A Case of Pterygopalatoma with Misdiagnosed as Secretory Otitis Media

Objective: This case improves the early etiologic diagnosis of recurrent and refractory secretory otitis media, avoiding missed diagnosis and misdiagnosis.Methods: Collecting the clinical manifestations of this case, fiberoptic otoscopy + fiber nasopharyngoscopy and imaging features.Results: This patient was admitted to the hospital with hearing loss and ear suffocation. He did not find the cause at the beginning of the disease. Before the hospital, he underwent the treatment of tympanic incision and eustachian tube balloon expansion with simple secretory otitis media, but still recurrent, he came into our hospital through imaging and other further examination this time, having the clear cause that the secretory otitis media recurrent episodes due to tumor lesions in the pterygopalatine. Under the general anesthesia, the navigation system assisted the endoscopic sinus combined with the cryo-plasma wing axillary tumor resection, and the right ear tympanic membrane incision was performed under the microscope.Conclusions: Clinicians need to be cautious and consider the causes in order to reduce missed diagnosis and misdiagnosis, and provide early diagnosis and early treatment to improve the quality of life of patients.

Primary Middle Ear Meningioma with Intact Tympanic Membrane: A Case Report and Literature Review

Primary ectopic meningioma of the middle ear is relatively rare in clinical practice. It is often difficult to distinguish it from chronic otitis media or otitis media with effusion due to its similar and atypical clinical symptoms. We report a case of epithelial tympanic ectopic meningioma with the main complaints of otalgia, aural fullness, and hearing loss. It was accidentally discovered during tympanotomy due to the symptoms of recurring refractory secretory otitis media. This article briefly reviews the relevant literature in recent years, summarizes the characteristics of primary ectopic tympanic meningioma with intact tympanic membrane, and emphasizes the diagnosis and treatment strategy of the middle ear mass.

Efficacy of Grommet Insertion for Improvement in Hearing among Patients of Secretory Otitis Media

Aim: To determine the improvement of hearing after grommet insertion in patients with secretory otitis media. Study Design:A Quasi-Experimental study. Place and Duration: ENT, Head & Neck Surgery department of Lady Reading Hospital MTI, Peshawar and Azra Nahid Medical College, Lahore for duration of two years from February 2019 to February 2021. Methods: The study was performed on 48 ears with secretory otitis media. Before the operation,evaluation of both ears along with tympanmontometry and Pure Tone Audiometry were performed. Documentation ofhearing loss was done pre-operatively. During the operation accomplished under GA, a grommetwas placed in the anterior inferior quadrant of the tympanic membrane. After the surgery, PTA was repeated in the postoperative period before the patient was discharged from the hospital. Results:Our study included 28 patients with secretory otitis media and a total of 48 ears. Of the ears, 27 (56.25%) were male and 21 (43.75%) were female. Both ears were affected in 21 patients. Two patients had unilateral ear involvement. The right ear was affected in 26 cases (51.1%) and the left ear in 22 cases (48.9%). 7-55 years was the age range of the patients and 14.10 ± 9.11 years was the mean age. The degree of preoperative hearing loss was mild (20-40 dB) in 5 (10.41%) ears, moderate (40-60 dB) in 37 (77.1%) ears and severe (60-80 dB) in 6 (12.5%) ears. The degree of postoperative hearing loss was mild (20-40 dB) in 36 ears (75%), moderate (40-60 dB) in 11 ears (22.9%) and severe (60-80 dB) in one ear (2.1%). Hearing improvement was not seen in 8 (16.6%) ears, an improvement of 5-10 dB in 34 (70.8%) ears, and an improvement of 10-20 dB in 6 (12.5%) ears. There was a statistically significant difference between preoperative and postoperative hearing loss in the ears, the hearing loss was significantly less after grommet insertion; p = 0.017. Conclusion:The insertion of Grommet provides a significant improvement in hearing in patients with secretory otitis media. Keywords:Pure tone audiometry, Tympanometry, Middle ear, Secretory otitis Media and Grommets.