A Case Report of a Middle Ear Mass Originated From Cartilage-like Tissue Treated With Transcanal Endoscopic Ear Surgery

2021 ◽  
pp. 014556132110655
Author(s):  
Satoshi Suda ◽  
Mitsuru Kitamura ◽  
Miho Kawaida ◽  
Masato Fujioka ◽  
Hiroyuki Ozawa
Keyword(s):  
Hearing Loss ◽  
Visual Field ◽  
Middle Ear ◽  
Histopathological Examination ◽  
Pure Tone Audiometry ◽  
Invasive Procedure ◽  
Endoscopic Ear Surgery ◽  
Tympanic Cavity ◽  
Ear Surgery ◽  
Conductive Hearing

Middle ear tumors are relatively rare, and among them, the diagnoses of middle ear lesions originating from cartilage-like tissue are even rarer. Use of transcanal endoscopic ear surgery (TEES) has increased in recent years because of its advantages, such as clear visual field and minimally invasive procedure. Here, we report a middle ear mass originating from cartilage-like tissue treated with TEES. A 62-year-old woman presented with progressive right-sided hearing loss. A white mass was revealed through the tympanic membrane, and pure-tone audiometry detected a mean 50.0 dB conductive hearing loss. Computed tomography showed a mass in the tympanic cavity. TEES was performed for diagnosis and treatment. A white translucent tumor was observed intraoperatively, and it was completely resected. Histopathological examination confirmed the diagnosis of a mass originating from degenerated cartilage-like tissue. To the best of our knowledge, this is the first study of a middle ear mass originating from cartilage-like tissue treated with TEES. TEES with its clear visual field and precise techniques was beneficial in treating the middle ear lesions circumscribed in the tympanic cavity.

Modification of auditory pathway functions in patients with hearing improvement after middle ear surgery

1998 ◽  
Vol 119 (1) ◽  
pp. 125-130 ◽  
Author(s):  
Juha-Pekka Vasama ◽  
Jyrki P. Mäkelä ◽  
Hans A. Ramsay
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Adult Patients ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Pure Tone Average ◽  
The Mean ◽  
Conductive Hearing

We recorded auditory-evoked magnetic responses with a whole-scalp 122-channel neuromagnetometer from seven adult patients with unilateral conductive hearing loss before and after middle ear surgery. The stimuli were 50-msec 1-kHz tone bursts, delivered to the healthy, nonoperated ear at interstimulus intervals of 1, 2, and 4 seconds. The mean preoperative pure-tone average in the affected ear was 57 dB hearing level; the mean postoperative pure-tone average was 17 dB. The 100-msec auditory-evoked response originating in the auditory cortex peaked, on average, 7 msecs earlier after than before surgery over the hemisphere contralateral to the stimulated ear and 2 msecs earlier over the ipsilateral hemisphere. The contralateral response strengths increased by 5% after surgery; ipsilateral strengths increased by 11%. The variation of the response latency and amplitude in the patients who underwent surgery was similar to that of seven control subjects. The postoperative source locations did not differ noticeably from preoperative ones. These findings suggest that temporary unilateral conductive hearing loss in adult patients modifies the function of the auditory neural pathway. (Otolaryngol Head Neck Surg 1998;119:125-30.)

Modified sleeve tympanotomy approach for removal of congenital cholesteatoma

2008 ◽  
Vol 122 (12) ◽  
pp. 1365-1367 ◽  
Author(s):  
H J Park ◽  
G H Park ◽  
J E Shin ◽  
S O Chang
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Conductive Hearing Loss ◽  
Tympanic Cavity ◽  
Operative Techniques ◽  
Congenital Cholesteatoma ◽  
The Right ◽  
Conductive Hearing

AbstractObjective:We present a technique which we have found useful for the management of congenital cholesteatoma extensively involving the middle ear.Case report:A five-year-old boy was presented to our department for management of a white mass on the right tympanic membrane. This congenital cholesteatoma extensively occupied the tympanic cavity. It was removed through an extended tympanotomy approach using our modified sleeve technique. The conventional tympanotomy approach was extended by gently separating the tympanic annulus from its sulcus in a circular manner. The firm attachment of the tympanic membrane at the umbo was not severed, in order to avoid lateralisation of the tympanic membrane.Conclusion:Although various operative techniques can be used, our modified sleeve tympanotomy approach provides a similarly sufficient and direct visualisation of the entire middle ear, with, theoretically, no possibility of lateralisation of the tympanic membrane and subsequent conductive hearing loss.

A bifid intra-tympanic facial nerve in association with a normal stapes

2006 ◽  
Vol 120 (5) ◽  
pp. 414-415 ◽  
Author(s):  
J Ahmed ◽  
P Chatrath ◽  
J Harcourt
Keyword(s):  
Hearing Loss ◽  
Facial Nerve ◽  
Middle Ear ◽  
Conductive Hearing Loss ◽  
Anatomical Variations ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Ossicular Reconstruction ◽  
Conductive Hearing

A rare facial nerve anomaly was incidentally discovered whilst performing a tympanoplasty and ossicular reconstruction on a patient with an acquired unilateral conductive hearing loss. The nerve was seen to bifurcate and straddle a normal stapes superstructure as it ran posteriorly through the middle ear, a unique and as yet unreported combination. This case highlights the importance of vigilance regarding facial nerve anatomical variations encountered during middle-ear surgery thus avoiding inadvertent damage. The purported embryological mechanism responsible for such anomalies of the intra-tympanic facial nerve is discussed.

Effect of Conductive Hearing Loss and Middle Ear Surgery on Binaural Hearing

1986 ◽  
Vol 95 (5) ◽  
pp. 525-530 ◽  
Author(s):  
Joseph W. Hall ◽  
Eugene L. Derlacki
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Auditory Processing ◽  
Conductive Hearing Loss ◽  
Binaural Hearing ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Hearing Thresholds ◽  
Masking Level Difference ◽  
Conductive Hearing

This study investigated whether conductive hearing loss reduces normal binaural hearing advantages and whether binaural hearing advantages are normal in patients who have had hearing thresholds improved by middle ear surgery. Binaural hearing was assessed at a test frequency of 500 Hz using the masking level difference and interaural time discrimination thresholds. Results indicated that binaural hearing is often poor in conductive lesion patients and that the reduction in binaural hearing is not always consistent with a simple attenuation of the acoustic signal. Poor binaural hearing sometimes occurs even when middle ear surgery has resulted in bilaterally normal hearing thresholds. Our preliminary results are consistent with the interpretation that auditory deprivation due to conductive hearing loss may result in poor binaural auditory processing.

A rare case of primary otoscleroma of the middle ear

2012 ◽  
Vol 126 (12) ◽  
pp. 1276-1277
Author(s):  
A R Kakeri ◽  
A H Patel
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Middle Ear ◽  
World Literature ◽  
Rare Case ◽  
Conductive Hearing Loss ◽  
Histopathological Examination ◽  
Suppurative Otitis Media ◽  
The World ◽  
Conductive Hearing

AbstractObjective:We report an extremely rare case of primary otoscleroma.Method:We present a case report and a review of the world literature concerning otoscleroma.Results:An adult woman presented with chronic suppurative otitis media with tubotympanic disease and conductive hearing loss. On mastoid exploration, dark granulations were seen, which were identified as otoscleroma on histopathological examination. The patient responded well to streptomycin.Conclusion:To the best of our knowledge, this is the first report of primary otoscleroma in the world literature. This case indicates that Frisch's bacillus can also spread to the middle ear.

Predictive role of Carhart's notch in pre-operative assessment for middle-ear surgery

2006 ◽  
Vol 121 (3) ◽  
pp. 219-221 ◽  
Author(s):  
H Yasan
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Middle Ear ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Pure Tone Audiometry ◽  
Stapes Footplate ◽  
Predictive Role ◽  
Conductive Hearing

Objectives: To evaluate the predictive role of the audiometric Carhart's notch for the assessment of middle-ear pathology prior to surgical intervention.Method: In this retrospective analysis, a total of 315 operated ears of 305 patients were evaluated regarding their pre-operative pure tone audiograms and peri-operative findings. The probable relationship between the middle-ear pathologies found and the Carhart's notch found on pre-operative pure tone audiometry was investigated. Patients with conductive hearing loss who obtained at least a 10 dB improvement (at 1 and 2 kHz frequencies) in their bone conduction threshold post-operatively were included in the Carhart's notch group. The pathologies underlying Carhart's notch were compared.Results: Three hundred and fifteen ears of 305 consecutive patients with conductive hearing loss were operated on due to middle-ear pathology. In patients with otosclerosis and tympanosclerosis, a Carhart's notch was seen at 2 kHz in 28 (93 per cent) patients but at 1 kHz in only two (7 per cent). However, in patients with chronic otitis media, a Carhart's notch was seen at 1 kHz in 10 (55 per cent) patients and at 2 kHz in eight (45 per cent) patients.Conclusions: Otitis media with effusion, tympanosclerosis and congenital malformations should be considered in the differential diagnosis of a patient with a Carhart's notch seen on pure tone audiometry. A Carhart's notch at 2 kHz indicates stapes footplate fixation, whereas one at 1 kHz indicates a mobile stapes footplate; the footplate mobility can thus be predicted pre-operatively.

scholarly journals Endoscopic Ear Surgery for the Management of Traumatic Ossicular Disruption with Intact Tympanic Membrane

2020 ◽  
Author(s):  
Chunlin Zhang ◽  
Dan Long ◽  
Yuan Deng ◽  
Mei Ynag ◽  
Dandan Guo ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Retrospective Study ◽  
Conductive Hearing Loss ◽  
Ossicular Chain ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
Temporal Bone Fracture ◽  
Hearing Outcomes ◽  
Conductive Hearing ◽  
Facial Function

Abstract Background Traumatic ossicular disruption (TOD) usually had a severe conductive hearing loss, the exploratory tympanotomy is critical for the diagnosis and improve hearing. Endoscopic ear surgery (EES) is becoming popular in the last decade, we conducted a retrospective study to explore the efficacy of EES for management of TOD and the accompanied injuries.Methods A retrospective study was performed on 18 ears (16 patients) of TOD with intact TM from May 2017 to Jun 2019 in our department. EES was conducted to check the ossicular chain anomalies, and to perform the ossiculoplasty and facial nerve (FN) decompression depending on the intraoperative findings. Hearing outcomes and surgical complications were assessed at 6 months postoperatively. Results The incus injury was the most common type of TOD, which was observed in 14 ears (77.8%), stapes suprastructure fracture was observed in 4 ears (22.2%). FN injury was found in 4 out of 13 ears with temporal bone fracture (TBF), the injury sites were mainly located in the perigeniculate area and the tympanic segment of FN. It showed the postoperative average pure-tone average (PTA) gain was 22.9 ± 9.5 dB, and the average ABG closure was 22.2 ± 8.3 dB, ABG closure to 20 dB or less and ABG closure to 10 dB or less were achieved in 18 ears (100%) and 14 ears (77.8%), respectively. The facial function achieved favorable recovery of House-Brackmann (H-B) grade Ⅰ (3 ears) and grade Ⅱ (1 ear) in all the 4 cases in 6 months after surgery. No iatrogenic FN paralysis and significant sensorineural hearing loss were observed. Conclusions ESS was effective in diagnosis and management of TOD and the accompanied otologic injuries, such as FN paralysis, it showed favorable surgical outcomes. ESS provides an alternative method to manage TOD with the advantage of excellent vision and less invasion.

Promontory osteoma mimicking otosclerosis: case report

2019 ◽  
Vol 133 (12) ◽  
pp. 1107-1109
Author(s):  
S Gülşen
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Middle Ear ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Pure Tone Audiometry ◽  
Additional Treatment ◽  
Recent Onset ◽  
History Of ◽  
Conductive Hearing

AbstractObjectiveThis case report presents a middle-ear osteoma mimicking otosclerosis that was located at the promontory. The osteoma was successfully excised using an endoscopic transcanal approach without any complication.Case reportA 21-year-old man presented with a 4-year history of progressive conductive hearing loss (47 dB with a 30-dB air–bone gap) with intermittent tinnitus of recent onset in his right ear. Endoscopic transcanal middle-ear exploration showed that an osteoma located on the promontory was restricting the mobility of the stapes by affecting the anterior crus of the stapes. After transcanal resection of the osteoma, pure tone audiometry improved to 23 dB with a 5-dB air–bone gap. Tinnitus resolved spontaneously without any additional treatment.ConclusionPromontory osteomas, a rare and usually asymptomatic clinical entity, should be taken into consideration in the differential diagnosis in patients with progressive conductive hearing loss and tinnitus with intact stapedial reflexes and normal otoscopic findings.

scholarly journals Cholesteatoma Masquerading as Cerumen

2021 ◽  
Author(s):  
S Prabakaran ◽  
RB Namasivaya Navin ◽  
R Guna Keerthana ◽  
S Rajasekaran ◽  
K Priya
Keyword(s):  
Hearing Loss ◽  
Conductive Hearing Loss ◽  
Histopathological Examination ◽  
Treatment Plan ◽  
Pure Tone Audiometry ◽  
The Elderly ◽  
Soft Tissue Density ◽  
Persistent Symptoms ◽  
Conductive Hearing ◽  
Otoscopic Examination

Cerumen is composed of glandular secretions and desquamated epithelial cells. It protects and lubricates the external auditory canal. Impacted cerumen causes canal occlusion and pressure over the tympanic membrane, causing ear discomfort, conductive hearing loss, itching, etc. Up to 6% of the general population are affected with impacted cerumen, which includes 10% of children, more than 30% of the elderly and people with cognitive impairment. Persistent symptoms despite resolution of impaction and patient repeatedly should raise suspicion of alternative diagnosis and prompt for further evaluation. A 20-year-old female patient came with complaints of decreased hearing and ear discharge. On otoscopic examination of left ear, impacted cerumen was seen in the attic region. On removal of wax with the aid of oto-endoscopy, attic region was found to be filled with cholesteatoma debris. On pure tone audiometry, patient had mild conductive hearing loss of 30 db and computed tomography of left temporal bone revealed ill-defined soft tissue density in the middle ear (epitympanum) with erosion of head of malleus and short process of incus. Blunting of scutum was also seen. Attic reconstruction and type III tympanoplasty was performed. On histopathological examination, the section showed keratin flakes with bacterial colonies which were consistent with cholesteatoma. In conclusion, any case of impacted cerumen should not be ignored by otorhinolaryngologist. Further evaluation with thorough examination under otomicroscope/otoendoscope has to be done which can lead to different diagnosis and treatment plan.

scholarly journals The first Malaysian experience on totally endoscopic ear surgery

2019 ◽  
Vol 29 (1) ◽  
pp. 5-9
Author(s):  
Khairunnisak Misron ◽  
Tengku Mohamed Izam Tengku Kamalden
Keyword(s):  
Middle Ear ◽  
External Auditory Canal ◽  
Intraoperative Complications ◽  
Endoscopic Ear Surgery ◽  
Ear Canal ◽  
Ear Surgery ◽  
Internal Acoustic Meatus ◽  
Canal Stenosis ◽  
Delayed Complications ◽  
Conductive Hearing

Introduction: Totally endoscopic ear surgery (TEES) is defined as exclusive application of endoscope transcanally in otologic surgery. This study is aimed to highlight indications and ear pathologies for TEES. In addition, intraoperative, early postoperative and delayed postoperative complications of TEES will be also described in this study. Methodology: This is a retrospective study of TEES performed by a single experienced and trained otologist in endoscopic ear surgery in a single institution between 1 July 2014 and 31 June 2018. A total of 43 patients were recruited in this study. Sociodemographic information, indications for TEES, ear pathologies, type of surgery performed and complications of TEES were analyzed. Results: The indications for TEES comprised middle ear lesion (65.1%), followed by second look surgery (14.0%), external auditory canal lesion (11.6%) and internal acoustic meatus lesion and surgery for conductive hearing loss which were 4.7%. Various external auditory canal pathologies encountered for TEES were ear canal osteoma (4.7%), acquired ear canal stenosis (2.3%) and tumor (4.7%). Regarding middle ear pathologies, limited atticoantral cholesteatoma accounted for most of the cases, 46.5%. Other middle ear lesions included adhesive otitis media (14.0%), recurrent cholesteatoma (14.0%), tumor (4.7%), otosclerosis (2.3%) and ossicular discontinuity (2.3%). Internal acoustic meatus lesion constituted 4.7% of cases. Some 4.7% of cases developed intraoperative complications, while early and delayed complications were 7.0%. Conclusion: TEES is a feasible surgical technique for diverse ear pathologies in the otologic specialty. It is also proven to be safe with good surgical outcomes.

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