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Acta Oto-laryngologica Feb 2022Ear canal and middle ear tumors are rare and exhibit variability in histology and clinical manifestation. Surgical resection remains the treatment of choice, but...
BACKGROUND
Ear canal and middle ear tumors are rare and exhibit variability in histology and clinical manifestation. Surgical resection remains the treatment of choice, but individualized approach is needed to preserve function when possible.
AIMS/OBJECTIVES
To review the management and outcome of ear canal and middle ear tumors at an academic referral center.
MATERIALS AND METHODS
Helsinki University Hospital (HUS) patient files were searched for clinically and histologically confirmed ear canal and middle ear tumors over a 14-year period. The minimum follow-up time was 2 years.
RESULTS
Eighty-seven patients with 88 tumors were identified. There were 20 (23%) benign external auditory canal (EAC), 36 (41%) benign middle ear space (MES), 29 (33%) malignant EAC, and 3 (3%) malignant MES tumors. Most (92%) tumors were managed with primary resection. Thirty-five percent of the operatively managed patients had a residual or a recurrent tumor.
CONCLUSIONS AND SIGNIFICANCE
EAC and MES tumors show great diagnostic and histologic heterogeneity with need for individualized investigative and treatment approaches. In benign tumors, we advocate aggressive local surgical control without sacrificing vital structures. In malignant tumors, we recommend local surgical control with or without adjunct RT.
Topics: Ear Canal; Ear Neoplasms; Ear, Middle; Humans; Neoplasm Recurrence, Local; Retrospective Studies
PubMed: 35148225
DOI: 10.1080/00016489.2022.2032824 -
Scientific Reports Jul 2023The ear canal is usually described as an S-shaped funnel. In attempting to classify ear-canal shapes obtained from point clouds digitized from molds of 300 ears, the...
The ear canal is usually described as an S-shaped funnel. In attempting to classify ear-canal shapes obtained from point clouds digitized from molds of 300 ears, the problem of designing criteria for distinguishing and organizing the canal shapes arose. In this work, we extracted features inspired by the S-shape characteristic (critical point, maximum, minimum, twist, writhe, translation, rotation) and, through them, introduced 14 types of ear-canal shapes. This classification allowed comparison of ears within a type and of ears between different types. It expanded our range of descriptors of canal shapes and unlocked perspectives for applications.
Topics: Ear Canal; Ear; Environment
PubMed: 37481591
DOI: 10.1038/s41598-023-38570-3 -
Ugeskrift For Laeger Jun 2023In this case report, a 68-year-old woman, with known insulin-dependent diabetes and myelomatosis, presented with ear pain in her right ear. Otomicroscopy showed exposed...
In this case report, a 68-year-old woman, with known insulin-dependent diabetes and myelomatosis, presented with ear pain in her right ear. Otomicroscopy showed exposed bone in the external auditory canal. The patient was examined with wound swab, biopsies, MRI and PET-CT scans to rule out necrotizing external otitis, cholesteatoma and malignancy. Later, the patient's bisphosphonate treatment for myelomatosis was suspected, because osteonecrosis of the external auditory canal is a rare side effect to this treatment. The bone lesion improved after local debridement and cessation of the bisphosphonate treatment.
Topics: Humans; Female; Aged; Diphosphonates; Ear Canal; Ear Diseases; Multiple Myeloma; Positron Emission Tomography Computed Tomography; Osteonecrosis
PubMed: 37325983
DOI: No ID Found -
European Archives of... Aug 2023It is unusual to have communication from the external auditory canal (EAC) directly to the mastoid, totally sparing the tympanum. These patients need a different...
PURPOSE
It is unusual to have communication from the external auditory canal (EAC) directly to the mastoid, totally sparing the tympanum. These patients need a different surgical approach, a modified canal wall-down procedure, to completely clear the disease but fully preserve the tympanum. We present one such exceptional case.
CASE PRESENTATION
A 28-year-old lady presented with ear discharge for 1 year. Imaging confirmed the canal-mastoid fistula, but the entire tympanum was normal. We performed a modified-modified radical mastoidectomy.
CONCLUSIONS
Canal-mastoid fistula is an infrequent entity and may be idiopathic. Despite being evident on clinical examination, imaging aids in assessing size and location of the defect. Although EAC reconstruction may be attempted, the majority require a canal wall-down procedure.
Topics: Female; Humans; Adult; Mastoidectomy; Retrospective Studies; Mastoid; Ear, Middle; Ear Diseases; Ear Canal; Cholesteatoma, Middle Ear
PubMed: 37195344
DOI: 10.1007/s00405-023-08021-w -
The Journal of the Acoustical Society... Aug 2019Ear-canal reflectance has been researched extensively for diagnosing conductive hearing disorders and compensating for the ear-canal acoustics in non-invasive...
Ear-canal reflectance has been researched extensively for diagnosing conductive hearing disorders and compensating for the ear-canal acoustics in non-invasive measurements of the auditory system. Little emphasis, however, has been placed on assessing measurement accuracy and variability. In this paper, a number of ear-canal-reflectance measurement methods reported in the literature are utilized and compared. Measurement variation seems to arise chiefly from three factors: the residual ear-canal length, the ear-probe insertion angle, and the measurement frequency bandwidth. Calculation of the ear-canal reflectance from the measured ear-canal impedance requires estimating the ear-canal characteristic impedance in situ. The variability in ear-canal estimated characteristic impedance and reflectance due to these principal factors is assessed in an idealized controlled setup using a uniform occluded-ear simulator. In addition, the influence of this measurement variability on reflectance-based methods for calibrating stimulus levels is evaluated and, by operating the condenser microphone of the occluded-ear simulator as an electro-static speaker, the variability in estimating the emitted pressure from the ear is determined. The various measurement methods differ widely in their robustness to variations in the three principal factors influencing the accuracy and variability of ear-canal reflectance.
Topics: Acoustic Impedance Tests; Acoustic Stimulation; Auditory Threshold; Calibration; Ear Canal; Humans; Models, Theoretical; Reproducibility of Results; Sensitivity and Specificity; Sound
PubMed: 31472530
DOI: 10.1121/1.5123379 -
Head and Neck Pathology Sep 2018Ceruminous glands are modified apocrine glands located in the external auditory canal (EAC). Neoplastic lesions arising from these glands are rare in humans and... (Review)
Review
Ceruminous glands are modified apocrine glands located in the external auditory canal (EAC). Neoplastic lesions arising from these glands are rare in humans and constitute a major differential diagnosis for glandular neoplasms of the EAC. Due to anatomic restrictions, benign and malignant neoplasms present with similar symptoms and to some extent even comparable radiologic features, particularly when the tumors are localized. Biopsies are frequently limited by small size, fragmentation and improper anatomic and architectural orientation, thereby hampering our ability to appreciate the relationship of peripheral edges of the tumor to the surrounding tissue. Benign and malignant tumors may also have overlapping histomorphologic features, which further magnifies the challenges in accurate diagnosis and management strategies. This article summarizes the salient clinical, radiologic and histologic features of common ceruminous gland tumors, in addition to discussing features that can aid in differentiating ceruminous tumors from other EAC tumors and to distinguish benign from malignant entities.
Topics: Apocrine Glands; Ear Canal; Ear Neoplasms; Humans; Neoplasms, Glandular and Epithelial
PubMed: 30069843
DOI: 10.1007/s12105-018-0909-3 -
Ear, Nose, & Throat Journal Dec 2012A cadaveric study was performed to test the hypothesis that intact-canal-wall mastoidectomy (ICWM) with otoendoscopy allows for equal or better visualization of the...
A cadaveric study was performed to test the hypothesis that intact-canal-wall mastoidectomy (ICWM) with otoendoscopy allows for equal or better visualization of the middle ear cavity structures when compared with canal-wall-down mastoidectomy (CWDM) with microscopy. Ten temporal bones were prepared with a reversible canal-wall-down tympanomastoidectomy technique. Five anatomic sites in each middle ear cavity (lateral epitympanum, posterior crus of the stapes, the sinus tympani, eustachian tube orifice, and round window niche) were marked with paint. Two otolaryngologists blinded to the purpose of the study viewed the temporal bones with the microscope. Following replacement of the posterior canal walls, the bones were then viewed with a 30° and a 70° otoendoscope. All visualized paint marks for each viewing were recorded and compared. We found that ICWM with 30° or 70° otoendoscopy provided significantly better visualization of the sinus tympani than did CWDM (p ≤ 0.001). There was no significant difference among the three methods in visualization of the lateral epitympanum, posterior crus of the stapes, and round window niche. With respect to the eustachian tube orifice, one of the observers reported significantly better visualization with CWDM (p = 0.036). With adjunctive otoendoscopy, it is not necessary to remove the posterior canal wall to adequately visualize or remove disease from various areas of the middle ear cleft. The use of otoendoscopy during cholesteatoma surgery may allow for more frequent preservation of the posterior canal wall and reduced rates of residual cholesteatoma, given the equal or better visualization of the middle ear cavity.
Topics: Ear Canal; Ear, Middle; Endoscopy; Humans; Mastoid; Microscopy; Tympanic Membrane
PubMed: 23288818
DOI: 10.1177/014556131209101208 -
Hearing Research Aug 2022There have been conflicting reports in the literature about the importance of the induced ear canal sound pressure for the perception of bone-conducted (BC) sound. Here...
There have been conflicting reports in the literature about the importance of the induced ear canal sound pressure for the perception of bone-conducted (BC) sound. Here we investigated this by comparing the ear canal sound pressure at threshold for air-conducted (AC) and BC stimulation. Twenty-one adults with subjectively normal hearing function participated. They were tested for their hearing thresholds in the frequency range 250 Hz to 12.5 kHz with AC and BC stimulation and the ear canal sound pressure within 5 mm of the eardrum was obtained with probe tube microphones. Contralateral masking used with BC stimulation shifted the hearing threshold by 5 to 10 dB due to central masking effects. When the ear canal sound pressures at threshold were investigated, the results indicate that the ear canal component for hearing BC sound is around 10 dB below other contributors at frequencies below 2 kHz and similar to other important contributors at frequencies between 2 and 4 kHz. At frequencies above 4 kHz, the contribution from the ear canal sound pressure on BC hearing declines and was around 40 dB below other contributors at 12.5 kHz. The contribution of the ear canal sound pressure in the mid-frequency region is facilitated by the ear canal resonance occurring in this frequency area. The results were similar irrespective of stimulation position. The study also revealed problems estimating the force out of BC transducers caused by a shift in resonance frequency when the artificial mastoid impedance deviates from the impedance of human mastoids. The current study indicates that model predictions have underestimated the contribution from the ear canal sound pressure on BC hearing by around 10 dB.
Topics: Acoustic Stimulation; Adult; Auditory Threshold; Bone Conduction; Ear Canal; Hearing; Humans
PubMed: 34776273
DOI: 10.1016/j.heares.2021.108388 -
Sensors (Basel, Switzerland) Apr 2021This paper aims to validate the performance and physical design of a wearable, unobtrusive ear-centered electroencephalography (EEG) device, dubbed "EARtrodes", using...
OBJECTIVES
This paper aims to validate the performance and physical design of a wearable, unobtrusive ear-centered electroencephalography (EEG) device, dubbed "EARtrodes", using early and late auditory evoked responses. Results would also offer a proof-of-concept for the device to be used as a concealed brain-computer interface (BCI).
DESIGN
The device is composed of a custom-fitted earpiece and an ergonomic behind-the-ear piece with embedded electrodes made of a soft and flexible combination of silicone rubber and carbon fibers. The location of the conductive silicone electrodes inside the ear canal and the optimal geometry of the behind-the-ear piece were obtained through morphological and geometrical analysis of the human ear canal and the region around-the-ear. An entirely conductive generic earpiece was also developed to assess the potential of a universal, more affordable solution.
RESULTS
Early latency results illustrate the conductive silicone electrodes' capability to record quality EEG signals, comparable to those obtained with traditional gold-plated electrodes. Additionally, late latency results demonstrate EARtrodes' capacity to reliably detect decision-making processes from the ear.
CONCLUSIONS
EEG results validate the performance of EARtrodes as a circum-aural and intra-aural EEG recording system adapted for a wide range of applications in audiology, neuroscience, clinical research, and as an unobtrusive BCI.
Topics: Brain-Computer Interfaces; Ear; Ear Canal; Electrodes; Electroencephalography; Evoked Potentials, Auditory; Humans
PubMed: 33922456
DOI: 10.3390/s21092953 -
Ear and Hearing Jul 2013Several alternative ear-canal measures are similar to absorbance in their requirement for prior determination of a Thévenin-equivalent sound source. Examples are (1)... (Review)
Review
Several alternative ear-canal measures are similar to absorbance in their requirement for prior determination of a Thévenin-equivalent sound source. Examples are (1) sound intensity level, (2) forward pressure level, (3) time-domain ear-canal reflectance, and (4) cochlear reflectance. These four related measures are similar to absorbance in their utilization of wideband stimuli and their focus on recording ear-canal sound pressure. The related measures differ from absorbance in how the ear-canal pressure is analyzed and in the type of information that is extracted from the recorded response. Sound intensity level and forward pressure level have both been shown to be better as measures of sound level in the ear canal compared with sound pressure level because they reduced calibration errors due to standing waves in studies of behavioral thresholds and otoacoustic emissions. Time-domain ear-canal reflectance may be used to estimate ear-canal geometry and may have the potential to assess middle ear pathology. Cochlear reflectance reveals information about the inner ear that is similar to what is provided by other types of otoacoustic emissions, and may have theoretical advantages that strengthen its interpretation.
Topics: Acoustic Impedance Tests; Acoustic Stimulation; Audiology; Ear Canal; Humans; Terminology as Topic
PubMed: 23900185
DOI: 10.1097/AUD.0b013e31829c7229