WorldWideScience

Sample records for ear middle

  1. Ear Infection (Middle Ear)

    Science.gov (United States)

    Ear infection (middle ear) Overview By Mayo Clinic Staff An ear infection (acute otitis media) is most often a bacterial or viral infection that affects the middle ear, the air-filled space behind the eardrum that ...

  2. Middle Ear Infections

    Science.gov (United States)

    ... Listen Español Text Size Email Print Share Middle Ear Infections Page Content Article Body What are the ... illness. What if a child with a middle ear infection is in great pain and discomfort? The ...

  3. Middle Ear Infections (For Parents)

    Science.gov (United States)

    ... Feeding Your 1- to 2-Year-Old Middle Ear Infections KidsHealth > For Parents > Middle Ear Infections Print ... 3 years old. A Close Look at the Ear To understand how ear infections develop, let's review ...

  4. Multiple Osteomas in Middle Ear

    Directory of Open Access Journals (Sweden)

    Yongxin Li

    2012-01-01

    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.

  5. Inner ear disturbances related to middle ear inflammation

    Science.gov (United States)

    Sone, Michihiko

    2017-01-01

    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. Middle ear infection (otitis media) (image)

    Science.gov (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 ...

  7. Carcinoid tumour of the middle ear

    LENUS (Irish Health Repository)

    Baig, Salman

    2012-09-01

    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.

  8. Optical assessment of middle ear inflammation

    OpenAIRE

    Jung, David S.

    2016-01-01

    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...

  9. Osteomas of the middle ear

    Directory of Open Access Journals (Sweden)

    Sente Marko

    2004-01-01

    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.

  10. Imaging of the postoperative middle ear

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2004-03-01

    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.)

  11. Osteoma of the middle ear: case report

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-07-15

    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.

  12. 21 CFR 874.3430 - Middle ear mold.

    Science.gov (United States)

    2010-04-01

    ... 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...

  13. 3D finite element model of the chinchilla ear for characterizing middle ear functions.

    Science.gov (United States)

    Wang, Xuelin; Gan, Rong Z

    2016-10-01

    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.

  14. Structure and function of the mammalian middle ear. I: Large middle ears in small desert mammals.

    Science.gov (United States)

    Mason, Matthew J

    2016-02-01

    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.

  15. [Bone Conduction and Active Middle Ear Implants].

    Science.gov (United States)

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

    2016-05-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2011-05-15

    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.)

  17. Passive and active middle ear implants

    Directory of Open Access Journals (Sweden)

    Beutner, Dirk

    2009-01-01

    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.

  18. Carcinoid tumor of the middle ear.

    Science.gov (United States)

    Nikanne, Elina; Kantola, Olli; Parviainen, Tapani

    2004-08-01

    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.

  19. 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

  20. 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

    2002-01-01

    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

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

    Science.gov (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. 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.

    1982-01-01

    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

  3. [The tempestuous history of middle ear operation].

    Science.gov (United States)

    Betlejewski, Stanisław; Betlejewski, Andrzej

    2008-01-01

    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.

  4. Acoustics of the human middle-ear air space.

    Science.gov (United States)

    Stepp, Cara E; Voss, Susan E

    2005-08-01

    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.

  5. Diseases of the middle ear in childhood

    Directory of Open Access Journals (Sweden)

    Minovi, Amir

    2014-12-01

    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.

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

    OpenAIRE

    Jacobson, John T.

    1981-01-01

    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.

  7. Microbiomes of the normal middle ear and ears with chronic otitis media.

    Science.gov (United States)

    Minami, Shujiro B; Mutai, Hideki; Suzuki, Tomoko; Horii, Arata; Oishi, Naoki; Wasano, Koichiro; Katsura, Motoyasu; Tanaka, Fujinobu; Takiguchi, Tetsuya; Fujii, Masato; Kaga, Kimitaka

    2017-10-01

    The aim of this study was to profile and compare the middle ear microbiomes of human subjects with and without chronic otitis media. Prospective multicenter cohort study. All consecutive patients undergoing tympanoplasty surgery for chronic otitis media or ear surgery for conditions other than otitis media were recruited. Sterile swab samples were collected from the middle ear mucosa during surgery. The variable region 4 of the 16S rRNA gene in each sample were amplified using region-specific primers adapted for the Illumina MiSeq sequencer (Illumina, CA, USA)). The sequences were subjected to local blast and classified using Metagenome@KIN (World Fusion, Tokyo, Japan). In total, 155 participants were recruited from seven medical centers. Of these, 88 and 67 had chronic otitis media and normal middle ears, respectively. The most abundant bacterial phyla on the mucosal surfaces of the normal middle ears were Proteobacteria, followed by Actinobacteria, Firmicutes, and Bacteroidetes. The children and adults with normal middle ears differed significantly in terms of middle ear microbiomes. Subjects with chronic otitis media without active inflammation (dry ear) had similar middle ear microbiomes as the normal middle ears group. Subjects with chronic otitis media with active inflammation (wet ear) had a lower prevalence of Proteobacteria and a higher prevalence of Firmicutes than the normal middle ears. The human middle ear is inhabited by more diverse microbial communities than was previously thought. Alteration of the middle ear microbiome may contribute to the pathogenesis of chronic otitis media with active inflammation. 2b. Laryngoscope, 127:E371-E377, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  8. 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.

  9. LDV measurement of bird ear vibrations to determine inner ear impedance and middle ear power flow

    Science.gov (United States)

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

    2016-06-01

    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.

  10. Magnetic resonance imaging in inflammatory lesions of the middle ear

    Energy Technology Data Exchange (ETDEWEB)

    Tono, Tetsuya; Saku, Kazuaki; Miyanaga, Satoshi; Kano, Kiyo; Morimitsu, Tamotsu; Suzuki, Yukiko.

    1988-05-01

    Eighteen patients with chronic otitis media, middle ear cholesteatoma, and postoperative inflammatory diseases of the middle ear underwent high resolution computerized tomography (CT) and magnetic resonance imaging (MRI) before surgical exploration of the middle ear. Results showed that CT provides higher detail resolution in middle ear structures, but provides limited density resolution in displaying inflammatory soft tissue lesions. By contrast, MRI differentiates among soft tissue lesions such as fluid-filled spaces, granulation tissues, and cholesteatomatous debris. Cholesterin granulomas show a particularly characteristic signal pattern with a very high intensity area in both T1 and T2 weighted images. It is concluded that MRI is useful in differentiating soft tissue density masses when used in conjunction with CT in middle ear inflammatory diseases.

  11. Scanning laser Doppler vibrometry of the middle ear ossicles.

    Science.gov (United States)

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

    1997-04-01

    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.

  12. 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)

    2014-10-15

    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.

  13. 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

    2005-01-01

    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.

  14. An in vitro model of murine middle ear epithelium

    Directory of Open Access Journals (Sweden)

    Apoorva Mulay

    2016-11-01

    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.

  15. Middle ear mucosal regeneration with three-dimensionally tissue-engineered autologous middle ear cell sheets in rabbit model.

    Science.gov (United States)

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

    2016-03-01

    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.

  16. Laser vibrometer measurements and middle ear prostheses

    Science.gov (United States)

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

    1997-05-01

    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.

  17. Imaging of postoperative middle ear cholesteatoma

    Energy Technology Data Exchange (ETDEWEB)

    Khemani, S.; Singh, A. [Department of Otolaryngology, Northwick Park and Central Middlesex Hospitals, London (United Kingdom); Lingam, R.K., E-mail: raviklingam@yahoo.co.uk [Department of Radiology, Northwick Park and Central Middlesex Hospitals, London (United Kingdom); Kalan, A. [Department of Otolaryngology, Northwick Park and Central Middlesex Hospitals, London (United Kingdom)

    2011-08-15

    Cholesteatoma is often treated surgically using canal wall-preserving techniques. Clinical and otoscopic diagnosis of residual or recurrent disease after this form of surgery is unreliable and thus radiological imaging is often used prior to mandatory 'second-look' surgery. Imaging needs to be able to differentiate residual or recurrent disease from granulation tissue, inflammatory tissue or fluid within the middle ear cavity and mastoid cavity. High-resolution computed tomography (HRCT), conventional magnetic resonance imaging (MRI), and delayed contrast MRI have all been used in detecting postoperative cholesteatoma. Although delayed contrast MRI performs better than HRCT and conventional MRI, the sensitivities and specificities of these different imaging methods are relatively poor. Diffusion-weighted MRI (DWI and, in particular, non-echo planar DWI) has been shown to have a high sensitivity and specificity for detecting recurrent cholesteatoma. In this review we provide examples of postoperative imaging appearances following cholesteatoma surgery and we review the relevant literature with an emphasis on studies evaluating the diagnostic accuracy of DWI.

  18. Impedance matching, optimum velocity, and ideal middle ears.

    Science.gov (United States)

    Peake, W T; Rosowski, J J

    1991-05-01

    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.

  19. 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.

    2004-01-01

    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

  20. Major evolutionary transitions and innovations: the tympanic middle ear

    Science.gov (United States)

    2017-01-01

    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

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

    Institute of Scientific and Technical Information of China (English)

    Song Jianlan

    2002-01-01

    @@ 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).

  2. Effects of low humidity on the rat middle ear.

    Science.gov (United States)

    Lovejoy, H M; McGuirt, W F; Ayres, P H; Hayes, A W; Coggins, C R; Sagartz, J

    1994-09-01

    Secretory otitis media is common in the winter, and the possible risk factors are numerous. This study examines the effect of low humidity on the middle ear using a Sprague-Dawley rat model: 23 test rats housed for 5 days in a low-humidity environment (10% to 12% relative humidity) and 23 control rats housed at 50% to 55% relative humidity. Microscopic ear examinations were graded for otitis media with effusion (OME) before testing and on test days 3 and 5. The mucosa of the middle ears and eustachian tubes was examined histopathologically. Significantly more effusions were observed in the low-humidity group on test days 3 (P = .003) and 5 (P = .01), but no intergroup histopathologic differences were noted. We conclude that a low-humidity environment contributed to the development of OME in the test animals, and that low-humidity warrants further investigation as a contributing factor in childhood middle ear disease.

  3. Congenital malformations of the external and middle ear

    Energy Technology Data Exchange (ETDEWEB)

    Koesling, S. [University of Halle, Department of Diagnostic Radiology (Germany)], E-mail: sabrina.koesling@medizin.uni-halle.de; Omenzetter, M. [University of Halle, Department of Diagnostic Radiology (Germany); Bartel-Friedrich, S. [University of Halle, Department of Otorhinolaryngology - Head and Neck Surgery, Section of Phoniatrics and Pedaudiology (Germany)

    2009-02-15

    With the focus on imaging, this paper gives a summarized view of the present knowledge on fields, which are necessary to know for a profound understanding of congenital malformations of the external and middle ear. Typical and less typical combinations of malformed parts of the ear can be derived from the embryogenesis. Clinical signs and audiometric findings lead to diagnosis in congenital aural atresia. Isolated middle ear malformations can be clinically mixed up especially with otosclerosis and tympanosclerosis. Imaging is needed for exact morphological information. In malformations of the external and middle ear, CT is the imaging modality of choice. Requirements on CT-technique as well as radiological findings including classification and pre-surgical rating are described. Morphological CT-correlates of congenital malformations and their differential diagnoses are enlisted and illustrated. The impact of CT-results on therapy is explained and actual therapeutic concepts are briefly presented.

  4. 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.

    1981-06-01

    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.

  5. Indications and candidacy for active middle ear implants.

    Science.gov (United States)

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

    2010-01-01

    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.

  6. 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

    2010-01-01

    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.

  7. Tympanoplasty without use of gelfoam in the middle ear

    Directory of Open Access Journals (Sweden)

    Samad Ghiasi

    2008-07-01

    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. ‍‍‍

  8. Vibrant soundbridge middle ear implant in otosclerosis: technique - indication.

    Science.gov (United States)

    Dumon, Thibaud

    2007-01-01

    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.

  9. Primary T-cell lymphoblastic lymphoma in the middle ear.

    Science.gov (United States)

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

    2016-03-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Mercer Kathryn J

    2010-02-01

    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.

  11. Modeling Ear-Canal Acoustics, Incorporating Visco-Thermal Effects and the Influence of the Middle Ear

    Science.gov (United States)

    Gowdy, Lauren E.; Withnell, Robert H.

    2011-11-01

    The ear canal, below about 6 kHz, is well described by a uniform cylinder (sound propagates predominantly as plane waves) with the middle ear being a non-rigid termination. A non-rigid termination can be viewed as altering, as a function of frequency, the acoustic length and radius of the cylinder. It is generally assumed that sound transmission in the ear canal over this frequency range is lossless. This paper presents a method for calculating the influence of visco-thermal losses and the middle ear on ear canal acoustics. The acoustic input impedance was derived from sound pressure measurements in the ear canal and then a nonlinear least-square-fit to the data with a one-dimensional model incorporating visco-thermal losses generated length, radius, and middle ear impedance parameters. It was found that a rigid wall assumption for visco-thermal calculations was insufficient to account for damping in the ear canal. The properties of the ear canal wall (not being a rigid, low-friction surface), incorporated into visco-thermal losses as a scaling factor, provided a better fit to the data. Viscous and thermal losses were both found to affect sound propagation in the ear canal, viscous losses being more significant, altering the acoustic input impedance of the ear primarily in the region of the standing wave frequency. The model data suggests that the middle ear influences ear canal acoustics up to about 3 kHz.

  12. Characteristics of CI children with complicated middle ear infections

    DEFF Research Database (Denmark)

    Hoberg, Søren; Danstrup, Christian; Laursen, Bjarke

    2017-01-01

    OBJECTIVE: To describe cases of complicated middle ear infections in children with cochlear implants (CI), i.e., episodes of acute otitis media (AOM) and acute mastoiditis (AM), resulting in hospitalization. METHODS: A total of 206 children under 16 years (300 implantations) were implanted between...... months, respectively. Children younger than 2 years were at highest risk of AOM and/or AM. All had antibiotics prescribed before admittance, and two- thirds of infected ears had already ventilation tubes inserted. Bacteria could not be detected in more than half of cases. The most frequently isolated...... of ventilation tubes is still much debated and more research in this field is needed. CONCLUSION: AOM and/or AM were seen in Danish children with CI as often as in other western countries. Treatment of complicated middle ear infections was sufficient with IV cephalosporin and ventilation tube insertion. Special...

  13. Middle ear adenoma. A tumor displaying mucinous and neuroendocrine differentiation.

    Science.gov (United States)

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

    1989-10-01

    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.

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

    Science.gov (United States)

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

    2008-09-01

    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.

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

    OpenAIRE

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

    2008-01-01

    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.

  16. Imaging evaluation of middle ear cholesteatoma: iconographic essay

    Energy Technology Data Exchange (ETDEWEB)

    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: fauassis@hotmail.com [Hospital Mater Dei, Belo Horizonte, MG (Brazil)

    2013-06-15

    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)

  17. The middle ear immune defense changes with age.

    Science.gov (United States)

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

    2016-01-01

    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.

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

    OpenAIRE

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

    2014-01-01

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-02-01

    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).

  20. Effect of the middle ear reflex on sound transmission to the inner ear of rat.

    Science.gov (United States)

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

    1997-03-01

    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.

  1. Poor oral hygiene and middle ear infections: any relationship?

    Science.gov (United States)

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

    2013-04-01

    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.

  2. Rheologic studies on middle ear effusions and their mucus glycoproteins.

    Science.gov (United States)

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

    1989-04-01

    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.

  3. The middle ear immune defense changes with age

    DEFF Research Database (Denmark)

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

    2016-01-01

    , 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......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...

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

    Directory of Open Access Journals (Sweden)

    K Biniyam

    2014-01-01

    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.

  5. Middle ear microsurgery in india: a retrospective audit study

    OpenAIRE

    Singh, Mangal; Rai, Ashutosh; Bandyopadhyay, Sarmishtha

    2006-01-01

    Around 2000 ENT Surgeons perform about 120000 middle ear microsurgery operations annually in India while the burden of otitis media is 50 million cases. A comprehensive questionnaire consisting of personal details of surgeons, his infrastructure, results, and complications was sent to 2000 ENT Surgeons from the latest AOI Directory. 400 Surgeons responded back from all over the country and the data collected was fed into a computer program and was analysed. Most of the responses were from wes...

  6. Age effects in the human middle ear: Wideband acoustical measures

    Science.gov (United States)

    Feeney, M. Patrick; Sanford, Chris A.

    2004-12-01

    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. .

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-08-01

    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).

  8. Chinchilla middle-ear admittance and sound power: high-frequency estimates and effects of inner-ear modifications.

    Science.gov (United States)

    Ravicz, Michael E; Rosowski, John J

    2012-10-01

    The middle-ear input admittance relates sound power into the middle ear (ME) and sound pressure at the tympanic membrane (TM). ME input admittance was measured in the chinchilla ear canal as part of a larger study of sound power transmission through the ME into the inner ear. The middle ear was open, and the inner ear was intact or modified with small sensors inserted into the vestibule near the cochlear base. A simple model of the chinchilla ear canal, based on ear canal sound pressure measurements at two points along the canal and an assumption of plane-wave propagation, enables reliable estimates of Y(TM,) the ME input admittance at the TM, from the admittance measured relatively far from the TM. Y(TM) appears valid at frequencies as high as 17 kHz, a much higher frequency than previously reported. The real part of Y(TM) decreases with frequency above 2 kHz. Effects of the inner-ear sensors (necessary for inner ear power computation) were small and generally limited to frequencies below 3 kHz. Computed power reflectance was ~0.1 below 3.5 kHz, lower than with an intact ME below 2.5 kHz, and nearly 1 above 16 kHz.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2012-11-15

    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.

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

    Science.gov (United States)

    Kim, Hong Chul; Jang, Han Won

    2012-01-01

    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

  11. Influence of middle ear mucosal condition on post-tympanoplasty audiologic outcome.

    Science.gov (United States)

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

    2016-03-01

    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.

  12. Anatomic Considerations on the Middle Ear in Dog

    Directory of Open Access Journals (Sweden)

    Carmen Berghes

    2010-05-01

    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.

  13. 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

    2008-01-01

    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.

  14. Congenital cholesteatoma of the middle ear - uncommon clinical presentation

    Directory of Open Access Journals (Sweden)

    Bukurov Bojana

    2014-01-01

    Full Text Available Introduction. Congenital cholesteatoma of the middle ear is un uncommon and yet not well-defined disease. Only few cases of cholesteatoma in the fossa ovalis with unusual clinical presentation have been reported in medical literature. Case report. We reported a 16-year-old girl with congenital cholesteatoma in the fossa ovalis with minimal clinical presentation. A small mass was found occluding the fossa ovalis and mimicking otosclerotic process within tympanic cavity. The operation started as stapedotomy, and when the process was confirmed it converted to mastoidectomy via the retroauricular approach. Conclusion. The diagnosis of congenital cholesteatoma in children should always be considered, even if the clinical symptoms imitate other ear disorders, in our case otosclerosis. [Projekat Ministarstva nauke Republike Srbije, br. 179055: Cochlear implantation impact on education of deaf and hearing-impaired

  15. Modeling Analysis of Biomechanical Changes of Middle Ear and Cochlea in Otitis Media

    Science.gov (United States)

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

    2011-11-01

    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.

  16. Middle ear and mastoid hemangioma treated by neurointerventional techniques

    Directory of Open Access Journals (Sweden)

    Sachin Kumbhar

    2013-01-01

    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.

  17. Phonemic Awareness and Middle-Ear Disease among Bedouin Arabs in Israel.

    Science.gov (United States)

    Abu-Rabia, Salim

    2002-01-01

    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…

  18. Drop weld thermal injuries to the middle ear.

    LENUS (Irish Health Repository)

    Keogh, I J

    2009-01-01

    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.

  19. Middle-Ear Microsurgery Simulation to Improve New Robotic Procedures

    Science.gov (United States)

    Kazmitcheff, Guillaume; Nguyen, Yann; Miroir, Mathieu; Péan, Fabien; Ferrary, Evelyne; Cotin, Stéphane; Sterkers, Olivier; Duriez, Christian

    2014-01-01

    Otological microsurgery is delicate and requires high dexterity in bad ergonomic conditions. To assist surgeons in these indications, a teleoperated system, called RobOtol, is developed. This robot enhances gesture accuracy and handiness and allows exploration of new procedures for middle ear surgery. To plan new procedures that exploit the capacities given by the robot, a surgical simulator is developed. The simulation reproduces with high fidelity the behavior of the anatomical structures and can also be used as a training tool for an easier control of the robot for surgeons. In the paper, we introduce the middle ear surgical simulation and then we perform virtually two challenging procedures with the robot. We show how interactive simulation can assist in analyzing the benefits of robotics in the case of complex manipulations or ergonomics studies and allow the development of innovative surgical procedures. New robot-based microsurgical procedures are investigated. The improvement offered by RobOtol is also evaluated and discussed. PMID:25157373

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

    Science.gov (United States)

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

    2016-02-01

    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.

  1. 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

    2010-01-01

    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....

  2. Middle Ear Pressure Changes during Balloon Eustachian Tuboplasty.

    Science.gov (United States)

    Smith, Matthew E; Tysome, James R

    2017-01-01

    Objective Balloon eustachian tuboplasty (BET) has entered clinical use as a treatment for eustachian tube dysfunction. Some surgeons perform myringotomy prior to BET due to concerns that the increase in middle ear (ME) pressure caused by BET may cause otic barotrauma. We investigated the ME pressure changes occurring during BET in cadavers. Study design Human cadaver investigation of a surgical technique Setting Laboratory study at a tertiary referral center. Subjects and Methods ME pressures were recorded from fresh-frozen cadavers, and BET was performed with the Bielefeld balloon catheter inflated to 10 bar. Peak ME pressures were recorded during catheter insertion, inflation, deflation, and removal. A second pressure measurement was taken 15 seconds after each stage to assess the residual pressures. All BET procedures were repeated at least once. Where transmastoid recordings were made, BET was repeated, measuring pressure via a myringotomy to ensure equivalence. Results Data from 25 procedures in 13 ears (9 heads) were analyzed. A consistent pattern of ME pressure change was observed in all cases. Positive pressures occurred on insertion (maximum, 26 daPa) and inflation (maximum, 99 daPa) and negative pressures on deflation (maximum, -46 daPa) and removal (maximum, -42 daPa). There were no significant pressure differences between first and second procedures, except at 15 seconds after insertion ( P = .04). Conclusion In adult cadaveric specimens, BET induces ME pressures within the normal physiologic range. On this basis, routine myringotomy prior to BET in adults is not necessary.

  3. Static analysis of C-shape SMA middle ear prosthesis

    Science.gov (United States)

    Latalski, Jarosław; Rusinek, Rafał

    2017-08-01

    Shape memory alloys are a family of metals with the ability to change specimen shape depending on their temperature. This unique property is useful in many areas of mechanical and biomechanical engineering. A new half-ring middle ear prosthesis design made of a shape memory alloy, that is undergoing initial clinical tests, is investigated in this research paper. The analytical model of the studied structure made of nonlinear constitutive material is solved to identify the temperature-dependent stiffness characteristics of the proposed design on the basis of the Crotti-Engesser theorem. The final integral expression for the element deflection is highly complex, thus the solution has to be computed numerically. The final results show the proposed shape memory C-shape element to behave linearly in the analysed range of loadings and temperatures. This is an important observation that significantly simplifies the analysis of the prototype structure and opens wide perspectives for further possible applications of shape memory alloys.

  4. MEMS capacitive accelerometer-based middle ear microphone.

    Science.gov (United States)

    Young, Darrin J; Zurcher, Mark A; Semaan, Maroun; Megerian, Cliff A; Ko, Wen H

    2012-12-01

    The design, implementation, and characterization of a microelectromechanical systems (MEMS) capacitive accelerometer-based middle ear microphone are presented in this paper. The microphone is intended for middle ear hearing aids as well as future fully implantable cochlear prosthesis. Human temporal bones acoustic response characterization results are used to derive the accelerometer design requirements. The prototype accelerometer is fabricated in a commercial silicon-on-insulator (SOI) MEMS process. The sensor occupies a sensing area of 1 mm × 1 mm with a chip area of 2 mm × 2.4 mm and is interfaced with a custom-designed low-noise electronic IC chip over a flexible substrate. The packaged sensor unit occupies an area of 2.5 mm × 6.2 mm with a weight of 25 mg. The sensor unit attached to umbo can detect a sound pressure level (SPL) of 60 dB at 500 Hz, 35 dB at 2 kHz, and 57 dB at 8 kHz. An improved sound detection limit of 34-dB SPL at 150 Hz and 24-dB SPL at 500 Hz can be expected by employing start-of-the-art MEMS fabrication technology, which results in an articulation index of approximately 0.76. Further micro/nanofabrication technology advancement is needed to enhance the microphone sensitivity for improved understanding of normal conversational speech.

  5. Mucin gene expression in human middle ear epithelium.

    Science.gov (United States)

    Kerschner, Joseph Edward

    2007-09-01

    To investigate the expression of recently identified human mucin genes in human middle ear epithelial (MEE) specimens from in vivo middle ear (ME) tissue and to compare this mucin gene expression with mucin gene expression in an immortalized cell culture in vitro source of human MEE. Human MEE was harvested as in vivo specimens, and human MEE cell cultures were established for in vitro experimentation. RNA was extracted from MEE and primers designed for reverse-transcription polymerase chain reaction to assess for mucin gene MUC1, MUC2, MUC3, MUC4, MUC5AC, MUC5B, MUC6, MUC7, MUC8, MUC9, MUC11, MUC12, MUC13, MUC15, MUC16, MUC18, MUC19, and MUC20 expression. Mucin gene expression in the in vivo and in vitro ME tissue was compared against tissues with known expression of the mucin genes in question. Mucin genes MUC1, MUC2, MUC3, MUC4, MUC5AC, MUC5B, MUC7, MUC8, MUC9, MUC11, MUC13, MUC15, MUC16, MUC18, MUC19, and MUC20 were identified and expressed in both the in vivo and in vitro samples of MEE. Mucin genes MUC6, MUC12, and MUC17 were not identified in either tissue samples. Many of the mucin genes that have been recently identified are expressed in human MEE. These genes are expressed in a similar manner in both in vivo and in vitro models. Understanding the mechanisms in which these genes regulate the physiology and pathophysiology of MEE will provide a more thorough understanding of the molecular mechanics of the MEE and disease conditions such as otitis media.

  6. 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

    2012-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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)

    2013-09-15

    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.

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

    DEFF Research Database (Denmark)

    Willis, Katie L; Christensen-Dalsgaard, Jakob; Ketten, Darlene R

    2013-01-01

    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......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...

  10. Middle ear osteoma: a rare cause of conductive hearing loss with normal tympanic membrane.

    Science.gov (United States)

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

    2011-01-01

    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.

  11. Characteristics of wideband acoustic immittance in patients with middle-ear dysfunction.

    Science.gov (United States)

    Sanford, Chris A; Brockett, Jeff E

    2014-05-01

    Wideband acoustic immittance (WAI) measurements are a relatively new class of aural acoustic tests that have shown promise as useful tools for evaluating middle-ear status. A growing body of work has described WAI for infants, children, and adults with normal middle-ear function, but a relatively limited number of studies have investigated the influence of specific middle-ear disorders on WAI. Although emerging WAI research data show promising results, additional measurements from ears of patients with a variety of middle-ear disorders are needed. The aims of the present study were to (1) obtain WAI data from patients with a variety of middle-ear conditions, (2) examine relationships between WAI data relative to standard audiometric tests, and (3) identify patterns or profiles in WAI data within and among patients with different middle-ear conditions. A descriptive study. Participants included 30 children and two adults with a variety of middle-ear disorders who were recruited from clinical audiology settings. Experimental ambient and tympanometric WAI data were gathered along with standard audiometric test data as part of clinical audiology appointments. Single-subject and small-group data sets for ears of patients with suspected otitis media with effusion (sOME), pressure equalization (PE) tubes, negative tympanometric peak pressure (TPP), tympanoplasty, and cerumen impaction were obtained. Qualitative analysis and descriptive statistics (means and percentiles) were used to characterize the data. Group mean absorbance for ears in the sOME group was reduced across the majority of frequencies; absorbance for ears with negative TPP was also reduced, although to a lesser degree. Absorbance patterns for ears with PE tubes show even greater differences because of the effects of the tube and open middle-ear cavity. WAI from ears with a tympanoplasty and cerumen impaction was suggestive of middle-ear dysfunction in the presence of normal single-frequency tympanometry

  12. Oral Pseudoephedrine Decreases the Rate of Trans-mucosal Nitrous Oxide Exchange for the Middle Ear

    Science.gov (United States)

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

    2015-01-01

    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

  13. Microtomography of the human middle and inner ear

    Science.gov (United States)

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

    2002-01-01

    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.

  14. [Long term results of congenital middle ear cholesteatoma in children].

    Science.gov (United States)

    Benhammou, A; Nguyen, D-Q; El Makhloufi, K; Charachon, R; Reyt, E; Schmerber, S

    2005-06-01

    To report the long term results of congenital cholesteatoma of the middle ear in children. Retrospective study of thirty two children with 33 congenital cholesteatoma (1 bilateral cholesteatoma) operated on by the same surgeon. The mean age was 6 years. The most common clinical presentation was unilateral hearing loss. A trans-canal approach was performed in 4 cases and an intact canal wall technique in 29 cases. A two staged surgery was necessary in 28 patients, whom a residual cholesteatoma was observed in 7 patients. A third stage was performed in 11 patients because of a residual cholesteatoma in 2 two cases and a functional failure in 9 cases. At five years postoperative audiometry (air bone gap inferior or equal to 20 dB HL), a functional success was obtained in 50% of cases. The diagnosis of congenital cholesteatoma must be evoked in every atypical otitis media with effusion or unilateral transmission hypoacusis. The intact canal wall technique in two stages is the most appropriate treatment, since congenital cholesteatoma in children appears aggressive in a well pneumatized mastoid. The choice for an intact canal wall technique is also justified by the ambition of a conservative surgery in the young child. The functional results are generally satisfactory in early diagnosed cases. Thus, ENT and pediatric physicians have a unique role in detecting congenital cholesteatoma in the early period of life, and in ensuring a long term follow-up.

  15. Middle ear microsurgery in india: a retrospective audit study.

    Science.gov (United States)

    Singh, Mangal; Rai, Ashutosh; Bandyopadhyay, Sarmishtha

    2006-04-01

    Around 2000 ENT Surgeons perform about 120000 middle ear microsurgery operations annually in India while the burden of otitis media is 50 million cases. A comprehensive questionnaire consisting of personal details of surgeons, his infrastructure, results, and complications was sent to 2000 ENT Surgeons from the latest AOI Directory. 400 Surgeons responded back from all over the country and the data collected was fed into a computer program and was analysed. Most of the responses were from western and southern parts of India. Almost all those who responded were performing myringoplasty while only 47 percent performed ossiculoplasty and 40 percent stapes surgery. Senior surgeons (more than 5 years after post graduation) had better infrastructure and better results as compared to junior surgeons, (less than 5 years). About 60 percent surgeons had Indian operating microscopes (commonest 80 percent being BEL) while 40 percent could afford foreign made microscopes (90 percent being Karl Zeiss). The procedure of myringoplasty is almost standardized while there is need to popularize ossiculoplasty and stupes surgery. Need was felt for technology transfer programmes from Southern and Western parts of India to Northern and Eastern parts of India.

  16. Endoscopic transcanal approach to the middle ear for management of pediatric cholesteatoma.

    Science.gov (United States)

    Ghadersohi, Saied; Carter, John M; Hoff, Stephen R

    2017-05-23

    To describe outcomes for endoscopic ear surgery (EES) for pediatric cholesteatoma at a tertiary pediatric hospital. Retrospective case series of 65 pediatric cholesteatoma cases in 38 ears. Subgrouping based on cholesteatoma type and EES type. Surgical findings, outcomes, and demographic data were evaluated. Endoscopes were used in 65 pediatric cholesteatoma cases in 38 primary ears (34 patients), followed for an average of 2.6 years (9 months to 4.6 years). The endoscope was used as the primary visualization tool in 31 (81.6%) ears (EES 2 or 3), and as an adjunct to the microscope in seven ears (EES 1). Twenty-two (57.9%) ears and 35 (53.4%) cases were transcanal endoscopic ear surgery (EES 3 or TEES). Overall, there was recurrence in five (13.2%) ears and residual in four (10.5%) ears. Cholesteatoma was acquired in 27 ears, with average age 10.9 years; and congenital in 11 ears, with average age 3.8 years. Surgical time was longer for acquired cases (226 vs. 154 minutes). Hearing outcomes were comparable for both cholesteatoma types. Residual disease was seen in three (11.1%) acquired ears and one (9.1%) congenital ear. Overall, the lowest rates of recurrent and residual disease were seen in EES 3 cases, and relatively low rates in EES 2 and 3 ears, including four (12.9%) recurrences and two (6.5%) ears with residual disease. The endoscopes are a viable tool for resection of pediatric cholesteatoma and provide excellent visualization of the middle ear and associated recesses. 4. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Ear barotrauma

    Science.gov (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 ...

  18. Middle ear packing materials: comparison between absorbable hemostatic gelatine sponge and sugarcane biopolymer sponge in rats

    Directory of Open Access Journals (Sweden)

    Débora Lopes Bunzen

    2014-06-01

    Full Text Available INTRODUCTION: Several biomaterials can be used in ear surgery to pack the middle ear or support the graft. The absorbable gelatin sponge is the most widely used, but it may produce fibrosis and impair ventilation of the middle ear. OBJECTIVE: This experimental study aimed to investigate the inflammatory effects of the sugarcane biopolymer sponge (BP in the rat middle ear compared with absorbable gelatin sponge (AGS. MATERIALS AND METHODS: Prospective experimental study design. Thirty adult female Wistar rats were allocated to receive the BP sponge into the right ear and AGS into the left ear. Animals were randomly killed at 4 and 12 weeks post-procedure. Qualitative histological assessments were performed to evaluate the inflammatory reaction in the tympanic bullae. RESULTS: The BP sponge caused inflammation more intense and persistent than AGS. The BP was not absorbed during the experiment. Fibrosis was observed only in the ears with AGS. There were thickening of the mucosa and neoangiogenesis in the group of AGS. CONCLUSION: Despite inflammation, the BP sponge produced less fibrosis and neoangiogenesis compared to AGS. The sponge BP appeared to be a non-absorbable biomaterial in the middle ear.

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

    DEFF Research Database (Denmark)

    Christensen-Dalsgaard, Jakob

    2014-01-01

    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...

  20. Effects of Consecutive Wideband Tympanometry Trials on Energy Absorbance Measures of the Middle Ear

    Science.gov (United States)

    Burdiek, Laina M.; Sun, Xiao-Ming

    2014-01-01

    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…

  1. Expression of the epidermal growth factor system in human middle ear cholesteatoma

    DEFF Research Database (Denmark)

    Thorup, Mette Bendixen; Munk, Mathias; Poulsen, Steen Seier

    2014-01-01

    the expression of the epidermal growth factor (EGF) system in human middle ear cholesteatoma. Methods: Forty-seven patients referred for surgery due to cholesteatoma were included in the study. Clinical data were collected. Biopsies of cholesteatoma and skin from the external ear canal were obtained during...

  2. Association of microRNA 146 with middle ear hyperplasia in pediatric otitis media.

    Science.gov (United States)

    Samuels, Tina L; Yan, Justin; Khampang, Pawjai; MacKinnon, Alexander; Hong, Wenzhou; Johnston, Nikki; Kerschner, Joseph E

    2016-09-01

    Toll-like receptor signaling activated by bacterial otitis media pathogens in the middle ear has been shown to play a key role in OM susceptibility, pathogenesis and recovery. Recent studies implicate microRNA 146 (miR-146) in regulation of inflammation via negative feedback of toll-like receptor signaling (TLR) in a wide variety of tissues, however its involvement in otitis media is unknown. Human middle ear epithelial cells were stimulated with proinflammatory cytokines, interleukin 1 beta or tumor necrosis factor alpha, for two to twenty-four hours. Middle ear biopsies were collected from children with otitis media with effusion (n = 20), recurrent otitis media (n = 9), and control subjects undergoing cochlear implantation (n = 10). miR-146a, miR-146b expression was assayed by quantitative PCR (qPCR). Expression of miR-146 targets involved in TLR signaling, IRAK1 and TRAF6, was assayed by qPCR in middle ear biopsies. Middle ear biopsies were cryosectioned and epithelial thickness measured by a certified pathologist. Proinflammatory cytokines induced expression of miR-146 in middle ear epithelial cells in vitro. Middle ear miR-146a and miR-146b expression was elevated in otitis media patients relative to control subjects and correlated with middle ear epithelial thickness. A trend towards inverse correlation was observed between miR-146 and TRAF6 expression in the clinical population. This report is the first to assess miRNA expression in a clinical population with OM. Findings herein suggest miR-146 may play a role in OM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. [Nasopharyngeal and middle ear flora in children with acute otitis media].

    Science.gov (United States)

    Zielnik-Jurkiewicz, Beata; Kolczyńska, Magdalena

    2005-01-01

    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.

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

    OpenAIRE

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

    2009-01-01

    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 ...

  5. Theoretic analysis of middle ear gas composition under conditions of nonphysiologic ventilation.

    Science.gov (United States)

    Ostfeld, E J; Silberberg, A

    1992-05-01

    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.

  6. Of mice, moles and guinea pigs: functional morphology of the middle ear in living mammals.

    Science.gov (United States)

    Mason, Matthew J

    2013-07-01

    The middle ear apparatus varies considerably among living mammals. Body size, phylogeny and acoustic environment all play roles in shaping ear structure and function, but experimental studies aimed ultimately at improving our understanding of human hearing can sometimes overlook these important species differences. This review focuses on three groups of mammals, bringing together anatomical, zoological and physiological information in order to highlight unusual features of their middle ears and attempt to interpret their function. "Microtype" ears, found in species such as mice and bats, are associated with high-frequency hearing. The orbicular apophysis, the focus of some recent developmental studies on mouse ears, is characteristic of microtype mallei but is not found in humans or other "freely mobile" species. The apophysis increases ossicular inertia about the anatomical axis of rotation: its adaptive purpose in a high-frequency ear is still not clear. Subterranean mammals have convergently evolved a "freely mobile" ossicular morphology which appears to favour lower-frequency sound transmission. More unusual features found in some of these animals include acoustically coupled middle ear cavities, the loss of middle ear muscles and hypertrophied ossicles which are believed to subserve a form of inertial bone conduction. Middle ears of the rodent group Ctenohystrica (which includes guinea pigs and chinchillas, important models in hearing research) show some striking characteristics which together comprise a unique type of auditory apparatus requiring a classification of its own, referred to here as the "Ctenohystrica type". These characteristics include a distinctive malleus morphology, fusion of the malleus and incus, reduction or loss of the stapedius muscle, a synovial stapedio-vestibular articulation and, in chinchillas, enormously expanded middle ear cavities. These characteristics may be functionally linked and associated with the excellent low

  7. Cavernous Hemangioma of the External Canal, Tympanic Membrane, and Middle Ear Cleft: A Case Report.

    Science.gov (United States)

    Odat, Haitham; Al-Qudah, Mohannad; Al-Qudah, Mohammad A

    2016-06-01

    Cavernous hemangioma involving the external canal, tympanic membrane, and middle ear cavity is extremely rare. We present a case of a 45-year-old woman who had progressive right sided decreased hearing, pulsatile tinnitus, and aural fullness of 7 months duration. Microscopic examination, imaging studies, surgical treatment, and histological evaluation are reported. To the best of our knowledge, this is the first case of cavernous hemangioma with simultaneous involvement of the external ear, tympanic membrane, middle ear, and attic reported in English literature.

  8. Malformations of the middle and inner ear on CT imaging in 22q11 deletion syndrome.

    Science.gov (United States)

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

    2016-11-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Prachi Gautam

    2011-01-01

    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.

  10. Evolution of the mammalian middle ear and jaw: adaptations and novel structures.

    Science.gov (United States)

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

    2013-01-01

    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.

  11. Antiadhesive effect of bioresorbable polylactide film in abraded middle ear mucosa.

    Science.gov (United States)

    Jang, Chul Ho; Jo, Si Young; Cho, Yong Beom; Choi, Cheol Hee; Jung, Won Kyo

    2014-12-01

    Polylactide film (PLF) is used to prevent postoperative peridural adhesion in spinal surgery. Up until now, the antiadhesive effect of bioresorbable PLF in ear middle surgery has not been reported. The purpose of this study is to evaluate the antiadhesive effect of PLF in guinea pigs serving as a model for middle ear mucosal trauma. The animals were divided into two groups: the PLF group and the silastic sheeting group. There were seven guinea pigs (fourteen ears) in both groups. Under aseptic conditions, the middle ear mucosa was abraded using a pick inserted transbullaly. A PLF or silicone sheet was then placed into the guinea pigs' middle ear cavities. The auditory brainstem responses (ABRs) were assessed preoperatively and at three weeks postoperatively while the animals were under general anesthesia. A histopathological study was performed 3 weeks after the operation. The difference between the ABR results before the operation and three weeks postoperatively were not statistically significant. The adhesion formation did not appeared in either group. Prominent fibrous capsule formation and inflammation were observed in the silastic sheeting group, but not in the PLF group. Mild fibrous thickening of regenerated mucosa was observed in the PLF group. From our results, bioresorbable PLF is nonototoxic and biocompatible with the guinea pig's middle ear cavity by short-term evaluation. Further long-term evaluation study is necessary before clinical application. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Expression of macrophage migration inhibitory factor and CD74 in the inner ear and middle ear in lipopolysaccharide-induced otitis media.

    Science.gov (United States)

    Ishihara, Hisashi; Kariya, Shin; Okano, Mitsuhiro; Zhao, Pengfei; Maeda, Yukihide; Nishizaki, Kazunori

    2016-10-01

    Significant expression of macrophage migration inhibitory factor and its receptor (CD74) was observed in both the middle ear and inner ear in experimental otitis media in mice. Modulation of macrophage migration inhibitory factor and its signaling pathway might be useful in the management of inner ear inflammation due to otitis media. Inner ear dysfunction secondary to otitis media has been reported. However, the specific mechanisms involved are not clearly understood. The aim of this study is to investigate the expression of macrophage migration inhibitory factor and CD74 in the middle ear and inner ear in lipopolysaccharide-induced otitis media. BALB/c mice received a transtympanic injection of either lipopolysaccharide or phosphate-buffered saline (PBS). The mice were sacrificed 24 h after injection, and temporal bones were processed for polymerase chain reaction (PCR) analysis, histologic examination, and immunohistochemistry. PCR examination revealed that the lipopolysaccharide-injected mice showed a significant up-regulation of macrophage migration inhibitory factor in both the middle ear and inner ear as compared with the PBS-injected control mice. The immunohistochemical study showed positive reactions for macrophage migration inhibitory factor and CD74 in infiltrating inflammatory cells, middle ear mucosa, and inner ear in the lipopolysaccharide-injected mice.

  13. 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

    2013-01-01

    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.

  14. Rifle impulse noise affects middle-ear compliance in soldiers wearing protective earplugs.

    Science.gov (United States)

    Job, A; Hamery, P; De Mezzo, S; Fialaire, J-C; Roux, A; Untereiner, M; Cardinale, F; Michel, H; Klein, C; Belcourt, B

    2016-01-01

    We tested middle-ear functioning in humans following intense exposure to noise. Noise generated by small caliber firearms was thought to have no effect on the middle-ear. A cross-over design. We measured middle-ear impedance, acoustic reflex, distortion product otoacoustic emissions (DPOAEs), and transient evoked otoacoustic emissions (TEOAEs) before and after practice rounds performed twice per day. Fifty-nine soldiers equipped with earplugs undergoing regular training for a special mission. The mean noise exposure (LAeq8h) was estimated to be 106 ±1 dB SPL. Impedancemetry revealed a significant increase in the compliance and gradient of the tympano-ossicular chain after impulse noise exposure in the right and left ears. Acoustic reflex reactivity did not show a significant change. DPOAEs and TEOAEs were slightly decreased at 2 kHz, and showed a marked asymmetry in disfavor of the left ear. In soldiers with initial high reactivity of acoustic reflex, increased compliance was associated with a significant decrease in left TEOAEs at 1.5 and 2 kHz. Our results suggest that the use of small-caliber firearms, even while wearing earplugs, affects middle-ear function and may play a role in the early stage of auditory fatigue encompassing tinnitus.

  15. What middle ear parameters tell about impedance matching and high frequency hearing.

    Science.gov (United States)

    Hemilä, S; Nummela, S; Reuter, T

    1995-05-01

    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.

  16. Laser interferometric vibration measurements of the middle ear in healthy humans

    Science.gov (United States)

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

    1996-01-01

    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.

  17. Outer- and middle-ear contributions to presbycusis in the Brown Norway rat.

    Science.gov (United States)

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

    2008-01-01

    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.

  18. Presence of viral nucleic acids in the middle ear: acute otitis media pathogen or bystander?

    Science.gov (United States)

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

    2012-04-01

    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.

  19. Activation of NLRP3 inflammasome in human middle ear cholesteatoma and chronic otitis media.

    Science.gov (United States)

    Kariya, Shin; Okano, Mitsuhiro; Zhao, Pengfei; Kataoka, Yuko; Yoshinobu, Junko; Maeda, Yukihide; Ishihara, Hisashi; Higaki, Takaya; Nishizaki, Kazunori

    2016-01-01

    The nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome plays an important role in the pathogenesis of middle ear diseases. Modulation of inflammasome-mediated inflammation may be a novel therapeutic strategy for cholesteatoma and chronic otitis media. NLRP3 inflammasome is a critical molecule mediating interleukin (IL)-1β responses. However, the expression of NLRP3 in the pathogenesis of cholesteatoma and chronic otitis media has not been fully examined. This study sought to assess the expression of NLRP3, ASC (apoptosis-associated speck-like protein containing a caspase recruitment domain and a pyrin domain), and caspase-1 in middle ear tissues in patients with cholesteatoma or chronic otitis media. Middle ear tissue samples were obtained from patients with cholesteatoma or chronic otitis media. Control middle ear samples were collected during cochlear implant surgery of patients without middle ear inflammation. The expression of NLRP3, ASC, and caspase-1 were examined by reverse transcription polymerase chain reaction (RT-PCR) assay and immunohistochemical study. The levels of mRNA of NLRP3, ASC, and caspase-1 were significantly elevated in cholesteatoma and chronic otitis media as compared with that of normal controls. The proteins of NLRP3, ASC, and caspase-1 were observed in infiltrating inflammatory cells in cholesteatoma and chronic otitis media.

  20. High-resolution computed tomography of cholesteatoma of the middle ear. CT, otological, and surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Ishii, Kiyoshi; Fukusumi, Akio; Okudera, Toshio; Kato, Toshihiko; Soda, Toyoji

    1988-08-01

    The high-resolution computed tomography (CT) appearances of 72 consecutive cases (92 ears) of chronic otomastoiditis were reviewed. The cholesteatomas were verified surgically and/or otologically in 35 of these 92 ears. Discussion was made with special emphasis on the differential diagnosis of cholesteatoma of the middle ear from the non-cholesteatoma otitis media. The CT findings suggestive of cholesteatoma were as follows: the definitive findings was of a soft-tissue opacity filling Purssak's space, with a medial displacement of the malleus and the incus; the possible findings were 1) a bony erosion of the wall of the middle ear cavity, 2) a partial or complete disappearance of the malleus and/or the incus, and 3) an opacification of Purssak's space and the superomedial aspect of the external auditory meatus.

  1. External auditory canal and middle ear cholesteatoma and osteonecrosis in bisphosphonate-treated osteoporosis patients

    DEFF Research Database (Denmark)

    Thorsteinsson, A-L; Vestergaard, P; Eiken, P

    2014-01-01

    reported in the world literature. Our aim was to describe the incidence of external auditory canal and middle ear diseases in Danish patients exposed to BPs in the treatment of osteoporosis. METHODS: This register-based nationwide cohort study was conducted on the Danish population of approximately 5.......6 million individuals. Patients who were prescribed BP for treatment of osteoporosis from 2003 to 2010 (n = 131,794) were included in the study and compared with the age- and gender-matched controls, unexposed to BP. RESULTS: The overall incidence of cholesteatoma in the ear was low. Only 350 events were...... seen in 527,176 cases and controls over 2,826,120.73 observation years. Totally, 119 events of cholesteatoma in the ear were recorded after initiation of BP therapy, 34 in the external auditory canal and 85 in the middle ear. Cholesteatoma in the external auditory canal was more frequent in the exposed...

  2. [Botulinum toxin to treat sweat caused sequelae in patients with hearing aids, active middle ear implants and cochlear implants].

    Science.gov (United States)

    Laskawi, R; Winterhoff, J; Blum, J; Matthias, C

    2012-11-01

    The production of sweat in the temporal skin region may be a serious problem for patients with hearing aids, active middle ear implants or cochlear implants. We report on two patients suffering from a loss of function of their hearing aid and a reduction of the "wear comfort" of an active middle ear implant. The patients underwent intracutaneous botulinum toxin (BTX) treatment of the temporal skin region. In both patients a distinct improvement of their complaints occurred, enabling them to use their hearing aids and active middle ear implants continuously. BTX injections are suited to improve sweat-caused complaints in patients with hearing aids, active middle ear implants and cochlear implants.

  3. 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

    2006-01-01

    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.

  4. 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))

    1983-11-01

    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.

  5. What the surgeon cannot see and needs to see before middle ear surgery.

    Science.gov (United States)

    Schmerber, Sébastien; Lefournier, Virginie; Karkas, Alexandre

    2010-01-01

    To define the utility of imaging prior to middle ear surgery. Different middle ear pathologies are subsequently described: conductive hearing loss with a normal tympanic membrane, labyrinthine fistulae, tegmen anomalies, opacified tympanic membrane, cholesteatoma, temporal bone fractures and glomus tumors. We discuss the indications and benefits of imaging in each of these pathologies. Preoperative imaging shows interesting features and can be very helpful in the differential diagnosis and in surgical decision-making and planning. However, it is not mandatory and should not be systematic in every middle ear surgery. The modern radiological era provides the otological surgeon with numerous imaging technologies. Yet, these techniques should by no means replace the surgeon's anatomical knowledge, clinical sense and surgical skills. Copyright 2010 S. Karger AG, Basel.

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

    Directory of Open Access Journals (Sweden)

    shahin abdollahi fakhim

    2014-10-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Leandro L. Martins

    2015-06-01

    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.

  8. Effects of polylactic acid film on middle ear mucosa and cochlear function in Guinea pigs.

    Science.gov (United States)

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

    2015-05-01

    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.

  9. Measurement of middle ear pressure changes during balloon eustachian tuboplasty: a pilot study.

    Science.gov (United States)

    Todt, Ingo; Abdel-Aziz, Tarek; Mittmann, Philipp; Lehmann, Martin; Ebmeyer, Jörg; Scholtz, Lars-Uwe; Sudhoff, Holger

    2017-05-01

    The middle ear pressure changes detected during BET can be directly attributed to the balloon inflation and may represent a second, immediate, mechanism of action of BET. BET seems to be safe with respect to the risk of a barotrauma. Further human studies are now necessary to confirm the results and gain more insight into the mechanism of action of BET. Since the introduction of Balloon Eustachian Tuboplasty (BET) as a treatment of chronic Eustachian tube dysfunction, the precise mechanism of action is unknown. Long-term effects of BET may be related to observed microfractures of the Eustachian tube cartilage. However, clinical observations indicate a second, immediate mode of action. Therefore, this study investigated and characterized middle ear pressure changes occurring directly during BET procedure. Using a micro-optical pressure sensor, pressure changes during BET were monitored transtympanically in a cadaveric animal study using heathland sheep. Middle ear pressure amplitudes during BET are dependent on the speed of balloon inflation as well as the maximum inflation pressure. A 10-bar inflation pressure yielded a mean middle ear pressure of 5.34 mmHg (71.0 daPA). Negative pressure amplitudes occurring on withdrawal of the balloon catheter are influenced by the speed of withdrawal. No pressure amplitudes capable of causing barotrauma to membranous ear structures could be detected.

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

    Directory of Open Access Journals (Sweden)

    Olusola Ayodele Sogebi

    2015-04-01

    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.

  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

    2012-01-01

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

    Science.gov (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

    2014-01-01

    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.

  13. In vivo imaging of middle-ear and inner-ear microstructures of a mouse guided by SD-OCT combined with a surgical microscope

    Science.gov (United States)

    Cho, Nam Hyun; Jang, Jeong Hun; Jung, Woonggyu; Kim, Jeehyun

    2014-01-01

    We developed an augmented-reality system that combines optical coherence tomography (OCT) with a surgical microscope. By sharing the common optical path in the microscope and OCT, we could simultaneously acquire OCT and microscope views. The system was tested to identify the middle-ear and inner-ear microstructures of a mouse. Considering the probability of clinical application including otorhinolaryngology, diseases such as middle-ear effusion were visualized using in vivo mouse and OCT images simultaneously acquired through the eyepiece of the surgical microscope during surgical manipulation using the proposed system. This system is expected to realize a new practical area of OCT application. PMID:24787787

  14. Femtosecond laser microstructuring of titanium surfaces for middle ear ossicular replacement prosthesis: results of preliminary studies

    Science.gov (United States)

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

    2009-07-01

    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.

  15. 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.

    2012-01-01

    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

  16. Jun N-Terminal Protein Kinase Enhances Middle Ear Mucosal Proliferation during Bacterial Otitis Media▿

    Science.gov (United States)

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

    2007-01-01

    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

  17. 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.

    2011-01-01

    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

  18. Influenza A virus alters pneumococcal nasal colonization and middle ear infection independently of phase variation.

    Science.gov (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

    2014-11-01

    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.

  19. 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.

    2011-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    S R Davanageri

    2014-01-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2014-03-15

    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.)

  2. 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

    2009-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Ramesh Bhandari

    2013-09-01

    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: http://dx.doi.org/10.3126/jcmsn.v8i4.8696

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

    Directory of Open Access Journals (Sweden)

    Ayaz Rehman

    2013-01-01

    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.

  5. Fetal development of the elastic-fiber-mediated enthesis in the human middle ear.

    Science.gov (United States)

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

    2013-10-01

    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.

  6. The character and consequences of disturbing sound sensations in retraction type middle ear disease.

    Science.gov (United States)

    Bunne, M; Falk, B; Hellström, S; Magnuson, B

    1999-11-15

    Transient sound disturbances are common but neglected symptoms in retraction type middle ear disease (R-MED). The aim of this study was to explore and describe their character, their individual consequences, and their role in the development of tympanic membrane retractions. Fifty-three subjects with manifest retractions and experiences of disturbing sound and ear sensations were interviewed. A qualitative method was used for analysis of the transcribed interviews. Two different patterns emerged from the interviews. 1. Too weak sound was the least common and most tolerable disturbance. It occurred in 45% and was eliminated by Valsalva's inflation. 2. Sudden and transient sensations of too loud and piercing sound, and intermittent autophony frequently caused intense and intolerable discomfort, which might in turn cause loss of control of speech and conversation. These types occurred in 74% and 60%, respectively, and were eliminated by evacuating the middle ear, for example by sniffing. Subjects who described too loud sound or intermittent autophony commonly preferred a retracted tympanic membrane position. This may explain why pressure equalization by swallowing, and inflation by Valsalva's manoeuvre often elicited discomfort. Transient experiences of too loud sound or intermittent autophony may indicate a shift of sound preference towards the sound experienced at negative middle ear pressure, and an unreliable tubal function in the sense that it fails to stay closed to protect the ear from sounds and pressure variations in the nasopharynx. Such experiences of altered sound may trigger evacuation of the middle ear, which eliminates the sound disturbance. It is crucial to identify, interpret, and explain the disturbances correctly in the therapy and prevention of retractions, since habitual evacuation exposes the tympanic membrane to strong negative pressure loads and a subsequent risk of developing retraction.

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

    Science.gov (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

    2016-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Derek Hood

    2016-01-01

    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.

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

    Science.gov (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.

    2016-01-01

    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

  10. CT and MR imaging after middle ear surgery

    Energy Technology Data Exchange (ETDEWEB)

    Koesling, Sabrina E-mail: sabrina.koesling@medizin.uni-halle.de; Bootz, F

    2001-11-01

    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.

  11. Middle ear adenoma is an amphicrine tumor: why call it adenoma?

    Science.gov (United States)

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

    2001-01-01

    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.

  12. Platelet-rich fibrin (PRF): an autologous packing material for middle ear microsurgery.

    Science.gov (United States)

    Garin, P; Mullier, F; Gheldof, D; Dogne, Jean-Michel; Putz, L; Van Damme, J P

    2014-01-01

    To assess the use of PRF prepared using an optimised protocol in middle ear surgery as a substitute for conventional packing products of animal origin such as collagen derived from porcine skin. A retrospective study of 108 patients in whom optimised PRF was used exclusively to pack the external auditory canal or middle ear. The effectiveness or harmlessness of the PRF was evaluated by assessing a range of parameters. A morphological comparison was also made of PRF produced using the Choukroun procedure and our procedure. The success rate of the repair of the tympanic membrane one year after the surgery was 45/48 patients. In 5 of 63 patients in whom a retro-auricular approach and wall-up technique were used, granuloma was observed along the incision in the ear canal. Granuloma was not seen in any of the 23 patients undergoing a procedure with an endaural approach. The use of a material prepared from patients themselves and not of animal origin has numerous advantages in terms of biocompatibility and safety, without any adverse effect on the success rate for general middle ear procedures. The protocol is simple and does not prolong the time spent by the patient in the operating theatre. The Choukroun technique should be modified to prevent excessive failure rates in PRF processing.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    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...

  14. Diagnostic and surgical challenge: middle ear dermoid cyst in 12 month old with branchio-oto-renal syndrome and multiple middle-ear congenital anomalies.

    Science.gov (United States)

    Johnston, D R; Whittemore, K; Poe, D; Robson, C D; Perez-Atayde, A R

    2011-10-01

    Described is the first case report, to our knowledge, of a middle-ear dermoid in a child with branchio-oto-renal (BOR) syndrome. Radiographic, pathologic, and intraoperative figures are shown. This was a diagnostic and surgical challenge as the presentation was similar to a congenital cholesteatoma and the child had numerous significant temporal bone abnormalities. After the intraoperative findings suggested a non-destructive process, the treatment strategy was altered. This case reiterates the need for a cautious, flexible operative approach in a syndromic child. Included is a relevant review of the literature and a detailed clinical analysis. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  15. Endoscopic middle ear exploration in pediatric patients with conductive hearing loss.

    Science.gov (United States)

    Carter, John M; Hoff, Stephen R

    2017-05-01

    To describe our indications, findings, and outcomes for transcanal endoscopic middle ear exploration in pediatric patients with conductive hearing loss of unknown etiology, without effusions. Prospective case series for all pediatric patients undergoing totally endoscopic transcanal middle ear exploration between April 2012 and October 2015 at a pediatric tertiary care referral hospital. Demographic data, operative findings, and hearing results were reviewed. 21 cases were performed in 20 ears (1 revision). Average age at surgery was 7.98 years and average follow up was 2.1 years. Middle ear pathology identified on CT imaging was confirmed in 55% of cases while identified in 45% of cases where pre-operative imaging was non-diagnostic. 6/20 patients (30%) had an ossicular deformity. 8/20(40%) had bony ossicular fixation. 5/20(25%) had ossicular discontinuity. 2/20(10%) had facial nerve dehiscence impinging on the stapes. 15% had adhesive myringosclerosis or severe granulation causing hearing loss. Prosthetic ossiculoplasty was done in 7/21 (33.3%) of the cases, with 1 TORP, 3 PORPs, and 3 IS joint replacements. Imaging was predictive of intra-operative findings in 13/20 cases (55%). Trainees assisted in 16/21(76%) of cases. The average improvement of PTA was 11.65 dB (range -10 to 36.25), and the average ABG improved 10.19 (range -11.25 to 28.75). There were no perioperative complications or adverse events. The endoscopic transcanal approach for middle ear exploration offers excellent visualization and is one of the best applications for the endoscopes in pediatric otology cases. This is particularly helpful for "unexplained" conductive hearing loss where ossicular deformity/fixation/discontinuity is suspected. The etiology of the conductive hearing loss was definitively found in 100% of cases, and can be repaired in the same sitting when applicable. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Replication of type 5 adenovirus promotes middle ear infection by Streptococcus pneumoniae in the chinchilla model of otitis media

    Science.gov (United States)

    Murrah, Kyle A.; Turner, Roberta L.; Pang, Bing; Perez, Antonia C.; Reimche, Jennifer L.; King, Lauren B.; Wren, John; Gandhi, Uma; Swords, W. Edward; Ornelles, David A.

    2015-01-01

    Adenoviral infection is a major risk factor for otitis media. We hypothesized that adenovirus promotes bacterial ascension into the middle ear through the disruption of normal function in the Eustachian tubes due to inflammation-induced changes. An intranasal infection model of the chinchilla was used to test the ability of type 5 adenovirus to promote middle ear infection by Streptococcus pneumoniae. The hyperinflammatory adenovirus mutant dl327 and the nonreplicating adenovirus mutant H5wt300ΔpTP were used to test the role of inflammation and viral replication, respectively, in promotion of pneumococcal middle ear infection. Precedent infection with adenovirus resulted in a significantly greater incidence of middle ear disease by S. pneumoniae as compared to nonadenovirus infected animals. Infection with the adenovirus mutant dl327 induced a comparable degree of bacterial ascension into the middle ear as did infection with the wild-type virus. By contrast, infection with the nonreplicating adenovirus mutant H5wt300ΔpTP resulted in less extensive middle ear infection compared to the wild-type adenovirus. We conclude that viral replication is necessary for adenoviral-induced pneumococcal middle ear disease. PMID:25251686

  17. Computed tomography and magnetic resonance imaging findings for primary middle-ear carcinoma.

    Science.gov (United States)

    Zhang, F; Sha, Y

    2013-06-01

    This study aimed to investigate the computed tomography and magnetic resonance imaging findings of primary middle-ear carcinoma. In this retrospective study of 13 patients with primary middle-ear carcinoma, we collected pre- and post-contrast magnetic resonance images for all 13 cases, high-resolution computed tomography scans for 11 cases, and conventional computed tomography scans with contrast for 2 cases. Soft-tissue masses were mainly located in the tympanum, tympanic sinus and deep within the external auditory canal, and involved the jugular fossa (9 of 13 patients), middle cranial fossa (5/13), parotid gland (2/13) and temporomandibular joint fossa (1/13). An irregular, 'moth-eaten' bone destruction pattern was seen on high-resolution computed tomography images, most commonly in the eustachian tube (9/13), jugular foramen (9/13) and facial nerve canal (7/13). On non-contrast magnetic resonances images, masses were isointense or slightly hypointense on T1-weighted images, and isointense or slightly hyperintense on T2-weighted images. On post-contrast images, lesions were moderately and homogeneously enhanced in seven cases and inhomogeneously enhanced in six. High-resolution computed tomography precisely detects regions of bone destruction, whereas MRI can better assess soft-tissue tumour margins, intracranial extension and vessel patency. Eustachian tube erosion is an important characteristic of primary middle-ear carcinoma.

  18. 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

    2009-01-01

    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.

  19. Spatial Motion in Natural and Reconstructed Middle Ears and the Impact on Sound Transfer

    Science.gov (United States)

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

    2011-11-01

    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.

  20. Conditioning the middle ear reflex at sensation levels below reflex threshold: air jet and electrical stimulation.

    Science.gov (United States)

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

    1980-01-01

    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.

  1. Middle ear adenoma with neuroendocrine differentiation: relate of two cases and literature review

    Science.gov (United States)

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

    2013-01-01

    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

  2. Virus and bacteria enhance histamine production in middle ear fluids of children with acute otitis media.

    Science.gov (United States)

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

    1994-06-01

    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.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...... of 260 genes were identified of which 22 genes were involved in bone metabolism. Gene set analysis revealed five enriched bone‐related gene sets. The identified differentially expressed bone‐related mRNAs and gene sets are of potential significance in the normally developing bulla. These factors and gene...

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

    Directory of Open Access Journals (Sweden)

    Motesaddi Zarandi M

    2003-10-01

    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.

  5. Middle-ear disease in remote Aboriginal Australia: a field assessment of surgical outcomes.

    Science.gov (United States)

    Mak, D; MacKendrick, A; Weeks, S; Plant, A J

    2000-01-01

    Chronic middle-ear disease is highly prevalent among Australian Aboriginal people, and many undergo surgical treatment. However, the outcomes of surgery in this group have not been fully evaluated. This is a descriptive study of operations for middle-ear disease (excluding grommets) on Aboriginal patients in Kimberley hospitals between 1 October 1986 and 31 December 1995. Logistic regression was used to model predictors of surgical outcome. Success was defined by an intact tympanic membrane and air-bone gap of 10 years, however, this does not take into account the necessity of hearing for language acquisition and learning. Dedicated resources must be allocated for post-operative follow-up of Aboriginal patients so that much-needed, rigorous evaluations of ENT surgery can be conducted.

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

    Directory of Open Access Journals (Sweden)

    Špirić Sanja

    2011-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Tabith Junior, Alfredo

    2009-03-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

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

    2012-01-01

    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...

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

    OpenAIRE

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

    2010-01-01

    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...

  11. 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

    1999-12-01

    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)

  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

    2012-06-01

    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. Superior semicircular canal dehiscence associated with external, middle, and inner ear abnormalities.

    Science.gov (United States)

    Wang, Jenny R; Parnes, Lorne S

    2010-02-01

    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.

  14. Your Ears

    Science.gov (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 ...

  15. Phase 3 Trials of Thermosensitive Ciprofloxacin Gel for Middle Ear Effusion in Children with Tubes.

    Science.gov (United States)

    Park, Albert H; White, David R; Moss, Jonathan R; Bear, Moraye; LeBel, Carl

    2016-08-01

    To investigate the efficacy, safety, and microbiology of a thermosensitive otic suspension of ciprofloxacin (OTO-201) in children with bilateral middle ear effusion undergoing tympanostomy tube placement. Two randomized, double-blind, sham-controlled phase 3 trials. Patients were randomized to intratympanic OTO-201 or sham. Children with bilateral middle ear effusion undergoing tympanostomy tube placement. Studies evaluated 532 patients (6 months to 17 years old) in a combined analysis of efficacy (treatment failure: presence of otorrhea, otic or systemic antibiotic use, lost to follow-up, missed visits), safety (audiometry, otoscopy, tympanometry), and microbiology. There was a lower cumulative proportion of treatment failures in patients receiving OTO-201 vs tympanostomy tubes alone (1) on days 4, 8, 15, and 29; (2) on day 15, primary end point (23.0% vs 45.1%; age-adjusted odds ratio, 0.341; P response) supported these findings. There were no drug-related serious adverse events; the most frequent treatment-emergent adverse events in both groups were pyrexia, postoperative pain, nasopharyngitis, cough, and upper respiratory tract infection. OTO-201 administration had no evidence of increased tube occlusion and no negative effect on audiometry, tympanometry, or otoscopy. Combined analysis of 2 phase 3 trials demonstrated a lower cumulative proportion of treatment failures through day 15 compared with TT alone when OTO-201 was administered intratympanically for otitis media with bilateral middle ear effusion at time of tympanostomy tube placement. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  16. 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.

    1983-08-01

    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.

  17. Correlative mRNA and protein expression of middle and inner ear inflammatory cytokines during mouse acute otitis media.

    Science.gov (United States)

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

    2015-08-01

    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.

  18. The ototoxic effect of boric acid solutions applied into the middle ear of guinea pigs.

    Science.gov (United States)

    Oztürkcan, Sedat; Dündar, Riza; Katilmis, Hüseyin; Ilknur, Ali Ekber; Aktaş, Sinem; Haciömeroğlu, Senem

    2009-05-01

    This study analyzed the ototoxic effects of boric acid solutions. Boric acid solutions have been used as otologic preparations for many years. Boric acid is commonly found in solutions prepared with alcohol or distilled water but can also be found in a powder form. These preparations are used for both their antiseptic and acidic qualities in external and middle ear infections. We investigated the ototoxic effect of boric acid solutions on guinea pigs. We are unaware of any similar, previously published study of this subject in English. The study was conducted on 28 young albino guinea pigs. Prior to application of the boric acid solution under general anesthesia, an Auditory Brainstem Response (ABRs) test was applied to the right ear of the guinea pigs. Following the test, a perforation was created on the tympanic membrane of the right ear of each guinea pig and small gelfoam pieces were inserted into the perforated area. Test solutions were administered to the middle ear for 10 days by means of a transcanal route. Fifteen days after inserting the gelfoams in all of the guinea pigs, we anasthesized the guinea pigs and removed the gelfoams from the perforated region of the ear and then performed an ABRs on each guinea pig. The ABRs were within the normal range before the applications. After the application, no significant changes were detected in the ABRs thresholds in neither the saline group nor the group administered boric acid and distilled water solution; however, significant changes were detected in the ABRs thresholds of the Gentamicine and boric acid and alcohol solution groups. We believe that a 4% boric acid solution prepared with distilled water can be a more reliable preparation than a 4% boric acid solution prepared with alcohol.

  19. Attenuated TLRs in middle ear mucosa contributes to susceptibility of chronic suppurative otitis media.

    Science.gov (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

    2014-08-01

    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.

  20. Ear Disorders

    Science.gov (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

    2016-03-01

    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. Indications and outcome of subtotal petrosectomy for active middle ear implants.

    Science.gov (United States)

    Verhaert, Nicolas; Mojallal, Hamidreza; Schwab, Burkard

    2013-03-01

    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.

  3. Streptococcus pneumoniae forms surface-attached communities in the middle ear of experimentally infected chinchillas.

    Science.gov (United States)

    Reid, Sean D; Hong, Wenzhou; Dew, Kristin E; Winn, Dana R; Pang, Bing; Watt, James; Glover, David T; Hollingshead, Susan K; Swords, W Edward

    2009-03-15

    Streptococcus pneumoniae (pneumococcus) causes respiratory and systemic infections that are a major public health problem worldwide. It has been postulated that pneumococci persist in vivo in biofilm communities. In this study, we analyzed whether pneumococci form biofilms in vivo, and if so, whether biofilms correlated with bacterial persistence. Chinchillas were infected with S. pneumoniae TIGR4 and euthanized at varying times after infection, after which the superior ear bullae were excised and examined by culture and microscopy. Dense material, resembling the biofilms of other otitis media pathogens, was visible in the middle ear as late as 12 days after infection. Scanning electron microscopy revealed bacteria within an electron-dense matrix, similar to pneumococcal biofilms formed in vitro. Viability staining revealed groups of viable diplococci, as well as viable and nonviable host cells, attached to a fibrous matrix that was positive when stained with propidium iodide. Cryosections of biofilms were treated with polyclonal antibodies against the pneumococcal surface components pneumococcal surface protein A family 2, pneumococcal surface protein C, choline-binding protein, and neuraminidase, coupled with appropriate secondary antibody conjugates. Immunofluorescent staining showed the presence of pneumococcal communities within the material recovered from the middle ear chamber. On the basis of these data, we conclude that pneumococci form biofilms in vivo and that this process may be intertwined with the formation of neutrophil extracellular traps. These findings provide new insights into the potential causes of antibiotic treatment failure and bacterial persistence in chronic pneumococcal otitis media.

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

    DEFF Research Database (Denmark)

    SA, Sami; Gaihede, Michael

    2010-01-01

    , MEP counter-regulation presented as Eustachian tube openings with steep and fast pressure changes toward 0 Pa, whereas in others, gradual and slow pressure changes presented related to the mastoid; these changes sometimes crossed 0 Pa into opposite pressures. In many cases, combinations......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...

  5. Cochlear implantation in chronic otitis media and previous middle ear surgery: 20 years of experience.

    Science.gov (United States)

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

    2014-08-01

    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

  6. 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)

    1995-02-01

    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).

  7. Middle fossa arachnoid cysts and inner ear symptoms: Are they related?

    Science.gov (United States)

    Proimos, E; Chimona, Ts; Memtsas, Z; Papadakis, Ce

    2014-04-01

    Arachnoid cysts most frequently occur in the middle cranial fossa and when they are symptomatic, patients present with central nervous symptoms. Nevertheless, a large proportion of arachnoid cysts are incidentally diagnosed during neuroimaging in cases with nonspecific symptoms. The cases of two males with middle cranial fossa arachnoid cysts with nonspecific inner ear symptoms were retrospectively reviewed. The first patient presented with mild headache, nausea, vertigo, unsteadiness, and tinnitus on the left ear while the second patient's main complaint was left sided tinnitus. Both patients (initially managed for peripheral disorders) underwent a thorough clinical and electrophysiological evaluation. Because of the patients' persistent clinical symptoms, and indications of CNS disorder in the first case, neuroimaging by brain MRI was performed revealing a middle cranial fossa arachnoid cyst in both patients. Occasionally, patients with arachnoid cysts may present with mild, atypical or intermittent and irrelevant symptoms which can mislead diagnosis. Otorhinolaryngologists should be aware of the fact that atypical, recurrent or intermittent symptoms may masquerade a CNS disorder. Hippokratia 2014; 18 (2):168-171.

  8. [The active middle ear implant for the rehabilitation of sensorineural, mixed and conductive hearing losses].

    Science.gov (United States)

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

    2011-09-01

    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.

  9. Forward and reverse middle ear frequency responses with various terminal loads

    CSIR Research Space (South Africa)

    Thejane, T

    2012-09-01

    Full Text Available Introduction Hearing loss is a prevalent sensory impairment. Conductive hearing loss, which often results from external or middle ear disorders, can be better treated through a in depth un- derstanding of the mechanics of the hearing organ [1]. Mid- dle... model of the auditory periphery for speech and hear- ing research. i. ascending path,? J. Acoust. Soc. Am., vol. 95, pp. 331?342, 1994. [4] G. von Bekesy and W. A. Rosenblith, ?The early his- tory of hearing-observations and theories,? J.Acoust. Soc...

  10. [The Vibrant Soundbridge as an active implant in middle ear surgery].

    Science.gov (United States)

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

    2014-07-01

    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.

  11. 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

    2000-02-01

    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)

  12. The paratympanic organ: a barometer and altimeter in the middle ear of birds?

    Science.gov (United States)

    von Bartheld, Christopher S; Giannessi, Francesco

    2011-09-15

    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.

  13. Middle ear capillary haemangioma: Review of literature and appraisal of management options.

    Science.gov (United States)

    Salamat, Ali A; Casselden, Elizabeth; Theaker, Jeffrey; Batty, Vincent; Thomas, Sebastian

    2016-12-01

    Infantile middle ear capillary haemangiomas (MECH) are a rare entity with only five reported cases in the literature. At present there is no consensus regarding the management of such lesions. Extra-cutaneous haemangiomas have been successfully managed with oral propranolol but not yet reported in MECH. We present a further case and appraise the management options. At present oral propranolol has not been used in the treatment of MECH. The literature suggests that infantile MECH have a higher propensity to spontaneously involute and a greater likelihood of response to propranolol. Surgical excision is the best option in older children and adults.

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

    OpenAIRE

    Tobias Strenger; Stefan Lehner; Frank Böhnke; Theodor Bretan

    2013-01-01

    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...

  15. [Histological evaluation of the condition of the trepanation cavity coating after radical surgery on the middle ear].

    Science.gov (United States)

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

    1998-01-01

    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.

  16. 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.

    Directory of Open Access Journals (Sweden)

    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.

  17. Speech evaluation of partially implantable piezoelectric middle ear implants in vivo.

    Science.gov (United States)

    Shen, J X; Xia, Y F; Xu, Z M; Zhao, S Q; Guo, J Z

    2000-08-01

    Cochlear microphonic responses (CMs) were measured in a rabbit model in the intact ear (CM1) and in ears with a partially implantable piezoelectric middle ear implant (P-MEI) (CM2) to investigate the characteristics of speech transmission of the P-MEI in vivo. The spectra of pure tones, voices, and elicited CM1 and CM2 obtained from the round window before and after the implantation of a P-MEI device were calculated by using fast Fourier transform. Frequency response functions of CM1 and CM2 were used to demonstrate the functional similarity between the implanted P-MEI and the normal ossicular chain. The coherence functions between the voices and CM1 and between CM1 and CM2 were evaluated to characterize speech transmission of the P-MEI in vivo. Ten rabbit ears were used in this study. Pure tones, six Chinese vowels, and six Chinese characters were the acoustic stimuli. The CMs elicited by a list of bisyllabic words were tape-recorded and then recognized by subjects with normal hearing. Using pure tones at the same intensity of 90 dB SPL, frequency response functions of the CMs between the two states (the intact ear with normal hearing and ears with a P-MEI device at the medium volume) were calculated showing great resemblance in shape. Compared with that at 1 kHz, gain factors were 10 and 20 dB, respectively, at higher frequencies. The correlation and spectral analyses of the vocalizations, CM1 and CM2, demonstrated that the harmonics of CM1 were approximately identical as those of the voices between 0.5 and 5.0 kHz with coherence functions of about 0.7 to approximately 1 at the formants' frequencies, whereas the harmonics of CM2 between 0.5 and 2.5 kHz were enhanced with the coherences near to unity at the formants' frequencies, and others 2.5 kHz were attenuated. The recognition score of the CMs elicited by a list of bisyllabic words was >90% using subjects with normal hearing. Data from this study suggest that cochlear microphonic potentials can be used as an

  18. Dosimetric analysis of the use of CBCT in diagnostic radiology: sinus and middle ear.

    Science.gov (United States)

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

    2015-01-01

    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.

  19. Middle ear and mastoid glomus tumors (glomus tympanicum): an algorithm for the surgical management.

    Science.gov (United States)

    Sanna, Mario; Fois, Paolo; Pasanisi, Enrico; Russo, Alessandra; Bacciu, Andrea

    2010-12-01

    Glomus tumors are slow-growing benign lesions and represent the most common primary neoplasms of the middle ear. The objective of the present study is to report our surgical strategy in the management of glomus tympanicum tumors. Between December 1988 and July 2008, 68 patients with histologically confirmed glomus tympanicum tumor underwent surgical treatment. The follow-up of the series ranged from 6 to 194 months (mean, 33.4 months). Distribution of tumors according to Fisch and Mattox classification was as follows: type A, 44 cases (64.7%); type B, 24 cases (35.3%). All of the 44 Class A tumors were safely removed via either a stapedectomy-type transcanal approach or a retroauricolar-transcanal approach. Five patients with Class B tumors were operated on through a transmastoid approach. Nineteen patients with larger Class B tumors underwent a subtotal petrosectomy with blind sac closure of the external auditory canal and middle ear obliteration. Gross total tumor removal was achieved in all 68 cases. In one case (1.4%) there was recurrence after 9 years, for which the patient was re-operated. No residual/recurrence has been detected on computed tomography in the rest of the patients. Surgical excision of glomus tympanicum tumors is a safe procedure, allowing total tumor removal with minimal morbidity, a low recurrence rate, and a low complication rate. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  20. A micropower miniature piezoelectric actuator for implantable middle ear hearing device.

    Science.gov (United States)

    Wang, Zhigang; Mills, Robert; Luo, Hongyan; Zheng, Xiaolin; Hou, Wensheng; Wang, Lijun; Brown, Stuart I; Cuschieri, Alfred

    2011-02-01

    This paper describes the design and development of a small actuator using a miniature piezoelectric stack and a flextensional mechanical amplification structure for an implantable middle ear hearing device (IMEHD). A finite-element method was used in the actuator design. Actuator vibration displacement was measured using a laser vibrometer. Preliminary evaluation of the actuator for an IMEHD was conducted using a temporal bone model. Initial results from one temporal bone study indicated that the actuator was small enough to be implanted within the middle ear cavity, and sufficient stapes displacement can be generated for patients with mild to moderate hearing losses, especially at higher frequency range, by the actuator suspended onto the stapes. There was an insignificant mass-loading effect on normal sound transmission (actuator was attached to the stapes and switched off. Improved vibration performance is predicted by more firm attachment. The actuator power consumption and its generated equivalent sound pressure level are also discussed. In conclusion, the actuator has advantages of small size, lightweight, and micropower consumption for potential use as IMHEDs.

  1. 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.

  2. Wideband energy reflectance measurements: effects of negative middle ear pressure and application of a pressure compensation procedure.

    Science.gov (United States)

    Shaver, Mark D; Sun, Xiao-Ming

    2013-07-01

    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.

  3. Evaluation of concordance between the microorganisms detected in the nasopharynx and middle ear of children with otitis media.

    Science.gov (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

    2013-05-01

    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.

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

    Science.gov (United States)

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

    2016-02-01

    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.

  5. 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;

    2014-01-01

    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...

  6. Middle and inner ear malformations in two siblings exposed to valproic acid during pregnancy: a case report.

    Science.gov (United States)

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

    2014-11-01

    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.

  7. 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

    2016-01-01

    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.

  8. Orpheus 0 G or ear In microgravity to establish symptoms concomitant of inner and middle ear and osteoporosis in microgravity

    Science.gov (United States)

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

    2005-08-01

    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.

  9. A new developmental mechanism for the separation of the mammalian middle ear ossicles from the jaw

    Science.gov (United States)

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

    2017-01-01

    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

  10. 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

    1992-02-01

    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).

  11. Fabrication of Bioactive Glass Nanopowder for Replacement of Ossicles in Middle ear

    Directory of Open Access Journals (Sweden)

    Ali Doostmohammadi

    2007-06-01

    Full Text Available Background and Aim: Due to its ability in bonding with hard and soft tissue, healing and repairing of the bone, and proper replacing of the ossicles in middle ear, bioactive glass has come into considera­tion. The aim of this work was preparation, development and characterization of nanopowder bioactive glass obtained by the sol-gel technique. Materials and Methods: Bioglass powder was made by sol-gel technique and the presence of desired ele­ments is tested by X-ray fluorescence analysis. Trans Electronic Microscopic (TEM technique was used to evaluate the powders shape and size. The prepared bioglass powder was immersed in the simu­lated body fluid solution for 30 days. Fourier transform infrared (FTIR spectroscopy was util­ized to recognize and to confirm the formation of apatite layer on prepared bioglass powder. (XRD as a structural characterization technique was used to investigate the microstructure. Results: The glass powder size was less than 100 nanometers. The formation of apatite layer con­firmed the bioactivity of the bioglass powder and tests revealed that all the films had the signs of bioactiv­ity. It was also found that at sintering temperatures above 900 ºC, crystalline phase Ca2SiO4 was formed. Conclusion: The sol-gel nanopowder bioglass can be used as a replacement for small bones such as ossi­cles in middle ear, and it leads to bone osteointegration and growth of the surrounding tissue.

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

    Science.gov (United States)

    Ngo, Chinh C; Massa, Helen M; Thornton, Ruth B; Cripps, Allan W

    2016-01-01

    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 otopathogens within

  13. 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

  14. 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;

    2015-01-01

    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...

  15. 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.

    2014-01-01

    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

  16. 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)

    2014-01-01

    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

  17. 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.

    2013-01-01

    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

  18. 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.

    2010-01-01

    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

  19. 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.

    2016-01-01

    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

  20. 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

    2000-01-01

    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

  1. 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)

    2016-12-15

    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.)

  2. Ear infection - chronic

    Science.gov (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. Ear tube insertion - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100045.htm Ear tube insertion - series—Normal anatomy To use the ... 4 Overview The eardrum (tympanic membrane) separates the ear canal from the middle ear. Review Date 8/ ...

  4. Better late than never: effective air-borne hearing of toads delayed by late maturation of the tympanic middle ear structures.

    Science.gov (United States)

    Womack, Molly C; Christensen-Dalsgaard, Jakob; Hoke, Kim L

    2016-10-15

    Most vertebrates have evolved a tympanic middle ear that enables effective hearing of airborne sound on land. Although inner ears develop during the tadpole stages of toads, tympanic middle ear structures are not complete until months after metamorphosis, potentially limiting the sensitivity of post-metamorphic juveniles to sounds in their environment. We tested the hearing of five species of toads to determine how delayed ear development impairs airborne auditory sensitivity. We performed auditory brainstem recordings to test the hearing of the toads and used micro-computed tomography and histology to relate the development of ear structures to hearing ability. We found a large (14-27 dB) increase in hearing sensitivity from 900 to 2500 Hz over the course of ear development. Thickening of the tympanic annulus cartilage and full ossification of the middle ear bone are associated with increased hearing ability in the final stages of ear maturation. Thus, juvenile toads are at a hearing disadvantage, at least in the high-frequency range, throughout much of their development, because late-forming ear elements are critical to middle ear function at these frequencies. We discuss the potential fitness consequences of late hearing development, although research directly addressing selective pressures on hearing sensitivity across ontogeny is lacking. Given that most vertebrate sensory systems function very early in life, toad tympanic hearing may be a sensory development anomaly. © 2016. Published by The Company of Biologists Ltd.

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

    Science.gov (United States)

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

    2013-03-01

    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 salivary gland choristoma related to branchio-oto-renal syndrome diagnosed by array-CGH].

    Science.gov (United States)

    Amrhein, P; Sittel, C; Spaich, C; Kohlhase, J; Boppert, R; Kohlhof, P; Koitschev, A

    2014-05-01

    Branchio-oto-renal (BOR) syndrome is characterized by ear malformations associated with sensorineural or mixed hearing loss. In addition, preauricular tags, preauricular pits, branchial cleft fistulas and cysts, as well as renal dysplasia are seen. A genetic mutation on chromosome 8, either autosomal dominantly inherited or occuring as a spontaneous mutation, is the cause in the majority of cases. Using array-based comparative genomic hybridization (CGH), it is possible to detect even the smallest genetic changes. Salivary gland choristoma in the middle ear is very rare. Surgical removal and histological clarification are required.

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

    Directory of Open Access Journals (Sweden)

    Khalid Almazrou

    2013-01-01

    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.

  8. Strategies for decreasing multidrug antibiotic resistance: role of ototopical agents for treatment of middle ear infections.

    Science.gov (United States)

    Klein, Jerome O

    2002-10-01

    Change in the susceptibility of bacterial pathogens to antimicrobial agents is constant. The efficacy of a new drug may change as it is used in clinical settings, and resistant bacterial clones result from the encounter of drug and organism. Soon after the introduction of the sulfonamides in the mid-1930s, the first effective agents of the antimicrobial era, resistance of pneumococci and group A streptococci was evident. In each of the following decades, a different problem in multidrug resistance occurred among common bacterial pathogens: beta-lactamase-producing staphylococci in the 1950s; highly resistant gram-negative enteric bacteria in the 1960s; beta-lactamase-producing Haemophilus influenzae and Moraxella catarrhalis in the 1970s; and multidrug-resistant pneumococci in the 1980s. Antimicrobial resistance among respiratory pathogens is now a common clinical problem throughout the world, and its management is a part of routine office practice. Currently in the United States, about 25% of pneumococci are resistant to penicillin, and 25% of H influenzae and 90% of M catarrhalis produce beta-lactamase and would be inactivated by organisms producing the enzyme. The emergence of penicillin and multidrug-resistant pneumococci and beta-lactamase-producing strains of H influenzae and M catarrhalis have special importance for the management of infections of the middle ear. The widespread use of oral and parenteral antimicrobial drugs for appropriate and inappropriate uses has driven the emergence and spread of resistant organisms. This article discusses current susceptibility patterns of organisms involved in middle ear infections, risk factors associated with development of resistant strains, strategies for limiting the incidence and spread of resistant organisms and, as part of the strategy, use of ototopical rather than systemic antimicrobial drugs for chronic suppurative otitis media (CSOM) and acute otitis media (AOM) in children with tympanostomy tubes. Although

  9. Femtosecond laser microstructuring of titanium surfaces for middle ear ossicular replacement prosthesis

    Science.gov (United States)

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

    2009-02-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Huettenbrink, K.B.

    1987-08-01

    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. [The relevance of Choukroun's Platelet-Rich Fibrin (PRF) during middle ear surgery: preliminary results].

    Science.gov (United States)

    Braccini, F; Tardivet, L; Dohan Ehrenfest, D M

    2009-01-01

    To evaluate the relevance of Leucocyte- and Platelet-Rich Fibrin (L-PRF, Choukroun's technique) Concentrates during tympanoplasty. 152 myringoplasties (including 2 cases with bilateral tympanic perforations) were treated by the senior surgeon in 150 patients, 63 women and 87 males aged between 25 and 55-years-old, between december 2004 and june 2008. These patients showed non marginal tympanic perforations, sized from punctiform to subtotal. For the smallest perforations, a PRF cylinder was used alone to fill the perforation without preparing a tympanomeatus flap (Champagne plug technique). For perforations largest than the third of the tympanic surface, temporal aponeurosis graft in underlay was preferred, and optimized by the lateral application of a PRF membrane (hamburger technique). 6 failures were recorded in this case series, with tympans showing residual microperforations, after a minimum follow-up of 6 months. The success rate was thus close to 96%. The mean success rate without PRF is normally 85%. All failures were recorded on large non marginal lesions. PRF will never save an inadequate surgical procedure, but it offers both mechanical and inflammatory protection to the tympanic graft and accelerates cell proliferation and matrix remodelling. Moreover, this autologous biomaterial induces no undesirable tissue reaction, is easy, quick and cheap to produce and is easily manipulated during the surgical procedure. It seems a precious help for the otologist, in order to improve tympanic healing. PRF potential applications in the middle-ear surgery seem numerous.

  12. Dental root agenesis secondary to irradiation therapy in a case of rhabdomyosarcoma of the middle ear

    Energy Technology Data Exchange (ETDEWEB)

    Dury, D.C.; Roberts, M.W.; Miser, J.S.; Folio, J.

    1984-06-01

    There have been only a few published reports on the dental-facial effects of radiation therapy and the subsequent oral management of these patients. A case involving a 13-year-old black male patient with a history of rhabdomyosarcoma is presented. The patient received 4,050 rads of radiation to the right middle ear when he was 2 years of age. His residual medical and dental difficulties are apparently complications from the initial therapy. Examination of the oral cavity revealed bimaxillary micrognathia and marked loss of vertical dimension. A Class II facial profile with Class I molar relationship was observed. The mandible was thin and hypoplastic, with a small knife-edge alveolar ridge. The remaining eighteen erupted permanent teeth were very mobile, and root development had ceased after only initial formation. All of the teeth except the first permanent molars were extracted, and immediate partial dentures were inserted at the time of surgery. A discussion of therapeutic considerations follows the case report.

  13. Ultrasound characterization of the mastoid for detecting middle ear effusion: A preliminary clinical validation

    Science.gov (United States)

    Chen, Chin-Kuo; Fang, Jui; Wan, Yung-Liang; Tsui, Po-Hsiang

    2016-06-01

    Ultrasound detection of middle ear effusion (MEE) is an emerging technique in otolaryngology. This study proposed using ultrasound characterization of the mastoid to noninvasively measure MEE-induced mastoid effusion (ME) as a new strategy for determining the presence of MEE. In total, 53 patients were enrolled (Group I: normal, n = 20 Group II: proven MEE through both otoscopy and tympanometry, n = 15 Group III: patients with MEE having effusions observed during grommet surgery, n = 18). A 2.25-MHz delay-line transducer was used to measure backscattered signals from the mastoid. The Nakagami parameter was estimated using the acquired signals to model the echo amplitude distribution for quantifying changes in the acoustic structures of mastoid air cells. The median Nakagami parameter and interquartile range were 0.35 (0.34–0.37) for Group I, 0.39 (0.37–0.41) for Group II, and 0.43 (0.39–0.51) for Group III. The echo amplitude distribution observed for patients with MEE was closer to Rayleigh distribution than that without MEE. Receiver operating characteristic (ROC) curve analysis further revealed that the area under the ROC was 0.88, sensitivity was 72.73%, specificity was 95%, and accuracy was 81.13%. The proposed method has considerable potential for noninvasive and comfortable evaluation of MEE.

  14. [Novel possibilities for the rehabilitation of patients presenting with congenital external and middle ear malformations].

    Science.gov (United States)

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

    2014-01-01

    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.

  15. 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

    2015-01-01

    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.

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

    Science.gov (United States)

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

    2015-01-01

    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

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

    OpenAIRE

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

    2015-01-01

    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 ...

  18. First report of a Staphylococcus caprae isolated from middle ear fluid of an infant with recurrent acute otitis media

    Directory of Open Access Journals (Sweden)

    Elżbieta Mazur

    2017-09-01

    Full Text Available Staphylococcus caprae was originally isolated from goat milk. This uncommon coagulase-negative staphylococcus, usually associated with animals, has only infrequently been detected in human clinical specimens. Its association with acute otitis media has not been demonstrated so far. The study reports the first isolation of S. caprae from the middle ear fluid of a 12-month-old infant with recurrent, bilateral acute otitis media. Biochemical traits and susceptibility pattern of the isolated strain are also presented

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

    OpenAIRE

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

    2015-01-01

    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 ...

  20. 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

    2013-01-01

    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.

  1. 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

    2015-01-01

    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.

  2. Mammalian development does not recapitulate suspected key transformations in the evolutionary detachment of the mammalian middle ear.

    Science.gov (United States)

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

    2016-01-13

    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.

  3. Middle ear microbiome differences in indigenous Filipinos with chronic otitis media due to a duplication in the A2ML1 gene

    National Research Council Canada - National Science Library

    Santos-Cortez, Regie Lyn P; Hutchinson, Diane S; Ajami, Nadim J; Reyes-Quintos, Ma. Rina T; Tantoco, Ma. Leah C; Labra, Patrick John; Lagrana, Sheryl Mae; Pedro, Melquiadesa; Llanes, Erasmo Gonzalo d. V; Gloria-Cruz, Teresa Luisa; Chan, Abner L; Cutiongco-de la Paz, Eva Maria; Belmont, John W; Chonmaitree, Tasnee; Abes, Generoso T; Petrosino, Joseph F; Leal, Suzanne M; Chiong, Charlotte M

    2016-01-01

    .... The goal of this study is to describe differences in the middle ear microbiome between carriers and non-carriers of an A2ML1 duplication variant that increases risk for chronic otitis media among...

  4. 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)

    2007-10-15

    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.)

  5. 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

    2009-01-01

    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.

  6. 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.

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

    Science.gov (United States)

    Dufeau, David L; Witmer, Lawrence M

    2015-01-01

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

  8. [Audiological evaluation of the middle ear implant--speech discrimination under noise circumstances].

    Science.gov (United States)

    Saiki, T; Gyo, K; Yanagihara, N

    1990-04-01

    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)

  9. 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)

    2007-02-07

    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.

  10. Dissection of the Auditory Bulla in Postnatal Mice: Isolation of the Middle Ear Bones and Histological Analysis.

    Science.gov (United States)

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

    2017-01-04

    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.

  11. Implementation of a direct install 3-pole type EM transducer in round window niche for implantable middle ear hearing aids.

    Science.gov (United States)

    Shin, Dong Ho; Lim, Hyung-Gyu; Jung, Eui Sung; Wei, Qun; Seong, Ki Woong; Lee, Jyung Hyun; Lee, Seung-Ha; Cho, Jin Ho

    2014-01-01

    Since the 1980's, various types of implantable hearing aids using unique means for delivering acoustic power to the inner ear have been developed. Recently, implantable hearing aids that stimulate the round window by the middle ear transducer have received great attention because it reduces loading effect at the ossicular chain. In this study, we have implemented a direct install 3-pole type EM transducer in round window niche for implantable middle ear hearing aid. The 3-pole type EM transducer consists of two permanent magnets and three coils and exhibit structural features that minimize leakage flux, thereby permitting high efficiency and low magnetic field interference. The stapes velocity was measured using a laser Doppler vibrometer in response to the round window stimulation from the transducer. To verify the usefulness of the 3-pole type EM transducer, we compared the stapes vibration characteristics produced by the transducer and those from a sound source. The magnitude of stapes velocity due to the round window stimulation at 1 mArms was equivalent to that of stapes velocity at 94 dB SPL sound stimulation. Thus, the evaluation study shows that the 3-pole type EM transducer is suitable for implantable hearing devices.

  12. [Our experience with the application of collagen-based preparations in reconstructive surgery of the middle ear].

    Science.gov (United States)

    Kulakova, L A; Eremeeva, K V; Triakina, E G; Lopatin, A S; Ovchinnikov, Iu M

    2012-01-01

    This paper summarizes our experience with the application of collagen-based preparations for reconstructive surgery of the middle ear. The best morphological results (88.46%) were obtained by the closure of extensive defects with the Oblecolum membrane as a temporary supporting structure and the outer atraumatic dressing for the tympanic transplant (in 30 patients) or by the use of the compact-porous explants from the "Sanguicol" preparation as an overlay on the transplant (in 22 patients). Twenty seven patients presenting with the so-called "operated ear disease" underwent mastoidoplasty with the use of the compact-porous preparation "Stimul-oss" as a supporting structure to induce the ingrowth of the bone tissue and the subsequent substitution of the defect. This treatment ensured the reduction of the volume of the bony trepanation cavity. In addition, we have obtained preliminary encouraging results of the application of collagene preparations for the surgical intervention on the stirrup in the patients suffering otosclerosis.

  13. Otitis media with effusion: Accuracy of tympanometry in detecting fluid in the middle ears of children at myringotomies

    Science.gov (United States)

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

    2016-01-01

    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

  14. Effect of osteopathic manipulative treatment on middle ear effusion following acute otitis media in young children: a pilot study.

    Science.gov (United States)

    Steele, Karen M; Carreiro, Jane E; Viola, Judith Haug; Conte, Josephine A; Ridpath, Lance C

    2014-06-01

    Childhood acute otitis media (AOM) is highly prevalent. Its usual sequela of middle ear effusion (MEE) can lead to conductive hearing loss, for which surgery is commonly used. To evaluate the efficacy of an osteopathic manipulative treatment (OMT) protocol on MEE resolution following an episode of AOM. The authors hypothesized that OMT provided adjunctively to standard care for young children with AOM would reduce the duration of MEE following the onset of AOM. We compared standard care only (SCO) and standard care plus OMT (SC+OMT) for the duration of MEE following AOM. Patients were aged 6 months to 2 years. The SC+OMT group received OMT during 3 weekly visits. Weekly tympanometric and acoustic reflectometer (AR) readings were obtained from all patients. There were 52 patients enrolled, with 43 completing the study and 9 dropping out. No demographic differences were noted. Only ears from each patient with abnormal tympanograms at entry were included. There were 76 ears in the tympanogram analysis (38 from SCO; 38 from SC+OMT) and 61 ears in the AR data analysis (31 from SCO; 30 from SC+OMT). Dependence of bilateral ear disease noted in AR readings was accounted for in statistical analysis. Tympanogram data demonstrated a statistically significant improvement in MEE at visit 3 in patients in the SC+OMT group (odds ratio, 2.98; 95% confidence interval, 1.16, 7.62; χ(2) test for independence, P=.02). The AR data analysis showed statistically significant improvement at visit 3 for the SC+OMT group (z=2.05; P=.02). There was no statistically significant change in MEE before or immediately after the OMT protocol. A standardized OMT protocol administered adjunctively with standard care for patients with AOM may result in faster resolution of MEE following AOM than standard treatment alone. (ClinicalTrials.gov number NCT00520039.). © 2014 The American Osteopathic Association.

  15. Changes in microvascular permeability of the middle ear mucosa following the occulsion of the eustachian tube of rabbits. The functional investigation using radioisotope

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, Yasutaka

    1988-12-01

    Serial changes in submucosal microvascular permeability of the middle ear and the response to histamine after occlusion of the eustachian tube were functionally investigated using radioisotope in rabbits with experimentally induced otitis media with effusion. Tritium water was administered through intravenous injection and transference of tritium water into the middle ear cavity was measured by radioactivity of the middle ear perfusate. Morphological changes were concurrently examined for comparison. Vascular permeability, as measured one, 7, and 14 days after occlusion of the eustachian tube, increased with time. A histological study showed an edematous hypertrophy of the submucosal tissue of the middle ear, suggesting a noticeable increase in microvascular permeability. The response of the middle ear mucosa to histamine, which was added to the fluid for perfusion, gradually decreased after occlusion of the eustachian tube, although the effect of histamine tended to persist for a long time, irrespective of the amount of administration. The results indicated that the mucosal membrane of the middle ear has a noticeable permeability at least up to 14 days after occlusion, and that histamine may be responsible for the increase of submucosal microvascular permeability not only in the normal middle ear cavity but also in otitis media with effusion which results in the persistance of the disease. The presence of factors permeable to the blood, other than histamine, caused microvascular peameability to increase, probably resulting in chronic or irreversible inflammation. This may be explained by markedly proliferative or parenchymatous connective tissues observed 7 and l0 weeks after occlusion. It should be noted that surgical treatment be performed as early as possible in the case of otitis media with effusion. (Namekawa, K) 80 refs.

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

    Directory of Open Access Journals (Sweden)

    Eser O

    2009-01-01

    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.

  17. Relationship of the Middle Ear Effusion Microbiome to Secretory Mucin Production in Pediatric Patients With Chronic Otitis Media.

    Science.gov (United States)

    Krueger, Anna; Val, Stéphanie; Pérez-Losada, Marcos; Panchapakesan, Karuna; Devaney, Joe; Duah, Vanessa; DeMason, Christine; Poley, Marian; Rose, Mary; Preciado, Diego

    2017-07-01

    Acute otitis media, an infection of the middle ear, can become chronic after multiple episodes. Microbial influence on chronic otitis media remains unclear. It has been reported that mucin glycoproteins are required for middle ear immune defense against pathogens. We aim to characterize the middle ear effusion (MEE) microbiome using high-throughput sequencing and assess potential associations in microbiome diversity with the presence of the secretory mucins MUC5B and MUC5AC. We hypothesize that MEEs containing MUC5B will exhibit a microbiome largely devoid of typical acute otitis media bacteria. Fifty-five MEEs from children undergoing myringotomy at Children's National Health System were recovered. Mucin was semiquantitatively determined through Western blot analysis. DNA was subjected to 16S rRNA amplicon sequencing using the Illumina MiSeq platform. Raw data were processed in mothur (SILVA reference database). Alpha- and beta-diversity metrics were determined. Abundance differences between sample groups were estimated. MUC5B was present in 94.5% and MUC5AC in 65.5% of MEEs. Sequencing revealed 39 genera with a relative abundance ≥0.1%. Haemophilus (22.54%), Moraxella (11.11%) and Turicella (7.84%) were the most abundant. Turicella and Pseudomonas proportions were greater in patients older than 24 months of age. In patients with hearing loss, Haemophilus was more abundant, while Turicella and Actinobacteria were less abundant. Haemophilus was also more abundant in samples containing both secretory mucins. The microbiome of MEEs from children with chronic otitis media differs according to specific clinical features, such as mucin content, age and presence of hearing loss. These associations provide novel pathophysiologic insights across the spectrum of otitis media progression.

  18. Middle ear bones of a mid-gestation ruminant foetus extracted from x-ray computed tomography

    Science.gov (United States)

    Costeur, Loic; Mennecart, Bastien; Müller, Bert; Schulz, Georg

    2016-10-01

    The timing of ossification of middle ear ossicles has been extensively studied in humans. This is an exception since it is vastly unknown in the +5000 extant species of placentals. As a preliminary approach, a cow foetus (around 115 days of gestation) was visualized using X-ray microtomography (μCT) and the ossicles including stapes, incus, and malleus could be extracted from the data set. All three bones have already undergone substantial ossification, which allow comparison to adult middle ear bones. Their ossification at this stage parallels ossification in humans at a comparable stage of gestation. While full ossification is not yet achieved almost all the morphological characters of the ossicles are observed. Bone tissue is still very porous, the stapes does not have the characteristic plate-like footplate, the lenticular process of the incus is missing and the manubrium of the malleus is very thin and not yet complete. Despite all this, the ossicles are articulate with each other and perfectly with the bony labyrinth. The stapes footplate is positioned on the oval window but is smaller than the latter while it should perfectly fit to transmit sound vibrations to the cochlea. All ossicles, especially the stapes, have not yet reached adult size, while the bony labyrinth already has. This is the first detailed description of a set of middle ear bones in a placental at mid-gestation based on high-resolution μCT. Similarities in ossification timing with humans encourage more work to be done on foetuses to understand if a general rule for placental mammals exists.

  19. Middle ear microbiome differences in indigenous Filipinos with chronic otitis media due to a duplication in the A2ML1 gene.

    Science.gov (United States)

    Santos-Cortez, Regie Lyn P; Hutchinson, Diane S; Ajami, Nadim J; Reyes-Quintos, Ma Rina T; Tantoco, Ma Leah C; Labra, Patrick John; Lagrana, Sheryl Mae; Pedro, Melquiadesa; Llanes, Erasmo Gonzalo D V; Gloria-Cruz, Teresa Luisa; Chan, Abner L; Cutiongco-de la Paz, Eva Maria; Belmont, John W; Chonmaitree, Tasnee; Abes, Generoso T; Petrosino, Joseph F; Leal, Suzanne M; Chiong, Charlotte M

    2016-11-01

    Previously rare A2ML1 variants were identified to confer otitis media susceptibility in an indigenous Filipino community and in otitis-prone US children. The goal of this study is to describe differences in the middle ear microbiome between carriers and non-carriers of an A2ML1 duplication variant that increases risk for chronic otitis media among indigenous Filipinos with poor health care access. Ear swabs were obtained from 16 indigenous Filipino individuals with chronic otitis media, of whom 11 carry the A2ML1 duplication variant. Ear swabs were submitted for 16S rRNA gene sequencing. Genotype-based differences in microbial richness, structure, and composition were identified, but were not statistically significant. Taxonomic analysis revealed that the relative abundance of the phyla Fusobacteria and Bacteroidetes, and genus Fusobacterium were nominally increased in carriers compared to non-carriers, but were non-significant after correction for multiple testing. We also detected rare bacteria including Oligella that was reported only once in the middle ear. These findings suggest that A2ML1-related otitis media susceptibility may be mediated by changes in the middle ear microbiome. Knowledge of middle ear microbial profiles according to genetic background can be potentially useful for therapeutic and prophylactic interventions for otitis media and can guide public health interventions towards decreasing otitis media prevalence within the indigenous Filipino community.

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

    Science.gov (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

    2015-01-01

    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.

  1. Ear - blocked at high altitudes

    Science.gov (United States)

    High altitudes and blocked ears; Flying and blocked ears; Eustachian tube dysfunction - high altitude ... eustachian tube is a connection between the middle ear (the space deep to the eardrum) and the ...

  2. A Fully-Implantable Cochlear Implant SoC with Piezoelectric Middle-Ear Sensor and Arbitrary Waveform Neural Stimulation.

    Science.gov (United States)

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

    2015-01-01

    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.

  3. Middle Ear Exploration Results in Suspected Otosclerosis Cases Referred to Amir-Almomenin and Golsar Hospitals, Rasht, 2001-2011: Are Ossicular and Footplate Area Anomalies Rare?

    Directory of Open Access Journals (Sweden)

    Shadman Nemati

    2013-06-01

    Full Text Available Introduction: Otosclerosis is a disease of bony labyrinth. Structural changes in the labyrinth often cause ossicular fixation, and thus conductive hearing loss. The purpose of this study was to evaluate middle ear exploration findings and frequency of ossicular and footplate area anomalies in patients with suspected otosclerosis referred to Amiralmomenin and Golsar Hospitals in Rasht, Iran.   Materials and Methods: In 47 patients undergone middle ear exploration in Amiralmomenin and Golsar hospitals from April 2001 to March 2011, the intraoperative findings, and other data were extracted from the medical records of the patients. The data was analyzed using SPSS 17 software.   Results: Frequency of fixation of stapes, malleus, and incus by age and sex in patients undergoing middle ear exploration showed that stapes had been fixed in 39 patients, malleus in 6 patients, and incus in 21 patients. Analysis of data showed that there was no significant association between sex and age with fixation of any of ossicles (P>0/05. Middle ear anomalies were seen in 16 cases (34.0%. Overhanging of facial nerve in 4 cases, thick stapedial crura in 5 cases, and perilymph gusher in 2 cases were the most frequent anomalies.   Conclusion:  This study show that the results of middle ear explorations in our patients in the north of Iran is somehow different from the typical otosclerotic cases, although the frequency of ossicular anomalies is better to be evaluated and compared in different areas of Iran, and other countries. 

  4. 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

    2013-10-01

    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.

  5. 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.

    Science.gov (United States)

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

    2013-03-01

    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.

  6. Passive flooding of paranasal sinuses and middle ears as a method of equalisation in extreme breath-hold diving.

    Science.gov (United States)

    Germonpré, Peter; Balestra, Costantino; Musimu, Patrick

    2011-06-01

    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.

  7. [Investigation of viral nucleic acids in middle-ear effusion specimens from children with acute otitis media].

    Science.gov (United States)

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

    2008-07-01

    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.

  8. Upregulation of Phosphorylated HSP27, PRDX2, GRP75, GRP78 and GRP94 in Acquired Middle Ear Cholesteatoma Growth

    Directory of Open Access Journals (Sweden)

    Kuen Yao Ho

    2013-07-01

    Full Text Available Cholesteatoma is a destructive and expanding growth of keratinizing squamous epithelium in the middle ear or petrous apex. The molecular and cellular processes of the pathogenesis of acquired middle ear cholesteatoma have not been fully understood. In this study, comparative proteomic analysis was conducted to investigate the roles of specific proteins in the pathways regarding keratinocyte proliferation in cholesteatoma. The differential proteins were detected by comparing the two-dimension electrophoresis (2-DE maps of the epithelial tissues of 12 attic cholesteatomas with those of retroauricular skins. There were 14 upregulated proteins in the epithelial tissues of cholesteatoma in comparison with retroauricular skin. The modulation of five crucial proteins, HSP27, PRDX2, GRP75, GRP78 and GRP94, was further determined by RT-PCR, Western blot and immunohistochemistry. Phosphorylation of HSP27 at Ser-82 was identified by mass spectroscopy. The results of this study suggested that phosphorylated HSP27 is the end expression of two potential signal-transduction pathways, and together with PRDX2, they are very likely involved in the proliferation of keratinocytes in cholesteatoma. Upregulations of GRP75, GRP78 and GRP94 in keratinocytes may be able to counter endoplasmic reticulum stress, to inhibit cell apoptosis, to prevent protein unfolding and to promote cholesteatoma growth.

  9. Sing It, Hear It, Play It! Ear Training for Middle School Students.

    Science.gov (United States)

    Huenink, Jeffrey S.

    2002-01-01

    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)

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

    NARCIS (Netherlands)

    Honings, J.; Dammeijer, P.F.

    2013-01-01

    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

  11. Vibrant SoundBridge application to middle ear windows versus conventional hearing aids: a comparative study based on international outcome inventory for hearing aids.

    Science.gov (United States)

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

    2014-01-01

    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.

  12. The benefit of the reverse transfer function in the fitting process of the Vibrant Soundbridge middle ear implant.

    Science.gov (United States)

    Karkas, Alexandre; Chahine, Karim; Schmerber, Sébastien

    2012-02-01

    Reverse transfer function (RTF) measurement of the Vibrant Soundbridge (VSB) middle ear implant (MEI) is an objective method to evaluate the function of the VSB and can be used to adjust the Connexx value required to reach the optimal VSB gain during fitting sessions. To investigate the sound transfer of the VSB with the RTF in implanted patients and evaluate the role of RTF in the fitting process of the VSB. This was a prospective study including patients undergoing VSB implantation and RTF recording from March 2007 to October 2010. Three parameters were analyzed. 1) RTF: energy transmitted in dB SPL to ear canal by retrograde vibration of malleus and tympanic membrane. 2) Connexx value: level of amplification in dB delivered by the audioprocessor to the floating mass transducer (FMT). 3) VSB gain: difference in dB HL in free field between aided and unaided conditions. Ten patients fitted the criteria. RTF measurements revealed a significant inter-patient disparity. We adjusted the Connexx value according to the RTF value to obtain an optimal VSB gain within comfort levels. The VSB gain and RTF with Connexx value were closely correlated together. The mean VSB gain and RTF value converted to dB HL had comparable values.

  13. 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

    2012-01-01

    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.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...

  15. 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

    1998-01-01

    . 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......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...... heterogeneity of 78 cultures of M. catarrhalis obtained from different localities in the nasopharynx of nine young children with secretory otitis media. Using HindIII and PstI as endonucleases, five different ribotypes were recognized, representing at least five different genotypes of M. catarrhalis...

  16. 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.

    2010-01-01

    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

  17. 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.

    2010-01-01

    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

  18. Iodine potassium iodide improves the contrast-to-noise ratio of micro-computed tomography images of the human middle ear.

    Science.gov (United States)

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

    2016-12-01

    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.

  19. Non-ossicular signal transmission in human middle ears: Experimental assessment of the “acoustic route” with perforated tympanic membranes

    Science.gov (United States)

    Voss, Susan E.; Rosowski, John J.; Merchant, Saumil N.; Peake, William T.

    2008-01-01

    Direct acoustic stimulation of the cochlea by the sound-pressure difference between the oval and round windows (called the “acoustic route”) has been thought to contribute to hearing in some pathological conditions, along with the normally dominant “ossicular route.” To determine the efficacy of this acoustic route and its constituent mechanisms in human ears, sound pressures were measured at three locations in cadaveric temporal bones [with intact and perforated tympanic membranes (TMs)]: (1) in the external ear canal lateral to the TM, PTM; (2) in the tympanic cavity lateral to the oval window, POW; and (3) near the round window, PRW. Sound transmission via the acoustic route is described by two concatenated processes: (1) coupling of sound pressure from ear canal to middle-ear cavity, HPCAV≡PCAV/PTM, where PCAV represents the middle-ear cavity pressure, and (2) sound-pressure difference between the windows, HWPD≡(POW−PRW)/PCAV. Results show that: HPCAV depends on perforation size but not perforation location; HWPD depends on neither perforation size nor location. The results (1) provide a description of the window pressures based on measurements, (2) refute the common otological view that TM perforation location affects the “relative phase of the pressures at the oval and round windows,” and (3) show with an intact ossicular chain that acoustic-route transmission is substantially below ossicular-route transmission except for low frequencies with large perforations. Thus, hearing loss from TM perforations results primarily from reduction in sound coupling via the ossicular route. Some features of the frequency dependence of HPCAV and HWPD can be interpreted in terms of a structure-based lumped-element acoustic model of the perforation and middle-ear cavities. PMID:17902851

  20. The Carina© middle ear implant: surgical and functional outcomes.

    Science.gov (United States)

    Bruschini, Luca; Berrettini, Stefano; Forli, Francesca; Murri, Alessandra; Cuda, Domenico

    2016-11-01

    The Carina© system (Cochlear Ltd, Sydney, Australia) is a totally implantable prosthesis designed to meet the needs of acoustic amplification in adults with moderate-to-severe sensorineural or mixed hearing loss. It mechanically stimulates the ossicles or labyrinthine windows. The object of this study was to update surgical and functional results obtained in a consistent sample of Carina© recipients. The data sheets of 26 patients who underwent Carina© surgery at two ENT units [i.e., ENT Audiology and Phoniatrics Unit of the University Hospital of Pisa (Pisa, Italy) and ENT Unit of "Guglielmo da Saliceto" Hospital of Piacenza (Piacenza, Italy)] were evaluated for the surgical and audiological outcomes. Twenty patients received a unilateral device, whereas six patients were bilaterally implanted (simultaneously in one patient and sequentially in the remaining five patients). The total number of ears implanted in this study was 32. Most implanted patients expressed a high degree of satisfaction with the prosthesis, which highlights the improvement in hearing in different environmental conditions, the cosmetic advantages, and greater freedom in performing common activities in daily living. Audiological examination demonstrated valid functional gain and significant improvement in speech perception in quiet. Based on this experience, the Carina© is a valid alternative to hearing aids. Moreover, a bilateral implantation, even a simultaneous implantation, is a viable option for selected motivated patients because the intervention is generally well tolerated and the surgery time is relatively fast.

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

    Directory of Open Access Journals (Sweden)

    Suat Terzi

    2016-01-01

    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.

  2. 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.

    Science.gov (United States)

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

    2013-12-01

    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.

  3. A molecular epidemiologic study of methicillin-resistant Staphylococcus aureus infection in patients undergoing middle ear surgery.

    Science.gov (United States)

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

    1998-01-01

    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

  4. Electrophysiological aspects of the middle ear muscle reflex in the rat: latency, rise time and effect on sound transmission.

    Science.gov (United States)

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

    1990-10-01

    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.

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

    Science.gov (United States)

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

    2013-11-01

    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.

  6. Primary radical radiotherapy for squamous cell carcinoma of the middle ear and external auditory cana--an historical series.

    Science.gov (United States)

    Pemberton, L S; Swindell, R; Sykes, A J

    2006-06-01

    To evaluate patients treated with radical radiotherapy alone for squamous cell carcinoma of the middle ear (MEC) and external auditory canal (EAC) in terms of freedom from local recurrence, cancer-specific survival and morbidity. Between 1965 and 1988, 123 patients were treated, 70 with MEC and 53 with EAC. The median age was 64 years (range 21-86) and 78% presented as late stage. The median dose was 55 Gy (range 39-55) in 16 once daily fractions (range 13-21). At 5 and 10 years, respectively, freedom from local recurrence was 56 and 56%, disease-free survival was 45 and 43%, cancer-specific survival was 53 and 51%, and overall survival was 40 and 21%. Cancer-specific survival was significantly worse with late stage as opposed to early stage (P = 0.0026), as was local recurrence (P = 0.0088). No differences in survival and local control were seen according to site. Radionecrosis developed in 6% of patients. Combined treatment using radiotherapy and radical surgery is often favoured. This large series shows that radical radiotherapy achieves comparable results in terms of local control and cancer-specific survival. Our radiotherapy regimen is now 55 Gy in 20 daily fractions to reduce late morbidity. Radiotherapy alone remains a viable option, especially as morbidity can be minimised and target volume delineation optimised using computer planning in the future.

  7. Influence of Pneumococcal Conjugate Vaccine on Acute Otitis Media with Severe Middle Ear Inflammation: A Retrospective Multicenter Study.

    Science.gov (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

    2015-01-01

    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.

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

    Science.gov (United States)

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

    2012-08-01

    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. Copyright © 2012 Wiley Periodicals, Inc.

  9. Minimal biofilm eradication concentration of antimicrobial agents against nontypeable Haemophilus influenzae isolated from middle ear fluids of intractable acute otitis media.

    Science.gov (United States)

    Takei, Shin; Hotomi, Muneki; Yamanaka, Noboru

    2013-06-01

    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.

  10. 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

    2006-01-01

    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.

  11. Classification and diagnosis of ear malformations

    OpenAIRE

    Bartel-Friedrich, Sylva; Wulke, Cornelia

    2008-01-01

    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...

  12. 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.

    Science.gov (United States)

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

    2016-01-01

    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.

  13. Postoperative Intensity-Modulated Radiotherapy for Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear: Treatment Outcomes, Marginal Misses, and Perspective on Target Delineation

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Wan-Yu [Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Kuo, Sung-Hsin [Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan (China); Chen, Yu-Hsuan; Lu, Szu-Huai; Tsai, Chiao-Ling [Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Chia-Hsien Cheng, Jason [Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan (China); Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Hong, Ruey-Long [Division of Medical Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Chen, Ya-Fang [Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan (China); Hsu, Chuan-Jen; Lin, Kai-Nan; Ko, Jenq-Yuh; Lou, Pei-Jen; Wang, Cheng-Ping [Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan (China); Chong, Fok-Ching [Graduate Institute of Electrical Engineering, National Taiwan University, Taipei, Taiwan (China); Wang, Chun-Wei, E-mail: cwwang@ntuh.gov.tw [Graduate Institute of Electrical Engineering, National Taiwan University, Taipei, Taiwan (China)

    2012-03-15

    Purpose: To report outcomes of the rare disease of squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear treated with surgery and postoperative intensity-modulated radiotherapy (IMRT). Failure patterns related to spatial dose distribution were also analyzed to provide insight into target delineation. Methods and Materials: A retrospective review was conducted of the records of 11 consecutive patients with SCC of the EAC and middle ear who were treated with curative surgery and postoperative IMRT at one institution between January 2007 and February 2010. The prescribed IMRT dose was 60 to 66 Gy at 2 Gy per fraction. Three patients also received concurrent cisplatin-based chemotherapy, and 1 patient received concurrent oral tegafur/uracil. The median follow-up time was 19 months (range, 6-33 months). Results: Four patients had locoregional recurrence, yielding an estimated 2-year locoregional control rate of 70.7%. Among them, 1 patient had persistent disease after treatment, and 3 had marginal recurrence. Distant metastasis occurred in 1 patient after extensive locoregional recurrence, yielding an estimated 2-year distant control rate of 85.7%. The estimated 2-year overall survival was 67.5%. The three cases of marginal recurrence were near the preauricular space and glenoid fossa of the temporomandibular joint, adjacent to the apex of the ear canal and glenoid fossa of the temporomandibular joint, and in the postauricular subcutaneous area and ipsilateral parotid nodes, respectively. Conclusions: Marginal misses should be recognized to improve target delineation. When treating SCC of the EAC and middle ear, care should be taken to cover the glenoid fossa of the temporomandibular joint and periauricular soft tissue. Elective ipsilateral parotid irradiation should be considered. The treatment planning procedure should also be refined to balance subcutaneous soft-tissue dosimetry and toxicity.

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

    Directory of Open Access Journals (Sweden)

    Raghu S Thota

    2015-01-01

    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.

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

    Science.gov (United States)

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

    2010-06-14

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

    Science.gov (United States)

    Stock, Karl; Wurm, Holger; Hausladen, Florian

    2016-02-01

    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.

  17. Ear Tubes

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Ear Tubes Ear Tubes Patient Health Information News media ... and throat specialist) may be considered. What are ear tubes? Ear tubes are tiny cylinders placed through ...

  18. [Middle ear cholesteatoma].

    Science.gov (United States)

    Ayache, D; Schmerber, S; Lavieille, J P; Roger, G; Gratacap, B

    2006-06-01

    Cholesteatoma is a serious form of chronic otitis media. The aim of this paper is to present the state of the art of disease management, including recent data from the literature and the authors' derived from their Mentors' teaching, Professor Pierre Roulleau (Paris, France) and Professor Robert Charachon (Grenoble, France). The main recent advances concern the use of cartilage grafts to reconstruct the canal wall and/or tympanic membrane (allowing a significant reduction in residual cholesteatoma) and progress in medical imaging allowing more acute preoperative determination of extension of the cholesteatoma (in order to propose an optimally designed surgical technique) and a less invasive postoperative follow-up.

  19. 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

    2012-01-01

    [目的]研究放疗后中耳胆固醇肉芽肿行乳突根治及鼓室成型术手术的效果.[方法]对在我科确诊为鼻咽癌放疗后中耳胆固醇肉芽肿的9例患者9耳进行手术治疗研究,放疗与手术间隔时间为6~14年(平均9年),术前接受的放射剂量为68~75 Gy.所有患耳采取的手术治疗方法包括开放乳突根治或完壁乳突根治术,同时行鼓室成型,其中3例行开放乳突根治+鼓室成型;6例行完壁乳突根治+鼓室成型.[结果]所有患者术后均随访2年以上,7耳鼓膜完整(占77.8%),2耳在术后3个月出现鼓膜再穿孔,但耳流脓、耳闷塞感明显较术前减少.平均纯音听阈PTA和A-B Gap分别由术前的90.5 dB和45.8 dB改善至术后6个月的62.3dB和25.5 dB.[结论]大多数鼻咽癌放疗后中耳胆固醇肉芽肿患者可采取手术改善症状,放疗引起的慢性中耳炎不是鼓室成型的禁忌证.%[Objective] To evaluate the surgical outcome of mastoidectomy plus tympanoplasty for cholesterin granuloma of the middle ear in post-irradiated patients. [Methods] Nine ears diagnosed cholesterin granuloma in the middle ear in post-irradiated NPC patients were included in this study. The time from radiotherapy termination to surgery ranged from 6 to 14 years (median 9 years). All the patients with NPC received radiotherapy of 68 to 75 Gy before surgery. All patients underwent radical tympanoplasty plus mastoidectomy with canal wall down or up. Three ears underwent canal wall down mastoidectomy plus tympanoplasty and six ears underwent canal wall up mastoidectomy plus tympanoplasty. [Results] All the patients were followed up for 2 years at least. There were 7 ears (77.8%) had intact tympanic membrane and 2 ears developed reperforation of eardrum 3 months after surgery, but otorrhea decreased significantly. All these patients reported improved quality of daily life after the surgery. The pure tone average (PTA) of pre-operation was 90.5 dB and air-bone gap

  20. Cauliflower Ear

    Science.gov (United States)

    ... dientes Video: Getting an X-ray What's Cauliflower Ear? KidsHealth > For Kids > What's Cauliflower Ear? Print A A A Have you ever seen someone whose ear looks bumpy and lumpy? The person might have ...

  1. Swimmer's ear

    Science.gov (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) ...

  2. Controlling the position and the dislocation of the middle ear transducer with high-resolution computed tomography and digital volume tomography: implications for the transducers' design.

    Science.gov (United States)

    Kontorinis, Georgios; Giesemann, Anja M; Witt, Thomas; Goetz, Friedrich; Schwab, Burkard

    2012-04-01

    A minimal tip dislocation of the middle ear transducer (MET(®), Otologics Ltd) may result in poor hearing performance. Our objective was to examine if a defined MET dislocation can be diagnosed by high-resolution computed tomography (HRCT) or digital volume tomography (DVT). A human cadaver head was sequentially implanted with different MET tips (incus application) including a ceramic tip (T 1c), a titanium tip (T 1t), a new, thinner titanium tip (T 2), and a spherical titanium tip (Ts). HRCT and DVT studies were performed. Afterward, the tips were pulled back 0.5 mm, so that they were not attached to the incus. HRCT and DVT scans were repeated to identify the dislocation. Using the best plain in HRCT images, the dislocation of the transducer could be measured reliably and reproducibly in half of the cases. In particular, the precise positioning and the dislocation could be identified when T 1t and Ts were implanted, with the Ts showing the best visibility. DVT failed in recognizing the dislocation in all cases. The identification of MET tip's dislocation with HRCT depends on the shape, size, and material of the tip. This knowledge is useful for the design of the implants, as determination of the right position of the middle ear transducer may be proven important for the hearing outcome. In some cases, however, surgical exploration may still be required. Although DVT represents a promising imaging method for the otologists, it can barely help when MET dislocation is suspected.

  3. 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.

  4. A Retrospective Multicentre Cohort Review of Patient Characteristics and Surgical Aspects versus the Long-Term Outcomes for Recipients of a Fully Implantable Active Middle Ear Implant

    Science.gov (United States)

    Lefebvre, Philippe P.; Gisbert, Javier; Cuda, Domenico; Tringali, Stéphane; Deveze, Arnaud

    2017-01-01

    Objective To summarise treatment outcomes compared to surgical and patient variables for a multicentre recipient cohort using a fully implantable active middle ear implant for hearing impairment. To describe the authors' preferred surgical technique to determine microphone placement. Study Design Multicentre retrospective, observational survey. Setting Five tertiary referral centres. Patients Carina recipients (66 ears, 62 subjects) using the current Cochlear® Carina® System or the legacy device, the Otologics® Fully Implantable Middle Ear, with a T2 transducer. Methods Patient file review and routine clinical review. Patient outcomes assessed were satisfaction, daily use and feedback reports at the first fitting and ≥12 months after implantation. Descriptive and statistical analysis of correlations of variables and their influence on outcomes was performed. Independently reported preferred methods for microphone placement are collectively summarised. Results The average implant experience was 3.5 years. Satisfaction increased significantly over time (p < 0.05). No correlation with covariates examined was observed. Feedback significantly decreased over time, showing a significant correlation with microphone location, primary motivation, gender, age at implantation, and contralateral hearing aid use (p < 0.05). Patient satisfaction was inversely correlated with reports of system feedback (p < 0.05). The implantable microphone was most commonly on the posterior inferior mastoid line, in 42/66 (65%) cases, correlating with less likelihood for feedback and consistent with author surgical preference. Conclusion Carina recipients in this study present as satisfied consistent daily users with very few reports of persistent feedback. As microphone location is an influencing factor, a careful surgical consideration of microphone placement is required. The authors prefer a posterior inferior mastoid line position whenever possible. PMID:28052264

  5. Ear wax

    OpenAIRE

    Browning, George GG

    2008-01-01

    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.

  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

    2014-07-01

    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. Ear Pieces

    Science.gov (United States)

    DiJulio, Betsy

    2011-01-01

    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…

  8. Interconnections between the Ears in Nonmammalian Vertebrates

    DEFF Research Database (Denmark)

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

    2010-01-01

    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. 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

    2010-01-01

    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

  10. Ear trauma.

    Science.gov (United States)

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

    2013-04-01

    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. The contralateral ear in cholesteatoma.

    Science.gov (United States)

    da Costa, Sady Selaimen; Teixeira, Adriane Ribeiro; Rosito, Letícia Petersen Schmidt

    2016-07-01

    Middle ear cholesteatoma has been extensively studied. Theories of cholesteatoma pathogenesis involving previous tympanic membrane retraction are the most widely accepted, but the contralateral ear in patients with cholesteatoma remains unstudied. This study aimed to investigate the contralateral ear in patients with cholesteatoma, and to determine whether the characteristics of it differ according to patient age and cholesteatoma growth patterns. This study was cross sectional. We evaluated 356 patients with middle ear cholesteatoma in at least one ear, and no history of surgery, between August 2000 and March 2013. Otoendoscopy was conducted on both the affected and the contralateral ear. They were classified as normal, tympanic membrane perforation, moderate to severe tympanic membrane retraction and cholesteatoma. The mean age of the patients was 32.77 years, and 53.1 % of the cohort were female. Only 34.8 % of the contralateral ears were normal. The most common abnormality was moderate to severe tympanic membrane retraction (41.6 %). Cholesteatoma was identified in 16 %. Children exhibited a greater frequency of tympanic membrane retractions, whereas adults exhibited a greater frequency of cholesteatoma. All of the contralateral ears in the anterior epitympanic group were normal, but otherwise there were no differences in the contralateral ear when we compared the cholesteatoma growth patterns. We conclude that patients diagnosed with acquired cholesteatoma of one ear are significantly more likely to exhibit abnormalities of the contralateral ear.

  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

    2011-01-01

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

    Science.gov (United States)

    Avnstorp, Magnus Balslev; Homøe, Preben; Bjerregaard, Peter; Jensen, Ramon Gordon

    2016-04-01

    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. 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. 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-frequencies: 500, 1000 and 2000Hz and the high-frequencies: 4000 and 6000Hz. HL was categorized according to the worst hearing ear and was compared within the groups: CSOM, OME, tympanic membrane sequelae of OM and normal. Of 207 children, 5.8% had CSOM, 13.9% had OME and 55.6% had tympanic membrane sequelae of OM. The median pure tone average in low-frequencies/high-frequencies were: CSOM: 34.2/31.3dB, OME: 23.3/22.5dB, Sequelae of OM: 13.3/15dB and normal ears: 11.7/12.5dB. We found a significant difference (p15dB in any frequency was found, while 6.5% suffered from a bilateral low-frequency HL>25dB. The severity of OM significantly corresponded to increased HL. The burden of CSOM and HL remains high in young Greenlandic children. Aggressive treatment with antibiotics, improved hearing rehabilitation, sound field amplification in classrooms and otosurgical capacity should be further promoted in Greenland. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Ear Tumors

    Science.gov (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 ...

  15. Classification and diagnosis of ear malformations

    Directory of Open Access Journals (Sweden)

    Bartel-Friedrich, Sylva

    2007-01-01

    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.

  16. Elephant ear

    Science.gov (United States)

    ... Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Elephant ear URL of this page: //medlineplus.gov/ency/article/002867.htm Elephant ear To use the sharing features on this page, please enable JavaScript. Elephant ear plants are indoor or outdoor plants with very large, ...

  17. Ear Problems in Swimmers

    Directory of Open Access Journals (Sweden)

    Mao-Che Wang

    2005-08-01

    Full Text Available 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.

  18. Ear problems in swimmers.

    Science.gov (United States)

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

    2005-08-01

    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.

  19. 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

    2013-01-01

    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

  20. 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)

    李增贤

    2015-01-01

    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.

  1. Listening to the ear

    Science.gov (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

  2. Detection of respiratory pathogens in pediatric acute otitis media by PCR and comparison of findings in the middle ear and nasopharynx.

    Science.gov (United States)

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

    2016-05-01

    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.

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

    Science.gov (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

    2017-01-17

    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.

  4. 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

    2009-01-01

    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

  5. Ear Problems

    Science.gov (United States)

    ... have cold or flu symptoms?YesNoDo you have tooth pain on the same side as the ear pain ... or 2 days, see your doctor.Start OverDiagnosisA tooth problem can radiate pain to the ear on the same side.Self ...

  6. 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

    2011-01-01

    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.

  7. 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

    2015-01-01

    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 .

  8. 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

    2017-01-01

    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.

  9. Pro-inflammatory interleukins in middle ear effusions from atopic and non-atopic children with chronic otitis media with effusion.

    Science.gov (United States)

    Zielnik-Jurkiewicz, Beata; Stankiewicz-Szymczak, Wanda

    2016-06-01

    Chronic otitis media with effusion (OME) is associated with irreversible changes in the middle ear, sometimes leading to hearing loss and abnormal language development in children. While the pathogenesis of OME is not fully understood, inflammatory and allergic factors are thought to be involved. The study aimed to investigate the role of cytokines in the local development of chronic OME, and assess differences in the cytokine profiles between atopic and non-atopic children. 84 atopic and non-atopic children with chronic OME (mean age of 6 years 7 months) were studied. Age-matched children with hypertrophy of the adenoids and Eustachian tube dysfunction served as the control group. The number of past acute otitis media (AOM) episodes, their age, and the type of effusion were recorded for all children. Pro-inflammatory cytokine concentrations (TNF-α, IL-1β, IL-6 and IL-8) were determined and the presence of pathogenic bacteria in the patients' effusions was examined. High concentrations of TNF-α, IL-1β, IL-6 and IL-8 were found in the effusions in all children with chronic OME, with the highest levels observed in the non-atopic group. The atopic group showed persistently high IL-1β levels, while in the non-atopic children, IL-1β and TNF-α levels positively correlated with the patient's age and the number of past AOM episodes. Pathogenic bacteria were more frequently isolated from effusions in non-atopic children. In both atopic and non-atopic children, pro-inflammatory cytokines are found at high concentrations. This argues in favor of instituting anti-inflammatory management for treating OME, regardless of atopy.

  10. The Galker test of speech reception in noise; associations with background variables, middle ear status, hearing, and language in Danish preschool children.

    Science.gov (United States)

    Lauritsen, Maj-Britt Glenn; Söderström, Margareta; Kreiner, Svend; Dørup, Jens; Lous, Jørgen

    2016-01-01

    We tested "the Galker test", a speech reception in noise test developed for primary care for Danish preschool children, to explore if the children's ability to hear and understand speech was associated with gender, age, middle ear status, and the level of background noise. The Galker test is a 35-item audio-visual, computerized word discrimination test in background noise. Included were 370 normally developed children attending day care center. The children were examined with the Galker test, tympanometry, audiometry, and the Reynell test of verbal comprehension. Parents and daycare teachers completed questionnaires on the children's ability to hear and understand speech. As most of the variables were not assessed using interval scales, non-parametric statistics (Goodman-Kruskal's gamma) were used for analyzing associations with the Galker test score. For comparisons, analysis of variance (ANOVA) was used. Interrelations were adjusted for using a non-parametric graphic model. In unadjusted analyses, the Galker test was associated with gender, age group, language development (Reynell revised scale), audiometry, and tympanometry. The Galker score was also associated with the parents' and day care teachers' reports on the children's vocabulary, sentence construction, and pronunciation. Type B tympanograms were associated with a mean hearing 5-6dB below that of than type A, C1, or C2. In the graphic analysis, Galker scores were closely and significantly related to Reynell test scores (Gamma (G)=0.35), the children's age group (G=0.33), and the day care teachers' assessment of the children's vocabulary (G=0.26). The Galker test of speech reception in noise appears promising as an easy and quick tool for evaluating preschool children's understanding of spoken words in noise, and it correlated well with the day care teachers' reports and less with the parents' reports. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. External Otitis (Swimmer's Ear)

    Science.gov (United States)

    ... to Pneumococcal Vaccine Additional Content Medical News External Otitis (Swimmer's Ear) By Bradley W. Kesser, MD, Associate ... the Outer Ear Ear Blockages Ear Tumors External Otitis (Swimmer's Ear) Malignant External Otitis Perichondritis External otitis ...

  12. Ear Infections in Children

    Science.gov (United States)

    ... Home » Health Info » Hearing, Ear Infections, and Deafness Ear Infections in Children On this page: What is ... additional information about ear infections? What is an ear infection? An ear infection is an inflammation of ...

  13. 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

    2015-01-01

    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

  14. Airplane Ear

    Science.gov (United States)

    ... severe hearing loss Ringing in your ear (tinnitus) Spinning sensation (vertigo) Vomiting resulting from vertigo Bleeding from ... the back of the nasal cavity and the top of the throat meet (nasopharynx). When an airplane ...

  15. Outcomes in Endoscopic Ear Surgery.

    Science.gov (United States)

    Kiringoda, Ruwan; Kozin, Elliott D; Lee, Daniel J

    2016-10-01

    Endoscopic ear surgery (EES) provides several advantages compared with traditional binocular microscopy, including a wide-field view, improved resolution with high magnification, and visual access to hidden corridors of the middle ear. Although binocular microscopic-assisted surgical techniques remain the gold standard for most otologists, EES is slowly emerging as a viable alternative for performing otologic surgery at several centers in the United States and abroad. In this review, we evaluate the current body of literature regarding EES outcomes, summarize our EES outcomes at the Massachusetts Eye and Ear Infirmary, and compare these results with data for microscopic-assisted otologic surgery.

  16. 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

    2011-01-01

    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

  17. Comparison of the cuff pressure of a TaperGuard endotracheal tube and a cylindrical endotracheal tube after lateral rotation of head during middle ear surgery

    Science.gov (United States)

    Choi, Eunkyung; Park, Yongmin; Jeon, Younghoon

    2017-01-01

    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

  18. Comparison of Serotype Prevalence of Pneumococci Isolated from Middle Ear, Lower Respiratory Tract and Invasive Disease Prior to Vaccination in Iceland

    Science.gov (United States)

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

    2017-01-01

    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

  19. 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.

    Science.gov (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

    2011-11-01

    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.

  20. 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.

  1. Numerical analysis of ossicular chain lesion of human ear

    Institute of Scientific and Technical Information of China (English)

    Yingxi Liu; Sheng Li; Xiuzhen Sun

    2009-01-01

    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.

  2. Development and Integration of the Ear.

    Science.gov (United States)

    Fuchs, Jennifer C; Tucker, Abigail S

    2015-01-01

    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.

  3. 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 ...

  4. Ear Plastic Surgery

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Ear Plastic Surgery Ear Plastic Surgery Patient Health Information ... they may improve appearance and self-confidence. Can Ear Deformities Be Corrected? Formation of the ear during ...

  5. Autoimmune Inner Ear Disease

    Science.gov (United States)

    ... Find an ENT Doctor Near You Autoimmune Inner Ear Disease Autoimmune Inner Ear Disease Patient Health Information ... with a hearing loss. How Does the Healthy Ear Work? The ear has three main parts: the ...

  6. Better Ear Health

    Science.gov (United States)

    ... Marketplace Find an ENT Doctor Near You Better Ear Health Better Ear Health Patient Health Information News ... often helpful to those with this condition. Swimmer’s Ear An infection of the outer ear structures caused ...

  7. How the Ear Works

    Science.gov (United States)

    ... Find an ENT Doctor Near You How the Ear Works How the Ear Works Patient Health Information News media interested in ... public relations staff at newsroom@entnet.org . The ear has three main parts: the outer ear (including ...

  8. Cosmetic ear surgery

    Science.gov (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 ...

  9. 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

    2011-08-01

    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

  10. 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

    2012-01-01

    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

  11. 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)

    王霞

    2015-01-01

    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

  12. Benign ear cyst or tumor

    Science.gov (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 ...

  13. 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

    2015-01-01

    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。

  14. 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

    2013-01-01

    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

  15. 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

  16. 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

    2003-01-01

    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

  17. Travel Inside the Ear

    Science.gov (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 ...

  18. 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

    2000-01-01

    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

  19. 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

    2000-01-01

    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

  20. 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

    Science.gov (United States)

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

    2017-01-01

    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

  1. 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.

    Science.gov (United States)

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

    2017-01-01

    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 and

  2. Ear Disorders in Scuba Divers

    Directory of Open Access Journals (Sweden)

    MH Azizi

    2010-12-01

    Full Text Available History of underwater diving dates back to antiquity. Breath-hold technique in diving was known to the ancient nations. However, deep diving progressed only in the early decades of the 19th century as the result of advancements in efficient underwater technologies which subsequently led to invention of sophisticated sets of scuba diving in the 20th century. Currently, diving is performed for various purposes including commercial, recreational, military, underwater construction, oil industry, underwater archeology and scientific assessment of marine life. By increasing popularity of underwater diving, dive-related medical conditions gradually became more evident and created a new challenge for the health care professionals, so that eventually, a specialty the so-called “diving medicine” was established. Most of the diving-associated disorders appear in the head and neck. The most common of all occupational disorders associated with diving are otologic diseases. External otitis has been reported as the most common otolaryngologic problem in underwater divers. Exostosis of the external ear canal may be formed in divers as the result of prolonged diving in cold waters. Other disorders of the ear and paranasal sinuses in underwater divers are caused by barometric pressure change (i.e., barotraumas, and to a lesser extent by decompression sickness. Barotrauma of the middle ear is the most prevalent barotrauma in divers. The inner ear barotraumas, though important, is less common. The present paper is a brief overview of diving-related ear disorders particularly in scuba divers.

  3. 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

    2015-01-01

    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

  4. Chronic discharging ear in a child: are we missing something?

    Science.gov (United States)

    Dutta, Mainak; Ghatak, Soumya; Biswas, Gautam

    2013-08-01

    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.

  5. Play it by Ear

    DEFF Research Database (Denmark)

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

    2014-01-01

    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....

  6. 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

    2001-01-01

    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

  7. 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

    2012-01-01

    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

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

    OpenAIRE

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

    2010-01-01

    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...

  9. Ear Infection and Vaccines

    Science.gov (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 ...

  10. Ear surgery - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100016.htm Ear surgery - series—Normal anatomy To use the sharing ... Overview This image demonstrates normal appearance of the ears in relation to the face. Review Date 10/ ...

  11. Otoplasty (Cosmetic Ear Surgery)

    Science.gov (United States)

    ... By Mayo Clinic Staff Otoplasty — also known as cosmetic ear surgery — is a procedure to change the ... Society of Plastic Surgeons. http://www.plasticsurgery.org/Cosmetic-Procedures/Ear-Surgery.html. Accessed June 16, 2015. ...

  12. 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

    2012-01-01

    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

  13. 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

    2013-01-01

    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

  14. Middle Ear Infections and Ear Tube Surgery (For Parents)

    Science.gov (United States)

    ... Child What Kids Say About: Handling Stress Anxiety, Fears, and Phobias Community Service: A Family's Guide to ... help normalize hearing. The presence of the tiny hole in the eardrum from the tube doesn't ...

  15. Ear Injuries (For Parents)

    Science.gov (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 ...

  16. 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

    2016-01-01

    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

  17. Surgical and Technical Modalities for Hearing Restoration in Ear Malformations.

    Science.gov (United States)

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

    2015-12-01

    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.

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

    DEFF Research Database (Denmark)

    Christiansen, Thomas Ulrich

    2004-01-01

    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...

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

    Science.gov (United States)

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

    2010-06-01

    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.

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

    Directory of Open Access Journals (Sweden)

    C Amarnath

    2016-01-01

    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

  1. High Intensity Pressure Noise Transmission in Human Ear: A Three Dimensional Simulation Study

    Science.gov (United States)

    Hawa, Takumi; Gan, Rong; Leckness, Kegan

    2015-03-01

    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.

  2. 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

    2012-02-01

    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

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

    Directory of Open Access Journals (Sweden)

    Sandra de O. Saes

    2005-04-01

    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

  4. Comparison of the cuff pressure of a TaperGuard endotracheal tube and a cylindrical endotracheal tube after lateral rotation of head during middle ear surgery: A single-blind, randomized clinical consort study.

    Science.gov (United States)

    Choi, Eunkyung; Park, Yongmin; Jeon, Younghoon

    2017-03-01

    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. 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. 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 pressure >30 cmH2O was higher in group T (96.2%) than in group C (30.8%) (P sore throat, hoarseness, and cough at 30 minutes, 6 hours, and 24 hours after surgery were comparable between two groups. 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.

  5. A RARE FOREIGN BODY IN THE EAR: REMOVED BY CANALOPLASTY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Shankar

    2015-08-01

    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.

  6. 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

    2012-01-01

    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

  7. 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

    2011-01-01

    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

  8. 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

    2001-01-01

    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。

  9. Travel Inside the Ear

    Medline Plus

    Full Text Available ... Search form Search A–Z Index Español Menu Home Health Info Hearing, Ear Infections, and Deafness Balance ... Committees Contact Us Get Involved You are here Home » Health Info » Hearing, Ear Infections, and Deafness Travel ...

  10. "Swimmer's Ear" (Otitis Externa) Prevention

    Science.gov (United States)

    ... infections, swimmer’s ear, and healthy swimming. "Swimmer's Ear" (Otitis Externa) What are the symptoms of swimmer's ear? ... Healthy page. Reference CDC. Estimated burden of acute otitis externa —United States, 2003–2007 . MMWR Morb Mortal ...

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

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Damghani

    2013-03-01

    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

  12. 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.

    Directory of Open Access Journals (Sweden)

    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

  13. 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)

    1990-07-15

    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)

  14. Ear infection and hearing loss amongst headphone users.

    Science.gov (United States)

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

    2002-07-01

    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.

  15. Swimmer's Ear (For Parents)

    Science.gov (United States)

    ... Child What Kids Say About: Handling Stress Anxiety, Fears, and Phobias Community Service: A Family's Guide to ... can drain into the ear canal through a hole in the eardrum and cause it. What Are ...

  16. 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 ...

  17. 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 ...

  18. Ototoxicity (Ear Poisoning) (For Parents)

    Science.gov (United States)

    ... Teaching Kids to Be Smart About Social Media Ototoxicity (Ear Poisoning) KidsHealth > For Parents > Ototoxicity (Ear Poisoning) Print A A A What's in ... result of taking the drugs. This is called ototoxicity or " ear poisoning ." Ototoxicity damages the inner ear — ...

  19. Sports injuries of the ear.

    Science.gov (United States)

    Wagner, G A

    1972-07-01

    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.

  20. Flying and Your Child's Ears

    Science.gov (United States)

    ... Media Flying and Your Child's Ears KidsHealth > For Parents > Flying and Your Child's Ears Print A A A What's in this article? Flying's Effects on Ears Tips for Easing Ear Pain en español Como cuidar los oídos de su hijo(a) cuando vuele en avión Flying's Effects on ...

  1. Diving injuries to the inner ear.

    Science.gov (United States)

    Farmer, J C

    1977-01-01

    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

  2. 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

    2010-01-01

    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

  3. 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;

    2015-01-01

    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....

  4. [Inner Ear Hearing Loss].

    Science.gov (United States)

    Hesse, G

    2016-06-01

    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.

  5. Ear, Hearing and Speech

    DEFF Research Database (Denmark)

    Poulsen, Torben

    2000-01-01

    An introduction is given to the the anatomy and the function of the ear, basic psychoacoustic matters (hearing threshold, loudness, masking), the speech signal and speech intelligibility. The lecture note is written for the course: Fundamentals of Acoustics and Noise Control (51001)......An introduction is given to the the anatomy and the function of the ear, basic psychoacoustic matters (hearing threshold, loudness, masking), the speech signal and speech intelligibility. The lecture note is written for the course: Fundamentals of Acoustics and Noise Control (51001)...

  6. The visible ear simulator: a public PC application for GPU-accelerated haptic 3D simulation of ear surgery based on the visible ear data

    DEFF Research Database (Denmark)

    Sørensen, Mads Sølvsten; Mosegaard, Jesper; Trier, Peter

    2009-01-01

    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 sour...

  7. 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)

    2011-12-15

    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.)

  8. Lumped parametric model of the human ear for sound transmission.

    Science.gov (United States)

    Feng, Bin; Gan, Rong Z

    2004-09-01

    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.

  9. 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

    2015-01-01

    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

  10. From Ear to Brain

    Science.gov (United States)

    Kimura, Doreen

    2011-01-01

    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…

  11. Seeing With the Ears

    NARCIS (Netherlands)

    Koenderink, Jan

    2015-01-01

    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

  12. 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)

    林曼舒

    2014-01-01

    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。

  13. Low-set ears and pinna abnormalities

    Science.gov (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 ...

  14. Ear, Nose & Throat Issues & Down Syndrome

    Science.gov (United States)

    ... Throat Issues & Down Syndrome Ear, Nose & Throat Issues & Down Syndrome Ear, nose, and throat (ENT) problems are common ... What ENT Problems Are Common in Children With Down Syndrome? External Ear Canal Stenosis Stenotic ear canals (narrow ...

  15. The analysis of ear canals

    Science.gov (United States)

    Ou, Gen

    In this thesis complex 3-D ear canal finite element models are simplified using transfer matrices to 1-D models. This simplification allows analysis on the sound propagation in the ear, which results in potentially using a non-invasive probe to determine the acoustical properties of the ear.

  16. A 3-D analysis of the protympanum in human temporal bones with chronic ear disease.

    Science.gov (United States)

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

    2017-03-01

    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.

  17. 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

    2011-01-01

    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

  18. 中药茶饮结合耳穴治疗中学生痤疮120例疗效观察%Curative Observation on Herbal Tea Combined with Ear Acupoint in Treating 120 Middle School Students with Acne

    Institute of Scientific and Technical Information of China (English)

    安维新; 张正华

    2016-01-01

    Objective: To survey curative effects of herbal tea and ear acupoint in the treatment for the students with acne. Methods: All 633 cases who were suffering from acne in health examination ofJiayuguan2014 College entrance examination, 230 patients were chosen and randomized into 120 cases of the treatment group and 110 cases of the control group, the treatment group were treated by herbal tea and ear acupoint and the control group orally took Viaminati capsules, 25mg each time, twice per day, and 0.025% tretinoin cream for external use, skin lesions ofthe acne were observed in six weeks. Results: Herbal tea and ear acupoint are effective in treating acne, and total ef-fective rate reached 95.8%. Conclusion: Spicy and sweet food and staying up late are the important inducing and ag-gravating factors of acne, herbal tea and ear acupoint are superior to western medicine in treating acne, and it's sim-ple and easily to accept by the students.%目的:观察中药茶饮和耳穴治疗中学生痤疮的临床疗效。方法:将嘉峪关市2014年高考体检痤疮学生633例,选择其中230例患者并随机分为治疗组120例和对照组110例,治疗组以中药茶饮结合耳穴治疗,对照组口服维胺酯胺囊25 mg/次,2次/d,并外用0.025%维A酸乳膏,6周后观察痤疮皮损情况。结果:中药茶饮结合耳穴治疗痤疮效果明显,总有效率达95.8%。结论:辛辣、甜腻饮食和熬夜是痤疮重要的诱发和加重因素,中药茶饮结合耳穴治疗学生痤疮优于西药对照组,而且方法简单,易为学生接受。

  19. nEar 05

    Institute of Scientific and Technical Information of China (English)

    S&C Labs

    2005-01-01

    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. 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

    2015-01-01

    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

  1. 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

    2004-01-01

    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

  2. Nonlinear dynamics of the mammalian inner ear

    CERN Document Server

    Szalai, Robert; Homer, Martin

    2015-01-01

    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.

  3. 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

    2014-01-01

    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。

  4. Prevalence of ear disease in dogs undergoing multidetector thin-slice computed tomography of the head.

    Science.gov (United States)

    Foster, Allison; Morandi, Federica; May, Elizabeth

    2015-01-01

    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.

  5. Ovine ear model for fully endoscopic stapedectomy training.

    Science.gov (United States)

    Cordero, A; Benítez, S; Reyes, P; Vaca, M; Polo, R; Pérez, C; Alonso, A; Cobeta, I

    2015-09-01

    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.

  6. Ear Recognition Based on Gabor Features and KFDA

    OpenAIRE

    Li Yuan; Zhichun Mu

    2014-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    Gaur Kiran

    2012-04-01

    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.

  8. Pressure difference receiving ears

    DEFF Research Database (Denmark)

    Michelsen, Axel; Larsen, Ole Næsbye

    2007-01-01

    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...

  9. The ear: Diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Vignaud, J.; Jardin, C.; Rosen, L.

    1986-01-01

    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.

  10. Manufacturing and in vivo inner ear visualization of MRI traceable liposome nanoparticles encapsulating gadolinium

    Directory of Open Access Journals (Sweden)

    Kinnunen Paavo KJ

    2010-12-01

    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.

  11. Naturopathic treatment for ear pain in children.

    Science.gov (United States)

    Sarrell, E Michael; Cohen, Herman Avner; Kahan, Ernesto

    2003-05-01

    Otitis media is 1 of the most frequent diseases of early infancy and childhood and 1 of the most common reasons for children to visit a physician. In the past 2 decades, there has been a substantial increase in the diagnosis of otitis media worldwide. In the United States, 93% of all children have had at least 1 episode of acute otitis media (AOM) by 7 years of age. Otalgia is the hallmark of AOM. Most affected children either complain of earache or manifest behavior that the parents interpret as indicating ear pain. Treatment of the ear pain early in the course of AOM decreases both parental anxiety and the child's discomfort and accelerates the healing process. The objective of this study was to determine the efficacy and tolerability of naturopathic versus traditional treatment for the management of otalgia commonly associated with AOM in children. The study was designed as a double-blind trial in an outpatient community clinic. A total of 171 children who were aged 5 to 18 years and had otalgia and clinical findings associated with middle-ear infection were studied. The children were randomly assigned to receive treatment with Naturopathic Herbal Extract Ear Drops (NHED) or anesthetic ear drops, with or without amoxicillin. On enrollment, the children were assigned by computer-numbered randomization to receive NHED (contents: allium sativum, verbascum thapsus, calendula flores, hypericum perfoliatum, lavender, and vitamin E in olive oil) 5 drops 3 times daily, alone (group A) or together with a topical anesthetic (amethocaine and phenazone in glycerin) 5 drops 3 times daily (group B), or oral amoxicillin 80 mg/kg/d (maximum 500 mg/dose) divided into 3 doses with either NHED 5 drops 3 times daily (group C) or topical anesthetic 5 drops 3 times daily (group D). A double-blind design was used, and all ear drops were placed in identical bottles. Treatment was initiated by the nurse in all cases. A single physician (M.S.) evaluated and treated all of the patients

  12. MICROBIOLOGY OF ITCHY EARS

    Directory of Open Access Journals (Sweden)

    Vijin Ravindran Nambiar

    2015-04-01

    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.

  13. [Cochlear implantation through the middle fossa approach].

    Science.gov (United States)

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

    2001-01-01

    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.

  14. The relationship between preoperative tympanograms and intraoperative ear examination results in children.

    Science.gov (United States)

    Knopke, Steffen; Irune, Ekpemi; Olze, Heidi; Bast, Florian

    2015-12-01

    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.

  15. A STUDY OF CONGENITAL MALFORMATIONS OF THE EXTERNAL EAR

    Directory of Open Access Journals (Sweden)

    Rubi Saikia

    2016-10-01

    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.

  16. 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

    2015-01-01

    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.

  17. Convergence vs. Specialization in the ear region of moles (Mammalia).

    Science.gov (United States)

    Crumpton, Nick; Kardjilov, Nikolay; Asher, Robert J

    2015-08-01

    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.

  18. Investigation of the ear-to-ear radio propagation channel

    DEFF Research Database (Denmark)

    Kvist, Søren Helstrup; Thaysen, J; Jakobsen, Kaj Bjarne

    2011-01-01

    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...

  19. Human ear recognition by computer

    CERN Document Server

    Bhanu, Bir; Chen, Hui

    2010-01-01

    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

  20. Subharmonic distortion in ear canal pressure and intracochlear pressure and motion.

    Science.gov (United States)

    Huang, Stanley; Dong, Wei; Olson, Elizabeth S

    2012-08-01

    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.

  1. Global Ear. Werke 2001 - 2006

    Index Scriptorium Estoniae

    2006-01-01

    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"

  2. Global Ear. Werke 2001 - 2006

    Index Scriptorium Estoniae

    2006-01-01

    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"

  3. 21 CFR 870.2710 - Ear oximeter.

    Science.gov (United States)

    2010-04-01

    ... 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...

  4. Effects of topical oxiconazole and boric acid in alcohol solutions to rat inner ears.

    Science.gov (United States)

    Özdemir, Süleyman; Tuncer, Ülkü; Tarkan, Özgür; Akar, Funda; Sürmelioğlu, Özgür

    2013-06-01

    The aim of this study is to evaluate the ototoxicity of topical oxiconazole and boric acid in alcohol solutions. Prospective controlled animal study. Research laboratory. Fifty adult Wistar albino rats were divided into 5 groups consisting of 10 animals each. The right tympanic membranes were perforated, and baseline and posttreatment distortion product otoacoustic emission (DPOAE) measurements were performed. The solutions were applied through the external ear canal to the middle ear twice a day for 14 days. The rats in group I and group II received 0.1 mL of oxiconazole-containing solution drops and 4% boric acid in alcohol solution drops, respectively. Group III received gentamicin solution (40 mg/mL) (ototoxic control), group IV received saline solution, and group V was followed without any medication. The baseline DPOAE results of the right ears of all animals tested were normal. Animals in groups I, II, IV, and V showed no statistically significant change in the DPOAE amplitudes. The rats in the gentamicin group showed a significant decrease. This study demonstrates that topically used oxiconazole and boric acid in alcohol solutions to the middle ear appear to be safe on the inner ear of rats. The safety of these drugs has not yet been confirmed in humans. Caution should be taken when prescribing these drugs, especially to patients who had tympanic membrane perforation. Ear drops should be chosen more carefully in an external ear infection for patients with tympanic membrane perforation to avoid ototoxicity.

  5. Human ear detection in the thermal infrared spectrum

    Science.gov (United States)

    Abaza, Ayman; Bourlai, Thirimachos

    2012-06-01

    In this paper the problem of human ear detection in the thermal infrared (IR) spectrum is studied in order to illustrate the advantages and limitations of the most important steps of ear-based biometrics that can operate in day and night time environments. The main contributions of this work are two-fold: First, a dual-band database is assembled that consists of visible and thermal profile face images. The thermal data was collected using a high definition middle-wave infrared (3-5 microns) camera that is capable of acquiring thermal imprints of human skin. Second, a fully automated, thermal imaging based ear detection method is developed for real-time segmentation of human ears in either day or night time environments. The proposed method is based on Haar features forming a cascaded AdaBoost classifier (our modified version of the original Viola-Jones approach1 that was designed to be applied mainly in visible band images). The main advantage of the proposed method, applied on our profile face image data set collected in the thermal-band, is that it is designed to reduce the learning time required by the original Viola-Jones method from several weeks to several hours. Unlike other approaches reported in the literature, which have been tested but not designed to operate in the thermal band, our method yields a high detection accuracy that reaches ~ 91.5%. Further analysis on our data set yielded that: (a) photometric normalization techniques do not directly improve ear detection performance. However, when using a certain photometric normalization technique (CLAHE) on falsely detected images, the detection rate improved by ~ 4%; (b) the high detection accuracy of our method did not degrade when we lowered down the original spatial resolution of thermal ear images. For example, even after using one third of the original spatial resolution (i.e. ~ 20% of the original computational time) of the thermal profile face images, the high ear detection accuracy of our method

  6. Ear surgery techniques results on hearing threshold improvement

    Directory of Open Access Journals (Sweden)

    Farhad Mokhtarinejad

    2013-01-01

    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.

  7. 3D Printed Bionic Ears

    Science.gov (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.

    2013-01-01

    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 precise 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. PMID:23635097

  8. 3D printed bionic ears.

    Science.gov (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

    2013-06-12

    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.

  9. 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

    2012-01-01

    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

  10. Investigation of the ear-to-ear radio propagation channel

    DEFF Research Database (Denmark)

    Kvist, Søren Helstrup; Thaysen, J; Jakobsen, Kaj Bjarne

    2011-01-01

    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....... The investigation is done by SAM head phantom measurements and HFSS simulations. The investigations include setups where some propagation paths are blocked by an absorbing material. It is found that the characteristics of the head may cause constructive or destructive interference that may result in up to 10 d...

  11. Numerical evaluation of implantable hearing devices using a finite element model of human ear considering viscoelastic properties.

    Science.gov (United States)

    Zhang, Jing; Tian, Jiabin; Ta, Na; Huang, Xinsheng; Rao, Zhushi

    2016-08-01

    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.

  12. DESING OF CYLINDIRICAL EAR OF POLISH

    Directory of Open Access Journals (Sweden)

    Yaşar KARAGÖZ

    2000-02-01

    Full Text Available Plough is an agricultural tool which is used for preparing land to male it ready for sowing. The funotion of lough is to break the compact land into small pieces and to allow a suitable condition for living of culture plants. The ear is the most important part of active plough surface. The geometrical form of ear determines the form of active surface together with the front iron tip. Ploughs are divided into two categories which are European and American types. There are important differencies betucen the European and American tyges with respect to ?, ß and ? angles. Gorjatschkin described the ear form of European ploughs under four main groups which are: 1. Cylindirical ear type, 2. Culture-form ear type, 3. Semi-curled ear type, 4. Curled ear type. In this work, the designing of cylindirical ear was studied.

  13. Mechanics of the frog ear

    NARCIS (Netherlands)

    Van Dijk, Pim; Mason, Matthew J.; Schoffelen, Richard L. M.; Narins, Peter M.; Meenderink, Sebastiaan W. F.

    2011-01-01

    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

  14. Proteomics and the Inner Ear

    Directory of Open Access Journals (Sweden)

    Isolde Thalmann

    2001-01-01

    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.

  15. COMMON INFECTIONS OF THE EAR

    African Journals Online (AJOL)

    Enrique

    April 2004 Vol.22 No.4 CME. 193. KAREN COHEN. MB ChB ... the ear canal and they are usually in the 40 - 50-year age group. ... Treatment. The treatment of choice is intravenous antibiotics consisting of aminoglyco- side, piperacillin and ...

  16. Ear recognition based on Gabor features and KFDA.

    Science.gov (United States)

    Yuan, Li; Mu, Zhichun

    2014-01-01

    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.

  17. Ear Recognition Based on Gabor Features and KFDA

    Directory of Open Access Journals (Sweden)

    Li Yuan

    2014-01-01

    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.

  18. Can Loud Music Hurt My Ears?

    Science.gov (United States)

    ... or Too Short All About Puberty 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 ...

  19. 21 CFR 878.3590 - Ear prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 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...

  20. Can Loud Music Hurt My Ears?

    Science.gov (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 ...

  1. Ear biometrics in 2D and 3D localization and recognition

    CERN Document Server

    Prakash, Surya

    2015-01-01

    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.

  2. Water used to visualize and remove hidden foreign bodies from the external ear canal.

    Science.gov (United States)

    Peltola, T J; Saarento, R

    1992-02-01

    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.

  3. CHRONIC OTITIS MEDIA WITH MIDDLE EAR CHOLESTEATOMA – CASEREPORT

    Directory of Open Access Journals (Sweden)

    Marko Četina

    2008-02-01

    The case is interesting because in one patient three different complications are present(labyrinth fistula, destruction of facial nerve bony canal and skull base with dura exposure.There are also some data about surgery approaches, hearing results and discussionabout complications

  4. 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

    1998-02-01

    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.

  5. The Effects of Middle Ear Pressure on Hearing.

    Science.gov (United States)

    1984-04-30

    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

  6. Effects of Acoustic Impulses on the Middle Ear

    Science.gov (United States)

    2015-10-01

    one prototype was required by the Bayesian criterion . The figure on the left of the panel shows an example of a trace in which 4 an acoustic...for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing...data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information . Send comments regarding this

  7. A Survey on Human Ear Recognition

    Directory of Open Access Journals (Sweden)

    Suvarnsing Bhable

    2015-11-01

    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.

  8. A simple ear splint for microtia patients

    Directory of Open Access Journals (Sweden)

    C J Venkata Krishnan

    2015-01-01

    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.

  9. A simple ear splint for microtia patients.

    Science.gov (United States)

    Krishnan, C J Venkata; Balaji, S M; Jain, Ashish R

    2015-01-01

    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.

  10. A New Acoustic Portal into the Odontocete Ear and Vibrational Analysis of the Tympanoperiotic Complex

    Science.gov (United States)

    2010-08-01

    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

  11. Technique for correction of lop ear.

    Science.gov (United States)

    Elsahy, N I

    1990-04-01

    Various techniques of correction of lop ear have been described. Minor lop ear deformity can easily be corrected with simple excision of the overhanging auricular cartilage. Moderate and severe lop ear deformities, on the other hand, are more difficult to correct because there is actual reduction in size of the upper third of the ear in addition to the overhanging auricular cartilage. The purpose of this paper was to present a new technique used to correct the moderate lop ear deformity. In addition to excising the overhanging cartilage, I rotate a cartilage flap from the anthelix upward where the missing superior crus was supposed to be. This flap increases the vertical height of the ear and creates a new superior crus. I applied this technique on three cases of moderate lop ear deformities with good results.

  12. Inner Time and Inner Ear

    CERN Document Server

    Rvachov, Michael

    2012-01-01

    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.

  13. 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

    2011-06-01

    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.

  14. Dominantly-inherited lop ears.

    Science.gov (United States)

    Leung, Alexander K C; Kong, Albert Y F; Robson, W Lane M; McLeod, D Ross

    2007-10-01

    We describe a four-generation Chinese family that included five members who had an isolated bilateral lop ear anomaly. The presentation suggested a dominant mode of inheritance. The absence of male-to-male transmission does not exclude an X-linked dominant mode of inheritance. Since the phenotypic anomaly of the male proband was no more severe than the affected female members, an autosomal dominant mode of inheritance is most likely. 2007 Wiley-Liss, Inc

  15. Inner ear of the coelacanth fish Latimeria has tetrapod affinities.

    Science.gov (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.

  16. Early and late surgical site infections in ear surgery.

    Science.gov (United States)

    Bastier, P L; Leroyer, C; Lashéras, A; Rogues, A-M; Darrouzet, V; Franco-Vidal, V

    2016-04-01

    A retroauricular approach is routinely used for treating chronic otitis media. The incidence of surgical site infections after ear surgery is around 10% in contaminated or dirty procedures. This observational prospective study describes surgical site infections after chronic otitis media surgery with the retroauricular approach and investigated their potential predictive factors. This observational prospective study included patients suffering from chronic otitis media and eligible for therapeutic surgery with a retroauricular approach. During follow-up, surgical site infections were defined as "early" if occurring within 30 days after surgery or as "late" if occurring thereafter. The data of 102 patients were analysed. Concerning early surgical site infections, four cases were diagnosed (3.9%) and a significant association was found with preoperative antibiotic therapy, wet ear at pre-operative examination, class III (contaminated) in the surgical wound classification, NNIS (National Nosocomial Infection Surveillance) index > 1, and oral post-operative antibiotic use. Seven late surgical site infections were diagnosed (7.1%) between 90 and 160 days after surgery and were significantly correlated to otorrhoea during the 6 months before surgery, surgery duration ≤60 minutes, canal wall down technique and use of fibrin glue. Surgical site infections after chronic otitis media surgery seem to be associated with factors related to the inflammatory state of the middle ear at the time of surgery in early infections and with chronic inflammation in late infections. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  17. 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

    2001-01-01

    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。

  18. 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: jan.casselman@pi.be; Offeciers, Erwin F.; Foer, Bert de; Govaerts, Paul; Kuhweide, Rudy; Somers, Thomas

    2001-11-01

    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.

  19. CT and MR imaging of congential abnormalities of the inner ear and internal auditory canal.

    Science.gov (United States)

    Casselman, J W; Offeciers, E F; De Foer, B; Govaerts, P; Kuhweide, R; Somers, T

    2001-11-01

    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.

  20. Big Stimulus, Little Ears: Safety in Administering Vestibular-Evoked Myogenic Potentials in Children.

    Science.gov (United States)

    Thomas, Megan L A; Fitzpatrick, Denis; McCreery, Ryan; Janky, Kristen L

    2017-05-01

    Cervical and ocular vestibular-evoked myogenic potentials (VEMPs) have become common clinical vestibular assessments. However, VEMP testing requires high intensity stimuli, raising concerns regarding safety with children, where sound pressure levels may be higher due to their smaller ear canal volumes. The purpose of this study was to estimate the range of peak-to-peak equivalent sound pressure levels (peSPLs) in child and adult ears in response to high intensity stimuli (i.e., 100 dB normal hearing level [nHL]) commonly used for VEMP testing and make a determination of whether acoustic stimuli levels with VEMP testing are safe for use in children. Prospective experimental. Ten children (4-6 years) and ten young adults (24-35 years) with normal hearing sensitivity and middle ear function participated in the study. Probe microphone peSPL measurements of clicks and 500 Hz tonebursts (TBs) were recorded in tubes of small, medium, and large diameter, and in a Brüel & Kjær Ear Simulator Type 4157 to assess for linearity of the stimulus at high levels. The different diameter tubes were used to approximate the range of cross-sectional areas in infant, child, and adult ears, respectively. Equivalent ear canal volume and peSPL measurements were then recorded in child and adult ears. Lower intensity levels were used in the participant's ears to limit exposure to high intensity sound. The peSPL measurements in participant ears were extrapolated using predictions from linear mixed models to determine if equivalent ear canal volume significantly contributed to overall peSPL and to estimate the mean and 95% confidence intervals of peSPLs in child and adult ears when high intensity stimulus levels (100 dB nHL) are used for VEMP testing without exposing subjects to high-intensity stimuli. Measurements from the coupler and tubes suggested: 1) each stimuli was linear, 2) there were no distortions or nonlinearities at high levels, and 3) peSPL increased with decreased tube diameter

  1. 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.

  2. 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.

  3. An Effective 3D Ear Acquisition System.

    Science.gov (United States)

    Liu, Yahui; Lu, Guangming; Zhang, David

    2015-01-01

    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.

  4. Evolution of a sensory novelty: tympanic ears and the associated neural processing

    DEFF Research Database (Denmark)

    Christensen-Dalsgaard, Jakob; Carr, Catherine E

    2008-01-01

    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...

  5. Human acoustics: From vocal chords to inner ear

    Science.gov (United States)

    Lamar, Michael Drew

    2005-11-01

    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.

  6. 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

    2015-01-01

    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

  7. Playing by Ear: Foundation or Frill?

    Science.gov (United States)

    Woody, Robert H.

    2012-01-01

    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…

  8. 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....

  9. INNER EAR EMBRYOGENESIS: GENETIC AND ENVIRONMENTAL DETERMINANTS

    Science.gov (United States)

    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...

  10. Coupled ears in lizards and crocodilians

    DEFF Research Database (Denmark)

    Carr, Catherine E; Christensen-Dalsgaard, Jakob; Bierman, Hilary

    2016-01-01

    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...

  11. Microbiology of discharging ears in Ethiopia

    Institute of Scientific and Technical Information of China (English)

    Getachew Tesfaye; Daniel Asrat; Yimtubezinash Woldeamanuel; Messele Gizaw

    2009-01-01

    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.

  12. 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)

    韩浩伦

    2012-01-01

    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.

  13. Core collapse supernova remnants with ears

    CERN Document Server

    Grichener, Aldana

    2016-01-01

    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...

  14. Inner-ear sound pressures near the base of the cochlea in chinchilla: Further investigation

    Science.gov (United States)

    Ravicz, Michael E.; Rosowski, John J.

    2013-01-01

    The middle-ear pressure gain GMEP, the ratio of sound pressure in the cochlear vestibule PV to sound pressure at the tympanic membrane PTM, is a descriptor of middle-ear sound transfer and the cochlear input for a given stimulus in the ear canal. GMEP and the cochlear partition differential pressure near the cochlear base ΔPCP, which determines the stimulus for cochlear partition motion and has been linked to hearing ability, were computed from simultaneous measurements of PV, PTM, and the sound pressure in scala tympani near the round window PST in chinchilla. GMEP magnitude was approximately 30 dB between 0.1 and 10 kHz and decreased sharply above 20 kHz, which is not consistent with an ideal transformer or a lossless transmission line. The GMEP phase was consistent with a roughly 50-μs delay between PV and PTM. GMEP was little affected by the inner-ear modifications necessary to measure PST. GMEP is a good predictor of ΔPCP at low and moderate frequencies where PV ⪢ PST but overestimates ΔPCP above a few kilohertz where PV ≈ PST. The ratio of PST to PV provides insight into the distribution of sound pressure within the cochlear scalae. PMID:23556590

  15. Some Remarks on Imaging of the Inner Ear: Options and Limitations.

    Science.gov (United States)

    Giesemann, A; Hofmann, E

    2015-10-01

    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.

  16. [Ear keloid and clinical research progress].

    Science.gov (United States)

    Du, Guangyuan; Zhu, Jiang

    2014-04-01

    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.

  17. Surgical Management of Ear Diseases in Rabbits.

    Science.gov (United States)

    Csomos, Rebecca; Bosscher, Georgia; Mans, Christoph; Hardie, Robert

    2016-01-01

    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.

  18. Injuries of the external ear.

    Science.gov (United States)

    Templer, J; Renner, G J

    1990-10-01

    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

  19. A RARE PRESENTATION OF FOREIGN BODY IN THE EAR WITH TRAUMATIC DISLOCATION OF THE INCUS IN A FEMALE CHILD: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Santhana Krishnan

    2014-02-01

    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

  20. 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

    1997-12-01

    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)