Differential Osteoclast Activation in Endochondral and Intramembranous Bone

1993 ◽  
Vol 102 (8) ◽  
pp. 616-619 ◽  
Author(s):  
Richard A. Chole

Osteoclast activation within the temporal bone leads to hearing loss in a variety of pathologic conditions, including otosclerosis, osteogenesis imperfecta, Paget's disease of bone, and chronic otitis media. Although endochondral (EC) bone is remodeled in these diseases, it is relatively more resistant to remodeling when compared to intramembranous (IM) bone. In this study, localized bone resorption and remodeling were induced on the inner surface of the middle ear by pressurization with air to 10 mm Hg above atmospheric. Osteoclast surface increased in IM bone, but not in EC bone. This study supports the concept that there may be fundamental differences between EC and IM bone and that EC is more resistant to pressure-induced localized resorption than IM bone.

Author(s):  
Leena Rajam K. ◽  
Vikram V. J. ◽  
Priyanka C. ◽  
Indumathi R.

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) is a serious healthcare concern worldwide, because of the distress and economic burden to the patient and their family. Temporal bone pneumatization plays an important role in etiology, behaviour, course and outcome of COM. Pneumatisation gets poorer with growing chronicity of the disease<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted between March 2015-March 2017 on female patients visiting with COM, at ENT department Kasturba Gandhi Hospital, Madras Medical College. The records were analysed of the age, duration of symptoms, associated complaints, pure tone audiogram, computerised tomography of temporal bone, mastoid surgery done according to the disease process affecting the ear<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> 35 female COM patients were analysed, most common age group is between 31-40 years in 14 patients. There hearing loss was mild category in 27. There were 27 cases of mucosal type of chronic otitis media and 8 cases of squamous type. The CT scan with sclerosis of mastoid was the common finding<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> In exclusive study on female patients with COM, the mucosal type of COM is common with mild hearing loss and sclerosed mastoid indicating the chronicity<span lang="EN-IN">.</span></p><p class="abstract"> </p>


Author(s):  
Mahesh B Mawale ◽  
Abhaykumar Kuthe ◽  
Anupama M Mawale ◽  
Sandeep W Dahake

The prevalence rate of chronic suppurative otitis media is high and its treatment continues to be a challenge for the otorhinolaryngologists. Due to middle ear infection, there may be pain, hearing loss and spontaneous rupture of the eardrum which results in perforation. Infections can cause a hole in the eardrum as a side effect of otitis media. The patients suffering from ear perforation or having a hole in eardrum require preventing entry of water in the ear. This article describes the development of ear cap using additive manufacturing and TRIZ (a collaborative tool) to prevent the entry of water in the ear during chronic otitis media.


1973 ◽  
Vol 82 (3) ◽  
pp. 290-296 ◽  
Author(s):  
Richard R. Gacek

Since the risk of sensorineural hearing loss from persistent chronic otitis media and mastoiditis is greater than the risk to loss of labyrinthine function from carefully performed surgery, it is felt that the best treatment for chronic suppurative middle ear disease in an only-hearing ear is surgical removal of disease. Between the years 1961 to 1970 14 cases of chronic otitis media and mastoiditis in only-hearing ears were treated surgically at the Massachusetts Eye and Ear Infirmary. Five cases presented with resistant foul otorrhea, while five patients presented with increasing hearing loss and four with vertigo. The patients with hearing loss and vertigo were subjected to surgery at the earliest possible date. Wide-field surgical exposure of the mastoid and middle ear spaces with thorough removal of diseased tissue was carried out. Particular attention to avoid injury to the labyrinth, either directly or indirectly, must be kept in mind and it is recommended that surgery in only-hearing ears be performed by only the most experienced and capable otologic surgeon. All 14 ears have remained dry after surgery. Hearing was significantly improved in ten cases, while two were unchanged and two were made worse, as regards the conductive loss only. In all 14 cases postoperative discrimination scores were normal, so that even those cases that did not achieve serviceable hearing levels from surgery were able to use amplification. The results in this series confirm the feeling that carefully performed and timed surgery is effective in controlling chronic suppurative disease, while preserving function in only-hearing ears.


2018 ◽  
Vol 26 (1) ◽  
pp. 43-47
Author(s):  
Santosh U P ◽  
Sridurga J ◽  
Aravind D R

Introduction             Chronic otitis media (COM) is a most common and prevalent disease of the middle ear. COM has been defined as a longstanding inflammatory condition of middle ear and mastoid, associated with perforation of the tympanic membrane. Tympanoplasties are common surgeries performed for chronic otitis media in inactive mucosal type. Any otological surgery may involve a menace/ hazard of hearing loss post operatively.             In this study, an attempt was made to correlate, size of tympanic membrane perforation, pure tone audiometry and intra-operative findings in tympanoplasties, results were analysed and conclusion drawn. Materials and Methods Forty patients attending ENT OPD with chronic otitis media (COM), inactive mucosal type, with conductive hearing loss undergoing tympanoplasties who were willing to participate in the study were selected.  Ear was examined pre-operatively to assess the size of perforation and then, pure tone audiometry (PTA) was done to assess the type of hearing loss and its severity. During tympanoplasty, middle ear was inspected for ossicular status and any other pathology was noted. Later, the size of tympanic membrane perforation, pure tone audiometry and intra operative findings were correlated with each other and analysed. Result  In small and medium sized perforation, PTA and intraoperative findings correlated with each other. Whereas, in large and subtotal perforation, there was no correlation. Conclusion             In small and medium sized perforation, middle ear inspection may not be necessary. Whereas, in large and subtotal perforation it is necessary. 


1989 ◽  
Vol 98 (1_suppl2) ◽  
pp. 2-32 ◽  
Author(s):  
George A. Gates ◽  
J. C. Cooper ◽  
Christine A. Avery ◽  
Thomas J. Prihoda

To study the effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion, we randomly assigned 578 4- to 8-year-old children to receive one of the following: Bilateral myringotomy and no additional treatment (group 1), tympanostomy tubes (group 2), adenoidectomy and myringotomy (group 3), or adenoidectomy and tympanostomy tubes (group 4). The 491 who accepted surgical treatment were evaluated at 6-week intervals for up to 2 years. Treatment effect was assessed by four main outcomes: Time with effusion, time with hearing loss, time to first recurrence of effusion, and number of surgical re-treatments. For the groups (in order), the mean percent of time with any effusion in either ear was 49, 35, 30, 26 (p < .0001); the mean percent of time with hearing thresholds 20 dB or greater was 19, 10, 8, and 7 (p < .0001) in the better ear; and 38, 30, 22 and 22 in the worse ear (p < .0001); the median number of days to first recurrence was 54, 222, 92, and 240 (p < .0001); and the number of surgical re-treatments was 66, 36, 17, and 17 (p < .0001). The most notable adverse sequela, purulent otorrhea, occurred in 22%, 29%, 11%, and 24% of the patients assigned to groups 1 through 4, respectively (p < .001). In severely affected children who have chronic otitis media with effusion resistant to medical therapy, adenoidectomy is an effective treatment. Adenoidectomy plus bilateral myringotomy lowered posttreatment morbidity more than tympanostomy tubes alone and to the same degree as did adenoidectomy and tympanostomy tubes. Adenoidectomy appears to modify the underlying pathophysiology of chronic otitis media with effusion. This effect is independent of the preoperative size of the adenoid. Tympanostomy tube drainage and ventilation of the middle ear provide adequate palliation so long as the tubes remain in place and functioning. We recommend that adenoidectomy be considered in the initial surgical management of 4- to 8-year-old children with hearing loss due to chronic secretory otitis media that is refractory to medical management and, further, that the size of the adenoid not be used as a criterion for adenoidectomy. Concomitant bilateral myringotomy with suction aspiration of the middle ear contents also should be done, with or without placement of tympanostomy tubes at the discretion of the surgeon.


2021 ◽  
Vol 9 ◽  
pp. 2050313X2110564
Author(s):  
Neeraj Rauniyar ◽  
Dipesh Shakya

Tuberculosis in the otomastoid compartment is extremely rare. The classical presentation of tuberculous otitis media includes chronic otorrhea, severe hearing loss irrespective of the disease, multiple perforations, and pale granulations in the middle ear cavity. However, most present with non-specific signs and symptoms making it a diagnostic dilemma. Here, we report a case that presented with a bony mastoid cyst which is the first case report to the best of our knowledge. A 12-year-old boy visited our center with a complaint of chronic ear discharge and hearing loss not improving with conventional antibiotic therapy. The computed tomography scan of the temporal bone revealed soft tissue opacification in the mastoid along with features suggestive of cholesteatomatous chronic otitis media. The patient underwent mastoidectomy under general anesthesia, which revealed a bony mastoid cyst filled with turbid fluid along with granulation tissues in the middle ear cleft without cholesteatoma. Final histopathology revealed tuberculous otitis media. Antitubercular chemotherapy was started and the patient’s condition recovered. Primary tuberculous mastoiditis is a rare clinical entity that requires a high index of suspicion. It can also present as chronic otorrhea with mastoid cyst, and thus need to be considered as one of the differential diagnoses.


1984 ◽  
Vol 93 (4_suppl) ◽  
pp. 125-128 ◽  
Author(s):  
Maxwell Abramson ◽  
Hiroshi Moriyama ◽  
Cheng Chun Huang

Factors present in cholesteatoma connective tissue induce bone resorption in chronic otitis media. The presence of skin and its products appears to exacerbate the destructive influence of connective tissue. One exacerbating factor is pressure, shown in an animal model to increase bone resorption by influencing the subepithelial connective tissue. Consideration of pathogenic factors provides a rationale for modifications in the treatment of middle ear cholesteatoma.


2001 ◽  
Vol 110 (10) ◽  
pp. 904-906 ◽  
Author(s):  
Yi-Ho Young ◽  
Ying-Chih Lu

A 10-year longitudinal follow-up study of hearing was conducted in patients with nasopharyngeal carcinoma (NPC) in order to elucidate the mechanism of hearing loss in irradiated ears. Ten NPC patients were subjected to a battery of audiological tests before irradiation and 6 months, 5 years, and 10 years after irradiation. The tests included pure tone audiometry, tympanometry, eustachian tube function testing, and myringotomy to confirm middle ear effusion. The prevalences of otitis media with effusion (OME) were 25%, 25%, 40%, and 25% at the 4 testing periods described above, respectively. The prevalences of chronic otitis media were 0%, 0%, 15%, and 25%, respectively. In myringotomized ears (n = 17), the mean hearing levels for both air conduction and bone conduction were preserved from the preirradiation period to 10 years after irradiation. In contrast, in grommeted ears (n = 3), the mean hearing levels for both air conduction and bone conduction deteriorated progressively from the preirradiation period to 10 years after irradiation. We conclude that hearing can be preserved in NPC patients 10 years after irradiation if middle ear inflammation is well controlled. We do not recommend grommet insertion in irradiated NPC patients with OME, as it may result in persistent otorrhea and hearing deterioration.


1980 ◽  
Vol 88 (3) ◽  
pp. 316-323 ◽  
Author(s):  
Timothy T.K. Jung ◽  
Douglas M. Smith ◽  
S.K. Juhn ◽  
Jonathan M. Gerrard

Prostaglandins (PG) are naturally occurring, cyclic, unsaturated fatty acids that possess a wide range of potent biologic activities. Prostaglandins have been found in human middle ear effusions and may have implications for understanding the inflammation and, possibly, the bone resorption seen in chronic otitis media. In the study presented, PGs were measured by radioimmuno-assay in middle ear effusions from experimentally induced serous and purulent otitis media in chinchillas. The ability of chinchilla middle ear mucosa to synthesize PGs from 14C-arachidonic acid was also demonstrated. The authors suggest an active role for PGs in the inflammation and the bone resorption seen in otitis media.


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