A dural arteriovenous fistula associated with an encephalocele presenting as otitis media with effusion

2018 ◽  
Vol 132 (11) ◽  
pp. 1032-1035 ◽  
Author(s):  
W Ahmed ◽  
S Connor ◽  
R Obholzer ◽  
I Pai
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Arteriovenous Fistula ◽  
Otitis Media ◽  
Dural Arteriovenous Fistula ◽  
Otitis Media With Effusion ◽  
Type I ◽  
Tegmen Tympani ◽  
Intracranial Vascular Malformation ◽  
Conductive Hearing

AbstractObjectiveThis case report illustrates an unusual case of a dural arteriovenous fistula and an associated encephalocele presenting as otitis media with effusion.Case reportA 53-year-old man presented with right-sided hearing loss and aural fullness of 2 years’ duration. Examination revealed ipsilateral post-auricular pulsatile tenderness. Computed tomography showed transcalvarial channels suggestive of dural arteriovenous fistula. Further magnetic resonance imaging demonstrated the presence of a temporal encephalocele herniating through the tegmen tympani defect, as well as the abnormal vascularity. Angiography confirmed a Cognard type I dural arteriovenous fistula, which is being managed conservatively. Surgical repair of the encephalocele was recommended but declined by the patient.ConclusionDural arteriovenous fistula is an uncommon intracranial vascular malformation rarely seen by otolaryngologists, with pulsatile tinnitus being the usual presentation. To our knowledge, this is the first reported case of dural arteriovenous fistula presenting with conductive hearing loss and otalgia.

scholarly journals Vestibular Screening in Pediatric Patients with Otitis Media

2020 ◽  
Vol 31 (03) ◽  
pp. 209-216
Author(s):  
Sonia Kim Rehagen ◽  
Maureen Valente ◽  
Judith E. C. Lieu
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Functional Evaluation ◽  
Validity And Reliability ◽  
Middle Ear Pressure ◽  
Screening Protocol ◽  
Oculomotor Function ◽  
Conductive Hearing ◽  
Oculomotor Abnormalities

AbstractOtitis media with effusion (OME) is a common cause of vestibular disturbances in children. However, young children often lack the language to express their symptoms, and it is uncommon to screen children for vestibular impairments.The purpose of this study was to develop a screening protocol for children presenting with OME to determine if diagnostic vestibular testing is necessary.Children with normal hearing (NH), sensorineural hearing loss (SNHL), and conductive hearing loss (CHL) due to OME participated in a vestibular screening.There were 30 participants, ages four to eight years, ranging from 48 to 101 months included in the study: 10 with NH, 11 with CHL due to OME, and 9 with SNHL.The vestibular screening consists of patient and parent questionnaires and a functional evaluation. The tests examined coordination, balance, oculomotor function, and nystagmus.Those with CHL were significantly more likely to display abnormal smoothness of pursuit, as measured with observations for rapid tracking, absence of or delayed saccades, and overshoot, than those with NH or SNHL (p = 0.012). Parents of children with CHL due to OME were more likely to report their child experiencing middle ear pressure than the parents of children with NH or SNHL (p = 0.010). In addition, children with CHL were less likely to report hearing loss than those with NH or SNHL. Parent and patient report were not found to be reliable indicators of vestibular disturbances.This pilot study suggests that children with CHL due to OME present with more oculomotor abnormalities than their peers with NH. Further research is necessary to determine validity and reliability of the findings for this present study.

scholarly journals Inner Ear Conductive Hearing Loss and Unilateral Pulsatile Tinnitus Associated with a Dural Arteriovenous Fistula: Case Based Review and Analysis of Relationship between Intracranial Vascular Abnormalities and Inner Ear Fluids

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Ettore Cassandro ◽  
Claudia Cassandro ◽  
Giuliano Sequino ◽  
Alfonso Scarpa ◽  
Claudio Petrolo ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Arteriovenous Fistula ◽  
Inner Ear ◽  
Dural Arteriovenous Fistula ◽  
Conductive Hearing Loss ◽  
Pulsatile Tinnitus ◽  
Vascular Abnormalities ◽  
First Case ◽  
Conductive Hearing ◽  
Inner Ear Fluids

While pulsatile tinnitus (PT) and dural arteriovenous fistula (DAVF) are not rarely associated, the finding of a conductive hearing loss (CHL) in this clinical picture is unusual. Starting from a case of CHL and PT, diagnosed to be due to a DAVF, we analyzed relationship between intracranial vascular abnormalities and inner ear fluids. DAVF was treated with endovascular embolization. Following this, there was a dramatic recovery of PT and of CHL, confirming their cause-effect link with DAVF. We critically evaluated the papers reporting this association. This is the first case of CHL associated with PT and DAVF. We describe the most significant experiences and theories reported in literature, with a personal analysis about the possible relationship between vascular intracranial system and labyrinthine fluids. In conclusion, we believe that this association may be a challenge for otolaryngologists. So we suggest to consider the possibility of a DAVF or other AVMs when PT is associated with CHL, without alterations of tympanic membrane and middle ear tests.

Evaluating the Frequency of Ear Problems in Patients with Cleft Lip and Palate

2021 ◽  
Author(s):  
Fatemeh Mirashrafi ◽  
Babak Saedi ◽  
Mahtab Rabbani Anari ◽  
Gholamreza Garmaroudi ◽  
Roja Toosi ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cleft Palate ◽  
Otitis Media ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Conductive Hearing Loss ◽  
Otitis Media With Effusion ◽  
Pure Tone Audiometry ◽  
Hearing Disorders ◽  
Conductive Hearing

Background: Orofacial cleft is one of the most common congenital malformations of craniofacial region. Otitis media with effusion causing conductive hearing loss is a considerable challenge for many children with cleft lip and palate. The aim of this study was to evaluate the prevalence of hearing disorders and associated malformations in these patients. Methods: The research population consisted of patients with cleft palate, between years 2012 and 2014, who were referred to Children’s Medical Center and Vali-e-Asr hospital in Tehran, Iran. Otoscopic examination, tympanometry, pure tone audiometry and echocardiography were performed for each patient. Results: Among patients with cleft palate, 73% suffered from hearing disorders. There was no relationship between prevalence of hearing loss and sex, presence of other congenital anomalies and degree of cleft, but middle ear diseases were significantly higher in children younger than 2 years. Among patients with cleft lip or palate, 10% suffered from cleft lip, 63% suffered from cleft palate and 27% suffered from cleft lip and palate. There was at least one congenital anomaly in 53% of patients. Conclusion: This study demonstrates high prevalence of otitis media with effusion and conductive hearing loss in patients with cleft. However, audiologic problems are alleviated when patients become older.

Auditory Brainstem Responses in Children with Otitis Media with Effusion

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 200-206 ◽  
Author(s):  
Thomas J. Fria ◽  
Diane L. Sabo
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Otitis Media With Effusion ◽  
Auditory Brainstem ◽  
Auditory Brainstem Responses ◽  
School Age Children ◽  
School Age ◽  
Conductive Hearing

Auditory brainstem responses (ABR) were recorded in 14 infants and toddlers and 12 school-age children with a previous history of recurrent otitis media with effusion (OME), or otoscopic and tympanometric evidence of persistent OME, or both. ABR tests were performed immediately before and after myringotomy and tympanostomy tube insertion in the younger subjects. For the school-age children, ABR tests were performed following otoscopy, tympanometry, and pure tone audiometry. The results demonstrate that the latency of both wave I and wave V of the ABR was sensitive (82% and 100%, respectively) to the presence of OME. Wave I also identified the absence of OME (specificity = 100%) whereas wave V did not (specificity = 25%). ABR latency was significantly decreased postoperatively in ears found to have OME, but not in ears found to have no OME. In the school-age subjects the ABR was used to predict the conductive hearing loss at 4000 Hz with less than a 20 dB error in virtually all subjects. The ABR latency delay was also found to be related to conductive hearing impairment at lower pure tone frequencies and to the average conductive loss at a variety of pure tone frequencies. Predictions of the presence of a conductive hearing loss from these relationships promise to be impressively accurate. The results suggest that the ABR can be a valuable tool for detecting the presence of conductive hearing impairment in infants and young children suspected to have OME and perhaps as an estimate of the degree of impairment.

Congenital Conductive Hearing Loss in Apert Syndrome

1986 ◽  
Vol 95 (4) ◽  
pp. 429-433 ◽  
Author(s):  
Susan G. Phillips ◽  
Richard T. Miyamoto
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Conductive Hearing Loss ◽  
Otitis Media With Effusion ◽  
Apert Syndrome ◽  
Review Of The Literature ◽  
Stapes Fixation ◽  
The Third ◽  
Hands And Feet ◽  
Conductive Hearing

Acrocephalosyndactyly (Apert syndrome) is a rare cranlosynostotic syndrome characterized by acrocephaly, syndactyly of the hands and feet, and—occasionally—-conductive hearing loss. We report three cases of conductive hearing loss in Apert syndrome. One patient was found to have bilateral stapes fixation. His daughter (the second case) had chronic bilateral otitis media with effusion. The third case involved a fixed Incus and hypomobile stapes. The management of these patients and a review of the literature are presented.

scholarly journals Study on Hearing Impairment in Bangladesh

2021 ◽  
Vol 20 (1) ◽  
pp. 72-76
Author(s):  
Mohammad Mahabubul Alam Chowdhury ◽  
Kamrul Hassan Tarafder ◽  
Pran Gopal Datta ◽  
Mostafa Zaman ◽  
Nasima Akhtar ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Otitis Media ◽  
Conductive Hearing Loss ◽  
Otitis Media With Effusion ◽  
Public Awareness ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Ear Wax ◽  
Conductive Hearing

Background : Hearing impairment is one of the leading causes of disability in Bangladesh. Since half the cases can be prevented through public awareness, early detection and timely management, planning of public health interventions become necessary. To achieve this, a nationwide level of evidence is required. This survey was conducted with the aim of determining the prevalence of hearing impairment in Bangladesh. Materials and methods : The study was a cross-sectional one, conducted between January to May 2013, where a multistage, geographically clustered sampling approach was used. A total of 52 primary sampling units were selected, and from each unit households were selected at random followed by random selection of an individual from each household. In total, 5,220 people were targeted out of which data collection could be completed from 4260 individuals. (82%). Following clinical assessment of study subjects, hearing status was assessed by pure tone audiometry and otoacoustic emission test. Results : The mean age was 32 years among which 58% were females. Among men, there were 29% students, 28% agriculture workers and 14% business men. A major portion of females (63%) were home makers. On clinical examination, 11.5% respondents had impacted ear wax, 6.2% had chronic middle ear infections with eardrum perforation, and 5.3% had otitis media with effusion.On hearing assessment, 34.6% respondents had some form of hearing loss (>25dB in better ear). Conductive hearing loss was found in 12.0%, sensorineural in 4.5% and mixed in 3.8%, where the latter two increased in prevalence with age. Out of the total respondents, 9.6% had disabling hearing loss according to WHO criteria, with a higher prevalence in adults > 60 years(37%). Logistic regression analysis showed age, socioeconomic status, presence of ear wax, chronic suppurative otitis media, otitis media with effusion and otitis externa were significant predictors of disabling hearing loss. Conclusion : The major causes of conductive hearing loss are chronic suppurative otitis media and otitis media with effusion. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 72-76

Otitis Media—Red Flags for Management: American Academy of Otolaryngology; Head and Neck Surgery 2013 Clinical Practice Guideline for Tympanostomy Tube Insertion

2014 ◽  
Vol 24 (1) ◽  
pp. 4-10
Author(s):  
Melody Harrison
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Middle Ear ◽  
Conductive Hearing Loss ◽  
Otitis Media With Effusion ◽  
Neck Surgery ◽  
Tympanostomy Tube ◽  
Red Flags ◽  
Tube Insertion ◽  
Conductive Hearing

Otitis media with effusion (OME) is described as a collection of fluid in the middle ear, without signs or symptoms of acute ear infection ( Stool, Berg, Berman, & Carney, 1994). The accumulated fluid decreases the ability of both the tympanic membrane (eardrum) and the ossicles in the middle ear to vibrate, resulting in a mild conductive hearing loss. Although 28 decibels (dB) is the average hearing loss associated with OME, the range is quite wide. While some children experience no hearing loss, about 20% have hearing loss of 35 dB or greater ( Gravel, 2003).

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