Bilateral spontaneous hemotympanum: Case report

BACKGROUND: The most common causes of hemotympanum are therapeutic nasal packing, epistaxis, blood disorders and blunt trauma to the head. Hemotympanum is characterized as idiopathic, when it is detected in the presence of chronic otitis media. A rare case of spontaneous bilateral hemotympanum in a patient treated with anticoagulants is presented herein. CASE PRESENTATION: A 72-year-old male presented with acute deterioration of hearing. In the patient's medical history aortic valve replacement 1 year before presentation was reported. Since then he had been administered regularly coumarinic anticoagulants, with INR levels maintained between 3.4 and 4.0. Otoscopy revealed the presence of bilateral hemotympanum. The audiogram showed symmetrical moderately severe mixed hearing loss bilaterally, with the conductive component predominating. Tympanograms were flat bilaterally with absent acoustic reflexes. A computerized tomography scan showed the presence of fluid in the mastoid and middle ear bilaterally. Treatment was conservative and consisted of a 10-day course of antibiotics, anticongestants and temporary interruption of the anticoagulant therapy. After 3 weeks, normal tympanic membranes were found and hearing had returned to previous levels. CONCLUSION: Anticoagulant intake should be included in the differential diagnosis of hemotympanum, because its detection and appropriate treatment may lead to resolution of the disorder

THE LEVELS OF IGG IN THE BLOOD SERUM OF CHILDREN WITH SECRETORY OTITIS MEDIA

THE AIM OF THIS STUDY WAS TO MEASURE THE LEVELS OF THE TOTAL IGG AND ITS SUBCLASSES IN THE BLOOD SERUM OF CHILDREN WITH SECRETORY OTITIS MEDIA. WE STUDIED THE VALUES OF IGG IN SERUM OF 60 CHILDREN AND WE CLASSIFIED THEM IN FOUR GROUPS. WE FOUND THAT THE VALUES OF THE TOTAL IGG WERE INCREASED IN ALL OF GROUPS.THE IGG1 VALUES WERE SIGNIFICANTLY INCREASED AS WELL AS THE IGG4 VALUES. THEIGG2 AND IGG3 VALUES HAVE NOT APPEARED ANY CONSISTENT STATISTICALLY EVALUATED DIFFERENCES. WE MEASURED OUT, ONE YEAR LATER, THE IGG LEVELS IN THE SERUMS OF 41 CHILDREN TREATED OF SECRETORY OTITIS MEDIA. THE VALUES OF THE TOTAL IGG AND ITS SUBCLASSES WERE NORMAL. THESE RESULTS WERE COMPARED TO THE VALUES OF THE IGG IN THE SERUMS OF A GROUP OF HEALTHY CHILDREN.ΣΚΟΠΟΣ ΤΗΣ ΜΕΛΕΤΗΣ ΑΥΤΗΣ ΕΙΝΑΙ ΝΑ ΜΕΤΡΗΘΕΙ Η ΟΛΙΚΗ ΤΙΜΗ ΚΑΘΩΣ ΚΑΙ ΤΟ ΕΠΙΠΕΔΟ ΤΩΝ ΥΠΟΟΜΑΔΩΝ ΤΗΣ ΑΝΟΣΟΣΦΑΙΡΙΝΗΣ G(IGG ΚΑΙ IGG1, IGG2, IGG3, IGG4) ΣΤΟΝ ΟΡΟ ΠΑΙΔΙΩΝ ΠΟΥ ΠΑΡΟΥΣΙΑΖΟΥΝ ΥΠΟΤΡΟΠΙΑΖΟΥΣΑ ΕΚΚΡΙΤΙΚΗ ΩΤΙΤΙΔΑ. ΜΕΛΕΤΗΘΗΣΑΝ ΣΥΝΟΛΙΚΑ ΕΞΗΝΤΑ ΜΙΚΡΟΙ ΑΣΘΕΝΕΙΣ ΠΟΥ ΤΑΞΙΝΟΜΗΘΗΚΑΝ ΣΕ ΟΜΑΔΕΣ ΤΩΝ ΔΕΚΑΠΕΝΤΕ ΑΤΟΜΩΝ ΑΝΑΛΟΓΑ ΜΕ ΤΗΝ ΗΛΙΚΙΑ ΤΟΥΣ. ΕΠΙΣΗΣ ΠΗΡΑΝ ΜΕΡΟΣ ΣΑΡΑΝΤΑ ΥΓΙΗ ΠΑΙΔΙΑ ΠΟΥ ΧΩΡΙΣΤΗΚΑΝ ΟΠΩΣ ΚΑΙ ΤΑ ΠΡΟΗΓΟΥΜΕΝΑ ΣΕ ΟΜΑΔΕΣ ΤΩΝ ΔΕΚΑ ΠΑΙΔΙΩΝ. ΑΠΟ ΤΑ ΑΠΟΤΕΛΕΣΜΑΤΑ ΔΙΑΠΙΣΤΩΣΑΜΕ ΟΤΙ ΕΧΟΥΜΕ ΑΥΞΗΣΗ ΤΗΣ ΟΛΙΚΗΣ IGG. ΑΥΤΟ ΔΕΝ ΣΥΜΒΑΙΝΕΙ ΣΕ ΟΛΕΣ ΤΙΣ ΥΠΟΟΜΑΔΕΣ ΤΗΣ IGG ΑΛΛΑ ΚΥΡΙΩΣ ΣΤΗΝ ΣΤΗΝ IGG1 KAI THN IGG4. ΟΣΟΝ ΑΦΟΡΑ ΤΙΣ IGG2 ΚΑΙ IGG3 ΔΕΝ ΕΥΡΙΣΚΟΜΕ ΕΝ ΓΕΝΕΙ ΣΤΑΤΙΣΤΙΚΑ ΣΗΜΑΝΤΙΚΕΣ ΔΙΑΦΟΡΕΣ, ΠΛΗΝ ΕΞΑΙΡΕΣΕΩΝ. ΗΜΕΤΡΗΣΗ ΤΩΝ ΑΝΟΣΟΣΦΑΙΡΙΝΩΝ ΣΤΑ ΙΔΙΑ ΑΤΟΜΑ ΕΓΙΝΕ ΚΑΙ ΕΝΑ ΧΡΟΝΟ ΜΕΤΑ ΤΗΝ ΘΕΡΑΠΕΙΑ ΤΗΣ ΩΤΙΤΙΔΑΣ. ΕΞΕΤΑΣΘΗΚΑΝ 41 ΠΑΙΔΙΑ ΠΟΥ ΧΩΡΙΣΤΗΚΑΝ ΣΤΙΣ ΙΔΙΕΣ ΟΜΑΔΕΣ ΗΛΙΚΙΑΣ. ΟΙ ΤΙΜΕΣ IGG ΕΙΧΑΝ ΕΠΑΝΕΛΘΕΙ ΣΤΑ ΦΥΣΙΟΛΟΓΙΚΑ ΕΠΙΠΕΔΑ ΠΛΗΣΙΑΖΟΝΤΑΣ ΤΑ ΕΠΙΠΕΔΑ ΤΩΝ ΜΑΡΤΥΡΩΝ