Evaluation of temporal processing skills in individuals with normal hearing

Objective: In a cumulative perspective, the aim of this study is to perform Frequency Pattern Test (FPT), Duration Pattern Test (DPT) and Gap In Noise (GIN) Test in order to determine descriptive values of these tests to evaluate central auditory processing on the individuals’ with normal hearing. Material and Methods: A total of 52 participants, as of 28 women and 24 men, with normal hearing, within the age range of 20 to 55 were included in the study. Otoscopic examination, pure tone audiometry and FPT, DPT GIN Test which are central auditory processing tests, were performed on the participants who meet the criteria of the study and voluntarily agreed to participate in the study. Results: Descriptive values were obtained as an average of 78% in FPT, 92.11% in DPT, an average of 61.22% in GIN Test and an average of 6.34 ms in Gap Detection Threshold Conclusions: It is thought that the obtained descriptive values will contribute to the clinics and the literature. Keywords: Auditory temporal tests, central auditory processing, duration pattern test, frequency pattern test, gap in noise test

Undergraduate audiology students’ perceived competence and confidence in conducting otoscopic examination following video otoscopic training

Background Emerging research indicates that video otoscopy can be used as a teaching tool to enhance students’ ability to identify outer and middle ear pathologies. However, there is little research on the perceptions of audiology students regarding their competence and confidence following video otoscopic training, and how they view the use of video otoscopy as a teaching tool. Therefore, this study aimed to determine undergraduate (UG) audiology students’ perceived competence and confidence in conducting otoscopy following training by video otoscopic examination. Methods A survey methodology with a cross sectional design was employed. An electronic questionnaire was distributed to all third and fourth year (senior) (N = 79) UG audiology students using Survey Monkey. Ethical approval and permission from relevant stakeholders were obtained. Data were analysed using both descriptive and inferential statistics. Results 60 % of the students felt competent in performing otoscopy, while 63.3 % felt less competent in interpreting otoscopic examination findings. 43.3 % felt they can confidently and competently identify outer ear pathologies. There was no association between the number of video otoscopic examinations performed and perceived competence or/and confidence. There was also no statistically significant relationship between year of study (e.g., third year versus fourth year) and perceived competence or/and confident (p = 0.7131). Almost all (97 %) students felt that video otoscopic training should continue to be part of the clinical training as it helped them enhance their skills in performing otoscopy. Conclusions Current findings highlight the need to improve students’ practical training, incorporating pathologic ears into the curriculum. These findings also highlight the importance of supplementing practical training methodologies with changing technological advancements, particularly where tele-audiology opportunities may exist.

A study on correlation between clinical prognostic markers glycated hemoglobin, erythrocyte sedimentation rate and C-reactive protein levels and the stage of disease in malignant otitis externa

<p><strong>Background: </strong>Objectives of the study were to establish a clinical correlation between the stages of MOE and biochemical markers namely glycated Hb (HbA1c), C-reactive protein (CRP) and erythrocyte sedimentation rate<strong> (</strong>ESR) levels, to identify improvement in clinical symptomology in MOE following treatment and to correlate with the duration of diabetes mellitus with treatment outcome.</p><p><strong>Methods: </strong>Patients with diabetes mellitus, otalgia and ear discharge presenting to ENT OPD were subjected to detailed history and clinical examination. Otoscopic examination was done. Pus from the EAC was taken for culture and sensitivity. Baseline glycated Hb, ESR and CRP levels and HRCT temporal bone in axial and coronal planes was done. According to clinical findings and CT findings the patients were staged using chandlers staging. Patients were followed up after 1^st and 2^nd month and otoscopic examination with blood tests was repeated and staged accordingly</p><p><strong>Results: </strong>Fall in the levels of glycated HbA1c serves as a good prognostic indicator of the disease. Duration of diabetes has no significant impact on the disease prognosis. Most common etiologic agent is Pseudomonas aeruginosa. In spite of improvement in clinical features and inflammatory parameters there was no improvement in clinical staging with treatment. There was a significant fall in ESR and CRP values after treatment for 2 months with antibiotics and analgesics.</p><p><strong>Conclusion</strong>s: The study highlights the need to control infection with medical line of treatment which can be monitored by ESR, CRP and glycated HbA1c and that the role for surgical management is limited for stage 1, 2 and 3.</p>

Congenital ossicular chain anomaly. Columella stapes

Congenital anomalies of the ossicular chain are a rare condition in clinical practice. In literature described different variants of the ossicular chain anomaly from stapes footplate ankylosis to complete aplasia of the ossicular chain, oval, and round window. Possible congenital ossicular chain anomaly should be suspected in case of non-progressive conductive hearing loss with a normal ear drum during an otoscopic examination, without a history of previous ear infections or trauma. In this article, we described the clinical case of congenital ossicular chain anomaly presented as fixed incus. Stapes was presented as single, straight, broad crus that were attached to the central part of the footplate. Stapedius tendon was absent. The footplate was completely mobile. Exploratory tympanotomy was performed to confirm a diagnosis of congenital ossicular chain anomaly. The ossicular chain was reconstructed with PORP titanium prosthesis. Furthermore, a literature review was done, conclusions presented.

Cholesteatoma Masquerading as Cerumen

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.

Successful treatment of otodemodicosis due to Demodex cati with sarolaner/selamectin topical solution in a cat

Case summary A 10-year-old spayed female Russian Blue cat was presented with a 3-month history of excessive otic discharge and scratching, only involving the right ear. Other than a moderate amount of ceruminous exudate present within the right ear on video-otoscopic examination, there were no other cutaneous abnormalities. The cat was deemed to be otherwise in good health based on physical examination and several laboratory profiles. A diagnosis of otodemodicosis was determined due to the presence of a large number of Demodex cati mites retrieved from cerumen. Treatment consisted only of monthly topical application of sarolaner/selamectin to the nape of the neck with a marked reduction in mite counts and otic pruritus after a single dose. Complete resolution was achieved after a total of four doses. Relevance and novel information This is the first report to describe the resolution of mite infestation owing to D cati after treatment with a sarolaner-containing spot-on product. In addition, to the best of the author’s knowledge, this is the first report of any isoxazoline product used in the successful treatment of demodicosis affecting the ear canal. In general, there is a lack of reports describing safe and effective treatments for feline otodemodicosis. Topically applied sarolaner/selamectin resulted in resolution of mites while avoiding any potential ototoxic events from medications applied directly into the ear, and provided a treatment that was easier to apply than oral or injectable macrocyclic lactones.

Tympanic Membrane Retractions in patients with Williams Syndrome: A Controlled Study

Introduction The role of elastin in tympanic retractions and chronic otitis media is not well established. Williams Syndrome (WS), a pathology related to a mutation in the elastin gene, could generate tympanic retractions. Objective To compare the prevalence of tympanic retractions among patients with WS and controls. Methods WS patients (n = 43 ears) and controls (n = 130 ears) were evaluated by digital otoscopic examination and the degree of tympanic membrane retraction was classified by 2 blinded experienced otolaryngologists. Results The agreement rate between the evaluators was 71.1% for pars tensa and 65% for pars flaccida retraction (p < 0.001). The pars tensa and pars flaccida retractions are present in patients with WS after an adjusted residue of respectively - 2.8 and - 2.6 (p = 0.011 and p = 0.022) compared with controls. Conclusions Tympanic membrane retractions are not more common in the WS group when compared with controls.

A Study on Prevalence of Hearing Loss as a Complication of Diabetes

The aim of this study is to assess the hearing loss prevalence in association with diabetes & correlate it with age and duration of diabetes. This study was done in outpatient and inpatient department of ENT & endocrinology department in PSG Institute of Medical Science and Research, Coimbatore, Tamilnadu, from July 2012 -2014. Evaluation of 200 patients with otoscopic examination of canal and tympanic membrane status, worked up with PTA .Audiogram was analyzed for hearing loss &classified by WHO criteria found that 72 % individuals with diabetes were noted to have mild SNHL ,20 % with moderate SNHL,3% moderate severe SNHL, 4 % severe ,1% with profound hearing loss .In our study we concluded that after analyzing audiogram of diabetic patient ,they are more prone to develop mild to moderate SNHL and duration of diabetes and gender were found to have no effect on incidence of hearing loss.