External auditory canal cholesteatoma and benign necrotising otitis externa: clinical study of 95 cases in the Capital Region of Denmark

2018 ◽  
Vol 132 (06) ◽  
pp. 514-518 ◽  
Author(s):  
J Hertz ◽  
C Siim
Keyword(s):  
External Auditory Canal ◽  
Otitis Externa ◽  
Treatment Time ◽  
Treatment Strategies ◽  
Retrospective Case ◽  
Capital Region ◽  
Leading Role ◽  
Tertiary Hospitals ◽  
History Of ◽  
External Auditory Canal Cholesteatoma

AbstractObjectiveTo identify epidemiological and pathophysiological factors, and treatment strategies, in external auditory canal cholesteatoma and benign necrotising otitis externa.MethodsA retrospective case study was conducted of patients suffering from external auditory canal cholesteatoma and benign necrotising otitis externa admitted to tertiary hospitals, in the Capital Region of Denmark, over a five-year period.ResultsEighty-three patients (95 ears) with external auditory canal cholesteatoma or benign necrotising otitis externa were identified. A minimum incidence rate of 0.97 per 100 000 inhabitants per year was demonstrated. Sixty-eight per cent of cases had a history of smoking. Most lesions (74 per cent) were localised in the floor of the ear canal. Treatment time was 3.2 months for patients who had surgery and 6.0 months for those who received conservative treatment.ConclusionIt is suggested that external auditory canal cholesteatoma and benign necrotising otitis externa are in fact the same disease, and therefore the diagnosis of external auditory canal cholesteatoma should be changed to benign necrotising otitis externa. Microangiopathy has a leading role in the aetiology. Surgery should be conducted in most cases.

scholarly journals Clinical Characteristics of External Auditory Canal Cholesteatoma Associated with a History of Long-term Bisphosphonate Therapy

2018 ◽  
Vol 121 (6) ◽  
pp. 783-790
Author(s):  
Hiromi Kanazawa ◽  
Akihiro Shinnabe ◽  
Eri Takahashi ◽  
Mariya Masuda ◽  
Satoshi Tamii ◽  
...  
Keyword(s):  
External Auditory Canal ◽  
Clinical Characteristics ◽  
Bisphosphonate Therapy ◽  
History Of ◽  
External Auditory Canal Cholesteatoma

Denosumab and bisphosphonate associated bilateral osteonecrosis of the external auditory canal

2021 ◽  
Vol 14 (6) ◽  
pp. e241203
Author(s):  
Harry David True ◽  
Rupert George Ricks ◽  
Joel Anthony Smith
Keyword(s):  
External Auditory Canal ◽  
Otitis Externa ◽  
Bisphosphonate Therapy ◽  
Severe Osteoporosis ◽  
First Case ◽  
History Of ◽  
Loss Of Hearing ◽  
Destructive Osteoarthritis

We present a case of non-surgically managed bilateral osteonecrosis of the external auditory canal with a history of long-term medical therapy for osteoporosis. A 79-year-old woman with severe osteoporosis and destructive osteoarthritis received >10 years of once weekly bisphosphonate therapy before switching to denosumab. Four months later, the patient presented with bilateral loss of hearing and right-sided otalgia. Necrotising otitis externa, cholesteatoma and malignancy were considered but with histology, microbiological and CT assessment, bilateral osteonecrosis of the external auditory canal was diagnosed. Surgical debridement with canalplasty was avoided due to our patient’s comorbidities. Treatment continued for 5 months with regular aural toilet, Terra-Cortril ointment and bismuth-iodine-paraffin paste packing. At 1-year follow-up, bilateral external auditory canals were completely re-epithelialised with no pain or affected hearing. We report the first case of bilateral osteonecrosis of the external auditory canal associated with denosumab and bisphosphonates with successful conservative management.

scholarly journals Isolated fracture of the manubrium of the malleus

2007 ◽  
Vol 122 (9) ◽  
pp. 898-904 ◽  
Author(s):  
W Chien ◽  
M J McKenna ◽  
J J Rosowski ◽  
S N Merchant
Keyword(s):  
External Auditory Canal ◽  
Case Series ◽  
Rare Condition ◽  
Sudden Onset ◽  
Laser Doppler ◽  
Retrospective Case ◽  
Laser Doppler Vibrometry ◽  
Isolated Fracture ◽  
History Of ◽  
Digital Manipulation

AbstractObjective:To describe a series of five patients with isolated fracture of the manubrium of the malleus.Design:Retrospective case series.Subjects:Five patients aged 44–64 years with isolated fracture of the manubrium who presented to our institution over a five-year period (2000–2005).Results:All patients presented with a history of digitally manipulating the external auditory canal, leading to the manubrial fracture, which we presume was due to a suction-type mechanism. Otomicroscopy often revealed a break in the smooth contour of the manubrium. All patients had air–bone gaps on audiometry, especially at higher frequencies. Tympanometry showed hypermobility of the tympanic membrane in four patients who were tested. Laser-Doppler vibrometry revealed increased umbo velocity in four out of five patients. Four patients were treated conservatively. One patient underwent exploratory tympanotomy with successful ossiculoplasty.Conclusions:Isolated fracture of the manubrium is a rare condition which may present as sudden-onset hearing loss after digital manipulation of the external auditory canal. The diagnosis can be made on the basis of otomicroscopy, audiometry, tympanometry and laser-Doppler vibrometry. Conservative treatment is often successful.

Aspergilloma of the middle ear mimicking necrotising otitis externa: case report

2010 ◽  
Vol 124 (11) ◽  
pp. 1209-1211 ◽  
Author(s):  
P Rainsbury ◽  
A Mitchell-Innes ◽  
H Wilson ◽  
M Prior
Keyword(s):  
Case Report ◽  
Middle Ear ◽  
Otitis Externa ◽  
Treatment Strategies ◽  
Operative Management ◽  
Facial Weakness ◽  
Malignant Otitis Externa ◽  
History Of ◽  
Bony Erosion ◽  
Rare Diagnosis

AbstractObjective:We report a case of a patient who presented with otalgia and facial nerve palsy secondary to an aspergilloma of the middle ear.Case report:A 72-year-old, diabetic man presented to the ENT department with a history of worsening right-sided otalgia, aural discharge and hearing loss, associated with a right-sided facial weakness. This was assumed to be secondary to malignant otitis externa, and treatment was commenced. Imaging showed soft tissue within the middle ear and no bony erosion. Surgical exploration and biopsy revealed an aspergilloma of the middle ear. The pre- and post-operative management, as well as treatment strategies, are discussed.Conclusion:To our knowledge, this is the first documented case of an aspergilloma of the middle ear with associated facial palsy. Readers are asked to consider this rare diagnosis in patients with suspected malignant otitis externa not responding to standard treatment.

The Difference of External Auditory Canal pH in 3 Groups of Otitis Externa

2012 ◽  
Vol 55 (10) ◽  
pp. 628
Author(s):  
Hong Jun Kim ◽  
Kyung Jin Roh ◽  
Ki Hoon Choi ◽  
Seung Hwan Noh ◽  
Joo Hyun Kim ◽  
...  
Keyword(s):  
External Auditory Canal ◽  
Otitis Externa ◽  
The Difference

From Propaganda to Scholarship: Dr Joseph Schechtman and the Origins of Israeli Polemics on the Palestinian Refugees

2004 ◽  
Vol 2 (2) ◽  
pp. 188-197 ◽  
Author(s):  
Nur Masalha
Keyword(s):  
Right Wing ◽  
Population Transfer ◽  
Arab Population ◽  
Palestinian Refugees ◽  
Leading Role ◽  
Archival Documents ◽  
History Of ◽  
Arab States ◽  
Refugee Problem ◽  
Secret History

In 1948 an official ‘Transfer Committee’ was appointed by the Israeli Cabinet to plan the Palestinian refugees' resettlement in the Arab states. Apart from doing everything possible to reduce the Arab population in Israel, the Transfer Committee sought to amplify and consolidate the demographic transformation of Palestine by: preventing the Palestinian refugees from returning to their homes; the destruction of Arab villages; settlement of Jews in Arab villages and towns; and launching a propaganda campaign to discourage Arab return. One of the Transfer Committee's initiatives was to invite Dr Joseph Schechtman, a right-wing Zionist Revisionist leader and expert on ‘population transfer’, to join its efforts. In 1952 Schechtman published a propagandists work entitled The Arab Refugee Problem. Since then Schechtman would become the single most influential propagator of the Zionist myth of ‘voluntary’ exodus in 1948. This article examines the leading role played by Schechtman in promoting Israeli propaganda and politics of denial. Relying on newly-discovered Israeli archival documents, the article deals with little known and new aspects of the secret history of the post-1948 period.

Is the Acidic pH of the External Auditory Canal Playing a Significant Role in the Treatment of Acute Otitis Externa?

2018 ◽  
Vol 69 (8) ◽  
pp. 2304-2305
Author(s):  
Oana Ruxandra Iana ◽  
Dragos Cristian Stefanescu ◽  
Viorel Zainea ◽  
Razvan Hainarosie
Keyword(s):  
External Auditory Canal ◽  
Otitis Externa ◽  
Proton Pumps ◽  
Acidic Ph ◽  
External Ear ◽  
Ph Values ◽  
The World ◽  
Subcutaneous Tissues ◽  
Low Levels ◽  
Value Changes

Variable pH values for skin have been reported in the literature, all within the acidic range, varying from 4.0 up to 7. 0. The origin of the acidic pH remains conjectural, and several factors have been incriminated with this role, such as eccrine and sebaceous secretions as well as proton pumps. Keeping low levels of pH prevents microbial dispersal as well as multiplication. The skin in the external auditory canal is also covered with this acidic mantle with antimicrobial value. Changes of pH in the external ear can lead to acute otitis externa. This condition is defined by the inflammation and infection of the cutaneous and subcutaneous tissues of the external auditory canal. 10% of the world�s population may suffer from acute otitis externa at least once in their lifetime. This paper aims to consolidate the relevance of an acidic pH in the healthy external ear and its relation to the pathogenesis and treatment of otitis externa through a prospective and interventional clinical study on 80 patients who presented to the outpatient department at Prof. Dr D. Hociota ENT Institute in Buch

scholarly journals History of Extensive Disease Small Cell Lung Cancer Treatment: Time to Raise the Bar? A Review of the Literature

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 998
Author(s):  
Chiara Lazzari ◽  
Aurora Mirabile ◽  
Alessandra Bulotta ◽  
Maria Grazia Viganó ◽  
Francesca Rita Ogliari ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Treatment Time ◽  
Small Cell ◽  
Review Of The Literature ◽  
Small Cell Lung ◽  
Extensive Disease ◽  
History Of ◽  
Line Standard

Several trials have tried for decades to improve the outcome of extensive disease small cell lung cancer (ED-SCLC) through attempts to modify the standard treatments. Nevertheless, platinum/etoposide combination and topotecan have remained respectively the first and the second line standard treatments for the last 40 years. With the advent of immunotherapy, this scenario has finally changed. Our review aims to provide an overview of the primary studies on the actual therapeutic strategies available for ED-SCLC patients, and to highlight emerging evidence supporting the use of immunotherapy in SCLC patients.

scholarly journals 651. Comparative Analysis Between Bacterial And Fungal Malignant Otitis Externa

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S383-S384
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Fatma Smaoui ◽  
Khaoula Rekik ◽  
...  
Keyword(s):  
Otitis Externa ◽  
Clinical Presentation ◽  
The Elderly ◽  
Causative Organism ◽  
Diabetic Patients ◽  
Duration Of Treatment ◽  
Evolutionary Features ◽  
Significant Difference ◽  
Malignant Otitis Externa ◽  
History Of

Abstract Background Malignant otitis externa is a fatal infection of the external ear and temporal bone. Pseudomonas aeruginosa is the most common causative organism, while fungi are a rare cause of malignant otitis externa. We aimed to compare the clinical, therapeutic and evolutionary features between bacterial and fungal malignant otitis externa. Methods We conducted a retrospective study including all patients hospitalized for malignant otitis externa in the infectious diseases department between 2000 and 2018. Results Overall, we encountered 82 cases of malignant otitis externa, among which there were 54 cases (65.9%) of bacterial malignant otitis externa (BMO) and 28 cases (34.1%) of fungal malignant otitis externa (FMO). The males were predominant among BMO cases (57.4% vs 50%; p=0.5). Patients with FMO were significantly older (70±9 years vs 61±10 years; p< 0.001) and had medical history of diabetes mellitus more frequently (96.4% vs 77.8%; p=0.03). The use of topical corticosteroids was significantly more reported among FMO cases (28.6% vs 5.6%; p=0.006). Otalgia (96.4% vs 81.5%), otorrhea (75% vs 66.7%) and cephalalgia (46.4% vs 42.6%) were the revealing symptoms among FMO and BMO, respectively, with no significant difference. Tenderness to palpation of the mastoid bone (64.3% vs 38.9%; p=0.02) and stenosis of the external auditory canal (92.9% vs 72.2%; p=0.02) were significantly more frequent among FMO cases. Complications were significantly more frequent among FMO cases (42.9% vs 9.3%; p< 0.001). Treatment duration was significantly longer among FMO cases (70[40-90] days vs 45[34-75] days; p=0.03). Conclusion Our study showed that FMO affected more frequently the elderly and diabetic patients, when compared with BMO. Regardless of the causative agent, the clinical presentation was similar. However, the outcome was poor among FMO cases with the occurrence of complications, requiring a longer duration of treatment. Disclosures All Authors: No reported disclosures

scholarly journals Incidence and Risk Factors of Symptomatic Venous Thromboembolism Following Foot and Ankle Surgery

2018 ◽  
Vol 40 (1) ◽  
pp. 98-104 ◽  
Author(s):  
Johanna Marie Richey ◽  
Miranda Lucia Ritterman Weintraub ◽  
John M. Schuberth
Keyword(s):  
Risk Factors ◽  
Hormone Replacement ◽  
Case Series ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Ankle Surgery ◽  
History Of ◽  
Low Incidence ◽  
Predictive Risk

Background: The incidence rate of venous thrombotic events (VTEs) following foot and ankle surgery is low. Currently, there is no consensus regarding postoperative prophylaxis or evidence to support risk stratification. Methods: A 2-part study assessing the incidence and factors for the development of VTE was conducted: (1) a retrospective observational cohort study of 22 486 adults to calculate the overall incidence following foot and/or ankle surgery from January 2008 to May 2011 and (2) a retrospective matched case-control study to identify risk factors for development of VTE postsurgery. One control per VTE case matched on age and sex was randomly selected from the remaining patients. Results: The overall incidence of VTE was 0.9%. Predictive risk factors in bivariate analyses included obesity, history of VTE, history of trauma, use of hormonal replacement or oral contraception therapy, anatomic location of surgery, procedure duration 60 minutes or more, general anesthesia, postoperative nonweightbearing immobilization greater than 2 weeks, and use of anticoagulation. When significant variables from bivariate analyses were placed into the multivariable regression model, 4 remained statistically significant: adjusted odds ratio (aOR) for obesity, 6.1; history of VTE, 15.7; use of hormone replacement therapy, 8.9; and postoperative nonweightbearing immobilization greater than 2 weeks, 9.0. The risk of VTE increased significantly with 3 or more risk factors ( P = .001). Conclusion: The overall low incidence of VTE following foot and ankle surgery does not support routine prophylaxis for all patients. Among patients with 3 or more risk factors, the use of chemoprophylaxis may be warranted. Level of Evidence: Level III, retrospective case series.

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