Mastoidectomy for chronic serous otitis media

1981 ◽  
Vol 95 (4) ◽  
pp. 333-339 ◽  
Author(s):  
Lewis B. Newberg

AbstractThe purpose of this paper is to show that satisfactory results following mastoidectomy can be obtained for the problem of chronic serous otitis. The success of the simple mastoid operation or mastoidectomy with facial recess approach and the subsequent increased aeration of the mastoidantral-attic-middle-ear complex is to be suggested when the repeated use of myringotomy tubes alone is not the answer to chronic serous otitis. It is chronic negative pressure due to eustachian tube dysfunction that leads to irreversible mastoid disease.Seven cases of mastoidectomy for chronic serous otitis media are presented. All cases had adequate conservative medical and surgical treatment over a period of years for chronic serous otitis before mastoidectomy was considered. The clinical history, as well as lateral mastoid X-ray, was used in diagnosing irreversible mastoid disease.

1973 ◽  
Vol 82 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Robert W. Veltri ◽  
Philip M. Sprinkle

The middle ear fluids of seven patients with bilateral, and five patients with unilateral serous otitis media (SOM), were demonstrated to be microbiologically sterile when assessed for the presence of bacteria, mycoplasma, viruses, and fungi. The concentrations of immunoglobulins G, M, A, D, and lysozyme (muramidase) were determined in the serum and middle ear fluids. Lysozyme levels of middle ear aspirates were found to be elevated in SOM patients. The elevated levels of lysozyme in combination with the antibody-containing classes of immunoglobulins may explain the microbiologically sterile condition of the middle ear fluids of SOM patients. Also, the elevated lysozyme concentrations in middle ear fluids may indicate the previous presence of neutrophils and hence a previous inflammatory insult. The increased levels of IgA demonstrated in middle ear fluids may indicate local synthesis of secretory IgA by secretory cells of Eustachian tube and middle ear. The closed Eustachian tube, partial vacuum conditions and absence of a portal of exit for accumulated serous fluids are offered as a possible explanation for SOM.


PEDIATRICS ◽  
1976 ◽  
Vol 58 (2) ◽  
pp. 151-153
Author(s):  
Edward A. Mortimer

In this issue of Pediatrics there is a report1 of a method by which abnormalities of the middle ear that affect mobility of the drum, and therefore hearing, may be assessed quantitatively. In brief, the technique, called tympanometry, measures the compliance of the ear drum and, by ascertaining compliance at different external pressures, estimates pressures in the middle ear. The value to pediatricians and their patients of a means by which ear drum compliance and middle ear pressure can be measured lies primarily in the diagnosis and management of serous otitis media. Clearly, the data presented in this report indicate that this technique will usually discriminate between ears with middle ear effusions and normal ears.


2021 ◽  
pp. 014556132110533
Author(s):  
Sarantis Blioskas ◽  
Iordanis Konstantinidis ◽  
Ioannis Antoniadis ◽  
Anastasia Kypriotou ◽  
Prodromos Hytiroglou ◽  
...  

Significance Statement: Primary middle ear inverted papilloma is an exceedingly rare finding posing a diagnostic challenge, as symptomatology often mimics common clinical entities like serous otitis media. Clinical and radiological findings are not specific, whilst high recurrence rates, local destruction, and potential malignant transformation constitute an overall demanding surgical challenge, requiring aggressive procedures. We report the case of a primary inverted papilloma of the middle ear, discussing diagnostic and therapeutic issues.


1986 ◽  
Vol 95 (4) ◽  
pp. 434-437 ◽  
Author(s):  
Douglas F. Wacker ◽  
Maridel L. Howe

Three hundred and twenty-six patients with diagnoses of serous otitis media—or mucold otitis medid—were reviewed for the presence or absence of middle ear cilia activity. This study strongly suggests that if active cilia can be observed, ventilating tubes are not needed. This easily observed activity in the anterior-inferior quadrant offers the otolaryngologist an accurate tool for determination of the future health of the middle ear.


1973 ◽  
Vol 82 (2) ◽  
pp. 192-195 ◽  
Author(s):  
S. K. Juhn ◽  
John S. Huff ◽  
Michael M. Paparella

Biochemical characteristics of middle ear effusions (MEE) should provide a better understanding of the etiopathogenesis of serous otitis media. In order to develop another parameter for the biochemical characterization of the MEE, lactate dehydrogenase (LDH) and LDH isoenzyme patterns in the serous middle ear effusion and serum from 20 patients with serous otitis media were compared. The LDH activity was measured by the usual spectrophotometric method. The isoenzyme patterns were compared on electropherograms using cellulose polyacetate strips. The LDH activity in MEE was significantly higher (P < 0.001) than it was in serum. Fractions of isoenzymes 1 and 2 were each smaller in MEE than in serum. Isoenzymes 4 and 5 have a significantly higher (P < 0.001) fraction in MEE than in serum. Since LDH is an intracellular enzyme and middle ear mucosa is reported to have high content of isoenzymes 4 and 5, the inflammatory changes in the middle ear mucosa which may release intracellular LDH, are suggested as the cause of both higher activity of LDH and the higher fractions of isoenzymes 4 and 5 in MEE than those in the serum.


1994 ◽  
Vol 103 (1) ◽  
pp. 59-69 ◽  
Author(s):  
William J. Doyle ◽  
Craig A. Buchman ◽  
David P. Skoner ◽  
James T. Seroky ◽  
Frederick Hayden ◽  
...  

Past studies showed that experimental rhinovirus colds in adults resulted in eustachian tube dysfunction and abnormal middle ear pressures. In the present study, the symptoms and pathophysiologic findings accompanying experimental influenza viral infection were documented. A total of 33 healthy adult volunteers were intranasally challenged with an influenza A/Kawasaki/86 (H1N1) virus and cloistered over a 9-day postchallenge period to monitor for evidence of infection, signs and symptoms of illness, and the extent and frequency of pathophysiologic responses of the nose, eustachian tube, and middle ear. Results showed a protective effect of high (≥16) prechallenge specific hemagglutination-inhibition antibody titer on the rate of infection and the magnitude and extent of provoked symptoms and pathophysiologic findings. Infected subjects with low (<16) prechallenge serum antibody titers (n = 21) developed significant respiratory illness. These subjects also had objectively measurable increases in nasal secretion production, and decreased nasal patency and mucociliary clearance rates. More than 80% of the infected subjects developed eustachian tube dysfunction, and approximately 80% had middle ear underpressures of less than −100 mm H2O on study days 4 and 5. Five of 21 infected subjects with low prechallenge antibody titers had otoscopic evidence of otitis media with effusion. These results support a causal role for viral upper respiratory tract infection in the pathogenesis of otitis media, possibly mediated by the early development of eustachian tube dysfunction and abnormal middle ear pressure.


2007 ◽  
Vol 122 (10) ◽  
pp. 1124-1126 ◽  
Author(s):  
N Choudhury ◽  
G Kumar ◽  
M Krishnan ◽  
D J Gatland

AbstractObjective:We report an atypical case of ossicular necrosis affecting the incus, in the absence of any history of chronic serous otitis media. We also discuss the current theories of incus necrosis.Case report:A male patient presented with a history of right unilateral hearing loss and tinnitus. Audiometry confirmed right conductive deafness; tympanometry was normal bilaterally. He underwent a right exploratory tympanotomy, which revealed atypical erosion of the proximal long process of the incus. Middle-ear examination was otherwise normal, with a mobile stapes footplate. The redundant long process of the incus was excised and a partial ossicular replacement prosthesis was inserted, resulting in improved hearing.Conclusion:Ossicular pathologies most commonly affect the incus. The commonest defect is an absent lenticular and distal long process of the incus, which is most commonly associated with chronic otitis media. This is the first reported case of ossicular necrosis, particularly of the proximal long process of the incus, in the absence of chronic middle-ear pathology.


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