardrums. A linear mathematical model with well-defined inputs is used for exploring how the directionality varies with the binaural directional cues and the amplitude and phase gain of the sound pathway to the inner surface...

  14. Manufacturing and in vivo inner ear visualization of MRI traceable liposome nanoparticles encapsulating gadolinium

    Directory of Open Access Journals (Sweden)

    Kinnunen Paavo KJ


    Full Text Available Abstract Background Treatment of inner ear diseases remains a problem because of limited passage through the blood-inner ear barriers and lack of control with the delivery of treatment agents by intravenous or oral administration. As a minimally-invasive approach, intratympanic delivery of multifunctional nanoparticles (MFNPs carrying genes or drugs to the inner ear is a future therapy for treating inner ear diseases, including sensorineural hearing loss (SNHL and Meniere's disease. In an attempt to track the dynamics and distribution of nanoparticles in vivo, here we describe manufacturing MRI traceable liposome nanoparticles by encapsulating gadolinium-tetra-azacyclo-dodecane-tetra-acetic acid (Gd-DOTA (abbreviated as LPS+Gd-DOTA and their distribution in the inner ear after either intratympanic or intracochlear administration. Results Measurements of relaxivities (r1 and r2 showed that LPS+Gd-DOTA had efficient visible signal characteristics for MRI. In vivo studies demonstrated that LPS+Gd-DOTA with 130 nm size were efficiently taken up by the inner ear at 3 h after transtympanic injection and disappeared after 24 h. With intracochlear injection, LPS+Gd-DOTA were visualized to distribute throughout the inner ear, including the cochlea and vestibule with fast dynamics depending on the status of the perilymph circulation. Conclusion Novel LPS+Gd-DOTA were visible by MRI in the inner ear in vivo demonstrating transport from the middle ear to the inner ear and with dynamics that correlated to the status of the perilymph circulation.

  15. The relationship between preoperative tympanograms and intraoperative ear examination results in children. (United States)

    Knopke, Steffen; Irune, Ekpemi; Olze, Heidi; Bast, Florian


    The tympanogram is an objective audiological method in adults and children which is often used in the evaluation of middle ear pathology. This should be alongside a thorough patient history and clinical examination prior to the decision to carry out a paracentesis or tympanostomy tube insertion. The goal of the study was to evaluate the relationship between the preoperative tympanogram and intraoperative ear examination results or middle ear findings. The retrospective study included 654 ears in 333 patients who underwent paracentesis with or without tympanostomy tube insertion between January and December 2011. The study cohort consisted of 206 male and 127 female patients with an average age of 3.7 ± 2.5 years. The results of the preoperative tympanogram were compared to those of the intraoperative ear findings. In 18.4 % of ears with a flat tympanogram, an air-filled middle ear was found intraoperatively (p < 0.01). Thus, tympanometry results cannot serve as the only indication for surgical intervention. A decision to treat should always be based on the merits of the symptomatology of the patient in conjunction with tympanometry findings.

  16. Comparative acoustic performance and mechanical properties of silk membranes for the repair of chronic tympanic membrane perforations. (United States)

    Allardyce, Benjamin J; Rajkhowa, Rangam; Dilley, Rodney J; Xie, Zhigang; Campbell, Luke; Keating, Adrian; Atlas, Marcus D; von Unge, Magnus; Wang, Xungai


    The acoustic and mechanical properties of silk membranes of different thicknesses were tested to determine their suitability as a repair material for tympanic membrane perforations. Membranes of different thickness (10-100μm) were tested to determine their frequency response and their resistance to pressure loads in a simulated ear canal model. Their mechanical rigidity to pressure loads was confirmed by tensile testing. These membranes were tested alongside animal cartilage, currently the strongest available myringoplasty graft as well as paper, which is commonly used for simpler procedures. Silk membranes showed resonant frequencies within the human hearing range and a higher vibrational amplitude than cartilage, suggesting that silk may offer good acoustic energy transfer characteristics. Silk membranes were also highly resistant to simulated pressure changes in the middle ear, suggesting they can resist retraction, a common cause of graft failure resulting from chronic negative pressures in the middle ear. Part of this strength can be explained by the substantially higher modulus of silk films compared with cartilage. This allows for the production of films that are much thinner than cartilage, with superior acoustic properties, but that still provide the same level of mechanical support as thicker cartilage. Together, these in vitro results suggest that silk membranes may provide good hearing outcomes while offering similar levels of mechanical support to the reconstructed middle ear.

  17. Quality of life and affective well-being in middle-aged and older people with chronic medical illnesses: a cross-sectional population based study.

    Directory of Open Access Journals (Sweden)

    Anna Wikman

    Full Text Available BACKGROUND: There has been considerable research into the impact of chronic illness on health-related quality of life. However, few studies have assessed the impact of different chronic conditions on general quality of life (QOL. The objective of this paper was to compare general (rather than health-related QOL and affective well-being in middle aged and older people across eight chronic illnesses. METHODS AND FINDINGS: This population-based, cross-sectional study involved 11,523 individuals aged 50 years and older, taking part in wave 1 of the English Longitudinal Study of Ageing. General QOL was assessed using the CASP-19, happiness was evaluated using two items drawn from the GHQ-12, and depression was measured with the CES-D. Analysis of covariance and logistic regression, adjusting for age, gender and wealth, were performed. General QOL was most impaired in people with stroke (mean 37.56, CI 36.73-38.39, and least in those reporting cancer (mean 41.78, CI 41.12-42.44, respectively, compared with no illness (mean 44.15, CI 43.92-44.39. Stroke (mean 3.65, CI 3.58-3.73 was also associated with the greatest reduction in positive well-being whereas diabetes (mean 3.81, CI 3.76-3.86 and cancer were least affected (3.85, CI 3.79-3.91, compared with no illness (mean 3.97, CI 3.95-4.00. Depression was significantly elevated in all conditions, but was most common in chronic lung disease (OR 3.04, CI 2.56-3.61, with more modest elevations in those with osteoarthritis (OR 2.08, CI 1.84-2.34 or cancer (OR 2.07, CI 1.69-2.54. Multiple co-morbidities were associated with greater decrements in QOL and affective well-being. CONCLUSION: The presence of chronic illness is associated with impairments in broader aspects of QOL and affective well-being, but different conditions vary in their impact. Further longitudinal work is needed to establish the temporal links between chronic illness and impairments in QOL and affective well-being.

  18. Standardized surgical approaches to ear surgery in rats

    Institute of Scientific and Technical Information of China (English)

    Peng Li; Dalian Ding; Kelei Gao; Richard Salvi


    Objective:To describe several approaches of ear surgeries for experimental studies in rats. Methods:Anesthetized rats were prepared for demonstration of various ear surgery approaches designed to optimize experimental outcomes in studies with specific goals and exposure requirements. The surgical approaches included the posterior tympanum, superior tympanum, inferior tympanum and occipital approaches. Results: The middle ear cavity and inner ear were successfully exposed from different angles via the mentioned surgical approaches. For example, electrode placement for recording of cochlear bioelectric responses was easily achieved through the posterior tympanum or inferior tympanum approach. Alternatively, drug delivery or gene transfection via round window membrane was most easily accomplished using the posterior tympanum approach. Cochlear perfusion of protective or ototoxic drugs was best performed using the inferior tympanum approach. Ossicular chain interruption to induce a prolonged conductive hearing loss was readily achieved using a superior tympanum approach. Lastly, surgical destruction of the endolymphatic sac to induce experimental endolymphatic hydrops was readily performed via an occipital surgical approach. Conclusion: These standardized surgical approaches can be applied in scientific studies of the ear with different purposes covering electro-physiology, conductive hearing loss, intra-cochlear drug perfusion and experimental studies relevant to Meniere's disease.

  19. Convergence vs. Specialization in the ear region of moles (Mammalia). (United States)

    Crumpton, Nick; Kardjilov, Nikolay; Asher, Robert J


    We investigated if and how the inner ear region undergoes similar adaptations in small, fossorial, insectivoran-grade mammals, and found a variety of inner ear phenotypes. In our sample, afrotherian moles (Chrysochloridae) and the marsupial Notoryctes differ from most other burrowing mammals in their relatively short radii of semicircular canal curvature; chrysochlorids and fossorial talpids share a relatively long interampullar width. Chrysochlorids are unique in showing a highly coiled cochlea with nearly four turns. Extensive cochlear coiling may reflect their greater ecological dependence on low frequency auditory cues compared to talpids, tenrecids, and the marsupial Notoryctes. Correspondingly, the lack of such extensive coiling in the inner ear of other fossorial species may indicate a greater reliance on other senses to enable their fossorial lifestyle, such as tactile sensation from vibrissae and Eimer's organs. The reliance of chrysochlorids on sound is evident in the high degree of coiling and in the diversity of its mallear types, and may help explain the lack of any semiaquatic members of that group. The simplest mallear types among chrysochlorids are not present in the basal-most members of that clade, but all extant chrysochlorids investigated to date exhibit extensive cochlear coiling. The chrysochlorid ear region thus exhibits mosaic evolution; our data suggest that extensive coiling evolved in chrysochlorids prior to and independently of diversification in middle ear ossicle size and shape.


    Directory of Open Access Journals (Sweden)

    Rubi Saikia


    Full Text Available BACKGROUND Congenital external ear malformations like Microtia, Anotia, Preauricular skin tags, etc. cause severe psychological problems in children. If accompanied with atresia of the external auditory canal and the middle ear; hearing loss, developmental delays are also associated with such malformations. AIM The aim of the present study is to evaluate the commonly occurring congenital external ear defects in this part of India. MATERIALS AND METHODS This study was undertaken in patients attending the Plastic Surgery OPD at Assam Medical College Hospital and Smile Train Centre at Srishti Hospitals and Research Centre at Dibrugarh, Assam, from July 2013 to July 2016. We did an analysis of 25 patients with visibly noticeable external ear deformities and recorded the findings as per proforma and took photographs. RESULTS Among the 25 cases, 9 (36% were males and 16 (64% were females. The most common congenital anomaly that we found was microtia 7 (28%. Of these, 1 (4% was isolated microtia and 6 (24% were associated with hemifacial microsomia. The second common finding was preauricular skin tags 5 (20%. 3 of the microtia cases also presented with external auditory canal atresia and hearing loss. CONCLUSION Congenital anomalies of the external ear can seriously change a child’s personality. Proper diagnosis and treatment of such cases will definitely reduce the possible psychological, physical and financial problems of the patient and family as most of them are surgically correctable.

  1. Experimental stereotactic gamma knife radiosurgery. Vascular contractility studies of the rat middle cerebral artery after chronic survival. (United States)

    Major, Otto; Szeifert, György Tamás; Radatz, Matthias W R; Walton, Lee; Kemeny, Andras Armand


    In vitro isometric small vessel myograph experiments and pathological investigations were performed on rat middle cerebral arteries. Thirty-four animals provided 68 normal vessels, six further rats had the endothelial layer mechanically removed from their 12 arteries. Eighteen animals received gamma knife irradiation to the middle cerebral arteries. Fifteen of these received 50 Gray, and three 25 Gray dose to the 50% isodose and the contralateral vessels offered 20 Gray and 15 Gray irradiated specimens. Survival times varied from 12 weeks to 18 months. In the acute stage, abolition of potassium-induced relaxation occurred as early as 24 h after irradiation whilst in one year this reaction seemed to recover and remained active to 18 months. The contraction response to prostaglandin F2 alpha was diminished at six weeks in the 50 Gray-irradiated vessels. However, from one year further reduction was seen and by 18 months this response was totally abolished. We demonstrated reduction of contractile capability of the irradiated normal vessels while the vessels remained patent. When using low irradiation dose there were no pathological changes even at 18 months, but marked physiological changes could be demonstrated. Different vessel wall functions appear to have different radiosensitivity, time course and capability for regeneration.

  2. Investigation of the ear-to-ear radio propagation channel

    DEFF Research Database (Denmark)

    Kvist, Søren Helstrup; Thaysen, J; Jakobsen, Kaj Bjarne


    The effect of the head size on the ear-to-ear radio propagation channel as a part of a body-centric wireless network is examined. The channel quality is evaluated at 2:45 GHz in terms of path gain (∣S21∣) between two monopole antennas that are placed normal to the surface of the head. The investi......The effect of the head size on the ear-to-ear radio propagation channel as a part of a body-centric wireless network is examined. The channel quality is evaluated at 2:45 GHz in terms of path gain (∣S21∣) between two monopole antennas that are placed normal to the surface of the head...

  3. Human ear recognition by computer

    CERN Document Server

    Bhanu, Bir; Chen, Hui


    Biometrics deals with recognition of individuals based on their physiological or behavioral characteristics. The human ear is a new feature in biometrics that has several merits over the more common face, fingerprint and iris biometrics. Unlike the fingerprint and iris, it can be easily captured from a distance without a fully cooperative subject, although sometimes it may be hidden with hair, scarf and jewellery. Also, unlike a face, the ear is a relatively stable structure that does not change much with the age and facial expressions. ""Human Ear Recognition by Computer"" is the first book o

  4. Subharmonic distortion in ear canal pressure and intracochlear pressure and motion. (United States)

    Huang, Stanley; Dong, Wei; Olson, Elizabeth S


    When driven at sound pressure levels greater than ~110 dB stimulus pressure level, the mammalian middle ear is known to produce subharmonic distortion. In this study, we simultaneously measured subharmonics in the ear canal pressure, intracochlear pressure, and basilar membrane or round window membrane velocity, in gerbil. Our primary objective was to quantify the relationship between the subharmonics measured in the ear canal and their intracochlear counterparts. We had two primary findings: (1) The subharmonics emerged suddenly, with a substantial amplitude in the ear canal and the cochlea; (2) at the stimulus level for which subharmonics emerged, the pressure in scala vestibuli/pressure in the ear canal amplitude relationship was similar for the subharmonic and fundamental components. These findings are important for experiments and clinical conditions in which high sound pressure level stimuli are used and could lead to confounding subharmonic stimulation.

  5. Global Ear. Werke 2001 - 2006

    Index Scriptorium Estoniae


    Dresdenis muusikafestivalil "Global Ear" 23.3.03 esitusel Eesti heliloojate muusika: Helena Tulve "lumineux/opaque", Jaan Rääts "Meditation", Mirjam Tally "Aura", Mati Kuulberg "Sonate Nr.4", Mari Vihmand "Seitsmele"

  6. 21 CFR 870.2710 - Ear oximeter. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear oximeter. 870.2710 Section 870.2710 Food and... CARDIOVASCULAR DEVICES Cardiovascular Monitoring Devices § 870.2710 Ear oximeter. (a) Identification. An ear... ear. The amount of reflected or scattered light as indicated by this device is used to measure...

  7. Compression fracture in the middle of a chronic instrumented fusion that developed into pseudarthrosis after balloon kyphoplasty. (United States)

    Pirris, Stephen M; Kimes, Sherri M


    There are only 2 documented cases of vertebral compression fractures occurring within a solid lumbar fusion mass: one within the fusion mass after hardware removal and the other within the levels of the existing instrumentation 1 year postoperatively. The authors report a case of fracture occurring in a chronic (> 30 years) solid instrumented fusion mass in a patient who underwent kyphoplasty. The pain did not improve after the kyphoplasty procedure, and the patient developed a posterior cleft in the fusion mass postoperatively. The patient, a 46-year-old woman, had undergone a T4-L4 instrumented fusion with placement of a Harrington rod when she was 12 years old. Adjacent-segment breakdown developed, and her fusion was extended to the pelvis, with pedicle screws placed up to L-3 to capture the existing fusion mass. Almost 2 years after fusion extension, she fell down the stairs and suffered an L-2 compression fracture, which is when kyphoplasty was performed without pain relief, and she then developed a cleft in the posterior fusion mass that was previously intact. She refused further surgical options. This case report is meant to alert surgeons of this possibility and allow them to consider the rare occurrence of fracture within the fusion mass when planning extension of chronic spinal fusions.

  8. Quantitative PCR of ear discharge from Indigenous Australian children with acute otitis media with perforation supports a role for Alloiococcus otitidis as a secondary pathogen

    Directory of Open Access Journals (Sweden)

    Marsh Robyn L


    Full Text Available Abstract Background Otitis media is endemic in remote Indigenous communities of Australia’s Northern Territory. Alloiococcus otitidis is an outer ear commensal and putative middle ear pathogen that has not previously been described in acute otitis media (AOM in this population. The aims of this study were to determine the presence, antibiotic susceptibility and bacterial load of A. otitidis in nasopharyngeal and ear discharge swabs collected from Indigenous Australian children with AOM with perforation. Methods Paired nasopharyngeal and ear discharge swabs from 27 children with AOM with perforation were tested by A. otitidis quantitative PCR (qPCR. Positive swabs were cultured for 21 days. Total and respiratory pathogen bacterial loads in A. otitidis-positive swabs were determined by qPCR. Results A. otitidis was detected by qPCR in 11 ear discharge swabs from 10 of 27 (37% children, but was not detected in paired nasopharyngeal swabs. A. otitidis was cultured from 5 of 11 qPCR-positive swabs from four children. All A. otitidis isolates had minimum inhibitory concentrations consistent with macrolide resistance. All A. otitidis qPCR-positive swabs were culture-positive for other bacteria. A. otitidis bacterial load ranged from 2.2 × 104-1.1 × 108 cells/swab (median 1.8 × 105 cells/swab. The relative abundance of A. otitidis ranged from 0.01% to 34% of the total bacterial load (median 0.7%. In 6 of 11 qPCR-positive swabs the A. otitidis relative abundance was A. otitidis bacterial load and relative abundance measures were comparable to that of Haemophilus influenzae. Conclusions A. otitidis can be a dominant species in the bacterial communities present in the ear discharge of Indigenous children with AOM with perforation. The absence of A. otitidis in nasopharyngeal swabs suggests the ear canal as the likely primary reservoir. The significance of A. otitidis at low relative abundance is unclear; however, at higher relative

  9. Ear surgery techniques results on hearing threshold improvement

    Directory of Open Access Journals (Sweden)

    Farhad Mokhtarinejad


    Full Text Available Background: Bone conduction (BC threshold depression is not always by means of sensory neural hearing loss and sometimes it is an artifact caused by middle ear pathologies and ossicular chain problems. In this research, the influences of ear surgeries on bone conduction were evaluated. Materials and Methods: This study was conducted as a clinical trial study. The ear surgery performed on 83 patients classified in four categories: Stapedectomy, tympanomastoid surgery and ossicular reconstruction partially or totally; Partial Ossicular Replacement Prosthesis (PORP and Total Ossicular Replacement Prosthesis (TORP. Bone conduction thresholds assessed in frequencies of 250, 500, 1000, 2000 and 4000 Hz pre and post the surgery. Results: In stapedectomy group, the average of BC threshold in all frequencies improved approximately 6 dB in frequency of 2000 Hz. In tympanomastoid group, BC threshold in the frequency of 500, 1000 and 2000 Hz changed 4 dB (P-value < 0.05. Moreover, In the PORP group, 5 dB enhancement was seen in 1000 and 2000 Hz. In TORP group, the results confirmed that BC threshold improved in all frequencies especially at 4000 Hz about 6.5 dB. Conclusion: In according to results of this study, BC threshold shift was seen after several ear surgeries such as stapedectomy, tympanoplasty, PORP and TORP. The average of BC improvement was approximately 5 dB. It must be considered that BC depression might happen because of ossicular chain problems. Therefore; by resolving middle ear pathologies, the better BC threshold was obtained, the less hearing problems would be faced.

  10. 3D printed bionic ears. (United States)

    Mannoor, Manu S; Jiang, Ziwen; James, Teena; Kong, Yong Lin; Malatesta, Karen A; Soboyejo, Winston O; Verma, Naveen; Gracias, David H; McAlpine, Michael C


    The ability to three-dimensionally interweave biological tissue with functional electronics could enable the creation of bionic organs possessing enhanced functionalities over their human counterparts. Conventional electronic devices are inherently two-dimensional, preventing seamless multidimensional integration with synthetic biology, as the processes and materials are very different. Here, we present a novel strategy for overcoming these difficulties via additive manufacturing of biological cells with structural and nanoparticle derived electronic elements. As a proof of concept, we generated a bionic ear via 3D printing of a cell-seeded hydrogel matrix in the anatomic geometry of a human ear, along with an intertwined conducting polymer consisting of infused silver nanoparticles. This allowed for in vitro culturing of cartilage tissue around an inductive coil antenna in the ear, which subsequently enables readout of inductively-coupled signals from cochlea-shaped electrodes. The printed ear exhibits enhanced auditory sensing for radio frequency reception, and complementary left and right ears can listen to stereo audio music. Overall, our approach suggests a means to intricately merge biologic and nanoelectronic functionalities via 3D printing.

  11. [Effects of noise on inner ear]. (United States)

    Bouccara, Didier; Ferrary, Evelyne; Sterkers, Olivier


    The effects of noise on health depend both on individual factors and characteristics of sound exposure. In case of acoustic trauma, reversible or irreversible lesions of inner ear components are possible. Most often there is immediately an acute tinnitus and hearing loss. Audiometric tests demonstrate hearing loss on the high frequency, generally focused on 4 kHz. Immediate treatment is recommended even there is no currently indicator of the ability to restore hearing. New perspectives on treatment are directed to local treatment and/or using new procedure as antioxidative treatment. Occupational and leisure are the two conditions in which chronic exposure to noise is found. Detection and prevention of noise-induced hearing loss is easier in case of industrial workers than in case of noise exposition for musicians and other sounds and stage technicians or concert managers, and of course non-professional with exposure to amplified music.

  12. Role of adenoid biofilm in chronic otitis media with effusion in children. (United States)

    Saafan, Magdy Eisa; Ibrahim, Wesam Salah; Tomoum, Mohamed Osama


    To study the extent of surface adenoid biofilm and to evaluate its role in the pathogenesis of chronic otitis media with effusion (COME) in children. The study was carried out on 100 children between 3 and 14 years of age, who were divided into two groups. The first group (50 children) had otitis media with effusion associated with adenoid hypertrophy, whereas the second group (50 children) had adenoid hypertrophy without middle ear effusion. Adenoidectomy with ventilation tube insertion was done for group 1 cases, whereas, only Adenoidectomy was done for group 2 cases. Microbiological study, Scanning electron microscope and multiplex- PCR were done for suspected adenoid biofilms and specimens from middle ear effusion. Adenoids removed from children with COME had higher grade biofilm formation (74 %) than the second group (42 %). No correlation was found between adenoid size and biofilm formation. Culture of adenoid tissue in group 1 patients was positive in 52 % of cases compared to 96 % by PCR, while in group 2 culture of adenoid tissue was positive in 38 % compared to 48 % by PCR. Culture of middle ear fluid was positive in 32 % of cases only compared to 80 % by PCR. A positive correlation was found between results of bacterial biofilm visualized by SEM and bacteria detected and identified by PCR technique. On the other hand, no correlation was found between results of bacterial biofilm visualized by SEM and bacteria detected by culture. The size of the adenoid is not the main determinant factor in OME pathogenesis but the degree of bacterial colonization is much more important. Adenoids in COME may act as a reservoir of chronic infection rather than causing mechanical Eustachian obstruction. Higher grade biofilm formation was found in cases with middle ear effusion than those with adenoid hypertrophy only. These findings support the hypothesis that there would be an association between adenoidal biofilm formation and COME. This study focused on the value of PCR

  13. Numerical evaluation of implantable hearing devices using a finite element model of human ear considering viscoelastic properties. (United States)

    Zhang, Jing; Tian, Jiabin; Ta, Na; Huang, Xinsheng; Rao, Zhushi


    Finite element method was employed in this study to analyze the change in performance of implantable hearing devices due to the consideration of soft tissues' viscoelasticity. An integrated finite element model of human ear including the external ear, middle ear and inner ear was first developed via reverse engineering and analyzed by acoustic-structure-fluid coupling. Viscoelastic properties of soft tissues in the middle ear were taken into consideration in this model. The model-derived dynamic responses including middle ear and cochlea functions showed a better agreement with experimental data at high frequencies above 3000 Hz than the Rayleigh-type damping. On this basis, a coupled finite element model consisting of the human ear and a piezoelectric actuator attached to the long process of incus was further constructed. Based on the electromechanical coupling analysis, equivalent sound pressure and power consumption of the actuator corresponding to viscoelasticity and Rayleigh damping were calculated using this model. The analytical results showed that the implant performance of the actuator evaluated using a finite element model considering viscoelastic properties gives a lower output above about 3 kHz than does Rayleigh damping model. Finite element model considering viscoelastic properties was more accurate to numerically evaluate implantable hearing devices.

  14. 慢性大脑中动脉狭窄或闭塞的CT灌注成像%CT perfusion imaging in patients with chronic middle cerebral artery stenosis or occlusion

    Institute of Scientific and Technical Information of China (English)

    苏凯燕; 刘增韬


    Objective To evaluate the blood perfusion character of chronic middle cerebral artery stenosis or occlusion with CT perfusion imaging. Methods The clinical and imaging dala of 11 cases with unilateral chronic middle cerebral artery stenosis or occlusion were collected. All cases were examined with CT perfusion and MR (MR1 and MKA). Results The CT perfusion character of chronic middle cerebral artery stenosis or occlusion included CBV elevated, CBF decreased, and MTI prolonged. Conclusion CT perfusion imaging can describe the blood perfusion character of chronic middle cerebral artery stenosis or occlusion, and provide theoretical basis for therapeutic plan.%目的 利用CT灌注成像技术研究慢性大动脉狭窄或闭塞患者的脑血流灌注特征.方法 搜集具有完整临床资料的单侧慢性大脑中动脉重度狭窄或闭寨患者11例,行CT灌注成像及磁共振(MRI及MRA)检查.结果 慢性大脑中动脉狭窄或闭塞患者的脑CT灌注特征是患侧脑血流量(CBF)降低,脑血容量(CBV)升高,平均通过时间(MTT)延长.结论 CT灌注成像能反映慢性大脑中动脉狭窄或闭塞患者的脑血流灌注特征,为临床治疗方案的制订提供理论依据.


    Directory of Open Access Journals (Sweden)



    Full Text Available Chronic suppurative otitis media (CSOM is the result of an initial episode of acute otitis media and is characterized by recurrent discharge from the middle ear through a tympanic perforation. It is an important cause of preventable hearing loss, especially in developing countries. Most approaches to treatment have been unsatisfactory or are very expensive and difficult. As per Acharya Sushruta Karnasrava is a disease characterized by ear discharge. Gandhaka taila is a unique oil based herbo-mineral formulation especially mentioned for Karnasrava with the procedure of karnapurana. To provide clinical evidence and to prove Gandhaka taila as a safe and effective medicine in chronic suppurative otitis media, this study has been carried out. In this study, 23 patients fulfilling the diagnostic and inclusion criteria of CSOM were selected and Gandhaka taila was instilled in to the affected ear for 7 days. The efficacy of the drug was analyzed in terms of the relief produced in the signs and symptoms before and after treatment. The paired t-test was used to check the significance of subjective and objective criteria. The results of the study were found encouraging and there was also a significant reduction in ear discharge.

  16. HIF-VEGF pathways are critical for chronic otitis media in Junbo and Jeff mouse mutants.

    Directory of Open Access Journals (Sweden)

    Michael T Cheeseman


    Full Text Available Otitis media with effusion (OME is the commonest cause of hearing loss in children, yet the underlying genetic pathways and mechanisms involved are incompletely understood. Ventilation of the middle ear with tympanostomy tubes is the commonest surgical procedure in children and the best treatment for chronic OME, but the mechanism by which they work remains uncertain. As hypoxia is a common feature of inflamed microenvironments, moderation of hypoxia may be a significant contributory mechanism. We have investigated the occurrence of hypoxia and hypoxia-inducible factor (HIF mediated responses in Junbo and Jeff mouse mutant models, which develop spontaneous chronic otitis media. We found that Jeff and Junbo mice labeled in vivo with pimonidazole showed cellular hypoxia in inflammatory cells in the bulla lumen, and in Junbo the middle ear mucosa was also hypoxic. The bulla fluid inflammatory cell numbers were greater and the upregulation of inflammatory gene networks were more pronounced in Junbo than Jeff. Hif-1α gene expression was elevated in bulla fluid inflammatory cells, and there was upregulation of its target genes including Vegfa in Junbo and Jeff. We therefore investigated the effects in Junbo of small-molecule inhibitors of VEGFR signaling (PTK787, SU-11248, and BAY 43-9006 and destabilizing HIF by inhibiting its chaperone HSP90 with 17-DMAG. We found that both classes of inhibitor significantly reduced hearing loss and the occurrence of bulla fluid and that VEGFR inhibitors moderated angiogenesis and lymphangiogenesis in the inflamed middle ear mucosa. The effectiveness of HSP90 and VEGFR signaling inhibitors in suppressing OM in the Junbo model implicates HIF-mediated VEGF as playing a pivotal role in OM pathogenesis. Our analysis of the Junbo and Jeff mutants highlights the role of hypoxia and HIF-mediated pathways, and we conclude that targeting molecules in HIF-VEGF signaling pathways has therapeutic potential in the treatment of

  17. Proteomics and the Inner Ear

    Directory of Open Access Journals (Sweden)

    Isolde Thalmann


    Full Text Available The inner ear, one of the most complex organs, contains within its bony shell three sensory systems, the evolutionary oldest gravity receptor system, the three semicircular canals for the detection of angular acceleration, and the auditory system - unrivaled in sensitivity and frequency discrimination. All three systems are susceptible to a host of afflictions affecting the quality of life for all of us. In the first part of this review we present an introduction to the milestones of inner ear research to pave the way for understanding the complexities of a proteomics approach to the ear. Minute sensory structures, surrounded by large fluid spaces and a hard bony shell, pose extreme challenges to the ear researcher. In spite of these obstacles, a powerful preparatory technique was developed, whereby precisely defined microscopic tissue elements can be isolated and analyzed, while maintaining the biochemical state representative of the in vivo conditions. The second part consists of a discussion of proteomics as a tool in the elucidation of basic and pathologic mechanisms, diagnosis of disease, as well as treatment. Examples are the organ of Corti proteins OCP1 and OCP2, oncomodulin, a highly specific calcium-binding protein, and several disease entities, Meniere's disease, benign paroxysmal positional vertigo, and perilymphatic fistula.

  18. Mechanics of the frog ear

    NARCIS (Netherlands)

    Van Dijk, Pim; Mason, Matthew J.; Schoffelen, Richard L. M.; Narins, Peter M.; Meenderink, Sebastiaan W. F.


    The frog inner ear contains three regions that are sensitive to airborne sound and which are functionally distinct. (1) The responses of nerve fibres innervating the low-frequency, rostral part of the amphibian papilla (AP) are complex. Electrical tuning of hair cells presumably contributes to the f

  19. Ear Recognition Based on Gabor Features and KFDA

    Directory of Open Access Journals (Sweden)

    Li Yuan


    Full Text Available We propose an ear recognition system based on 2D ear images which includes three stages: ear enrollment, feature extraction, and ear recognition. Ear enrollment includes ear detection and ear normalization. The ear detection approach based on improved Adaboost algorithm detects the ear part under complex background using two steps: offline cascaded classifier training and online ear detection. Then Active Shape Model is applied to segment the ear part and normalize all the ear images to the same size. For its eminent characteristics in spatial local feature extraction and orientation selection, Gabor filter based ear feature extraction is presented in this paper. Kernel Fisher Discriminant Analysis (KFDA is then applied for dimension reduction of the high-dimensional Gabor features. Finally distance based classifier is applied for ear recognition. Experimental results of ear recognition on two datasets (USTB and UND datasets and the performance of the ear authentication system show the feasibility and effectiveness of the proposed approach.

  20. Ear recognition based on Gabor features and KFDA. (United States)

    Yuan, Li; Mu, Zhichun


    We propose an ear recognition system based on 2D ear images which includes three stages: ear enrollment, feature extraction, and ear recognition. Ear enrollment includes ear detection and ear normalization. The ear detection approach based on improved Adaboost algorithm detects the ear part under complex background using two steps: offline cascaded classifier training and online ear detection. Then Active Shape Model is applied to segment the ear part and normalize all the ear images to the same size. For its eminent characteristics in spatial local feature extraction and orientation selection, Gabor filter based ear feature extraction is presented in this paper. Kernel Fisher Discriminant Analysis (KFDA) is then applied for dimension reduction of the high-dimensional Gabor features. Finally distance based classifier is applied for ear recognition. Experimental results of ear recognition on two datasets (USTB and UND datasets) and the performance of the ear authentication system show the feasibility and effectiveness of the proposed approach.

  1. Water used to visualize and remove hidden foreign bodies from the external ear canal. (United States)

    Peltola, T J; Saarento, R


    Small foreign bodies lodged anteriorly in the tympanic sulcus are usually not visible, due to the curve of the external ear canal. Such objects can be seen with the aid of an otomicroscope and micromirror or with an endoscope, and removed by irrigation. If irrigation fails, epithelial migration on the tympanic membrane may remove lodged foreign bodies, although this may take months. Our new method, which uses water to locate small objects lodged in the tympanic sulcus, includes irrigation of the ear, adjustment of the water level to the middle curve of the external ear canal, and use of the water surface as a concave lens, making the tympanic sulcus visible. With otomicroscopy a curved ear probe can then be used to remove lodged foreign bodies from behind the curve.

  2. Ear biometrics in 2D and 3D localization and recognition

    CERN Document Server

    Prakash, Surya


    This book presents the state-of-the-art techniques and recent research progress on Ear Biometrics. Among the various physiological traits, the reasons for the ear to gain much attention in recent years are many folds. It has been found to be a reliable biometrics for human verification and identification. Ears are remarkably consistent and unlike face, it does not change shape with different expressions or age, and remain fixed in the middle of the side of the head against a predictable background. The book contains figures, tables and plots to illustrate the techniques in an easy and lucid manner. The book also provides an extensive literature on the subject, where readers have the benefit of receiving all the relevant material at one place in a very comprehensive manner. This book caters students, academics, researchers, practitioners who are interested in the field of Ear Biometrics and its applications in face recognition and security.

  3. 21 CFR 878.3590 - Ear prosthesis. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear prosthesis. 878.3590 Section 878.3590 Food and... GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An ear prosthesis is a silicone rubber solid device intended to be implanted to reconstruct the...

  4. Can Loud Music Hurt My Ears? (United States)

    ... dientes Video: Getting an X-ray Can Loud Music Hurt My Ears? KidsHealth > For Kids > Can Loud Music Hurt My Ears? Print A A A en ... up? Oh! You want to know if loud music can hurt your ears . Are you asking because ...

  5. Can Loud Music Hurt My Ears? (United States)

    ... What Happens in the Operating Room? Can Loud Music Hurt My Ears? KidsHealth > For Kids > Can Loud Music Hurt My Ears? A A A en español ... up? Oh! You want to know if loud music can hurt your ears . Are you asking because ...

  6. [Microbial biocenoss in chronic purulent otitis media]. (United States)

    Beloglazova, N N; Vasil'eva, L I; Bragina, L E; Kiselev, V V; Naboka, Iu L


    The objective of the present work was to study microflora in the middle ear of 100 patients aged from 30 to 70 years presenting with chronic purulent otitis media (CPOM) by microbiological and genetic (PCR) methods. An important role of persistence factors, pathogenicity, and microbial antibiotic resistance in the development of CPOM was demonstrated. The frequency of occurrence of herpes and papilloma viruses was estimated. The most common form of the mixed infection was two-component virobacterial associations (46.2%). Three-component associations of viruses with bacteria (Chlamydiae or Mycoplasmas) formed less frequently (34.6%). In 19.2% of the cases, yeast-like fungi of the genus Candida were identified in these associations.

  7. Effects of music videos on sleep quality in middle-aged and older adults with chronic insomnia: a randomized controlled trial. (United States)

    Lai, Hui-Ling; Chang, En-Ting; Li, Yin-Ming; Huang, Chiung-Yu; Lee, Li-Hua; Wang, Hsiu-Mei


    Listening to soothing music has been used as a complementary therapy to improve sleep quality. However, there is no empirical evidence for the effects of music videos (MVs) on sleep quality in adults with insomnia as assessed by polysomnography (PSG). In this randomized crossover controlled trial, we compared the effects of a peaceful Buddhist MV intervention to a usual-care control condition before bedtime on subjective and objective sleep quality in middle-aged and older adults with chronic insomnia. The study was conducted in a hospital's sleep laboratory. We randomly assigned 38 subjects, aged 50-75 years, to an MV/usual-care sequence or a usual-care/MV sequence. After pretest data collection, testing was held on two consecutive nights, with subjects participating in one condition each night according to their assigned sequence. Each intervention lasted 30 min. Sleep was assessed using PSG and self-report questionnaires. After controlling for baseline data, sleep-onset latency was significantly shorter by approximately 2 min in the MV condition than in the usual-care condition (p = .002). The MV intervention had no significant effects relative to the usual care on any other sleep parameters assessed by PSG or self-reported sleep quality. These results suggest that an MV intervention may be effective in promoting sleep. However, the effectiveness of a Buddhist MV on sleep needs further study to develop a culturally specific insomnia intervention. Our findings also suggest that an MV intervention can serve as another option for health care providers to improve sleep onset in people with insomnia.

  8. Robust and enduring atorvastatin-mediated memory recovery following the 4-vessel occlusion/internal carotid artery model of chronic cerebral hypoperfusion in middle-aged rats. (United States)

    Zaghi, Gislene Gonçalves Dias; Godinho, Jacqueline; Ferreira, Emilene Dias Fiuza; Ribeiro, Matheus Henrique Dal Molin; Previdelli, Isolde Santos; de Oliveira, Rúbia Maria Weffort; Milani, Humberto


    Chronic cerebral hypoperfusion (CCH) is a common condition associated with the development and/or worsening of age-related dementia.We previously reported persistent memory loss and neurodegeneration after CCH in middle-aged rats. Statin-mediated neuroprotection has been reported after acute cerebral ischemia. Unknown, however, is whether statins can alleviate the outcome of CCH. The present study investigated whether atorvastatin attenuates the cognitive and neurohistological outcome of CCH. Rats (12–15 months old) were trained in a non-food-rewarded radial maze, and then subjected to CCH. Atorvastatin (10 mg/kg, p.o.) was administered for 42 days or 15 days, beginning 5 h after the first occlusion stage. Retrograde memory performance was assessed at 7, 14, 21, 28, and 35 days of CCH, and expressed by “latency,” “number of reference memory errors” and “number of working memory errors.” Neurodegeneration was then examined at the hippocampus and cerebral cortex. Compared to sham, CCH caused profound and persistent memory loss in the vehicle-treated groups, as indicated by increased latency (91.2% to 107.3%) and number of errors (123.5% to 2508.2%), effects from which the animals did not spontaneously recover across time. This CCH-induced retrograde amnesia was completely prevented by atorvastatin (latency: −4.3% to 3.3%; reference/working errors: −2.5% to 45.7%), regardless of the treatment duration. This effect was sustained during the entire behavioral testing period (5 weeks), even after discontinuing treatment. This robust and sustained memory-protective effect of atorvastatin occurred in the absence of neuronal rescue (39.58% to 56.45% cell loss). We suggest that atorvastatin may be promising for the treatment of cognitive sequelae associated with CCH.

  9. Results of the Dyslipidemia International Study (DYSIS-Middle East: clinical perspective on the prevalence and characteristics of lipid abnormalities in the setting of chronic statin treatment.

    Directory of Open Access Journals (Sweden)

    Saud N Al Sifri

    Full Text Available BACKGROUND: Therapeutic intervention with low-density lipoprotein cholesterol-lowering agents known as statins has been demonstrated to reduce cardiovascular risk. However, many patients on statin treatment have persistent dyslipidemia and remain at a high risk of cardiovascular disease. Therefore, the objective of this study was to assess the frequency of lipid abnormalities in patients receiving chronic statin treatment. METHODS: As part of an international, cross-sectional, observational study, DYSIS-Middle East enrolled 2,182 patients in the United Arab Emirates (UAE, Saudi Arabia, Lebanon and Jordan. All patients were over 45 years of age and had been on statin treatment for at least three months. Data on demographics, lipid parameters and cardiovascular risk profile were recorded. Cardiovascular risk was defined according the guidelines of the European Society of Cardiology. RESULTS: The majority of patients (82.6% were classified as being at very high risk of cardiovascular events, and 61.8% of all patients did not attain LDL-C target levels. Low high-density lipoprotein cholesterol levels and elevated triglyceride levels were noted in 55.5% and 48.5% of patients, respectively. Multivariate logistical regression modeling indicated that factors independently associated with LDL-C levels not being at goal were lifestyle choices, diabetes mellitus, ischemic heart disease, and blood pressure ≥ 140/90 mmHg. CONCLUSIONS: Almost two-thirds of statin-treated patients in the United Arab Emirates, Saudi Arabia, Lebanon and Jordan had inadequately controlled lipid levels. More comprehensive surveillance, awareness and treatment regimens, as well as modification of lifestyle choices, is necessary to halt the rise in cardiovascular disease-related mortality.

  10. The Association Between Unhealthy Lifestyle Behaviors and the Prevalence of Chronic Kidney Disease (CKD in Middle-Aged and Older Men

    Directory of Open Access Journals (Sweden)

    Ryoma Michishita


    Full Text Available Background: This cross-sectional study evaluated the association between unhealthy lifestyle behaviors and the prevalence of chronic kidney disease (CKD in middle-aged and older men. Methods: The subjects included 445 men without a history of cardiovascular disease, stroke, or dialysis treatment, who were not taking medications. Unhealthy lifestyle behaviors were evaluated using a standardized selfadministered questionnaire and were defined as follows: 1 lack of habitual moderate exercise, 2 lack of daily physical activity, 3 slow walking speed, 4 fast eating speed, 5 late-night dinner, 6 bedtime snacking, and 7 skipping breakfast. The participants were divided into four categories, which were classified into quartile distributions based on the number of unhealthy lifestyle behaviors (0–1, 2, 3, and ≥4 unhealthy behaviors. Results: According to a multivariate analysis, the odds ratio (OR for CKD (defined as estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2 and/or proteinuria was found to be significantly higher in the ≥4 group than in the 0–1 group (OR 4.67; 95% confidence interval [CI], 1.51–14.40. Moreover, subjects’ lack of habitual moderate exercise (OR 3.06; 95% CI, 1.13–8.32 and presence of late-night dinner (OR 2.84; 95% CI, 1.40–5.75 and bedtime snacking behaviors (OR 2.87; 95% CI, 1.27–6.45 were found to be significantly associated with the prevalence of CKD. Conclusions: These results suggest that an accumulation of unhealthy lifestyle behaviors, especially those related to lack of habitual moderate exercise and presence of late-night dinner and bedtime snacking may be associated with the prevalence of CKD.

  11. The Effects of Middle Ear Pressure on Hearing. (United States)


    flow. Hear. Yes. 11: 385-394, 1983. *52. Bennett, C.L., Davis, P.T. and Miller, J.M.: Demonstration of presbycusis across repeated measures in non-human...Bennett, C.L., Davis, R.T. and Miller, J.M.: Demonstration of presbycusis across repeated measures in non-human primate species. Behav. Neuroscience 97

  12. Effects of Acoustic Impulses on the Middle Ear (United States)


    using Audiometric Research Tool (ART) software, which presents stimuli via a National Instruments (NI) dynamic signal analyzer module. Threshold is...measurements are obtained bilaterally using the Interacoustics Titan system. The manufacturer’s software is opened automatically by the MATLAB shell script

  13. A New Acoustic Portal into the Odontocete Ear and Vibrational Analysis of the Tympanoperiotic Complex (United States)


    to test models that allowed simulations of the functional morphology, and consider possible functional implications. Materials and Methods Ethics ...principles of the mammalian middle ear. Advances in Anatomy Embryology and Cell Biology 55: 1–70. 24. McCormick JG, Wever EG, Ridgway SH, Palin J (1980

  14. A simple ear splint for microtia patients. (United States)

    Krishnan, C J Venkata; Balaji, S M; Jain, Ashish R


    Microtia is a congenital anomaly of the ear can occur as an isolated birth defect or as part of a spectrum of anomalies or as a syndrome. Microtia is often associated with impaired hearing and or total loss of hearing. Such patients typically require treatment for surgical ear reconstruction and for hearing impairment. Maintenance of ear projection and post auricular sulcus in staged ear reconstruction in microtia is a trying problem. So also is the maintenance of the patency of the external auditory meatus following recanalization and meatoplasty.This case report describes a simple effective way of fabrication of ear splint prosthesis.

  15. A simple ear splint for microtia patients

    Directory of Open Access Journals (Sweden)

    C J Venkata Krishnan


    Full Text Available Microtia is a congenital anomaly of the ear can occur as an isolated birth defect or as part of a spectrum of anomalies or as a syndrome. Microtia is often associated with impaired hearing and or total loss of hearing. Such patients typically require treatment for surgical ear reconstruction and for hearing impairment. Maintenance of ear projection and post auricular sulcus in staged ear reconstruction in microtia is a trying problem. So also is the maintenance of the patency of the external auditory meatus following recanalization and meatoplasty.This case report describes a simple effective way of fabrication of ear splint prosthesis.

  16. A Survey on Human Ear Recognition

    Directory of Open Access Journals (Sweden)

    Suvarnsing Bhable


    Full Text Available This paper presents an efficient ear recognition technique which derives benefits from the local features of the ear and attempt to handle the problems due to pose, poor contrast, change in illumination and lack of registration. Recognizing humans by their ear have recently received significant attention in the field of research. Ear is the rich in characteristics. This paper provides a detailed survey of research done in ear detection and recognition. This survey paper is very useful in the current state-of- art for those who are working in this area and also for those who might exploit this new approach.

  17. Streptococcus pneumoniae serotypes isolated from the middle ear of Mexican children diagnosed with acute otitis media Serotipificación de Streptococcus pneumoniae aislados de líquido de oído medio en niños mexicanos con diagnóstico de otitis media aguda

    Directory of Open Access Journals (Sweden)

    Demóstenes Gómez-Barreto


    Full Text Available OBJECTIVE: The aim of this study was to identify the etiology and the serotypes of S. pneumoniae (Sp in Mexican children with acute otitis media (AOM. MATERIALS AND METHODS: The study includessamples frompatientsdiagnosed with AOM at the Federico Gomez Children's Hospital of Mexico (2002-2003,with positive culture for Sp bacteriologically confirmed in middle ear fluid obtained by tympanocentesis. All Sp were serotyped. A total of 138 samples from 135 children with AOM were included. RESULTS: Sp was isolated in 72 samples from 70 children. Sixty (85.7% were previously healthy and 10 (14.3% were immunocompromised. The most common serotypes were 6B and 19F (16.67%, and 6 A, 14 and 23F (15.27%. CONCLUSION: The distribution of serotypes among the children with AOM in the study is similar to that reported in developing cities, and 63.9% of the isolated serotypes are found to be included in the 7-Valent Pneumococcal Conjugate Vaccine (PCV, 68.1% in the 10-Valent PCV and 83.3% in 13-Valent PCV.OBJETIVO: Conocer la etiología y serotipos de S. pneumoniae (Sp en niños mexicanos, con otitis media aguda (OMA. MATERIAL Y MÉTODOS: Se incluyeron las muestras de pacientes con OMA del Hospital Infantil de México Federico Gómez (2002-2003, con cultivo positivo para Sp, (bacteriológicamente confirmados en el líquido del oído medio obtenido por timpanocentesis. Todos los Sp. fueron serotipificados. Se incluyeron 138 muestras de 135 niños con OMA. RESULTADOS: Sp. se aisló en 72 muestras de 70 niños: 60 (85.7% eran previamente sanos y 10 (14.3% eran inmunocomprometidos. Los serotipos más frecuentes fueron 6B y 19F (16.67%, y 6 A, 14 y 23F (15.27%. CONCLUSIONES: La distribución de los serotipos en niños con otitis media aguda fue similar a la reportada en ciudades en desarrollo y se observó que 63.9% de los serotipos aislados están incluidos en la vacuna conjugada 7-valente, 68.1% en la 10-valente y 83.3% en la 13-valente.

  18. Prevalence of weathering nodules of the ear in patients treated at the state civil servant's hospital of São Paulo, Brazil*


    Cilento, Juliana Nunes Maciel; Valente,Neusa Yuriko Sakai


    BACKGROUND: Weathering nodules of the ear are pale yellow, asymptomatic lesions which predominate on the helices of the ears. Although their pathogenesis remains unknown, there is an association with chronic exposure to ultraviolet radiation, age and thermal injuries. Few studies have been conducted to date, and these involved a very small number of patients. OBJECTIVE: Study the prevalence of weathering nodules of the ear in patients treated in the Dermatology Service...

  19. Inner Time and Inner Ear

    CERN Document Server

    Rvachov, Michael


    Sounds are information sequences that cannot exist outside of a time base and therefore cannot be analyzed inside an animal without an accurate internal clock. It is suggested that the clock may be hidden in the inner ear. It is shown that if a mechanism of counting of the electrical charge passing through the inner ear hair cells exists then the mechanism can be used both for the conversion of acceleration into velocity and as the inner clock, in the presence of a constant current. The causes of vertigo during rotation are discussed. It is shown that if a continuous inner time exists then sleeping is a mathematical necessity. It is indicated that both for visual and hearing inputs the recognition of an input signal is recognition of function(s) of two variables.

  20. Image analysis of the inner ear with CT and MR imaging; Pre-operative assessment for cochlear implant surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kumakawa, Kohzoh; Takeda, Hidehiko; Mutoh, Naoko; Miyakawa, Kohichi (Toranomon Hospital, Tokyo (Japan)); Yukawa, Kumiko; Funasaka, Sohtaro


    Recent progress in magnetic resonance imaging (MRI) has made it possible to obtain detailed images of the inner ear by delineating the lymphatic fluid within the labyrinth. We analyzed CT scans and MR imaging in 70 ears manifesting profound deafness owing to inner ear lesions and compared their detective ability for inner ear lesions. The following results were obtained. CT scan examination showed slight to extensive ossification of the labyrinth in six ears (9%), whereas MRI examination revealed low to absent signal intensity of the inner ear in nine ears (13%). Therefore, it was concluded that MRI is more sensitive in detecting abnormalities of the inner ear than CT scan. MRI provided useful information as to whether the cochlear turn is filled with lymphatic fluid or obstructed. This point was one of the greatest advantages of MRI over CT scan. Abnormal findings in either or both the CT scan and the MRI were detected in suppurative labyrinthitis occurring secondary to chronic otitis media, bacterial meningitis and in inner ear trauma. However, such abnormal findings were not detected in patients with idiopathic progressive sensorineural hearing loss, ototoxity or sudden deafness. These findings should be taken into consideration in pre-operative assessment of cochlear implant candidates. (author).

  1. 郑州市2009年初中生慢性鼻-鼻窦炎调查%Investigation of chronic rhinosinusitis on junior middle school students in Zhengzhou area in 2009

    Institute of Scientific and Technical Information of China (English)

    郑振宇; 李玲玲; 王海威; 李倩; 李社亭; 李灏然; 王江波; 王重建


    Objective To investigate the incidence of chronic rhinosinusitis and its influence on life quality for junior middle school students in Zhengzhou Municipal.Methods Two thousand and twenty junior middle school students in Zhengzhou Municipal were randomly selected as the object of investigation by designed survey and visual analogue scale (VAS) questionnaire of chronic rhinosinusitis the sino-nasal outcome test-20 (SNOT-20) and nasal examination.Effect on the quality of life was investigated based on the degree of troubles caused by symptoms.Results The incidence of chronic rhinosinusitis in junior middle school students in Zhengzhou Municipal was 6.73% (136/2 020),in which,22.79% (31/136) of these students' quality of life was affected (VAS > 5).Conclusions Chronic rhinosinusitis is common in junior middle school students,and the life quality is affected.So we should pay attention to this diseases and take the positive and effective intervention measures.%目的 了解郑州市区初一学生慢性鼻-鼻窦炎疾病的患病情况及对其生活质量的影响程度.方法 按分层随机整群抽样法选取郑州市2 020名初一学生为调查对象;采用慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)相关症状调查表、视觉模拟量表(visual analogue scale,VAS)、鼻腔鼻窦结局测试20条(the sino-nasal outcome test-20,SNOT-20)及专科检查进行调查;依据症状对学生造成的困扰程度,调查其对学生生活质量的影响.结果 郑州市初一学生CRS的患病率为6.73%(136/2 020);患病学生中生活质量受到影响者(VAS >5)占22.79%(31/136).结论 所调查人群CRS患病率较高,对生活质量有较大影响,应重视该群体CRS的患病情况,采取积极有效的干预措施.

  2. Inner ear of the coelacanth fish Latimeria has tetrapod affinities. (United States)

    Fritzsch, B

    Auditory reception in elasmobranchs, teleosts and amphibians may be mediated by various inner-ear sensory epithelia 1–3, including the basilar papilla, which seems to be the precursor of the cochlea in mammals. The origin of the basilar papilla remains a major unsolved problem for understanding the evolution of hearing in terrestrial vertebrates4–6. Study of living species indicates that the basilar papilla is a unique feature of tetrapods 6,7, but palaeonto-logical data indicate that this epithelium as well as a middle ear, is already present in crossopterygian fish 8–10. However, no basilar papilla has been found in the only living crossopterygian species, the coelacanth Latimeria chalumnae 11. I have re-examined the inner ear of adult and embryonic Latimeria and find a membranous specialization which resembles in structure, position and innerva-tion pattern the basilar papilla of tetrapods, in particular amniotes. No epithelium comparable to the basilar papilla was found in lungfish. I suggest that the basilar papillae of Latimeria and tetrapods are homologous and evolved only once in their common ancestor.

  3. Causes of 279 Cases with Sensation of Ear Fullness%279例耳闷胀感的病因分析

    Institute of Scientific and Technical Information of China (English)

    陈平; 周永; 谭颂华; 唐安洲; 黄东红


    Objective To analyze the causes inducing the sensation of ear fullness.Methods 362 ears with sensation of ear fullness were collected.The clinic features,audiogram,tympanogram and Eustachian tube function in these ears were analysed.Results 203 ears with type A,111 ears with type B,33 ears with type C and 15 ears with perforated tympanum membrane were found in 362 ears as tympanograms were done.Among audiograms of 362 ears,conductive deafness,sensorineural deafness,mixed deafness and normal ears were 83、81、105 and 93 ears respectively.Eustachian tube test revealed 208 abnormal ears out of 362 ears,and 67 abnormal ears were found in 203 ears with type A tympanogram.Conclusion The causes inducing sensation of ear fullness covered the outer,middle and inner ear,and face nerve.In these cases with sensation of ear fullness,the diseases resulted in sensation of ear fullness mainly were secretory otitis media,sensorineural deafness induced by vary causes and abnormal eustachian tube function.%目的 探讨产生耳闷胀感的部位和原因。方法 收集耳闷胀感为主诉的279例362耳,对患耳的临床表现、鼓室导抗图、纯音测听和咽鼓管功能进行分析。结果 362耳中鼓室导抗图A型203耳、B型111耳、C型33耳以及鼓膜穿孔15耳。纯音测听表现为传导性聋、感音神经性聋、混合性聋以及正常者分别是83耳、81耳、105耳和93耳。在362耳中,咽鼓管功能异常208耳,在A型鼓室导抗图203耳中,咽鼓管功能异常67耳。结论 产生耳闷胀感的病变部位包括外、中、内耳和面神经的病变,其中以分泌性中耳炎、各种原因引起的感音神经性聋和“咽鼓管狭窄症”为多。

  4. CT and MR imaging of congenital abnormalities of the inner ear and internal auditory canal

    Energy Technology Data Exchange (ETDEWEB)

    Casselman, Jan W. E-mail:; Offeciers, Erwin F.; Foer, Bert de; Govaerts, Paul; Kuhweide, Rudy; Somers, Thomas


    The embryology of the inner ear must be known as many of the inner ear malformations present as a result of the arrest during the various stages of embryology. These malformations are described in this 'embryologic' perspective and specific names for certain malformations are no longer used. Both CT and MR can be used to look at inner ear malformations but often both techniques are complementary. However, CT is preferred when associated middle- or external ear malformations must be excluded. Magnetic resonance is preferred when subtle changes in the membranous labyrinth or abnormalities of the nerves in the internal auditory canal must be visualised. The CT and MR technique must however be adapted as more and more subtle congenital malformations can only be seen when the right technique is used. The heavily T2-weighted gradient-echo or fast spin-echo MR techniques are mandatory if malformations of the inner ear must be excluded. The purpose of this paper is to describe the techniques used to study these patients and to give an overview of the most frequent and important congenital malformations which can be found in the inner ear and internal auditory canal/cerebellopontine angle.

  5. CT and MR imaging of congential abnormalities of the inner ear and internal auditory canal. (United States)

    Casselman, J W; Offeciers, E F; De Foer, B; Govaerts, P; Kuhweide, R; Somers, T


    The embryology of the inner ear must be known as many of the inner ear malformations present as a result of the arrest during the various stages of embryology. These malformations are described in this "embryologic" perspective and specific names for certain malformations are no longer used. Both CT and MR can be used to look at inner ear malformations but often both techniques are complementary. However, CT is preferred when associated middle- or external ear malformations must be excluded. Magnetic resonance is preferred when subtle changes in the membranous labyrinth or abnormalities of the nerves in the internal auditory canal must be visualised. The CT and MR technique must however be adapted as more and more subtle congenital malformations can only be seen when the right technique is used. The heavily T2-weighted gradient-echo or fast spin-echo MR techniques are mandatory if malformations of the inner ear must be excluded. The purpose of this paper is to describe the techniques used to study these patients and to give an overview of the most frequent and important congenital malformations which can be found in the inner ear and internal auditory canal/cerebellopontine angle.

  6. An evaluation report on the efficacy of partial middle turbinate resection in the treatment of chronic rhinosinusitis%中鼻甲部分切除术治疗慢性鼻-鼻窦炎疗效评估报告

    Institute of Scientific and Technical Information of China (English)



    目的:探讨中鼻甲部分切除术治疗慢性鼻-鼻窦炎患者的治疗效果。方法:收治慢性鼻-鼻窦炎患者30例,所有患者均接受中鼻甲部分切除术,回顾性分析和总结其临床资料。结果:痊愈23例(76.7%),好转5例(16.7%),无效2例(6.7%)。结论:中鼻甲部分切除术治疗慢性鼻-鼻窦炎能够有效提高治疗效果,保持鼻窦良好的引流和通气,符合人体的生理功能。%Objective:To investigate the therapeutic effect of partial middle turbinate resection in the treatment of patients with chronic rhinosinusitis.Methods:30 patients with chronic rhinosinusitis were selected.All of them were given partial middle turbinate resection.Then we analyzed and summarized their clinical data retrospectively.Results:23 cases(76.7%) were cured,5 cases(16.7%) were improved,and 2 cases(6.7%) were ineffective.Conclusion:Partial middle turbinate resection can improve the therapeutic of chronic rhinosinusitis effectively,and it also can keep good drainage and ventilation of sinus,and conform to the physiological functions of the human body.

  7. Novel in vivo imaging analysis of an inner ear drug delivery system in mice: comparison of inner ear drug concentrations over time after transtympanic and systemic injections.

    Directory of Open Access Journals (Sweden)

    Sho Kanzaki

    Full Text Available OBJECTIVE: Systemic steroid injections are used to treat idiopathic sudden-onset sensorineural hearing loss (ISSHL and some inner ear disorders. Recent studies show that transtympanic (TT steroid injections are effective for treating ISSHL. As in vivo monitoring of drug delivery dynamics for inner ear is lacking, its time course and dispersion of drugs is unknown. Here, we used a new in vivo imaging system to monitor drug delivery in live mice and to compare drug concentrations over time after TT and systemic injections. METHODS: Luciferin delivered into the inner ears of GFAP-Luc transgenic mice reacted with luciferase in GFAP-expressing cells in the cochlear spiral ganglion, resulting in photon bioluminescence. We used the Xenogen IVIS® imaging system to measure how long photons continued to be emitted in the inner ear after TT or systemic injections of luciferin, and then compared the associated drug dynamics. RESULTS: The response to TT and IP injections differed significantly. Photons were detected five minutes after TT injection, peaking at ~20 minutes. By contrast, photons were first detected 30 minutes after i.p. injection. TT and i.p. drug delivery time differed considerably. With TT injections, photons were detected earlier than with IP injections. Photon bioluminescence also disappeared sooner. Delivery time varied with TT injections. CONCLUSIONS: We speculate that the drug might enter the Eustachian tube from the middle ear. We conclude that inner-ear drug concentration can be maintained longer if the two injection routes are combined. As the size of luciferin differs from that of therapeutics like dexamethasone, combining drugs with luciferin may advance our understanding of in vivo drug delivery dynamics in the inner ear.

  8. Evolution of a sensory novelty: tympanic ears and the associated neural processing

    DEFF Research Database (Denmark)

    Christensen-Dalsgaard, Jakob; Carr, Catherine E


    Tympanic hearing is a true evolutionary novelty that appears to have developed independently in at least five major tetrapod groups-the anurans, turtles, lepidosaurs, archosaurs and mammals. The emergence of a tympanic ear would have increased the frequency range and sensitivity of hearing...... sensitivity and directionality at low frequencies. Therefore, tetrapod auditory processing may originally have been organized into low- and high-frequency streams, where only the high-frequency processing was mediated by tympanic input. The closure of the middle ear cavity in mammals and some birds...

  9. An Effective 3D Ear Acquisition System.

    Directory of Open Access Journals (Sweden)

    Yahui Liu

    Full Text Available The human ear is a new feature in biometrics that has several merits over the more common face, fingerprint and iris biometrics. It can be easily captured from a distance without a fully cooperative subject. Also, the ear has a relatively stable structure that does not change much with the age and facial expressions. In this paper, we present a novel method of 3D ear acquisition system by using triangulation imaging principle, and the experiment results show that this design is efficient and can be used for ear recognition.

  10. An Effective 3D Ear Acquisition System. (United States)

    Liu, Yahui; Lu, Guangming; Zhang, David


    The human ear is a new feature in biometrics that has several merits over the more common face, fingerprint and iris biometrics. It can be easily captured from a distance without a fully cooperative subject. Also, the ear has a relatively stable structure that does not change much with the age and facial expressions. In this paper, we present a novel method of 3D ear acquisition system by using triangulation imaging principle, and the experiment results show that this design is efficient and can be used for ear recognition.

  11. Human acoustics: From vocal chords to inner ear (United States)

    Lamar, Michael Drew


    Part I covers the vocal chords, more accurately known as the vocal folds (VF). Modeling efforts are split into two areas: the VF tissue and the airflow. There are multiple existing models of the VF, with varying ranges of complexity for both the tissue and the airflow. In our model, the tissue is based on a recent two-mass model of Bogaert's [5], while the airflow is quasi-one-dimensional and is derived from the two-dimensional compressible Navier-Stokes equations. Our model is more accurate than Bernoulli's law (quasi-steady approximation), yet less complex than the full Navier-Stokes system. The model is shown to reproduce important transient behaviour intrinsic in vocal fold motion, such as pressure peaks before and after vocal fold closure. Part II concerns the inner ear, or cochlea. Again the modeling effort is split into two areas: the cochlear tissue and the cochlear fluid. We model the cochlear fluid with the well known two-dimensional box model of the cochlea, derived from the three-dimensional compressible Navier-Stokes equations. The cochlear tissue structure is where the complexity takes place. We start with Neely and Kim's [25] linear active model for the cochlear structure and modify their active gain parameter into a nonlinear nonlocal functional. The nonlinearity forces us to work in the time domain, which is prone to dispersive instabilities if one uses a frequency domain middle ear model. The middle ear's role as a transient absorber is discussed and its time domain formulation is shown to reduce the dispersive instability. We perform simulations on the full system and show that the model recovers many important nonlinear phenomena, such as suppression and difference tones. A spectrogram based on the cochlear response is created and compared with the spectrogram of the input waveform. In both Part I and Part II, the emphasis is on time dependent modeling and numerical implementation.

  12. A Novel Mycobacterium cosmeticum-Like Bacterium Isolated from the Ear Swab of a Patient with Otitis Externa

    Directory of Open Access Journals (Sweden)

    Jeanette W. P. Teo


    Full Text Available We describe the identification and characterization of a novel nontuberculous mycobacterium (NTM, isolated from an ear swab of an adult male patient with chronic otitis externa. Genetically, the bacterium is most closely related to Mycobacterium cosmeticum; however, growth and biochemical features indicate that it is distinctly different. Here, we highlight for the first time an unusual NTM that is a probable cause of ear infection.

  13. The plastic ear and perceptual relearning in auditory spatial perception. (United States)

    Carlile, Simon


    The auditory system of adult listeners has been shown to accommodate to altered spectral cues to sound location which presumably provides the basis for recalibration to changes in the shape of the ear over a life time. Here we review the role of auditory and non-auditory inputs to the perception of sound location and consider a range of recent experiments looking at the role of non-auditory inputs in the process of accommodation to these altered spectral cues. A number of studies have used small ear molds to modify the spectral cues that result in significant degradation in localization performance. Following chronic exposure (10-60 days) performance recovers to some extent and recent work has demonstrated that this occurs for both audio-visual and audio-only regions of space. This begs the questions as to the teacher signal for this remarkable functional plasticity in the adult nervous system. Following a brief review of influence of the motor state in auditory localization, we consider the potential role of auditory-motor learning in the perceptual recalibration of the spectral cues. Several recent studies have considered how multi-modal and sensory-motor feedback might influence accommodation to altered spectral cues produced by ear molds or through virtual auditory space stimulation using non-individualized spectral cues. The work with ear molds demonstrates that a relatively short period of training involving audio-motor feedback (5-10 days) significantly improved both the rate and extent of accommodation to altered spectral cues. This has significant implications not only for the mechanisms by which this complex sensory information is encoded to provide spatial cues but also for adaptive training to altered auditory inputs. The review concludes by considering the implications for rehabilitative training with hearing aids and cochlear prosthesis.

  14. The plastic ear and perceptual relearning in auditory spatial perception.

    Directory of Open Access Journals (Sweden)

    Simon eCarlile


    Full Text Available The auditory system of adult listeners has been shown to accommodate to altered spectral cues to sound location which presumably provides the basis for recalibration to changes in the shape of the ear over a life time. Here we review the role of auditory and non-auditory inputs to the perception of sound location and consider a range of recent experiments looking at the role of non-auditory inputs in the process of accommodation to these altered spectral cues. A number of studies have used small ear moulds to modify the spectral cues that result in significant degradation in localization performance. Following chronic exposure (10-60 days performance recovers to some extent and recent work has demonstrated that this occurs for both audio-visual and audio-only regions of space. This begs the questions as to the teacher signal for this remarkable functional plasticity in the adult nervous system. Following a brief review of influence of the motor state in auditory localisation, we consider the potential role of auditory-motor learning in the perceptual recalibration of the spectral cues. Several recent studies have considered how multi-modal and sensory-motor feedback might influence accommodation to altered spectral cues produced by ear moulds or through virtual auditory space stimulation using non-individualised spectral cues. The work with ear moulds demonstrates that a relatively short period of training involving sensory-motor feedback (5 – 10 days significantly improved both the rate and extent of accommodation to altered spectral cues. This has significant implications not only for the mechanisms by which this complex sensory information is encoded to provide a spatial code but also for adaptive training to altered auditory inputs. The review concludes by considering the implications for rehabilitative training with hearing aids and cochlear prosthesis.

  15. Objective Audiometry using Ear-EEG

    DEFF Research Database (Denmark)

    Christensen, Christian Bech; Kidmose, Preben

    life. Ear-EEG may therefore be an enabling technology for objective audiometry out of the clinic, allowing regularly fitting of the hearing aids to be made by the users in their everyday life environment. In this study we investigate the application of ear-EEG in objective audiometry....


    The anatomy and developmental molecular genetics of the inner ear from establishment of the otic placode to formation of the definitive cochlea and vestibular apparatus will be reviewed and the complex 3-D structural changes that shape the developing inner ear will be illustrated...

  17. Playing by Ear: Foundation or Frill? (United States)

    Woody, Robert H.


    Many people divide musicians into two types: those who can read music and those who play by ear. Formal music education tends to place great emphasis on producing musically literate performers but devotes much less attention to teaching students to make music without notation. Some would suggest that playing by ear is a specialized skill that is…


    Directory of Open Access Journals (Sweden)



    Full Text Available OBJECTIVE: Prevalence of ear diseases is more common in rural school going children. Most commonly observed ear diseases include chronic otits media, otitis media with effusion, acute otitis media, otitis externa and impact ed wax. The causes of ear diseases are due to lack of health education, poor socio - economic status and unhygienic practices. These diseases cause decrease in hearing in children which leads to decrease in learning abilities and also leading to more number of school dropouts. The objective of the study is to assess the prevalence of ear diseases among rural school going children and to identify the causes for the occurrence, there by suggesting measures to reduce the occurrence. MATERIALS AND METHOD S: This is a non - randomized, cross - sectional study. The study was conducted in schools located in and around the Rural health training C entre, Nagavalli attached to Sri Siddhartha Medical College, Tumkur district Karnataka. The study period was 14 months from December 2010 to February 2012; the study was conducted on students from 18 schools within the age group of 6 years to 15 years. The students less than 6 years were excluded from the study. The total student population was 741 and all of them were examine d for ear pathologies. The method of examination was done by using otoscopy, tuning forks tests and pure tone audiometry. RESULTS: Out of 741 students examined, 43 students had ear pathologies. Hence, the percentage of students with ear pathologies was fou nd to be 5.8%. The common ear pathologies observed was impacted wax, acute otitis media, otitis externa and chronic otitis media and these students were of low socio - economic status. CONCLUSION: Ear diseases are common in rural children due to lack of heal th education, low socio - economic status and unhygienic practices followed. Hence this survey was undertaken to assess the prevalence of ear diseases among rural school going children and to find out the causes

  19. Microbiology of discharging ears in Ethiopia

    Institute of Scientific and Technical Information of China (English)

    Getachew Tesfaye; Daniel Asrat; Yimtubezinash Woldeamanuel; Messele Gizaw


    Objectives:To isolate and identify the bacterial etiologic agents,including their antibiotic susceptibility pat-tern isolated from patients with discharging ear infections.Methods:Between September 2006 and February 2007,178 patients with discharging ear visiting ENT clinics of St.Paul and Tikur Anbessa University Hospi-tals Addis Ababa,Ethiopia were investigated.Results:Of the patients investigated,52.8% were males and 47.2% were females resulting in an overall male to female ratio of 1.1:1.Ear discharge was the commonest clinical finding followed by hearing problem (91.2%),otalgia (ear pain)(74.7%),fever (17.9%)and itching of external ear (5.1%).S.aureus accounted for 30.2% of the total isolates followed by Proteus ssp. (P.mirabilis,P.vulgaris )(25.4%),and P.aeruginosa (13.4%).Both gram positive and negative bac-teria isolated from ear infections showed low resistance rates to most antimicrobial agents tested.Overall ceftri-axone and ciprofloxacin were the most effective drugs when compared to other drugs tested against the gram-positive and gram-negative bacteria.Conclusion:Otitis media was the most common clinical finding in pa-tients with ear infection.With discharging ear,the gram-negative bacteria were the predominant isolates.The susceptibility pattern of isolates from the study showed that ceftriaxone,ciprofloxacin and gentamicin were the most effective drugs.It is recommended that treatment of ear infections should be based on culture and sensi-tivity at the study sites.Therefore,efforts should be directed towards early diagnosis and treatment of acute ear infection and continued re-evaluation of the resistant patterns of organisms to optimize treatments and reduce complications.

  20. Increased subsequent risk of erectile dysfunction among middle and old age males with chronic osteomyelitis: a nationwide population-based cohort study. (United States)

    Wang, H-Y; Chao, C-H; Lin, C-L; Tseng, C-H; Kao, C-H


    Chronic inflammation may cause endothelial dysfunction and atherosclerosis, resulting in subsequent erectile dysfunction (ED). We examined the relationship between chronic osteomyelitis, which is a chronic inflammatory disease, and ED. A retrospective cohort study was conducted using data from the National Health Insurance Research Database. After excluding patients <40 years of age, 677 male patients newly diagnosed with chronic osteomyelitis (COM) from 1 January 2000 to 31 December 2011 were identified for the study. The non-osteomyelitis comparison cohort consisted of 2706 male participants. The incidence of ED was 2.66-fold higher in the COM cohort than in the non-osteomyelitis cohort (4.01 vs 1.51 per 10 000 person-years). After adjusting for age and comorbidities of coronary heart disease, hypertension, hyperlipidemia, depression, stroke, diabetes, peripheral vascular disease, chronic kidney disease, chronic obstructive pulmonary disease and asthma, the patients with COM had a 2.82-fold risk of ED (95% confidence interval=1.44-5.56). The incidence of ED increased with that of comorbidities in both cohorts. The highest hazard ratio was in patients between 40 and 59 years of age who had COM. Our data showed, for the first time, that COM is a possible risk factor for the development of ED.

  1. Surgical advances for congenital ear malformation%先天性小耳畸形手术治疗进展

    Institute of Scientific and Technical Information of China (English)



    Congenital ear malformation is caused by developmental abnormalities of the first and second branchial arch. Congenital ear malformation is performance ear hypoplasia and smaller than normal size, often accompanied by external auditory canal atresia and middle ear deformities. Surgery is the main treatment for congenital microtia. This article mainly reviewed the progress on auricle reconstruction, auditory rehabilitation and other surgical treatment.%先天性小耳畸形是由第一鳃弓和第二鳃弓发育异常引起的,为耳郭发育不全且较正常者为小,常伴有外耳道闭锁、中耳畸形.手术治疗是小耳畸形治疗的最主要手段,本文就小耳畸形耳郭成形术、听力重建以及相关手术进展做一综述.

  2. Cl(-) conduction of GABAA receptor complex of synaptic membranes in the cortex of rats at the middle stage of chronic cerebral epileptization (pharmacological kindling). (United States)

    Rebrov, I G; Karpova, M N; Andreev, A A; Klishina, N Yu; Kalinina, M V; Kusnetzova, L V


    Experiments on Wistar rats showed a decrease in basal and muscimol-stimulated 36Cl(-) entry into synaptoneurosomes isolated from the cerebral cortex during the middle stage of kindling (30 mg/kg pentylenetetrazole intraperitoneally for 14 days) characterized by the development of convulsions of higher (2 points) severity in comparison with the previous stage.

  3. Some Remarks on Imaging of the Inner Ear: Options and Limitations. (United States)

    Giesemann, A; Hofmann, E


    The temporal bone has a highly complex anatomical structure, in which the sensory organs of the cochlea and the vestibular system are contained within a small space together with the sound-conducting system of the middle ear. Detailed imaging is thus required in this anatomical area. There are a great many clinical aims for which the highest-possible spatial resolution is required. These include the localization of cerebrospinal fluid fistulas, the detection of malformations of the middle and inner ear and the vestibulocochlear nerve, an aberrant course of the facial nerve and anomalies of the arterial and venous structures, the confirmation of dehiscence of the semicircular canals and finally, the verification of endolymphatic hydrops in cases of Ménière's disease. However, the term 'high resolution' is very time dependent. Two milestones in this respect have been (in 1991) the 3D visualization of the inner ear by means of maximum-intensity projection (MIP) of a T2-weighted constructive interference in steady state (CISS) sequence of a 1.5-tesla magnetic resonance imaging (MRI) scanner (Tanioka et al., Radiology 178:141-144, 1991) and (in 1997) imaging of the vestibulocochlear nerve for the diagnosis of hypoplasia inside the internal auditory canal using the same sequence (Casselman et al., Radiology 202:773-781, 1997).The objective of this article is to highlight the options for, and the challenges of, contemporary imaging with regard to some clinical issues relating to the inner ear.

  4. Core collapse supernova remnants with ears

    CERN Document Server

    Grichener, Aldana


    We study the morphologies of core collapse supernova remnants (CCSNRs) and find that about third of CCSNRs have two opposite `ears' protruding from their main shell, and that the typical energy that is required to inflate these ears is about 10 percents of the explosion kinetic energy. We argue that these properties are most compatible with the expectation from the explosion jet feedback mechanism (JFM). Based on previous studies of ears in CCSNRs and the similarity of some ears to those found in planetary nebulae, we assume that the ears are inflated by jets that are launched during the explosion, or a short time after it. In the JFM explosion process the last jets' launching episode takes place just after the core has been ejected. These jets expand freely, interact with the exploding gas at some distance from the center, and form the ears. Under simple geometrical assumptions we find that the extra kinetic energy of the ears is in the range of 1 to 10 percents of the explosion energy. As not all of the kin...

  5. Coupled ears in lizards and crocodilians

    DEFF Research Database (Denmark)

    Carr, Catherine E; Christensen-Dalsgaard, Jakob; Bierman, Hilary


    Lizard ears are coupled across the pharynx, and are very directional. In consequence all auditory responses should be directional, without a requirement for computation of sound source location. Crocodilian ears are connected through sinuses, and thus less tightly coupled. Coupling may improve...... the processing of low-frequency directional signals, while higher frequency signals appear to be progressively uncoupled. In both lizards and crocodilians, the increased directionality of the coupled ears leads to an effectively larger head and larger physiological range of ITDs. This increased physiological...

  6. [Ear keloid and clinical research progress]. (United States)

    Du, Guangyuan; Zhu, Jiang


    Keloid refers to the damaged skin due to excessive fibroblast proliferation. Ear is one predilection site. The pathogenesis of ear keloid is not very clear, and the treatment is also varied. Surgery, postoperative radiotherapy and laser treatment, steroid hormones, pressure therapy are the basic treatment methods. Integrated application of a variety of treatments, classification research and new materials using revealed the prospect for the treatment of the disease. This thesis reviews literature about ear keloid in recent 10 years, and introduces this disease and clinical research progress.

  7. Surgical Management of Ear Diseases in Rabbits. (United States)

    Csomos, Rebecca; Bosscher, Georgia; Mans, Christoph; Hardie, Robert


    Otitis externa and media are frequently diagnosed disorders in rabbits and are particularly common in lop-eared breeds because of the specific anatomy of the ear canal. Medical management for otitis externa and media often provides only a temporary improvement in clinical signs. Surgery by means of partial or total ear canal ablation (PECA or TECA) combined with lateral bulla osteotomy (LBO) represents a feasible approach that is well tolerated and provides a good clinical outcome. Short-term complications associated with PECA/TECA-LBO include facial nerve paralysis and vestibular disease.


    Directory of Open Access Journals (Sweden)

    Santhana Krishnan


    Full Text Available Foreign bodies in the middle ear are a rare occurrence. This is a case report of a 5 year old female , with plastic button in the left ear , with history of attempted removal using a metal hook , leading to subtotal perforation of the tympanic membrane and traumatic dislocation of the incus. On surgery a yellow colored plastic button , measuring about 1x 1 cm size was removed from middle ear by retroauricular approach . Myringostapediopexy using autologous incus and temporalis fascia under general anesthesia was done. P atient improved clinically post operatively. Foreign bodies in the ear should be removed with caution. Blind removal by instrumentation can lead to complications like tympanic membrane perforation and ossicular disruption. Early surgical intervention with tympanoplasty under anesthesia with tympanoplasty at the same sitting can prevent further complications and correct the hearing loss

  9. Injuries of the external ear. (United States)

    Templer, J; Renner, G J


    Ear injuries occur in people of all ages but predominate in active people such as wrestlers, boxers, and bike riders. The types and extent of injury are a function of the force causing the injury. Shearing forces of moderate intensity cause hematoma formation, whereas greater force causes lacerations or even amputation. Sharp objects cause lacerations determined by the force, direction, and point of impact. The high ratio of surface area to mass makes the auricle vulnerable to extremes of temperature. People participating in high-risk activities should wear protective headgear. The goal of treatment is to restore the normal contours while preventing infection. Hematoma results in disfigurement by organization or chondritis. Evacuation and pressure dressings using sterile technique correct the condition. Second-degree burns are treated by regular cleansing and application of topical antimicrobials. Deeper burns require debridement, biologic dressings, or burying the cartilage subcutaneously for later reconstruction. Simple lacerations are closed under aseptic technique using either skin-to-skin sutures only or sutures of the skin combined with intercartilage sutures. Extensive and complex lacerations require meticulous care to match all fragments and prevent infection or loss of tissue. Bare cartilage must be covered with vascularized tissue. The treatment of total amputation is controversial. Some advocate reattachment as a composite graft using intravenous low molecular weight dextrans and heparin as adjuvants. Mladick dermabrades the amputated pinna, reattaches it with sutures, and then slips it into a pocket of elevated postauricular skin for 2 weeks. Others urge microvascular reanastomosis of the small nutrient vessels. Brent and Byrd separate the cartilage from its overlying skin and envelope it first with vascularized temporoparietal fascia and then a split-thickness skin graft. Chondritis is the most feared complication of injury or surgery of the pinna. It

  10. [Inner Ear Hearing Loss Part II: Sudden Sensorineural Hearing Loss, Therapeutic Options]. (United States)

    Hesse, Gerhard


    The great majority of hearing disorders generates from pathologies in the inner ear, mainly the outer hair cells, as mentioned in the first part of this review. Very often, however, hearing loss appears suddenly and even without external causes like noise exposure. This sudden hearing loss is mostly unilateral, recovers very often spontaneously and should be treated, if persisting. Only in this acute stage there are therapeutic options available. If the inner ear hearing loss is chronic there is no curative therapy, an effective management of the hearing disorder is only possible through rehabilitation. This is due to the fact, that hair cells of all mammals, incl. humans, have no regenerative capacity and neither pharmaceutic agents nor other means can induce regeneration and recovery of hair cells. Even a gen-therapy is not available yet. In the second part of this review the main focus lies in sudden hearing loss and general therapeutic options for inner ear hearing loss.

  11. Three dimensional and high resolution magnetic resonance imaging of the inner ear. Normal ears and anomaly scanned with 3D-CISS sequence

    Energy Technology Data Exchange (ETDEWEB)

    Edamatsu, Hideo [Dokkyo Univ., Saitama (Japan). Koshigaya Hospital; Uechi, Yoko; Honjyo, Shiro; Yamashita, Koichi; Tonami, Hisao


    The MRI system used in this study was a new scanning sequence, 3D-CISS (Three dimensional-constructive interference in steady state) with 1.5 Tesla. Ten normal ears and one ear with Mondini type anomaly were scanned and reconstructed. In imagings of normal inner ears, the cochlea has three spiral layers; basal, middle and apical turns. Each turn was separated into three parts; the scala vestibuli, osseous spiral lamina and scala tympani. Three semicircular ducts, utricle and saccule were also reconstructed in one frame. In the inner ear of Mondini anomaly, 3D MRI showed cochlear aplasia, hypoplasia of semicircular ducts and widely dilated vestibule. The imaging was identical with findings of ``common cavity``. The anomaly was easily recognized in 3D MRI more than in 2D imagings. The detailed and cubic imagings of the Mondini anomaly in 3D MRI could not be observed with conventional 2D MRI. 3D MRI is not invasive method and can scan a target very quickly. (author)

  12. Ear Mite Removal in the Santa Catalina Island Fox (Urocyon littoralis catalinae: Controlling Risk Factors for Cancer Development.

    Directory of Open Access Journals (Sweden)

    Megan E Moriarty

    Full Text Available Ear mites (Otodectes cynotis and ear canal tumors are highly prevalent among federally endangered Island foxes (Urocyon littoralis catalinae living on Santa Catalina Island off the coast of Southern California. Since studies began in the 1990s, nearly all foxes examined were found to be infected with ear mites, and ceruminous gland tumors (carcinomas and adenomas were detected in approximately half of all foxes ≥ 4 years of age. We hypothesized that reduction of ear mite infection would reduce otitis externa and ceruminous gland hyperplasia, a risk factor for tumor development. In this study, we conducted a randomized field trial to assess the impact of acaricide treatment on ear mite prevalence and intensity of infection, otitis externa, ceruminous gland hyperplasia, and mite-specific IgG and IgE antibody levels. Treatment was highly effective at eliminating mites and reducing otitis externa and ceruminous gland hyperplasia, and mite-specific IgG antibody levels were significantly lower among uninfected foxes. Ceruminous gland hyperplasia increased in the chronically infected, untreated foxes during the six month study. Our results provide compelling evidence that acaricide treatment is an effective means of reducing ear mites, and that mite removal in turn reduces ear lesions and mite-specific IgG antibody levels in Santa Catalina Island foxes. This study has advanced our understanding of the underlying pathogenesis which results in ceruminous gland tumors, and has helped inform management decisions that impact species conservation.

  13. Mechanisms of hearing loss after blast injury to the ear.

    Directory of Open Access Journals (Sweden)

    Sung-Il Cho

    Full Text Available Given the frequent use of improvised explosive devices (IEDs around the world, the study of traumatic blast injuries is of increasing interest. The ear is the most common organ affected by blast injury because it is the body's most sensitive pressure transducer. We fabricated a blast chamber to re-create blast profiles similar to that of IEDs and used it to develop a reproducible mouse model to study blast-induced hearing loss. The tympanic membrane was perforated in all mice after blast exposure and found to heal spontaneously. Micro-computed tomography demonstrated no evidence for middle ear or otic capsule injuries; however, the healed tympanic membrane was thickened. Auditory brainstem response and distortion product otoacoustic emission threshold shifts were found to be correlated with blast intensity. As well, these threshold shifts were larger than those found in control mice that underwent surgical perforation of their tympanic membranes, indicating cochlear trauma. Histological studies one week and three months after the blast demonstrated no disruption or damage to the intra-cochlear membranes. However, there was loss of outer hair cells (OHCs within the basal turn of the cochlea and decreased spiral ganglion neurons (SGNs and afferent nerve synapses. Using our mouse model that recapitulates human IED exposure, our results identify that the mechanisms underlying blast-induced hearing loss does not include gross membranous rupture as is commonly believed. Instead, there is both OHC and SGN loss that produce auditory dysfunction.

  14. Inner ear malformations: a practical diagnostic approach. (United States)

    Mazón, M; Pont, E; Montoya-Filardi, A; Carreres-Polo, J; Más-Estellés, F


    Pediatric sensorineural hearing loss is a major cause of disability; although inner ear malformations account for only 20-40% of all cases, recognition and characterization will be vital for the proper management of these patients. In this article relevant anatomy and development of inner ear are surveyed. The role of neuroimaging in pediatric sensorineural hearing loss and cochlear preimplantation study are assessed. The need for a universal system of classification of inner ear malformations with therapeutic and prognostic implications is highlighted. And finally, the radiological findings of each type of malformation are concisely described and depicted. Computed tomography and magnetic resonance imaging play a crucial role in the characterization of inner ear malformations and allow the assessment of the anatomical structures that enable the selection of appropriate treatment and surgical approach.

  15. Environment for Auditory Research Facility (EAR) (United States)

    Federal Laboratory Consortium — EAR is an auditory perception and communication research center enabling state-of-the-art simulation of various indoor and outdoor acoustic environments. The heart...

  16. Evolution: Fossil Ears and Underwater Sonar. (United States)

    Lambert, Olivier


    A key innovation in the history of whales was the evolution of a sonar system together with high-frequency hearing. Fossils of an archaic toothed whale's inner ear bones provide clues for a stepwise emergence of underwater echolocation ability.

  17. Female Climacteric Syndrome Treated by Ear Embedding

    Institute of Scientific and Technical Information of China (English)



    @@ Female climacteric syndrome is a common disease occurring before and after menopause. The author has treated the disease with ear embedding therapy, and achieved satisfactory therapeutic results. The following is a report of the clinical observation.

  18. Ear Infection Treatment: Do Alternative Therapies Work? (United States)

    ... in books and magazines. They include chiropractic adjustments, homeopathy, herbal eardrops and others. Perhaps you're seeking ... infection treatments have been studied with mixed results. Homeopathy. A controversial treatment for ear infection, homeopathy involves ...

  19. Mozart ear: diagnosis, treatment, and literature review. (United States)

    Yamashita, Ken; Yotsuyanagi, Takatoshi; Saito, Tamotsu; Isogai, Noritaka; Mori, Hiromasa; Itani, Yoshihito


    Mozart ear is a congenital auricular deformity, which is mainly characterized by a bulging appearance of the anterosuperior portion of the auricle, a convexly protruded cavum conchae, and a slit-like narrowing of the orifice of the external auditory meatus. It is said to be uncommon, and because no one has yet fully described neither the disease nor the treatment, the concept of Mozart ear has not been unified. This report describes a case of a 13-year-old girl presented with an unusual congenital deformity which showed the features of Mozart ear. It is an extremely rare deformity that only about 4 clinical cases have been reported in medical literature thereby a treatment method has not been fully discussed. For surgical correction of our cases, we excised deformed conchal cartilage, turned it over, regrafted, and maintained a cosmetically positive result. We also reviewed and described the origin, current concept, and treatment method of Mozart ear.

  20. Neonatal Ear Molding: Timing and Technique. (United States)

    Anstadt, Erin Elizabeth; Johns, Dana Nicole; Kwok, Alvin Chi-Ming; Siddiqi, Faizi; Gociman, Barbu


    The incidence of auricular deformities is believed to be ∼11.5 per 10,000 births, excluding children with microtia. Although not life-threatening, auricular deformities can cause undue distress for patients and their families. Although surgical procedures have traditionally been used to reconstruct congenital auricular deformities, ear molding has been gaining acceptance as an efficacious, noninvasive alternative for the treatment of newborns with ear deformations. We present the successful correction of bilateral Stahl's ear deformity in a newborn through a straightforward, nonsurgical method implemented on the first day of life. The aim of this report is to make pediatric practitioners aware of an effective and simple molding technique appropriate for correction of congenital auricular anomalies. In addition, it stresses the importance of very early initiation of ear cartilage molding for achieving the desired outcome.

  1. Otologic surgeries in National Ear Care Centre, Kaduna, Nigeria: A 5 years review

    Directory of Open Access Journals (Sweden)

    Grema Umar Sambo


    Full Text Available Background: Otologic surgeries that endure are based on a detailed knowledge of anatomy, physiology, and pathology of the temporal bone. Ear surgeries are challenging to most otolaryngologists practicing in Nigeria. The aim was to present a 5 years review of indications, types, complications, success, and limitations of the ear surgeries at the study center. Materials and Methods: A 5 years retrospective review of all the otologic surgeries are done under general and local anesthesia from July, 2009 to July, 2014. Results: There were 1067 patients who had ear, nose, and throat surgeries within the period under review, out of which 68 were ear surgeries. Prevalence was 6.37%, there were 25 (37% males and 43 (63% females, male: female 1:1.7. Age ranged from 1 to 58 years, mean age 21 ± 6 years. Chronic suppurative otitis media was the most common diagnosis 39 (57.4% and indication for tympanoplasty 31 (46.6%. Meatocanaloplasty was the least with 2 (2.9%, mastoidectomy 7 (10.3%, myringotomy and grommet insertion 11 (16.2%, excisional biopsy 7 (10.3%, foreign body removal 4 (5.90%, tympanomastoidectomy 3 (4.40%, and pinnaplasty 3 (4.40%. Forty-one (60.3% achieved resolution of symptoms while 8 (11.8% had persistence of symptoms. One (1.5% had revision surgery. The success rate is about 60.3% within the period under review. Postoperative complications (facial nerve paralysis, persistence discharge from the mastoid cavity, worsened deafness, postauricular fistula were seen in 14 (20.6%. While 4 (5.9% were lost to follow-up. Conclusion: Ear surgeries are still underdeveloped when compared to nose and throat surgeries in our center. Complication (chronic suppurative otitis media was the most common indication for ear surgery. Provision of adequate training facilities, especially in the field of otology and review of the training curriculum for otorhinolaryngology residency in Nigeria is indispensable.

  2. The acoustical significance of age-dependent ear elongation

    DEFF Research Database (Denmark)

    Christensen, Flemming


    Elderly people, especially some old men, appear to have very large ears. This paper presents an investigation on the acoustic significance of the age dependent ear elongation. HRTFs and ear lengths were measured for two groups of young and old people. The older groups had larger ears on average...

  3. 21 CFR 874.4140 - Ear, nose, and throat bur. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear, nose, and throat bur. 874.4140 Section 874...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4140 Ear, nose, and throat bur. (a) Identification. An ear, nose, and throat bur is a device consisting of an interchangeable drill bit that...

  4. Chronic caffeine consumption prevents cognitive decline from young to middle age in rats, and is associated with increased length, branching, and spine density of basal dendrites in CA1 hippocampal neurons. (United States)

    Vila-Luna, S; Cabrera-Isidoro, S; Vila-Luna, L; Juárez-Díaz, I; Bata-García, J L; Alvarez-Cervera, F J; Zapata-Vázquez, R E; Arankowsky-Sandoval, G; Heredia-López, F; Flores, G; Góngora-Alfaro, J L


    Chronic caffeine consumption has been inversely associated with the risk of developing dementia and Alzheimer's disease. Here we assessed whether chronic caffeine treatment prevents the behavioral and cognitive decline that male Wistar rats experience from young (≈3 months) to middle age (≈10 months). When animals were young they were evaluated at weekly intervals in three tests: motor activity habituation in the open field (30-min sessions at the same time on consecutive days), continuous spontaneous alternation in the Y-maze (8 min), and elevated plus-maze (5 min). Afterward, rats from the same litter were randomly assigned either to a caffeine-treated group (n=13) or a control group (n=11), which received only tap water. Caffeine treatment (5 mg/kg/day) began when animals were ≈4 months old, and lasted for 6 months. Behavioral tests were repeated from day 14 to day 28 after caffeine withdrawal, a time period that is far in excess for the full excretion of a caffeine dose in this species. Thirty days after caffeine discontinuation brains were processed for Golgi-Cox staining. Compared with controls, we found that middle-aged rats that had chronically consumed low doses of caffeine (1) maintained their locomotor habituation during the second consecutive day exposure to the open field (an index of non-associative learning), (2) maintained their exploratory drive to complete the conventional minimum of nine arm visits required to calculate the alternation performance in the Y-maze in a greater proportion, (3) maintained their alternation percentage above chance level (an index of working memory), and (4) did not increase the anxiety indexes assessed by measuring the time spent in the open arms of the elevated plus maze. In addition, morphometric analysis of hippocampal neurons revealed that dendritic branching (90-140 μm from the soma), length of 4th and 5th order branches, total dendritic length, and spine density in distal dendritic branches were greater in

  5. Temporal bone CT findings of tuberculous otitis media : comparison with chronic otitis media

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Jeong A; Rho, Myung Ho; Kim, Young Min; Lee, Ho Seung; Choi, Pil Yeob; Seong, Young Soon; Kwon, Jae Soo; Lee, Sang Wook [Masan Samsung Hospital, Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of); Jung, Keon Sik [Pohang Sunrin Hospital, Pohang (Korea, Republic of)


    To compare the differential findings of tuberculous otitis media(TOM) with those of chronic sup purative otitis media with or without cholesteatoma, as seen on high resolution temporal bone CT. We retrospectively reviewed 14 cases of TOM, 30 cases of chronic suppurative otitis media(CSOM), and 30 cases of chronic otitis media with cholesteatoma(Chole). All had been pathologically confirmed. We evaluated the preservation of mastoid cells without sclerotic change, the location and extension of soft tissue to the external auditary canal, and erosion of ossicles, the tegmen tympani, scutum, bony labyrinth, facial nerve canal and sigmoid sinus, and the presence of intracranial complications. Soft tissue in the mastoid antrum was seen in all cases of TOM(100%), 29 cases of CSOM(96.7%), and 26 cases of Chole(86.7%). In contrast, the soft tissue in the entire middle ear cavity was noted in 13 cases of TOM(92.8%), 7 cases of CSOM(23.3%), and 12 cases of Chole(40%). Soft tissue extended to the superior aspect of the external auditory canal in 4 cases of TOM (28.6%) and 5 cases of Chole (16.7%). Mastoid air cells were seen in 9 cases of TOM (64.3%), 4 cases of CSOM (13.3%), and 3 cases of Chole(10%). Ossicular erosion was noted in 6 cases of TOM (42.9%), 12 cases of CSOM (40%), and 26 cases of Chole(86.7%), while in one case of TOM (7.1%), 5 cases of CSOM (16.7%), and 15 cases of Chole(50%) there was erosion of the scutum. In one case of TOM, follow-up CT study after 9 months of antituberculous medication without surgery revealed complete clearing of previously noted soft tissue in the middle ear cavity. Specific CT findings of TOM were not seen, but if there were findings of soft tissue in the entire middle ear cavity, soft tissue extension to the external auditory canal, preservation of mastoid air cells without sclerotic change, and intact scutum, TOM may be differentiated from other chronic otitis media.

  6. Hearing impairment and ear pathology in Nepal. (United States)

    Little, P; Bridges, A; Guragain, R; Friedman, D; Prasad, R; Weir, N


    A stratified random cluster sample of 15,845 subjects was performed in two regions of Nepal to determine the prevalence and main causes of hearing impairment (the most common disability) and the prevalence of ear disease. Subjects reporting current ear pain, or ear discharge, or hearing impairment on direct questioning by a Nepali health worker (primary screening failed), had otoscopy and audiometry (using the Liverpool Field Audiometer) performed, and a questionnaire administered relating to past history. In every fifth house subjects who passed the primary screening (1,716 subjects) were examined to assess the false negative rate of screening. An estimated 16.6 per cent of the study population have hearing impairment (either ear worse than 30 dB hearing threshold level (HTL) 1.0-4.0 kHz, or 50 dB HTL 0.5 kHz), and 7.4 per cent ear drum pathology, equivalent to respectively 2.71 and 1.48 million people extrapolated to the whole of Nepal. Most hearing impairment in the school age group (55.2 per cent) is associated with otitis media or its sequelae. Probably at least 14 per cent of sensorineural deafness is preventable (7 per cent infectious disease, 3.9 per cent trauma, 0.8 per cent noise exposure, 1 per cent cretinism, and 1 per cent abnormal pregnancy or labour). Most individuals reporting current ear pathology (61 per cent) had never attended a health post, and of those receiving ear drop treatment, 84 per cent still had serious pathology. Of subjects who reported ear drop treatment at any time, 31 per cent still had serious pathology. The use of traditional remedies was prevalent.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Commissioning of n_TOF EAR2

    CERN Multimedia

    The construction of the second beam line and experiment area (EAR2) of the n_TOF facility is currently ongoing and scheduled to be completed by July 2014. An extensive series of measurements is planned in order to determine the beam characteristics like the neutron flux, the spatial beam profile and the resolution function, as well as the response of several detectors considered for use in future measurements at EAR2. A rigorous study of backgrounds will be undertaken in various conditions.

  8. A study on hearing evaluation in patients of chronic renal failure

    Directory of Open Access Journals (Sweden)

    Ravinder Sharma


    Full Text Available Aims and Objective: The aim of the study was to evaluate hearing threshold and the severity of hearing loss at different frequencies (250Hz, 500Hz, 1000Hz, 2000Hz, 3000Hz, 4000Hz, 6000Hz, and 8000Hz in patients of chronic renal failure (CRF, and to analyze the role of duration of disease on hearing threshold in patients of CRF. Materials and Methods: Fifty two patients of CRF were evaluated in Nephrology unit and ENT OPD. Cases with middle ear involvement were not included in the study. Pure tone audiometry was done in all cases to establish hearing threshold at different frequencies. Cases with hearing loss were classified according to the severity of hearing loss. In patients with sensorineural hearing loss, mean hearing threshold was calculated. Cases were classified in two groups on the basis of duration of disease (less than two years and more than two years and the mean hearing thresholds were calculated. The significant differences between the mean hearing thresholds of these two groups were assessed using student′s t test for unequal samples. Results : A total of 52 patients (28 males and 24 females were included in the study. Majority of the patients were in 21 to 40 year age group (mean age 36.84 years. Of the 104 ears, 76 ears (73.07% had sensorineural hearing loss and 28 ears (26.93% had normal hearing. Majority of the ears with hearing loss had mild (44.73% or moderate (42.11% sensorineural hearing loss. Mean hearing threshold was higher at low frequencies and high frequencies with a relative sparing of mid frequencies. Comparison of the mean hearing threshold in patients of Group I (duration of disease less than two years - 42 ears and Group II (duration of disease more than two years - 34 ears showed a statistically significant difference (P<0.05 in mean hearing threshold at 250 Hz. Conclusion: Hearing loss is present in majority of the patients of CRF. Most of the cases have mild to moderate sensorineural hearing loss. Hearing

  9. Retrospective study of ear findings of dogs submitted to cranial tomography in FMVZ - UNESP, Botucatu; Estudo retrospectivo dos achados otologicos de caes submetidos a tomografia craniana na FMVZ - UNESP, Botucatu

    Energy Technology Data Exchange (ETDEWEB)

    Babicsak, Viviam Rocco; Oliveira, Hugo Salvador de; Belotta, Alexandra Frey; Santos, Debora Rodrigues dos; Zardo, Karen Maciel; Mamprim, Maria Jaqueline; Machado, Vania Maria de Vasconcelos; Vulcano, Luiz Carlos, E-mail: [Universidade Estadual Paulista Julio de Mesquita Filho (FMVZ/UNESP), Botucatu, SP (Brazil). Faculdade de Medicina Veterinaria e Zootecnia. Dept. de Reproducao Animal e Radiologia Veterinaria


    Computed tomography (CT) is an important imaging modality in the diagnosis of ear alterations, especially those affecting the middle ear. In this retrospective study, in which the cranial CT scans of 151 dogs were evaluated, the most common finding was the mineralization of the external auditory cartilage, followed by secretions in external and middle ear and tissue in these two regions. The average age of affected animals ranged from 6-9 years. Mixed breed dogs were the most affected animals, followed by cockers, boxers, poodles, labrador retrievers, german shepherds and pit bulls. (author)

  10. Ear-to-Ear On-Body Channel Fading in the ISM-band for Tangentially-Polarized Antennas

    DEFF Research Database (Denmark)

    Kvist, Søren Helstrup; Thaysen, Jesper; Jakobsen, Kaj Bjarne


    The ear-to-ear on-body channel fading has been studied in the ISM-band. The ear-to-ear path gain was measured on six persons in an indoor environment for a duration of 200 s. The channel fading has been characterized in terms of empirical cumulative distribution functions (CDF), average fade...

  11. Optical techniques as validation tools for finite element modeling of biomechanical structures, demonstrated in bird ear research (United States)

    Muyshondt, Pieter; De Greef, Daniël; Soons, Joris; Dirckx, Joris J. J.


    In this paper we demonstrate the potential of stroboscopic digital holography and laser vibrometry as tools to gather vibration data and validate modelling results in complex biomechanical systems, in this case the avian middle ear. Whereas the middle ear of all mammal species contains three ossicles, birds only feature one ossicle, the columella. Despite this far simpler design, the hearing range of most birds is comparable to mammals, and is adapted to operate under very diverse atmospheric circumstances. This makes the investigation of the avian middle ear potentially very meaningful, since it could provide knowledge that can improve the design of prosthetic ossicle replacements in humans such as a TORP (Total Ossicle Replacement Prosthesis). In order to better understand the mechanics of the bird's hearing, we developed a finite element model that simulates the transmission of an incident acoustic wave on the eardrum via the middle ear structures to the fluid of the inner ear. The model is based on geometry extracted from stained μCT data and is validated using results from stroboscopic digital holography measurements on the eardrum and LDV measurements on the columella footplate. This technique uses very short high-power laser pulses that are synchronized to the membrane's vibration phase to measure the dynamic response of the bird's eardrum to an incident acoustic stimulus. Vibration magnitude as well as phase relative to the sound wave can be deduced from the results, the latter being of great importance in the elastic characterization of the tympanic membrane. In this work, the setup and results from the optical measurements, as well as the properties and optimization of the finite element model are presented. Observed phase variations across the eardrum's surface on the holography results strongly suggest the presence of internal energy losses in the membrane due to damping. Therefore, a viscoelastic characterisation of the model based on a complex

  12. Correlates of hot day air-conditioning use among middle-aged and older adults with chronic heart and lung diseases: the role of health beliefs and cues to action. (United States)

    Richard, Lucie; Kosatsky, Tom; Renouf, Annie


    Extreme ambient heat is a serious public health threat, especially for the elderly and persons with pre-existing health conditions. Although much of the excess mortality and morbidity associated with extreme heat is preventable, the adoption of effective preventive strategies is limited. The study reported here tested the predictive power of selected components of the Health Belief Model for air-conditioning (AC) use among 238 non-institutionalized middle-aged and older adults with chronic heart failure and/or chronic obstructive pulmonary disease living in Montréal, Canada. Respondents were recruited through clinics (response rate 71%) and interviews were conducted in their homes or by telephone. Results showed that 73% of participants reported having a home air conditioner. The average number of hours spent per 24-hour period in air-conditioned spaces during heat waves was 14.5 hours (SD = 9.4). Exploratory structural equation modeling showed that specific beliefs about the benefits of and drawbacks to AC as well as internal cues to action were predictive of its level of use, whereas the perceived severity of the effects of heat on health was not. The findings are discussed in light of the need to adequately support effective response to extreme heat in this vulnerable population.

  13. The assessment and management of inner ear barotrauma in divers and recommendations for returning to diving. (United States)

    Elliott, Elizabeth J; Smart, David R


    Inner ear barotrauma (IEBt) constitutes a spectrum of pressure-related pathology in the inner ear, with antecedent middle ear barotrauma (MEBt) common. IEBt includes perilymph fistula, intralabyrinthine membrane tear, inner ear haemorrhage and other rarer pathologies. Following a literature search, the pathophysiology, diagnosis, and treatment of IEBt in divers and best-practice recommendations for returning to diving were reviewed. Sixty-nine papers/texts were identified and 54 accessed. Twenty-five case series (majority surgical) provided guidance on diagnostic pathways; nine solely reported divers. IEBt in divers may be difficult to distinguish from inner ear decompression sickness (IEDCS), and requires dive-risk stratification and careful interrogation regarding diving-related ear events, clinical assessment, pure tone audiometry, a fistula test and electronystagmography (ENG). Once diagnosed, conservative management is the recommended first line therapy for IEBt. Recompression does not appear to cause harm if the diagnosis (IEBt vs IEDCS) is doubtful (limited case data). Exploratory surgery is indicated for severe or persisting vestibular symptoms or hearing loss, deterioration of symptoms, or lack of improvement over 10 days indicating significant pathology. Steroids are used, but without high-level evidence. It may be possible for divers to return to subaquatic activity after stakeholder risk acceptance and informed consent, provided: (1) sensorineural hearing loss is stable and not severe; (2) there is no vestibular involvement (via ENG); (3) high-resolution computed tomography has excluded anatomical predilection to IEBt and (4) education on equalising techniques is provided. There is a need for a prospective data registry and controlled trials to better evaluate diagnostic and treatment algorithms.

  14. Imaging of the inner ear; Bildgebung des Innenohrs

    Energy Technology Data Exchange (ETDEWEB)

    Casselman, J.W. [Dept. of Radiology, A.Z.St.-Jan Brugge (Belgium); Bensimon, J.L. [Imagerie O.R.L. et Generale, Paris (France)


    New computed tomography (CT) and magnetic resonance (MR) techniques allow more detailed anatomic studies of the inner ear. CT is still the best technique to study patients with fractures, congenital malformations and otodystrophies involving the inner ear. During recent years MR imaging has emerged as an excellent method to detect pathology in the internal auditory canal, membranous labyrinth and bony labyrinth and to characterize petrous apex lesions. MR has even proved its value in patients with fractures and congenital malformations making the diagnosis of, for instance, labyrinthine concussion and absence of the vestibulocochlear nerve possible. The diagnosis of acute/chronic labyrinthitis and intralabyrinthine tumors has also became possible. However, MR and CT are often complementary, as is the case in patients with mixed hearing loss, congenital malformations and petrous apex lesions. (orig.) [Deutsch] Neuere CT- und MR-Untersuchungsmethoden erlauben eine detaillierte anatomische Darstellung des Innenohres. Die CT ist unveraendert die beste Bildgebungstechnik zur Darstellung von Frakturen, angeborenen Missbildungen und Otodystrophien im Innenohr. In den letzten Jahren hat sich die MRT im Nachweis pathologischer Veraenderungen von innerem Gehoergang, membranoesem und knoechernem Labyrinth und zur Charakterisierung von Schlaefenbeinspitzenlaesionen als diagnostisch aeusserst wertvoll erwiesen. Bei Patienten mit Frakturen oder kongenitalen Missbildungen erlaubt die MRT den Nachweis von labyrinthaeren Kontusionen bzw. Aplasie des vestibulocochlearen Nervs. Die Diagnose einer Labyrinthitis sowie von intralabyrinthaeren Tumoren wurde erstmals bildgebend mittels MRT moeglich. Es muss aber betont werden, dass MRT und CT meist komplementaere Methoden sind. Dies trifft insbesondere bei Patienten mit gemischtem Hoerverlust, kongenitalen Missbildungen und Schlaefenbeinapexlaesionen zu. (orig.)

  15. Analysis of bone mineral density in 143 middle- and elder-aged patients with chronic renal failure%143例中老年慢性肾衰竭患者双能X线骨密度结果分析

    Institute of Scientific and Technical Information of China (English)

    李桂英; 邸彬; 肖太玲


    目的 研究中老年慢性肾衰竭CKD3期~CKD5期患者骨质疏松情况,分析骨质疏松与慢性肾衰竭、年龄、体重指数及性别的相关性,探讨慢性肾衰竭所致骨质疏松的早期表现。方法 ①采用双能X线骨密度仪测定腰椎正位(L1~L4)和股骨颈、Ward's三角、大粗隆的骨密度;②测量143例中老年慢性肾衰竭患者及对照组165例骨密度(BMD)值,采用病例对照法分析慢性肾衰竭对骨质疏松发病率的影响;③采用Logistic多元回归法分析慢性肾衰竭、年龄、性别及体重指数对骨质疏松的影响。结果 ①中老年慢性肾衰竭患者的骨质疏松发病率为79.02%,明显高于对照组(47.88%);②CKD3、4、5期患者中,骨质疏松患病率随肾功能减退而逐渐增加;骨质疏松与慢性肾衰竭及年龄正相关,与体重指数负相关;④Ward's三角的骨质疏松患病率及骨量减少程度高于股骨其他部位及腰椎。结论 慢性肾衰竭是骨质疏松的重要影响因素。Ward's三角可作为早期诊断骨质疏松的首选检查部位。%Objective To study the osteoporosis status in middle- and elder-aged patients with stage 3-5 of chronic renal failure, and to analyze the correlation among osteoporosis and chronic renal failure, age, body mass index, and gender, and to explore the early manifestations of osteoporosis in chronic renal failure patients. Methods 1 ) Dual-energy X-ray absorptiometry was used to measure the bone mineral densities (BMD) of the lumbar vertebra (L,-L4), the femoral neck, the Ward' s triangle, and the femoral trochanter. 2) BMDs were measured in 143 middle- and elder-aged patients with chronic renal failure and 165 controls. Case-control analysis was used to show the effect of chronic renal failure on the incidence of osteoporosis. 3) Logistic multiple regression analysis was used to analyze the contributions of chronic renal failure, age, gender, and body mass index to

  16. Ear Acupuncture in European Traditional Medicine

    Directory of Open Access Journals (Sweden)

    Luigi Gori


    Full Text Available Auricular acupuncture is a diagnostic and treatment system based on normalizing the body's dysfunction through stimulation of definite points on the ear. Rudimentary forms of acupuncture which probably arose during the Stone Age have survived in many parts of the world right down to present day. It was used in the ancient Egypt, Rome, Greece and all the Mediterranean area. It is a microacupuncture technique similar to reflexology, and was first described in France in 1950 by Paul Nogier who is considered the Father of modern ear acupuncture. It was speculated that the technique works because groups of pluripotent cells contain information from the whole organism and create regional organization centers representing different parts of the body. Nevertheless stimulation of a reflex point in the ear seems relieve symptoms of distant pathologies. Modern research is confirming the efficacy of ear acupuncture for analgesia and anxiety related disease, while tobacco dependence and other substance abuse still need confirmation. Actually main methodological problems with auricular acupuncture are that exist too many maps with little agreement regarding point location in the ear, and that the correspondence or reflex systems does not correlated with modern knowledge of anatomy and physiology.

  17. The acoustical significance of age-dependent ear elongation

    DEFF Research Database (Denmark)

    Christensen, Flemming


    Elderly people, especially some old men, appear to have very large ears. This paper presents an investigation on the acoustic significance of the age dependent ear elongation. HRTFs and ear lengths were measured for two groups of young and old people. The older groups had larger ears on average......, corresponding to what is reported in the literature. For female ears, virtually no acoustical effect was found. For male ears directional dependent effects in the range up to 5 dB on average was found for certain directions and frequencies. Implications on age dependent hearing loss (presbycusis...

  18. Precise individualized armature for ear reconstruction (United States)

    Evenhouse, Raymond J.; Chen, Xiaoming


    The cosmetic result of an ear restored surgically or via prosthetics is dependent on the surgeon''s ability to carve a precise cartilage armature at the time of surgery or the prosthetist''s ability to sculpt in wax an exact duplicate of the patient''s " missing" ear. Introducing CAD/CAM technology into the process benefits the esthetic outcome of these procedures. By utilizing serial section information derived from CAT MRI or moulage techniques a mirrorimage of the patient''s " donor" ear is generated. The resulting earform data is then used for the design of a cartilage armature produced by multi-axis milling or to produce by stereolithography a model which serves as the basis for a prosthesis.

  19. The coexistence of asthma and chronic obstructive pulmonary disease (COPD: prevalence and risk factors in young, middle-aged and elderly people from the general population.

    Directory of Open Access Journals (Sweden)

    Roberto de Marco

    Full Text Available BACKGROUND: The joint distribution of asthma and chronic obstructive pulmonary disease (COPD has not been well described. This study aims at determining the prevalence of self-reported physician diagnoses of asthma, COPD and of the asthma-COPD overlap syndrome and to assess whether these conditions share a common set of risk factors. METHODS: A screening questionnaire on respiratory symptoms, diagnoses and risk factors was administered by mail or phone to random samples of the general Italian population aged 20-44 (n = 5163 45-64 (n = 2167 and 65-84 (n = 1030 in the frame of the multicentre Gene Environment Interactions in Respiratory Diseases (GEIRD study. RESULTS: A physician diagnosis of asthma or COPD (emphysema/chronic bronchitis/COPD was reported by 13% and 21% of subjects aged <65 and 65-84 years respectively. Aging was associated with a marked decrease in the prevalence of diagnosed asthma (from 8.2% to 1.6% and with a marked increase in the prevalence of diagnosed COPD (from 3.3% to 13.3%. The prevalence of the overlap of asthma and COPD was 1.6% (1.3%-2.0%, 2.1% (1.5%-2.8% and 4.5% (3.2%-5.9% in the 20-44, 45-64 and 65-84 age groups. Subjects with both asthma and COPD diagnoses were more likely to have respiratory symptoms, physical impairment, and to report hospital admissions compared to asthma or COPD alone (p<0.01. Age, sex, education and smoking showed different and sometimes opposite associations with the three conditions. CONCLUSION: Asthma and COPD are common in the general population, and they coexist in a substantial proportion of subjects. The asthma-COPD overlap syndrome represents an important clinical phenotype that deserves more medical attention and further research.

  20. The Frog Inner Ear: Picture Perfect?


    Mason, Matthew James; Segenhout, Johannes M.; Cobo-Cuan, Ariadna; Quiñones, Patricia M.; van Dijk, Pim


    This is the accepted manuscript of a paper published in the Journal of the Association for Research in Otolaryngology (2015) DOI: 10.1007/s10162-015-0506-z Many recent accounts of the frog peripheral auditory system have reproduced Wever’s (1973) schematic cross-section of the ear of a leopard frog. We sought to investigate to what extent this diagram is an accurate and representative depiction of the anuran inner ear, using three-dimensional reconstructions made from serial sections of Ra...

  1. up to one’s ears

    Institute of Scientific and Technical Information of China (English)


    up to one’s ears可以解释成"很忙"的意思。如:Half the people in my office are home sick,so I’m up to my ears!我办公室里有一半的人有病请假,所以我简直忙得不得了。I’d like to help you paint the kitchen tonight,but I’m up to my ears in paper work I had to bring home from the office.我很愿意今晚帮你把厨房上油漆。可

  2. A Man With Two Burned Ears

    Institute of Scientific and Technical Information of China (English)



    Mr Smith was in troublethose days. He drove a car forMr Black, a rich business-man. He worked hard and theshopkeeper liked him. But hecouldn't work when he dranktoo much. And once he al-most fell into the river whenhe drove along the bridge. MrBlack became angry and wasgoing to send him away. Hehad a big family and wasafraid of that and promisedhe would stop drinking atonce. The man told him towait to be dealt with. OneMonday morning, Mr Smithcame into the office, with twobadly burned ears. “Whathappened to your ears?”asked Mr Black.

  3. Real-ear measurements in conductive hearing loss: discrepancies between probe-tube microphone measurements and sound field test results. (United States)

    Cleaver, V C


    This study was designed to investigate earlier observations that probe-tube microphone measurements of insertion gain overestimates the functional gain received from hearing aids by users with significant conductive hearing losses. This was originally thought to be due to artefacts in the probe-tube measurement caused by middle ear pathology, but is now believed to be the result of the bone conduction stimulation of the ear exposed to high intensities of airborne sound during sound field threshold measurements. Since the functional gain must relate to the true aided benefit in such cases, these findings suggest that probe-tube microphone measurements in ears with significant air-bone gaps should be interpreted with caution.

  4. Correlation between bone mineral density with chronic periodontitis in middle-aged and elderly people%中老年人骨密度与慢性牙周炎的相关性研究

    Institute of Scientific and Technical Information of China (English)

    王景洁; 付婕; 王行; 谢昊; 郭小斌


    目的:研究中老年人骨密度降低及骨质疏松与牙周炎之间的关系。方法:选取122名进行体格检查的中老年人,女104名,男18名,进行骨密度测定及口腔检查。根据骨密度值(T值)分为观察组(T<-1.0)与对照组(T>-1.0)。根据附着丧失(CAL)、余留牙数目分为轻、中、重度牙周炎。运用统计学软件进行骨密度与慢性牙周炎分级间的χ2检验,并与牙周附着丧失进行相关性分析。结果:观察组较对照组,中、重度牙周炎的患病率显著增高(χ2=4.41, P<0.05)。中老年人群的骨密度值与CAL值显著负相关(tr=-3.88,P<0.001),即随着骨密度降低,CAL呈增加趋势。结论:中老年人群中,骨量减少及骨质疏松与慢性牙周炎的严重程度相关;骨密度降低可能是中老年人中、重度慢性牙周炎进展的促进因素。%Objective:To study the correlation between osteoporosis and chronic periodontitis in middle-aged and elderly people. Method: The oral condition of 122 individuals who had bone mineral density examination was examined. They were divided into observation group and control group according to the bone density. T score of the observation group was less than -1.0, the control group was more than -1.0. The severity of periodontitis was divided into mild, moderate and advanced according to clinical attachment loss and number of remaining teeth. The chi-square test was made between bone density and severity of periodontitis. Correlation analysis was made between bone density and clinical attachment loss. Result:In observation group, the rate of moderate and advanced chronic periodontitis was significantly higher than that in control group. (χ2=4.41, P<0.05). There was significant correlation between bone density and severity of periodontitis (χ2=4.41, P<0.05). There was negative correlation between bone density and clinical attachment loss (tr=-3.88, P<0.001). As the

  5. Cholesterol granuloma presenting as a mass obstructing the external ear canal

    Directory of Open Access Journals (Sweden)

    Psifidis Dimosthenis


    Full Text Available Abstract Background Cholesterol granuloma (CG may involve the middle ear, the mastoid bone and the petrous apex. However, CG presenting as a mass obstructing the external ear canal (EEC is relatively rare and it can be a diagnostic challenge. Case Presentation We report a case of a CG occupying the mastoid antrum and presenting as a mass into the EEC. Temporal bone computerized tomography showed a soft tissue mass which eroded the posterior-superior bony wall of the EEC. On magnetic resonance imaging, the mass revealed a high signal on both T1 and T2-weighted images. The CG was removed by a mastoidectomy procedure and the histopathologic report confirmed the diagnosis of CG. A type III tympanoplasty was performed. Conclusions The postoperative course was uneventful.

  6. Mechanics of the exceptional anuran ear

    NARCIS (Netherlands)

    Schoffelen, Richard L. M.; Segenhout, Johannes M.; van Dijk, Pim


    The anuran ear is frequently used for studying fundamental properties of vertebrate auditory systems. This is due to its unique anatomical features, most prominently the lack of a basilar membrane and the presence of two dedicated acoustic end organs, the basilar papilla and the amphibian papilla. O

  7. DNA isolation from rat tail or ear

    NARCIS (Netherlands)

    Cuppen, E.


    This protocol describes a rapid procedure for isolating DNA from rat tail or ear punches. The simplest version of the protocol can be scaled for use in 96-well (deep-well) plates. The quality of the DNA is sufficient for any polymerase chain reaction (PCR)-based genotyping approach.

  8. Objective Audiometry using Ear-EEG

    DEFF Research Database (Denmark)

    Christensen, Christian Bech; Kidmose, Preben

    therefore be an enabling technology for objective audiometry out of the clinic, allowing regularly fitting of the hearing aids to be made by the users in their everyday life environment. The objective of this study is to investigate the application of ear-EEG in objective audiometry....

  9. The inner ear produces a natriuretic hormone

    DEFF Research Database (Denmark)

    Qvortrup, K; Rostgaard, J; Holstein-Rathlou, N H


    Cytoplasmic granules have been demonstrated in epithelial cells from the endolymphatic sac, an extraosseus part of the inner ear located in the posterior cranial fossa. Intravenously infused extracts from endolymphatic sacs in anesthetized rats elicited a potent natriuresis and diuresis without...

  10. The first neutron beam hits EAR2

    CERN Multimedia

    Antonella Del Rosso


    On 25 July 2014, about a year after construction work began, the Experimental Area 2 (EAR2) of CERN’s neutron facility n_TOF recorded its first beam. Unique in many aspects, EAR2 will start its rich programme of experimental physics this autumn.   The last part of the EAR2 beamline: the neutrons come from the underground target and reach the top of the beamline, where they hit the samples. Built about 20 metres above the neutron production target, EAR2 is in fact a bunker connected to the n_TOF underground facilities via a duct 80 cm in diameter, where the beamline is installed. The feet of the bunker support pillars are located on the concrete structure of the n_TOF tunnel and part of the structure lies above the old ISR building. A beam dump located on the roof of the building completes the structure. Neutrons are used by physicists to study neutron-induced reactions with applications in a number of fields, including nuclear waste transmutation, nuclear technology, nuclear astrop...

  11. Infrared tympanic temperature and ear canal morphology

    NARCIS (Netherlands)

    Daanen, H.A.M.


    Several publications indicate that the infrared tympanic temperature (IRTT) underestimates the core temperature of the body when the ear canal is long, curvy and narrow. In order to quantify these observations, a study was performed in 10 subjects. The IRTT was determined and compared to the oesopha

  12. 40 CFR 211.206-1 - Real ear method. (United States)


    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Real ear method. 211.206-1 Section 211... PRODUCT NOISE LABELING Hearing Protective Devices § 211.206-1 Real ear method. (a) The value of sound... “Method for the Measurement of Real-Ear Protection of Hearing Protectors and Physical Attenuation...

  13. Hearing with an atympanic ear: good vibration and poor sound-pressure detection in the royal python, Python regius. (United States)

    Christensen, Christian Bech; Christensen-Dalsgaard, Jakob; Brandt, Christian; Madsen, Peter Teglberg


    Snakes lack both an outer ear and a tympanic middle ear, which in most tetrapods provide impedance matching between the air and inner ear fluids and hence improve pressure hearing in air. Snakes would therefore be expected to have very poor pressure hearing and generally be insensitive to airborne sound, whereas the connection of the middle ear bone to the jaw bones in snakes should confer acute sensitivity to substrate vibrations. Some studies have nevertheless claimed that snakes are quite sensitive to both vibration and sound pressure. Here we test the two hypotheses that: (1) snakes are sensitive to sound pressure and (2) snakes are sensitive to vibrations, but cannot hear the sound pressure per se. Vibration and sound-pressure sensitivities were quantified by measuring brainstem evoked potentials in 11 royal pythons, Python regius. Vibrograms and audiograms showed greatest sensitivity at low frequencies of 80-160 Hz, with sensitivities of -54 dB re. 1 m s(-2) and 78 dB re. 20 μPa, respectively. To investigate whether pythons detect sound pressure or sound-induced head vibrations, we measured the sound-induced head vibrations in three dimensions when snakes were exposed to sound pressure at threshold levels. In general, head vibrations induced by threshold-level sound pressure were equal to or greater than those induced by threshold-level vibrations, and therefore sound-pressure sensitivity can be explained by sound-induced head vibration. From this we conclude that pythons, and possibly all snakes, lost effective pressure hearing with the complete reduction of a functional outer and middle ear, but have an acute vibration sensitivity that may be used for communication and detection of predators and prey.

  14. Toxic inner ear lesion following otitis media with effusion: a comparative CT-study regarding the morphology of the inner ear. (United States)

    Wilhelm, Thomas; Stelzer, Tim; Wiegand, Susanne; Güldner, Christian; Teymoortash, Afshin; Günzel, Thomas; Hagen, Rudolf


    Viral infections of the upper respiratory airways can lead to a delayed viral otitis media (VOM) caused by a diffusion of viruses/virus particles through the round window membrane and resulting in sensorineural hearing loss. The treatment of choice is immediate paracentesis, evacuation of all fluids from the middle ear cavity, and haemorrheological infusions. However, in some cases, persistent symptoms may be an indication for a surgical approach using mastoidectomy. In high-resolution computed tomography, an extended small-sized pneumatisation of the mastoid cells with complete shading was found in these non-responsive cases. Therefore, a direct means of inner ear affliction through weak parts of the labyrinthine bone may be hypothesised. Patients suffering from a toxic inner ear lesion (TIEL) following a common cold, treated over a 10-year period in a Tertiary Care Centre (N = 52, 57 ears), were identified and the morphological characteristics of the temporal bones of affected patients were examined by means of high-resolution computed tomography (hrCT). The findings were compared with a matched control group of 64 normal ears (CONT). Measurements included the grade of pneumatisation, distances within the temporal bones and Hounsfield units (HU) at defined anatomical structures. In the TIEL group, we found a small-sized pneumatisation in 79.4 % and a medium-sized pneumatisation in 10.9 %, thus differing from the CONT group and the literature data. Thickness of the bone wall of the lateral semicircular canal (LSC) and distances within the aditus ad antrum were significantly reduced in the TIEL group. HU's were markedly lower in the TIEL group at the precochlea, the LSC, and dorsolateral to the promentia of the LSC. There was a correlation between the HU's at the prominentia of the LSC and the hearing loss (p = 0.002). Persisting interosseous globuli, as described in 1897 by Paul Manasse, form an osseochondral network within the otic capsule and may be responsible

  15. Study on Psychological Nursing of the Young or Middle-aged Patients with Chronic hepatitis B%中青年慢性乙型肝炎患者心理干预的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    朴顺梅; 田思思; 陈左翼; 于洪博; 于雷


    目的:研究中青年慢性乙型肝炎患者的个性特征和心理状态,探讨适合患者的心理护理方法.方法:将100例中青年慢性乙型肝炎患者随机分为干预组和对照组,每组50例,两组在应用传统保肝治疗同时,对照组给予常规护理治疗,而干预组依照患者的一般资料,艾森克人格问卷测得的患者的个性特征,SCL-90测评的患者的心理状态,实施相应的心理护理,内容包括相关知识教育、支持性心理护理、音乐心理护理以及睡眠心理护理.两组均治疗六个月,通过对干预组和对照组治疗效果及护理满意度的比较,探讨适合中青年慢性乙型肝炎患者的心理护理方法.结果:中青年慢性乙型肝炎患者具有特殊的个性特征和心理状态,其气质类型以抑郁质和胆汁质占多数,并且不同性别、年龄、职业的患者其个性特征不同,其心理状态也不同.干预组的治疗效果和护理满意度评分明显高于对照组,具有统计学意义(P<0.05).结论:心理护理按照患者的不同个性特征和心理状态制定,能够有效减轻抑郁、焦虑等症状,缓解心理压力,稳定情绪,提高睡眠质量,有利于疾病的治疗.%Objective: To analyse the personality characteristic and psychological state of the young or middle-aged patients suffer form chronic hepatitis B, and to reseach the proper psychological nursing methods on these patients. Methods: 100 cases were randomly divided into treatment group and control group with 50 cases in each. Both groups were given conventional liver-protecting drags. Routine nursing and therapy were performed in control group while psychological nursing include health education,supportive, music and sleep psychological nursing according to the result of general data, Eysenck Personality Questionnaire and Symptom Checklist 90, were given to the treatment group, then research the proper psychological nursing methods on the young or middle


    Directory of Open Access Journals (Sweden)

    Nilufar Jurakulovna Khushvakova


    Full Text Available  In this article, we have analyzed the results of the application of the combined solution of decasan and ozone-oxygen mixture, as a local conservative treatment, for 135 patients with acute exacerbation of chronic purulent medial otitis (CPOM. Its use increases the effectiveness of treatment and reduces time. The study of long-term results has shown persistence of sustained remission in 91,4% of patients.A comparative analysis of traditional treatments and topical administration of antiseptic 0.002 % solution of “Dekasan” (dekametansin, in combination with ozone-oxygen mixture in patients with suppurative otitis media, was carried out. The analysis was conducted using ozone-oxygen mixture along with a local irrigation of middle ear cavity with “Dekasan.”

  17. Study of the central auditive pathway by encephalic trunk evoked e auditory responses (ear) in children with language retard


    Gallardo, Manuel; Servicio de Otorrinolaringología, Hospital Central de la Fuerza Aérea del Perú; Vera, Carlos; Servicio de Otorrinolaringología, Hospital Central de la Fuerza Aérea del Perú


    Objetive: To determine the functional integrity of the brainstem auditory pathway by the auditive brainstem response (ABR) in language-retarded children without pathology in both the middle ear and central nervous system and no neonatal hearing loss risk factors. Design: Retrospective transversal study. Setting: Naval Medical Center and Air Force Central Hospital Otorhinolaryngology Services, Lima. Peru. Material and methods: Analysis of children’s ABR performed in the last ten years included...

  18. Assessment of senses of hearing and balance in chronic suppurative otitis media

    Directory of Open Access Journals (Sweden)

    Babić Borivoj


    Full Text Available Chronic suppurative otitis media is among the most frequent illnesses treated in ENT wards. To establish the diagnosis, otomicroscopy alone usually suffice. Assessing the sense of hearing, often the sense of balance, too, is mandatory. Assessment of hearing will show the extent of conductive and sensorineural hearing loss. Apart from this, sometimes, when the finding is not obvious, it is necessary to conduct audiological investigation in more detail in order to establish whether the diagnosis of chronic suppurative otitis media is correct. Existence and extent of conductive hearing loss or confIrmation of tympanic membrane perforation by tympanometry can help a great deal. Also, some new results about the site of perforation and the middle ear volume influence on conductive hearing loss may help have a better insight into chronic suppurative otitis media. Assessing the sense of balance may show dysfunctions with not yet necessarily permanent damage: perilymphatic fistula and benign paroxysmal positional vertigo (BPPV. Unilateral or bilateral damage may be diagnosed with appropriate tests of vestibuloocular reflex (VOR: spontaneous nystagmus, head impulse test, head shaking test. These bedside tests do not require bulky, expensive equipment for stimulus delivery or special equipment for recording nystagmus. In addition, their significance is their ability to provide enough information without performing caloric testing which is contraindicated in chronic suppurative otitis media.

  19. Current strategies for drug delivery to the inner ear

    Directory of Open Access Journals (Sweden)

    Hongzhuo Liu


    Full Text Available For many years, drug delivery to the inner ear has been a challenge to physicians in the treatment of inner ear disorders. In the past decade, the field of inner ear drug delivery has emerged with the development of new biomaterials and drug delivery technologies to improve the effectiveness of inner ear drug therapy. This paper reviews a number of inner ear drug delivery strategies including systemic, intratympanic, and intracochlear delivery. A focus of this review is the recent advances in intratympanic delivery of medications; approaches utilizing novel biomaterials as well as other recent developments are also discussed. Biotechnology-based approaches, such as gene and stem cell therapy methods are also reviewed. Among the various strategies, local drug delivery approaches including intratympanic and intracochlear drug delivery methods that limit systemic exposure are particularly promising. These inner ear drug delivery systems provide a new opportunity to improve the treatment of inner ear disorders.

  20. Statistical Shape Analysis of the Human Ear Canal with Application to In-the-Ear Hearing Aid Design

    DEFF Research Database (Denmark)

    Paulsen, Rasmus Reinhold


    This thesis is about the statistical shape analysis of the human ear canal with application to the mechanical design of in-the-ear hearing aids. Initially, it is described how a statistical shape model of the human ear canal is built based on a training set of laser-scanned ear impressions. A thin...... work on image restoration. It is shown how the method significantly improves the shape model. In the second part of the thesis, the shape model is used in software tools that mimic the skills of the expert hearing aid makers. The first result is that it is possible to learn an algorithm to cut an ear...