Text Box: Abstract: Objective: To evaluate the relationship between hearing level and temporal bone abnormalities in patients with microtia. Study Design: Retrospective case series study between 1992 and 2004. Setting: Academic, tertiary care referral medical center. Patients: We evaluated 115 ears of 89 patients (68 males, 21 females; mean age, 11 yr; range, 5-44 yr) with microtia. Main Outcome Measures: Hearing level was examined in patients with microtia. Developmental abnormalities of the temporal bone were evaluated by Jahrsdoerfer’s computed tomography (CT) scoring system using high-resolution CT (HRCT) scans of the temporal bone. Temporal bone malformation scores were divided into four subgroups: ossicular development, windows connected to the cochlea, aeration of the middle ear cavity, and facial nerve aberration. Patients were divided into the stenosis and atresia groups on the basis of the appearance of the external auditory canal (EAC). We also evaluated the relationships between hearing level and four subtotal scores of the HRCT findings in the stenosis and atresia groups. Results: There was no relationship between hearing level and total points of HRCT scoring system or between hearing level and severity of microtia scored by Marx classification. With regard to subtotal points related to ossicles (4 points), the hearing level in ears with low scores (<2) (64.7 ± 1.6 dB) was significantly different (P = .03) from that in ears with high scores (>=2) (54.0 ± 2.8 dB) in the stenosis group. In the atresia group, the hearing level was 64.3 ± 2.2 dB in ears with low scores and 62.3 ± 1.1 in ears with high scores (P > .5). As for subtotal points related to the windows connected to cochlea (2 points), the hearing level was 64.8 ± 2.6 dB in ears with low scores (0) and 55.9 ± 2.4 dB in ears with high scores (> = 1) in the stenosis group. In the atresia group, the hearing level was 67.7 ± 2.3 dB in ears with low scores and 61.5 ± 1.0 in ears with high scores. There was significant difference between ears with low and high scores in the stenosis group (P = .03) and atresia group (P = .009). There was no significant difference between ears with low and high scores with  respect to the subtotal points related to aeration of the middle ear cavity and aberration of the facial nerve. Conclusion: The hearing level in microtic ears correlated with the formation of oval/round windows and ossicular development but not with the degree of middle ear aeration, facial nerve aberration, or severity of microtia. The hearing level can also serve as an indictor, such as the HRCT findings, to determine whether a subject’s hearing will likely improve after reconstructive surgery.  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Text Box: March 11, 2007

Text Box: Otorhinolaryngology News

Text Box:   Inside This Issue · LigTBA, Microtia & HL...? · IMIM, Tonsillitis & Lympho-WCC ratio..? · TinStill On ET Dysfunction.? *     Case of the Week

 Case Review

 Clinical Audiogram of The Week

A 37-year old female presented with 1 year history of right aural tinnitus, hearing loss, and initial vertigo which had since resolve. The only significant medical history is allergic rhinitis which is seasonal. Clinical examination including Otoscopy was negative. Pure Tone Audiometry revealed the audiogram demonstrated below:

What is the Diagnosis and Best Management Option?

 

1.     25th Alexandria Combined ORL Congress, April 18 - 20 2007; Alexandria, Egypt. Deadline for Abstract submission January 15, 2007. Click HERE for Details

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3.      IX éme Congrès Panafricane d'ORL et de Chirugie Cervicofaciaie (PAFOS)  & XXX éme Congrès National Société           Marocaine d'ORL. 2007. April 28 - 31. Abstracts before 15th January, 2007 email benghalem@wanadoopro.ma .         Hotel Booking email fct@menara.ma , Secretariat email bouchra@par3com.com

4.    The 9th International Symposium on Recent Advances in Otitis Media on June 3-7, 2007 in St. Pete Beach, Florida. Website address : www.otitis2007.org ;email address for information and questions: otitis2007@hei.org ; Abstract site is open for submission until March 1, 2007. Click HERE to Register, and Click Here To Submit Abstract.

 

Text Box: Infectious Mononucleosis, Bacterial Tonsillitis & Lympho-WCC Ratio...?

Recall the immediate issue of otorhinolaryngology news that featured the study on microdebridder Eustachian tuboplasty? This recent study from Japan ( A. Takano et al, European Archives of Oto-Rhino-Laryngology and Head & Neck, Volume 264, Number 4 / April, 2007) employed a little bit more radical approach to same clinical problem, by suturing the pharyngeal orifice of the ET under endoscopic view, and reported success rate of just 60%.

Abstract:

Pharyngeal orifice of the eustachian tube was ligated on ten patients, 15 ears with intractable patulous eustachian tube. While the eustachian tube orifice was observed by an endoscope inserted through the contralateral nostril, the orifice was ligated transnasally and/or transorally using instruments usually used in the endoscopic nasal surgery. Now 13–27 months after the surgery, the outcome was excellent (both symptoms and sonotubometry were normalized) in two ears, good (either symptoms or sonotubometry was improved) in seven ears, and unchanged in the remaining six ears. In one of the ears with an outcome of unchanged, the ligation was found to be spontaneously released soon after surgery, but the symptom was improved after the second operation 2.5 months after the first operation. Temporary otitis media with effusion was seen in one ear, mild inflammation around the ligated site also in one ear, but no other serious complication has been observed. Although further improvement in the surgical procedure and further discussion about its long-term outcome should be required, this procedure appeared to be one of the therapeutic options for intractable patulous eustachian tube.

     Journal Watch : [Streptococcus milleri. An early sign of cancer in otorhinolaryngologic patients?], Stojan, Muller & Pfyffer, 2006 (Article in German)
 

 1.   The Monaco Head & Neck Multidisciplinary Meeting has just released the program of events, which can be viewed HERE. .

 2.  From  http://www.otolaryngologyinafrica.net/grandround/  is a new addition - a recent conference poster presentation. This presentation is available at http://www.otolaryngologyinafrica.net/grandround/archive.htm .

 3.   DODA has been redesigned. Take time to view the new look of this program at the DODA Images Page..

 4.   otolaryngologyinafrica.net website is being re-organized to enable multi-language access. Take time to review the new HomePage. When Completed, it might be possible to assess the contents of the site in the six major languages widely spoken all over Africa

 5.  Otolaryngologyinafrica.net is experimenting with use of SMS notification of newsletter release. Feel free to air your view on this issue by emailing orl-mailer@otolaryngologyinafrica.net .

 Till Next Week, Welcome to 2007!

 Biodun

 
 

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