scholarly journals Adenomatous Tumors of the Middle Ear: A Literature Review

2017 ◽  
Vol 21 (03) ◽  
pp. 308-312 ◽  
Author(s):  
Flavia Cardoso ◽  
Eduardo Machado Monteiro ◽  
Livia Lopes ◽  
Marianna Avila ◽  
Bernardo Scarioli
Keyword(s):  
Middle Ear ◽  
Age Of Onset ◽  
Case Reports ◽  
Preoperative Evaluation ◽  
Somatostatin Analogs ◽  
Clinical Manifestations ◽  
Ossicular Chain ◽  
Final Diagnosis ◽  
Small Series ◽  
Conductive Hearing

Introduction Neuroendocrine adenomas of the middle ear (NAME) are uncommon causes of middle ear masses. Mostly limited to case reports and small series, the literature is poor in providing an overall assessment of these tumors. Objective To review the current literature about all aspects of the disease, including its etiology, clinical manifestations, diagnosis, and treatment. Data Synthesis The pathogenesis of adenomatous tumors of the middle ear is not clear yet. One potential explanation is that an undifferentiated pluripotent endodermal stem cell may still be present in the middle ear mucosal surface, and may be the origin of the tumors. It typically appears as a nonspecific retrotympanic mass. The average age of onset for the disease is the fifth decade, and the most common clinical symptom is conductive hearing loss. Malign behavior is rare. There are numerous differential diagnoses of NAME. The final diagnosis depends on microscopic findings. The preoperative evaluation should include the use of computed tomography and magnetic resonance imaging. The adjunctive therapy of middle ear adenomatous tumors with radiotherapy, chemotherapy or somatostatin analogs is generally not recommended. Conclusion There is still much debate on pathogenesis and classification of NAME. Saliba's classification is currently the most complete and preferable one. Aggressive surgical procedure with ossicular chain excision is the gold standard treatment. Follow-up with physical and radiological exams is mandatory, particularly if the first procedure was conservative, without the removal of the encased ossicles.

scholarly journals Perioperative Management of Endocrine Active Adrenal Tumors

2018 ◽  
Vol 127 (02/03) ◽  
pp. 137-146 ◽  
Author(s):  
Florentine Schreiner ◽  
Gurpreet Anand ◽  
Felix Beuschlein
Keyword(s):  
Current Knowledge ◽  
Case Reports ◽  
Perioperative Complications ◽  
Preoperative Evaluation ◽  
Surgical Techniques ◽  
Adrenal Tumors ◽  
Prospective Data ◽  
Retrospective Data Analysis ◽  
Small Series ◽  
Weak Evidence

AbstractEndocrine active adrenal tumors are associated with a relevant risk of complications during surgery, either due to direct hemodynamic effects of the hormone excess or due to hormone related comorbidities. Over the last decades, careful preoperative evaluation and improved peri-interventional medical management of affected patients has resulted in a significant reduction of perioperative complications. In addition, improvement in anesthesia and surgical techniques with the feasibility of laparoscopic adrenalectomy have contributed to reduce morbidity. Nevertheless, there are still several challenges to be considered in the perioperative care of these patients. Due to the rarity of functionally active adrenal tumors, there are no prospective data available to guide clinical management. Accordingly, most recommendations are based on retrospective data analysis, expert opinion or carry weak evidence based on small series or case reports. The aim of this review is to summarize the current knowledge and to suggest practical approaches to reduce perioperative complications in endocrine active adrenal tumors. This review exclusively deals with data from adult patients with functionally active adrenal tumors.

scholarly journals Penetrating Middle Ear Trauma: A Report of 2 Cases

2005 ◽  
Vol 84 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Michael C. Neuenschwander ◽  
Ellen S. Deutsch ◽  
Anthony Cornetta ◽  
Thomas O. Willcox
Keyword(s):  
Hearing Loss ◽  
Physical Examination ◽  
Middle Ear ◽  
Conductive Hearing Loss ◽  
Penetrating Trauma ◽  
Ossicular Chain ◽  
The Other ◽  
Ear Injury ◽  
The Right ◽  
Conductive Hearing

Penetrating middle ear injury can result in hearing loss, vertigo, and facial nerve injury. We describe the cases of 2 children with penetrating trauma to the right ear that resulted in ossicular chain disruption; one injury was caused by cotton-tipped swabs and the other by a wooden matchstick. Symptoms in both children included hearing loss and otalgia; in addition, one child experienced ataxia and the other vertigo. Physical examination in both cases revealed a perforation in the posterosuperior quadrant of the tympanic membrane and visible ossicles. Audiometry identified a moderate conductive hearing loss in one child and a mild sensorineural hearing loss in the other. Both children underwent middle ear exploration and reduction of a subluxed stapes. We discuss the diagnosis, causes, and management of penetrating middle ear trauma. To reduce the morbidity associated with these traumas, otologic surgeons should act promptly and be versatile in choosing methods of repairing ossicular chain injuries.

Isolated Congenital Middle Ear Malformations: Comparison of Preoperative High-Resolution CT and Surgical Findings

2019 ◽  
Vol 129 (3) ◽  
pp. 216-223 ◽  
Author(s):  
Na Zhang ◽  
Yi Li ◽  
Xiaobo Ma ◽  
Danni Wang ◽  
Shuling Li ◽  
...  
Keyword(s):  
High Resolution ◽  
Middle Ear ◽  
Clinical Information ◽  
Ossicular Chain ◽  
Final Diagnosis ◽  
Oval Window ◽  
High Resolution Computed Tomography ◽  
Ear Malformations ◽  
Negative Findings ◽  
Clinical Records

Objectives: To compare preoperative temporal bone high-resolution computed tomography (HRCT) readings to intraoperative findings during exploratory tympanotomy for suspected cases of isolated congenital middle ear malformations (CMEMs) and summarize the malformations that can and cannot be diagnosed with HRCT. Methods: A retrospective study was conducted. All cases were confirmed as isolated CMEMs during surgery. Detailed clinical records were reviewed, with a focus on imaging and surgical findings. Results: One hundred and thirty-two patients and 145 ears were reviewed. Ninety cases (62.1%) could be identified as isolated CMEMs and at least one as middle ear anomaly using preoperative HRCT. Fifty-five cases (37.9%) were reported to be completely normal and the patients underwent exploratory tympanotomy to determine the final diagnosis. Stapes fixation, either alone or associated with other ossicular chain anomalies, contributed to 53.1% of the cases. Most cases of aplasia or dysplasia of the ossicular chain, for example, aplasia/dysplasia of the long process of the incus, aplasia of the stapes’ superstructure, and atresia of the oval window were easily identified in preoperative HRCT. However, fixation of the ossicular chain can be elusive in HRCT, and exploratory tympanotomy is needed for a definitive diagnosis. Conclusions: HRCT provides helpful preoperative clinical information in CMEM and may obviate the need for middle ear exploration in some cases. The negative findings (anomalies that are difficult to identify through preoperative HRCT) and the positive findings (anomalies that are relatively easy to identify through preoperative HRCT) were summarized.

Gynecologic Cancer InterGroup (GCIG) Consensus Review for Carcinoid Tumors of the Ovary

2014 ◽  
Vol 24 (Supp 3) ◽  
pp. S35-S41 ◽  
Author(s):  
Nicholas Simon Reed ◽  
Eva Gomez-Garcia ◽  
Dolores Gallardo-Rincon ◽  
Brigitte Barrette ◽  
Klaus Baumann ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Case Reports ◽  
Gynecologic Cancer ◽  
Somatostatin Analogs ◽  
Mammalian Target Of Rapamycin ◽  
International Studies ◽  
New Developments ◽  
Small Series ◽  
Localized Disease ◽  
Level I

AbstractNeuroendocrine tumors (NETs) are a heterogeneous group of neoplasms most commonly occurring in the gastrointestinal tract or the lungs. More frequent are gastrointestinal tumors, but over the past 30 years, there have been a number of small series or anecdotal case reports on ovarian NETs. Neuroendocrine tumors in the gynecologic tract are uncommon and account for about 2% of all gynecologic malignancies but may also be metastatic from other sites. They require a multimodality therapeutic approach determined by the extent of disease and the primary organ of involvement. Pathological diagnosis is critical to guide therapy. Surgery is the cornerstone of treatment for localized disease. There have been many new developments for treatment of advanced NETs including somatostatin analogs, hepatic artery embolization, chemotherapy, interferons, mammalian target of rapamycin inhibitors and radiolabeled somatostatin analogs. Given the rarity and lack of level I evidence, this is by nature more of a guidance and recommendation for management of these rare tumors until we can mount international studies.

scholarly journals Tuberculous Otitis Media: Two Case Reports and Literature Review

2002 ◽  
Vol 81 (11) ◽  
pp. 792-794 ◽  
Author(s):  
Mohammad Sohail Awan ◽  
Iftikhar Salahuddin
Keyword(s):  
Literature Review ◽  
Otitis Media ◽  
Middle Ear ◽  
Case Reports ◽  
Final Diagnosis ◽  
Tuberculous Otitis Media

Tuberculous otitis media can be difficult to diagnose because it can easily be confused with other acute or chronic middle ear conditions. Compounding this problem is the fact that physicians are generally unfamiliar with the typical features of tuberculous otitis media. Finally, the final diagnosis can be difficult because it requires special culture and pathologic studies. To increase awareness of this condition, we describe two cases of tuberculous otitis media and we review the literature.

Differential Clinical and Radiographic Features of Cholesterol Granulomas and Cholesteatomas of the Petrous Apex

1988 ◽  
Vol 97 (6) ◽  
pp. 599-604 ◽  
Author(s):  
Peter G. Smith ◽  
John P. Leonetti ◽  
G. Robert Kletzker
Keyword(s):  
Middle Ear ◽  
Perioperative Management ◽  
Case Reports ◽  
Cranial Nerves ◽  
Clinical Manifestations ◽  
Petrous Apex ◽  
Otic Capsule ◽  
Radiographic Features

Cholesterol granulomas and cholesteatomas are expansile, destructive lesions of the petrous apex that occur more frequently than we previously realized. Having obscure causes, they grow silently, often reaching impressive proportions, until they encroach on adjacent cranial nerves or the otic capsule. The lesions have distinguishing histopathologies, early clinical manifestations, and neuroradiographic features that, when integrated, allow for a critical preoperative differentiation. Cholesterol granulomas are treated effectively through internal marsupialization into the mastoid or middle ear cavity. Cholesteatomas, however, are managed usually by a much more aggressive and complicated exteriorization or exenteration. Selected case reports are used to emphasize salient clinical and radiographic features and perioperative management.

scholarly journals The Effect of Ossicular Chain Disorders on Sound Transmission and Tinnitus Perception using Electrical Model

2021 ◽  
Vol 9 (8) ◽  
pp. 1196-1204
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Sound Transmission ◽  
Ossicular Chain ◽  
Clinical Results ◽  
Electrical Model ◽  
Disorder Effects ◽  
Middle Ear Transfer Function ◽  
Human Middle Ear ◽  
Conductive Hearing

Human middle ear ensures sound transfer due its ossicular chain, any disorder or abnormalities in this structure leads to a conductive hearing loss (CHL). Tinnitus is a health problem, associated with hearing loss, it remains a devastating symptom. In this work, we present an electrical model of the human middle ear including middle ear cavities (ZMEC), tympanic membrane with ossicular chain (ZTOC), and stapes complex with cochlea load (ZSC). This model is modified to represent more closely the related pathologies affecting the middle ear. We will focus our analysis on ossicular chain disorder by studying the effect of increasing ossicular chain (OC) stiffness and mass in both normal middle ear structures and disconnected stapes superstructure. The change in middle ear structures and impedance allows us to simulate ossicular chain disorder effects and analyze their impact on sound transmission. This analysis allowed us to know if this disorder can eventually cause tinnitus. The results showed that the effect of ossicular chain anomalies can be studied based on frequency response of middle ear transfer function by applying only the principle of mass and stiffness, and demonstrate compared to clinical results the efficiency and simplicity of using the electrical model.

scholarly journals Isolated Incudostapedial Cholesteatomas: Unique Radiologic and Surgical Features

2020 ◽  
pp. 014556132097378
Author(s):  
Bridget MacDonald ◽  
Krishna Bommakanti ◽  
Moises Mallo ◽  
Daniela Carvalho
Keyword(s):  
Hearing Loss ◽  
Soft Tissue ◽  
Ct Scan ◽  
Middle Ear ◽  
Conductive Hearing Loss ◽  
Soft Tissue Mass ◽  
Ossicular Chain ◽  
Ct Scans ◽  
Tissue Mass ◽  
Conductive Hearing

Objectives: Congenital cholesteatomas originate from epithelial tissue present within the middle ear in patients with an intact tympanic membrane, no history of otologic surgery, otorrhea, or tympanic membrane perforation. They are diagnosed by a pearl-like lesion on otoscopy and computed tomography (CT) scan showing an expansile soft-tissue mass. We describe a series of patients with no prior otologic history presenting with progressive unilateral conductive hearing loss and normal otoscopy. The CT scans showed ossicular erosion without obvious soft-tissue mass. Surgery confirmed incudostapedial erosion found to be cholesteatoma. In this study, we characterize the clinical course of patients diagnosed with isolated incudostapedial cholesteatoma (IIC) and review possible pathologic mechanisms. Methods: Retrospective review of IIC cases treated by the Department of Pediatric Otolaryngology, Rady Children’s Hospital, San Diego, 2014 to 2020. Data included patient demographics, clinical features, imaging, surgical findings, and audiologic data. Results: Five patients were diagnosed with IIC (3 [60%] female; mean age at presentation 10.7 years [range 5.5-16.0]). All patients presented with postlingual unilateral conductive hearing loss and normal otoscopy without any past otologic history; delay in diagnosis ranged from 4 months to several years. The CT scans showed ossicular chain erosion with an absent long process of the incus and/or stapes superstructure. All patients underwent middle ear exploration, revealing a thin layer of cholesteatoma in the incudostapedial region, confirmed by histopathology. Mean preoperative speech reception threshold was 55 dB and improved to a mean of 31 dB in the 4 patients who underwent ossicular chain reconstruction. Conclusion: Isolated incudostapedial cholesteatoma should be included as a possible etiology in pediatric patients with insidious onset of unilateral conductive hearing loss with normal otoscopy, unremarkable otologic history, and a CT scan showing ossicular abnormality/disruption without notable middle ear mass. These patients should be counseled preoperatively regarding the possibility of cholesteatoma and should undergo middle ear exploration with possible ossiculoplasty.

Effects of Conductive Hearing Loss on Auditory Brainstem Response

1982 ◽  
Vol 91 (3) ◽  
pp. 304-309 ◽  
Author(s):  
Therese J. McGee ◽  
Jack D. Clemis
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Auditory Brainstem Response ◽  
Conductive Hearing Loss ◽  
Ossicular Chain ◽  
Auditory Brainstem ◽  
Middle Ear Effusion ◽  
Brainstem Response ◽  
Conductive Hearing ◽  
Ear Effusion

The purpose of this paper is not to propose that auditory brainstem response (ABR) be utilized for the assessment of conductive losses, but to define the effects of conductive hearing loss on the ABR when such a complication occurs. Conductive losses attenuate cochlear stimulation. Since wave V latency is inversely related to stimulus intensity, the magnitude of the conductive loss should be a predictor of the wave V latency delay. In this study, ABR wave V latencies from patients with known conductive losses due to canal occlusion, middle ear effusion, ossicular fixation and chain interruption were compared with latency values calculated from the magnitude of the loss. In those patients with occlusion of the external auditory canal and middle ear effusion, the shift of the wave V latency-intensity function correlated well with the air-bone gap. This correlation was poor for patients with ossicular chain disorders. In mixed hearing losses, the increased wave V latency due to the conductive component may totally mask an increase in latency caused by a retrocochlear component.

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