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BMC Oral Health Nov 2023Symptoms of temporomandibular disorders (TMD) could be present as otologic symptoms like earache and dizziness in some patients. In most cases, these symptoms are not...
Symptoms of temporomandibular disorders (TMD) could be present as otologic symptoms like earache and dizziness in some patients. In most cases, these symptoms are not recognized because otolaryngologists fail to diagnose TMD as a source of the problem. This investigation was conducted to evaluate the effect of TMD treatments on the otologic symptoms which after taking history and clinical examinations seemed to be related to TMD. In the present study, the patients who were complaining of otalgia, ear fullness, tinnitus, hearing loss, and dizziness were evaluated by an ear fellow. Forty patients who had no known otologic or other primary causes to explain their symptoms, were referred to the orofacial pain clinic with the possible diagnosis of TMD. If the diagnosis was confirmed by an orofacial pain specialist, a combination of TMD treatments was administered to each case and the patients were followed up. The results showed that following implementation of treatment protocols for TMD, more than 50% of the patients reported complete or partial recovery in the second follow-up (p < 0.05). The most common otologic symptom of the referred cases was earache, and the most common associated complaint was neck pain. All the patients had one or more parafunctional habits. This study showed that TMD treatments were significantly efficient in improving otologic symptoms partially or completely and the authors concluded that for the patients with otolaryngologic unexplained symptoms, an overhaul examination is needed to assess TMD as a possible cause of the patient complaint. It is recommended that in cases with unexplained otologic symptoms, otolaryngologists care more about the neck trigger points (TP) and ask about the patient's parafunctional habits. Otolaryngologists and dentists need to be aware of the risk of developing otologic symptoms caused by these habits or cervical TPs.
Topics: Humans; Ear Diseases; Earache; Dizziness; Tinnitus; Vertigo; Temporomandibular Joint Disorders; Facial Pain
PubMed: 37996839
DOI: 10.1186/s12903-023-03627-2 -
BMJ Case Reports Sep 2023The incidence of sebaceous carcinoma (SC) in the outer one-third of the external auditory canal is considered extremely rare, and only eight case reports have been...
The incidence of sebaceous carcinoma (SC) in the outer one-third of the external auditory canal is considered extremely rare, and only eight case reports have been published. We present a case of a male patient in his late 70s known case of hypertension on indapamide. His medical history included a postspinal tumour that had been treated with surgery and radiation more than 40 years ago and current complaints of right ear pain and purulent discharge. A right ear soft granular tissue mass was found. Complete debulking of the right ear mass was done in conjunction with middle ear exploration, moderately differentiated SC diagnosis was made based on the histopathological analysis. The patient was free of recurrence but then died of an unrelated pulmonary infection. SC should be suspected in elderly patients who present with long-term complaints of a mass with or without otalgia, and these patients should be examined for the presence of such tumours especially if they report a history of radiation. Additionally, more research is warranted to investigate the association of diuretics with SC.
Topics: Humans; Male; Aged; Ear Canal; Ear Diseases; Ear, Middle; Earache; Carcinoma; Ear Neoplasms
PubMed: 37775279
DOI: 10.1136/bcr-2023-255038 -
Canadian Family Physician Medecin de... Nov 2023To provide family physicians and general otolaryngologists with a practical, evidence-based, and comprehensive approach to the management of patients presenting with... (Review)
Review
OBJECTIVE
To provide family physicians and general otolaryngologists with a practical, evidence-based, and comprehensive approach to the management of patients presenting with suspected referred otalgia.
SOURCES OF INFORMATION
The approach described is a review based on the authors' clinical practices along with research and clinical review articles published between 2000 and 2020. MEDLINE and PubMed were searched using the terms , , and . Current guidelines for the management of referred otalgia were also reviewed.
MAIN MESSAGE
Otalgia is defined as pain localized to the ear. It is one of the most common head and neck presentations in primary care, otolaryngology, and emergency medicine. Secondary otalgia arises from nonotologic pathology and represents nearly 50% of otalgia cases. Otalgia in the absence of other otologic symptoms is highly indicative of a secondary cause. A thorough assessment of patients presenting with referred otalgia requires an understanding of the possible causes of this condition, including dental and oral mucosal pathologies, temporomandibular joint disorders, cervical spine pathology, sinusitis, upper airway infection, and reflux, as well as head and neck malignancy. This paper aims to highlight the most common causes of referred otalgia, their presentations, and initial options for assessment and management.
CONCLUSION
The prevalence of referred otalgia makes this an important condition for family physicians to be able to assess, manage, and triage based on patient presentation and examination. Understanding the common causes of referred otalgia will help reduce wait times for specialist assessment and allow ease and speed of access to management options for patients in community clinics.
Topics: Humans; Earache; Ear; Temporomandibular Joint Disorders; Sinusitis; Neck
PubMed: 37963787
DOI: 10.46747/cfp.6911757 -
Journal of Patient-reported Outcomes Aug 2023Spontaneous intracranial hypotension (SIH) is an underdiagnosed and debilitating condition caused by a spinal cerebrospinal fluid (CSF) leak. Although SIH can lead to...
BACKGROUND & OBJECTIVES
Spontaneous intracranial hypotension (SIH) is an underdiagnosed and debilitating condition caused by a spinal cerebrospinal fluid (CSF) leak. Although SIH can lead to substantial morbidity and disability, little data exists about patients' perspectives. Without hearing directly from patients, our understanding of the full experience of having SIH is limited, as is our ability to identify and use appropriate patient-reported outcome measures (PROMs) within clinical care and research. The purpose of this study was to conduct qualitative interviews with confirmed SIH patients to fully describe their experiences and identify relevant concepts to measure.
METHODS
Patients were recruited from an SIH specialty clinic at a large, U.S.-based healthcare center. Patients undergoing an initial consultation who were ≥ 18 years old, English-speaking, met the International Classification of Headache Disorders-3 criteria for SIH, and had a brain MRI with contrast that was positive for SIH were eligible to participate. During semi-structured qualitative interviews with a trained facilitator, participants were asked to describe their current SIH symptoms, how their experiences with SIH had changed over time, and the aspects of SIH that they found most bothersome. Analysts reviewed the data, created text summaries, and wrote analytic reports.
RESULTS
Fifteen participants completed interviews. Common symptoms reported by patients included headache, tinnitus, ear fullness/pressure/pain, and neck or interscapular pain. Patients reported that their symptoms worsened over the course of their day and with activity. The most bothersome aspect of SIH was disruption to daily activities and limits to physical activities/exercise, which were severe. With regard to symptoms, the most bothersome and impactful included physical pain and discomfort (including headache), as well as fatigue.
CONCLUSIONS
Patients reported a diverse set of symptoms that were attributed to SIH, with devastating impacts on functioning and high levels of disability. Researchers considering use of PROMs for SIH should consider inclusion of both symptom scales and aspects of functioning, and future work should focus on evaluating the validity of existing measures for this patient population using rigorous qualitative and quantitative methods in diverse samples. Additionally, these data can be used to assist clinicians in understanding the impacts of SIH on patients.
Topics: Humans; Adolescent; Intracranial Hypotension; Cerebrospinal Fluid Leak; Headache; Pain; Earache; Patient Outcome Assessment
PubMed: 37581717
DOI: 10.1186/s41687-023-00625-4 -
Indian Journal of Pathology &... Apr 2024Diphtheria is an infectious disease caused by gram-positive bacilli C. diphtheriae involving nasal, pharyngeal, tonsillar, or laryngeal mucus membranes. The mortality...
INTRODUCTION
Diphtheria is an infectious disease caused by gram-positive bacilli C. diphtheriae involving nasal, pharyngeal, tonsillar, or laryngeal mucus membranes. The mortality rate is as high as 20%, with India contributing almost 78% of the world incidence.
AIMS AND OBJECTIVES
We report a fatal case of nasopharyngeal diphtheria with carrier study in close contacts.
MATERIALS AND METHODS
Seven years child presented with fever, throat pain, and earache for 3 days followed by neck swelling and noisy respiration. On examination, membrane was present in the throat, which was received for Albert and Gram staining and reported as positive for C. diphtheria like organisms followed by culture. The patient was treated with ADS and antibiotics, and intensively managed, but still succumbed to death. Follow-up was done for carriage of C. diphtheriae on the throat and nasopharyngeal swabs of siblings and close contacts. It was isolated in 3 of them. Samples were processed for Gram, Albert stain, and culture. Identification, antibiotic sensitivity, and toxigenicity were done.
RESULTS AND DISCUSSION
Four samples, one from the patient and three from contacts showed the presence of gram-positive slender bacilli with cuneiform arrangement, less cellular infiltrate on the Gram stain, and the presence of few metachromatic granules in the Albert stain. C. diphtheriae was grown on Potassium Tellurite agar. Antibiogram of all isolates was similar with resistance to Erythromycin and sensitivity to Penicillin. Isolates were confirmed by PCR and ToxA gene was detected. Contacts were treated with Penicillin and repeat swabs were negative.
CONCLUSION
Present health statistics and this study suggests, fight against diphtheria in India is far from being over. It still lurks in some remote areas. It is a need to remain vigilant, keep tracing, and treating contacts to curtail down the rate of infection. In view of the resurgence, Government has given directives to replace TT with Td in UIP. Still, a lot needs to be done.
Topics: Humans; Diphtheria; Corynebacterium diphtheriae; Child; India; Nasopharynx; Carrier State; Anti-Bacterial Agents; Fatal Outcome; Male; Pharynx; Female; Microbial Sensitivity Tests
PubMed: 38394413
DOI: 10.4103/ijpm.ijpm_265_23 -
Tidsskrift For Den Norske Laegeforening... Jan 2024A woman in her forties developed intermittent pain in her ear and pharynx which worsened when talking and swallowing. Multidisciplinary approach confirmed a rare...
BACKGROUND
A woman in her forties developed intermittent pain in her ear and pharynx which worsened when talking and swallowing. Multidisciplinary approach confirmed a rare diagnosis.
CASE PRESENTATION
The patient reported left-sided ear fullness, followed by otalgia and burning pain in the palate. Numbness in the palate and nasal cavity, and soreness upon palpation of the external ear canal were noted upon examination. Magnetic resonance imaging (MRI) with contrast showed a vessel located in close proximity to the glossopharyngeal nerve on the left side. A diagnosis of glossopharyngeal neuralgia was made, and the patient was treated with antiepileptic medications without substantial effect. Microvascular decompression of the glossopharyngeal nerve was therefore performed. A large vein located along the glossopharyngeal nerve was separated and fixated away from the nerve. The patient reported pain alleviation after the operation, which has continued to improve on follow-ups.
INTERPRETATION
Glossopharyngeal neuralgia is a rare condition characterised by intermittent, unilateral pain in the base of the tongue, oropharynx, and/or angle of the mandible which radiates to the ipsilateral ear. The condition should be treated medically, but open surgical treatment should be considered in refractory cases. Early diagnosis and treatment are essential.
Topics: Female; Humans; Anticonvulsants; Chronic Pain; Earache; Glossopharyngeal Nerve Diseases; Hypesthesia; Adult; Middle Aged
PubMed: 38258718
DOI: 10.4045/tidsskr.23.0543 -
Medical Gas Research 2024Mask use during the coronavirus disease 2019 (COVID-19) pandemic has been widely recommended and mandated worldwide. However, there is a lack of comprehensive research... (Observational Study)
Observational Study
Mask use during the coronavirus disease 2019 (COVID-19) pandemic has been widely recommended and mandated worldwide. However, there is a lack of comprehensive research on the potential adverse health effects of mask usage. This study aimed to investigate and evaluate the negative effects of surgical mask use on scientifically proven cardiopulmonary functions in undergraduate and associate degree students, as well as its impact on coronaphobia. A total of 145 volunteer university students (49 males, 96 females, with a mean age of 20 years) were enrolled in the study, which consisted of two 120-minute sessions. Blood oxygen saturation, heart rate, and blood pressure were assessed before and immediately after each session. The Coronavirus-19 Phobia Scale was utilized to measure levels of COVID-19 phobia. While a time-dependent decrease in oxygen saturation level, blood pressure, and heart rate was measured when vital signs were evaluated at 1 and 120 minutes, none of the values fell outside the reference range. The study also investigated the effects of mask use on various symptoms including headaches, visual impairment, facial discomfort, earaches, shortness of breath, and anxiety. Significantly increased occurrences of all these symptoms were observed at the 60 and 120 minute compared with the baseline. The participants enrolled in the study demonstrated a moderate level of COVID-19 phobia based on the mean total score. Furthermore, high scores were recorded in the psychological and social sub-dimensions, while lower scores were recorded in the economic and psychosomatic sub-dimensions. In the post-COVID-19 normalization phase, the use of a surgical mask during a 120-minute course was found to have no significant impact on cardiopulmonary functions, but moderately affected coronaphobia scores.
Topics: Female; Humans; Male; Young Adult; COVID-19; Pandemics; SARS-CoV-2; Students; Universities
PubMed: 37929511
DOI: 10.4103/2045-9912.385440 -
Ear, Nose, & Throat Journal Apr 2024Cochlear implantation (CI) is the most effective solution for patients with severe-to-profound sensorineural hearing loss, especially in children. However, a major...
Cochlear implantation (CI) is the most effective solution for patients with severe-to-profound sensorineural hearing loss, especially in children. However, a major postoperative complication, known as chronic suppurative otitis media (CSOM), poses challenges for both doctors and families of the patients, which can affect post-CI hearing outcomes. We present the case of post-CI CSOM in a 15-year-old girl. She had been utilizing a unilateral cochlear implant for 7 years and had been experiencing intermittent earache and discharge in her only audible ear for the past 15 months. After antibiotic treatment failed to resolve her symptoms, we opted for a tympanomastoidectomy, and removed the receiver-stimulator package while keeping the electrode inside her cochlea. Simultaneously, we inserted an irrigation and drainage tube into the mastoid and middle ear space to discharge the exudate and control infection by applying topical antibiotics. The patient's ear discharge had resolved within 1 month, and her tympanic membrane healed naturally. Our successful experience shows that antibiotic irrigation and draining have effectively controlled infection and accelerated wound healing in this patient with post-CI CSOM, and it further prompted the patient to undergo bilateral CI 9 months later.
PubMed: 38590173
DOI: 10.1177/01455613241238829 -
Molecules (Basel, Switzerland) Jan 2024Bunge, a perennial herb belonging to the Ranunculaceae family, has been extensively used in traditional Chinese medicine. Documented in the Supplements to the... (Review)
Review
Bunge, a perennial herb belonging to the Ranunculaceae family, has been extensively used in traditional Chinese medicine. Documented in the Supplements to the Compendium of Materia Medica, its medicinal properties encompass a spectrum of applications, including heat clearance, detoxification, alleviation of oral/throat sores, earaches, eye pain, cold-induced fever, and vision improvement. Furthermore, is used in clinical settings to treat upper respiratory infections, pharyngitis, tonsillitis, esoenteritis, canker, bronchitis, etc. It is mainly used to treat inflammation, such as inflammation of the upper respiratory tract and nasal mucosa. This comprehensive review explores the evolving scientific understanding of , covering facets of botany, materia medica, ethnopharmacological use, phytochemistry, pharmacology, and quality control. In particular, the chemical constituents and pharmacological research are reviewed. Polyphenols, mainly flavonoids and phenolic acids, are highly abundant among and are responsible for antiviral, antimicrobial, and antioxidant activities. The flower additionally harbors trace amounts of volatile oil, polysaccharides, and other bioactive compounds. The active ingredients of the flower have fewer side effects, and it is used in children because of its minimal side effects, which has great research potential. These findings validate the traditional uses of and lay the groundwork for further scientific exploration. The sources utilized in this study encompass Web of Science, Pubmed, CNKI site, classic monographs, Chinese Pharmacopoeia, Chinese Medicine Dictionary, and doctoral and master's theses.
Topics: Child; Humans; Materia Medica; Ethnopharmacology; Botany; Quality Control; Inflammation
PubMed: 38257334
DOI: 10.3390/molecules29020421