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Medical Science Monitor : International... Jun 2023BACKGROUND Otosclerosis is a pathology that interferes with the conduction of vibrations to the inner ear, triggering changes in the auditory ossicles and their...
BACKGROUND Otosclerosis is a pathology that interferes with the conduction of vibrations to the inner ear, triggering changes in the auditory ossicles and their associated joints due to mechanical overload. This study primarily aims to evaluate these overload-induced modifications in the stapes head resulting from the immobilization of the base of the third auditory ossicle in otosclerosis patients. MATERIAL AND METHODS We conducted a comparative analysis of patients undergoing their first surgery for otosclerosis. The test group consisted of 31 patients who underwent stapedotomy between 2020-2021. For comparison, we utilized a control group comprising stapes samples extracted during vestibular schwannoma surgeries via a transcochlear approach. A prospective analysis of bone tissue surface topography and chemical composition was executed using scanning electron microscopy (SEM). RESULTS SEM analysis of the stapes head in otosclerosis patients relative to the control group displayed no significant differences in chemical composition or the presence of otosclerotic foci. Nonetheless, various forms of bone tissue surface damage were noted on the stapes head in all otosclerosis patients. Mild changes were evident in 90% of the samples, while small linear bone tissue fractures were observed in 58% of the samples. Furthermore, minor osteophytic changes were detected in 16% of the samples. CONCLUSIONS The immobilization of the stapes base by otosclerotic foci instigates overloads in the incus-stapes joint, leading to the eventual remodeling of the stapes head articular surface.
Topics: Humans; Stapes; Otosclerosis; Microscopy, Electron, Scanning; Ear Ossicles; Stapes Surgery; Bone and Bones
PubMed: 37337421
DOI: 10.12659/MSM.939679 -
Otology & Neurotology : Official... Aug 2023A special presentation of foreign body granuloma originating from the lateral process of the malleus (FBGLP) was noted in the absence of a history of foreign body entry...
OBJECTIVE
A special presentation of foreign body granuloma originating from the lateral process of the malleus (FBGLP) was noted in the absence of a history of foreign body entry into the external auditory canal (EAC). This study reported the clinical features, pathology, and prognosis of patients with FBGLP.
DESIGN
Retrospective study.
SETTING
Shandong Provincial ENT Hospital.
PATIENTS
Nineteen pediatric patients (age, 1-10 yr) with FBGLP.
INTERVENTIONS
Clinical data were collected from January 2018 to January 2022.
MAIN OUTCOME MEASURES
Clinicopathologic characteristics of the patients were analyzed.
RESULTS
All patients had an acute course, and were within 3 months of ineffective medical treatment. The most common symptoms were suppurative (57.9%) and hemorrhagic (42.1%) otorrhea. FBGLP imaging examinations demonstrated a soft mass blocking the EAC without bone destruction and occasionally concomitant effusion in the middle ear. The most common pathologic findings were foreign body granuloma (94.7%,18/19), granulation tissue (73.7%, 14/19), keratotic precipitate (73.7%, 14/19), calcium deposition (63.2%, 12/19), hair shafts (47.4%, 9/19), cholesterol crystals (5, 26.3%), and hemosiderin (15.8%, 3/19). Foreign body granuloma and granulation tissue showed higher expression levels of CD68 and cleaved caspase-3 than did the normal tympanic mucosa, whereas Ki-67 levels were similarly low in all tissues. The patients were followed up for 3 months to 4 years without recurrence.
CONCLUSION
FBGLP is caused by endogenous foreign particles in the ear. We recommend the trans-external auditory meatus approach for FBGLP surgical excision, as this shows promising outcomes.
Topics: Child; Humans; Infant; Child, Preschool; Malleus; Retrospective Studies; Granuloma, Foreign-Body; Ear Canal; Ear, Middle
PubMed: 37311639
DOI: 10.1097/MAO.0000000000003918 -
Cureus May 2023We present a case report of a middle ear osteoma presenting as gradual unilateral conductive hearing loss in a healthy 32-year-old lady. The decision for treatment was...
We present a case report of a middle ear osteoma presenting as gradual unilateral conductive hearing loss in a healthy 32-year-old lady. The decision for treatment was influenced by the relatively small burden of the disease, and the size and location of the osteoma, which made the decision for surgical excision prohibitively difficult. Taking patient wishes and circumstances into account, the decision was made for a bone conduction hearing implant in conjunction with close follow-up.
PubMed: 37273302
DOI: 10.7759/cureus.38478 -
Indian Journal of Otolaryngology and... Apr 2023The functional aspect of preservation of every healthy anatomical structure, particularly the ossicles, non-diseased mastoid cortex and middle ear mucosa, and to achieve...
The functional aspect of preservation of every healthy anatomical structure, particularly the ossicles, non-diseased mastoid cortex and middle ear mucosa, and to achieve this by transacanal endoscopic dual hand approach to middle ear, aditus and mastoid antrum with minimal posterior atticotomy and proximal aditotomy. The prospective study has been conducted over a period of 12 years from 2009 to 2021 in the Jorhat Medical College, Assam Medical College and Niramoy Hospital, Jorhat, Assam. Follow up was for a minimum of 4 years. The current study was a prospective hospital based study, carried out from May 1st, 2009 to April 30th, 2021 involving 157 subjects from 18 to 65 years with mean age of 38 + 2.5. Graft uptake rate of 93.6%. Minimal atticotomy with proximal aditotomy offers a clear view of the antrum with angled scopes of 30 degree and 45 degree and if any disease is located it can be removed through the transcanal approach with angled instruments and aditus patency can be confirmed by visual inspection. Hence, decreasing the need of unnecessary bone drilling as done with cortical mastoidectomy to create a parallel view.The endoscopic ear surgeries done with "dual hand endo-holder" were uneventful and much more comfortable as compared to the single hand technique. Functional approach by minimizing bone drilling, reestablishment of ventilation pathways and preservation of ossicles with disease clearance give better postoperative results in long term follow-up.
PubMed: 37206818
DOI: 10.1007/s12070-022-03450-1 -
Indian Journal of Otolaryngology and... Apr 2023Chronic otits media (COM) is surgically treatable disease which includes complete removal of disease and improving hearing via ossicular reconstruction. Therefore,...
Chronic otits media (COM) is surgically treatable disease which includes complete removal of disease and improving hearing via ossicular reconstruction. Therefore, thorough assessment of the disease, ossicles and various factors causing it plays a major role in surgical outcome prediction. MERI (Middle ear risk index) is one such tool being used worldwide. Our aim was to evaluate the surgical outcome of tympanomastoid surgery using MERI and find out correlation between them as well as categorize cases into their severity score in a developing country. Observational prospective study conducted in a tertiary care center. 200 patients were included. After complete history and examination, they were given MERI scores and prediction of surgical outcome was done. Postoperatively it was compared with the real outcome of the surgery. Out of 200 patients, 71.5% had mild, 15.5% had moderate and 13% had severe MERI scores preoperatively. There was a success rate of 88.5% in graft uptake and the mean score of hearing benefit (A-B gain) among patients was 8.75 ± 8.82 dB postoperatively. MERI may be used as a prognostic indicator for predicting surgical outcome. Based on the MERI score, chances of surgical success and hearing benefit can be explained to the patient with certain limitations.
PubMed: 37206807
DOI: 10.1007/s12070-022-03320-w -
Philosophical Transactions of the Royal... Jul 2023Mammals are diagnosed by more than 30 osteological characters (e.g. squamosal-dentary jaw joint, three inner ear ossicles, etc.) that are readily preserved in the fossil... (Review)
Review
Mammals are diagnosed by more than 30 osteological characters (e.g. squamosal-dentary jaw joint, three inner ear ossicles, etc.) that are readily preserved in the fossil record. However, it is the suite of physiological, soft tissue and behavioural characters (e.g. endothermy, hair, lactation, isocortex and parental care), the evolutionary origins of which have eluded scholars for decades, that most prominently distinguishes living mammals from other amniotes. Here, we review recent works that illustrate how evolutionary changes concentrated in the cranial and dental morphology of mammalian ancestors, the Permian-Jurassic Cynodontia and Mammaliaformes, can potentially be used to document the origin of some of the most crucial defining features of mammals. We discuss how these soft tissue and behavioural traits are highly integrated, and how their evolution is intermingled with that of craniodental traits, thus enabling the tracing of their previously out-of-reach phylogenetic history. Most of these osteological and dental proxies, such as the maxillary canal, bony labyrinth and dental replacement only recently became more easily accessible-thanks, in large part, to the widespread use of X-ray microtomography scanning in palaeontology-because they are linked to internal cranial characters. This article is part of the theme issue 'The mammalian skull: development, structure and function'.
Topics: Animals; Female; Phylogeny; Biological Evolution; Mammals; Skull; Paleontology; Fossils
PubMed: 37183903
DOI: 10.1098/rstb.2022.0084 -
Philosophical Transactions of the Royal... Jul 2023Modularity (segmentation), homology and heterochrony were essential concepts embraced by Gavin de Beer in his studies of the development and evolution of the vertebrate... (Review)
Review
Modularity (segmentation), homology and heterochrony were essential concepts embraced by Gavin de Beer in his studies of the development and evolution of the vertebrate skull. While his pioneering contributions have stood the test of time, our understanding of the biological processes that underlie each concept has evolved. We assess de Beer's initial training as an experimental embryologist; his switch to comparative and descriptive studies of skulls, jaws and middle ear ossicles; and his later research on the mammalian skull, including his approach to head segmentation. The role of cells of neural crest and mesodermal origin in skull development, and developmental, palaeontological and molecular evidence for the origin of middle ear ossicles in the evolutionary transition from reptiles to mammals are used to illustrate our current understanding of modularity, homology and heterochrony. This article is part of the theme issue 'The mammalian skull: development, structure and function'.
Topics: Animals; Beer; Biological Evolution; Skull; Head; Mammals
PubMed: 37183898
DOI: 10.1098/rstb.2022.0078 -
Scientific Reports May 2023For over 40 years, finite-element models of the mechanics of the middle ear have been mostly deterministic in nature. Deterministic models do not take into account the...
For over 40 years, finite-element models of the mechanics of the middle ear have been mostly deterministic in nature. Deterministic models do not take into account the effects of inter-individual variabilities on middle-ear parameters. We present a stochastic finite-element model of the human middle ear that uses variability in the model parameters to investigate the uncertainty in the model outputs (umbo, stapes, and tympanic-membrane displacements). We demonstrate: (1) uncertainties in the model parameters can be magnified by more than three times in the umbo and stapes footplate responses at frequencies above 2 kHz; (2) middle-ear models are biased and they distort the output distributions; and (3) with increased frequency, the highly-uncertain regions spatially spread out on the tympanic membrane surface. Our results assert that we should be mindful when using deterministic finite-element middle-ear models for critical tasks such as novel device developments and diagnosis.
Topics: Humans; Finite Element Analysis; Models, Biological; Ear, Middle; Tympanic Membrane; Stapes
PubMed: 37147426
DOI: 10.1038/s41598-023-34018-w -
Veterinary Sciences Mar 2023The skull is divided into neurocranium and splanchnocranium, and its variation allows ecomorphological studies to learn about possible evolutionary and adaptive...
The skull is divided into neurocranium and splanchnocranium, and its variation allows ecomorphological studies to learn about possible evolutionary and adaptive characteristics. The basicranial organization of the neurocranium and splanchnocranium modules was studied in a sample of 31 skulls from adult Araucanian horses by means of 2D geometric morphometric techniques. The neurocranium and splanchnocranium modules on the ventral aspect were analyzed separately using a set of 31 landmarks. The RV coefficient (the multivariate analog of a correlation) was estimated to analyze the independence of these two parts, as well as their morphological integration, using a two-block analysis of least squares. The study results confirm the modular development of the neurocranium and the splanchnocranium, the former being more stable than the latter as well as low morphological integration between the two. The development between both parties is structured in a modular way but allows relative independence. Now it would be interesting for future studies to add muscles (those that connect the cranial parts, but also the cervical), the hyoid apparatus, and the ossicles of the internal ear and the jaw and analyze if they behave as integrated modules between them. Since this research has been conducted at the subspecific breed level, it could be plausible that in other breeds, this integrative development was different.
PubMed: 37104410
DOI: 10.3390/vetsci10040255