Metallic foreign body in middle ear: an unusual cause of hearing loss

This is a rare case report of a foreign metallic body found in the middle ear. During the use of an electric welding by a metalworker, a glowing drop of dissolved metal overrun, burning the skin of his external auditory meatus, perforated the tympanic membrane and finally was implanted around the ossicles as a foreign body. Due to difficulty of the physical examination and the moderate symptoms (hearing loss and sense of fullness), the foreign body was detected six months after the incident, by CT scanning and it was removed by a transcanal approach under general anesthesia. A successful ossiculoplasty-tympanoplasty was followed four weeks later

Comparison of ultrasound turbinate reduction, radiofrequency tissue ablation and submucosal cauterization in inferior turbinate hypertrophy

Chronic nasal obstruction owed to chronic hypertrophic rhinitis is a common cause of nasal airway obstruction. In cases unresponsive to conservative treatment, various surgical techniques are commonly performed, but the issue of the optimal surgical procedure is still controversial. The objective of the present study was to evaluate the eVectiveness and safety of ultrasound treatment of the hypertrophied inferior turbinates, which is a technique recently applied in rhinologic surgery. We aimed, also, to compare this method with the radiofrequency cold cobla-tion turbinate reduction and the traditional submucosal monopolar inferior turbinate cauterization. We studied pro-spectively 60 patients with chronic hypertrophic rhinitis of nonallergic etiology, who underwent diVerent surgical methods of turbinate reduction, divided into two groups: (1) in 30 patients, inferior turbinate volume reduction using ultrasound procedure on the left side and monopolar diathermy on the right was performed; (2) in 30 patients, radiofrequency coblation technique on the left side and ultrasound turbinate reduction on the right side was undertaken. Subjective evaluation of nasal obstruction and pain was performed using visual analog scales and objective evaluation of the surgical outcome was obtained using active anterior rhinomanometry and acoustic rhinometry. Examinations were performed preoperatively, and 1, 3 and 6 months after surgery. Both subjective and objective evaluation showed signiWcant postoperative improvement in all cases. The best results were obtained with the ultrasound procedure, and second with the radiofrequency technique. The least improvement was observed in the electrocautery group, although its results did not diVer signiWcantly from the radiofrequency group. It may be, thus, concluded that ultrasound turbinate reduction is an eVective and safe procedure for the management of chronic hypertrophic rhinitis, in patients failing to respond to medical treatment. Using this method, better results were obtained in decreasing subjective symptoms and nasal obstruction, in comparison with radiofrequency and electrocautery. © 2010 Springer-Verlag

Newborn hearing screening resources on the Internet

Starting as a small military and academic network, the Internet has gradually evolved into a worldwide web, which connects most local networks as well as millions of personal computers from individual users. It is of interest to the medical practitioner, that ever more biomedical resources are becoming available on-line to assist in clinical medicine, research and education. In this paper a detailed list of the World Wide Web sites accessible through the Internet is provided, in which data about newborn hearing screening may be found. Web resources of medical equipment and suppliers and sites including otoacoustic emissions topics, are presented as well. This review is intended to present the wealth of the accessible information on the Internet and to promote further presentation on the web of any available hearing screening data from hospitals and Audiology Departments in which such programs are implemented. © 2002 Elsevier Science Ireland Ltd. All rights reserved

Audiological assessment in Ramsay Hunt syndrome

Ramsay Hunt syndrome is known to cause symptoms and signs of vestibulocochlear dysfunction, including sensorineural hearing loss. The present study investigates the audiological features of a group of 15 patients with this syndrome. A complete otolaryngological, neurologic, and audiological workup was performed in every patient, including auditory brain stem response measurements and recording of transiently evoked otoacoustic emissions. In most patients, some degree of hearing loss was evident, and abnormal latencies and interpeak latencies of the auditory brain stem response, or even absence of the waves, were observed. Transiently evoked otoacoustic emissions were present in only 6 cases, and caloric tests showed unilateral weakness in the majority of the patients. In all of the performed tests, abnormalities were present only on the affected side. The audiological data suggested cochlear or retrocochlear involvement or involvement at more than one site along the auditory pathway

Modifications of the Caldwell-Luc procedure for the prevention of post-operative sensitivity disorders

The effectiveness of some modifications of the Caldwell-Luc standard procedure in the prevention of post-operative mid-facial sensitivity disorders was investigated in a prospective comparative study at the ENT Department, Faculty of Medicine, University of Athens, Greece, from 1986-1992. Sixty-nine maxillary sinuses were operated on in 61 patients suffering from benign pathological conditions. The modifications concerned the type of mucoperiosteal incision and the site and size of the created anterior antrostomy. Only 8.7 per cent of the sinuses operated on by the modified technique presented with post-operative disorders whereas among those operated on by the classical technique, the ratio climbed to 33 per cent. In view of the findings of this study, the modifications applied can be valuable in treating non-extensive maxillary sinus disease with minimal post-operative sensitivity disorders

Effect of the number of averaged responses in transient evoked otoacoustic emissions on the results of neonatal hearing screening [Efecto del número promediado de emisiones otoacusticas evocadas por transitorios en el tamizaje auditivo nonatal]

I This study examined the effect of the number of accepted responses in transient evoked otoacoustic emissions on the results of neonatal hearing screening programmes. The ILO88 Otodynamics Analyzer Quickscreen programme was used for all testing, and a three-stage procedure was adopted by averaging 20, 30, and 260 low-noise samples in total. The results were recorded after each stage of the testing in those cases in which, after the first 20 accepted responses, the “pass” criteria were met. Under these circumstances, 117 ears were included in the study from a total number of 334 screened ears. It was concluded that 20 averaged quiet responses are adequate for screened newborn babies to pass the test if the conditions of the “pass” criteria are fulfilled at this stage. In the rest of the newborn babies, testing should be continued using a larger number of clicks. For diagnostic and clinical purposes, the full 260 quiet samples must be used since the results indicated statistically better scores in response and reproducibility measures after the 260 averaged responses. Sumario Este estudio examina el efecto del número promediado de respuestas aceptadas en las emisiones otoacústicas evocadas por transitorios en los progra-mas de tamizaje auditivo infantil. Se utilizó el pro-grama rápido de tamizaje del IL088 de Otodynamics; se realizó el estudio con un total de 20, 30 y 260 promediaciones con bajo ruido. Se grabaron los resultados después de cada etapa de la prueba, en aquellos casos en los que después de los primeras 20 respuestas aceptadas se obtuvo el criterio “pasa”. En estas condiciones se incluyeron 117 oídos de un total de 334 analizados. Se concluyó que 20 respuestas silenciosas son suficientes cuando se alcanza el criterio “pasa” en esa etapa. En el resto de los neonatos, se debe continuar con un mayor número de clicks. Para propósitos clínicos y de diagnóstico, se deben reunir las 260 respuestas; con esta cifra la reproductibilidad y la respuesta en sí es mucho mejor. © 2000, Informa UK Ltd All rights reserved: reproduction in whole or part not permitted

Dermoid cyst of the lateral neck: Report of a case

Dermoid cysts of the floor of the mouth and submandibular space represent an unusual clinical entity. A case of an enlarged dermoid cyst in the left submandibular space in a 19-year-old female is reported, along with a review of the literature. Copyright © 2001 S. Karger AG, Basel

Metallic foreign body in middle ear: An unusual cause of hearing loss

This is a rare case report of a foreign metallic body found in the middle ear. During the use of an electric welding by a metalworker, a glowing drop of dissolved metal overrun, burning the skin of his external auditory meatus, perforated the tympanic membrane and finally was implanted around the ossicles as a foreign body. Due to difficulty of the physical examination and the moderate symptoms (hearing loss and sense of fullness), the foreign body was detected six months after the incident, by CT scanning and it was removed by a transcanal approach under general anesthesia. A successful ossiculoplasty- tympanoplasty was followed four weeks later