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The Journal of International Advanced... Jan 2023Invasive fungal otitis media is clinically rare. The clinical features are often atypical in the early stages of the disease, and delayed treatment results in poor... (Review)
Review
BACKGROUND
Invasive fungal otitis media is clinically rare. The clinical features are often atypical in the early stages of the disease, and delayed treatment results in poor outcomes.
METHODS
In this study, we report 2 patients with invasive fungal otitis media with diabetes. The early diagnosis was confirmed by comprehensive methods such as laboratory tests and imaging examinations, and the condition was significantly improved by antifungal drugs and surgical treatment.
RESULTS
By reviewing the literature, we found that invasive fungal infections confined to the middle ear and mastoid were rarely reported, and the diagnosis and treatment were still controversial.
CONCLUSION
In this article, we summarized and evaluated the different diagnoses and treatment methods so as to better diagnose and improve the cure rate in the early stage of invasive fungal infection of the middle ear.
Topics: Humans; Antifungal Agents; Diabetes Mellitus; Ear, Middle; Mastoid; Otitis Media
PubMed: 36718038
DOI: 10.5152/iao.2023.22743 -
Brazilian Journal of Otorhinolaryngology 2019Acute mastoiditis remains the most common complication of acute otitis media. It may rarely appear also in cochlear implant patients. However, the treatment...
INTRODUCTION
Acute mastoiditis remains the most common complication of acute otitis media. It may rarely appear also in cochlear implant patients. However, the treatment recommendations for this disease are not precisely defined or employed, and in the current literature the differences regarding both the diagnosis and management are relatively substantial.
OBJECTIVE
The aim of this study was to determine a standard and safe procedure to be applied in case of pediatric acute mastoiditis.
METHODS
A retrospective chart review of 73 patients with 83 episodes of acute mastoiditis hospitalized at our tertiary-care center between 2001 and 2016 was conducted. Bacteriology, methods of treatment, hospital course, complications, and otologic history were analyzed. Based on our experience and literature data, a protocol was established in order to standardize management of pediatric acute mastoiditis.
RESULTS
All the patients treated for acute mastoiditis were submitted to an intravenous antibiotic regimen. In the analyzed group pharmacological treatment only was applied in 11% of children, in 12% myringotomy/tympanostomy was added, and in the vast majority of patients (77%) mastoidectomy was performed. In our study recurrent mastoiditis was noted in 8% of the patients. We also experienced acute mastoiditis in a cochlear implant child, and in this case, a minimal surgical procedure, in order to protect the device, was recommended.
CONCLUSIONS
The main points of the management protocol are: initiate a broad-spectrum intravenous antibiotic treatment; mastoidectomy should be performed if the infection fails to be controlled after 48h of administering intravenous antibiotic therapy. We believe that early mastoidectomy prevents serious complications, and our initial observation is that by performing broad mastoidectomy with posterior attic and facial recess exposure, recurrence of acute mastoiditis can be prevented.
Topics: Acute Disease; Anti-Bacterial Agents; Child; Child, Preschool; Humans; Infant; Mastoiditis; Otitis Media; Retrospective Studies
PubMed: 30056031
DOI: 10.1016/j.bjorl.2018.06.002 -
European Annals of Otorhinolaryngology,... Oct 2022The purpose of this Technical Note is to describe the surgical technique to transform canal wall down tympanoplasty into canal wall up tympanoplasty, that is, to...
The purpose of this Technical Note is to describe the surgical technique to transform canal wall down tympanoplasty into canal wall up tympanoplasty, that is, to rehabilitate a recess cavity by filling the mastoid and epitympanic cavities with synthetic tissue (bioactive glass) and recreating a normal-caliber external auditory canal. Mastoid cavity obliteration leads to a clinically significant improvement in health-related quality of life without increasing risk of recurrent or residual cholesteatoma, conditional upon technically impeccable surgery.
Topics: Cholesteatoma, Middle Ear; Ear Canal; Humans; Mastoid; Quality of Life; Retrospective Studies; Treatment Outcome; Tympanoplasty
PubMed: 34535425
DOI: 10.1016/j.anorl.2021.09.001 -
Anatomical Record (Hoboken, N.J. : 2007) Sep 2019Incus angles of axes (the angle between "short process axis" and the "long process axis") are more open in humans than chimpanzees: 64.0 versus 55.7 degrees (Quam et...
Incus angles of axes (the angle between "short process axis" and the "long process axis") are more open in humans than chimpanzees: 64.0 versus 55.7 degrees (Quam et al.: J Anat 225 (2014) 167-196). However, Flohr et al. (Anat Rec 293 (2010) 2094-2106) raise concern about interobserver agreement of the axes. The concern is important as phylogenetic relationships of mammals are inferred from the incus (and malleus and stapes). We sought to check (1) interobserver agreement; and (2) if the angles of the axes of incudes (incuses) exhibit bilateral symmetry, which is expected if the axes are genetically determined. We studied incudes from 41 modern adult crania with clinically normal temporal bones. Angles of axes were determined on rectilinear digital photographs of incudes in standard lateral orientation. Two observers independently drew the axes and measured the axes. Interobserver agreement was within 4 degrees for 24 of 34 left-sided incudes and for 27 of 35 right-sided incudes. The mean of the two observers' angle determinations were used. Left incudes' median was 67 degrees, range 60-73; right 67.5 degrees, range 58-77. Bilateral symmetry of angles of axes was found: r = 0.55, N = 31, 95% CI 0.24-0.75. Angles of axes of modern human incudes are probably genetically determined features, but are of doubtful physiologic or evolutionary advantage in modern humans. Interobserver agreement of angles of modern human axes is concerning and must be specified in reports. Consideration should be given to a convention to designate axes in ambiguous cases. Anat Rec, 302:1615-1619, 2019. © 2019 American Association for Anatomy.
Topics: Adult; Humans; Incus; Mastoid; Observer Variation; Temporal Bone
PubMed: 31120197
DOI: 10.1002/ar.24178 -
Revista Espanola de Quimioterapia :... Jun 2023
Topics: Humans; Tuberculosis; Otitis Media; Mastoiditis
PubMed: 36966385
DOI: 10.37201/req/139.2022 -
BMC Neurology Mar 2020The top of the mastoid notch (TMN) is close to the transverse-sigmoid sinus junction. The spatial position relationship between the TMN and the key points (the...
BACKGROUND
The top of the mastoid notch (TMN) is close to the transverse-sigmoid sinus junction. The spatial position relationship between the TMN and the key points (the anterosuperior and inferomedial points of the transverse-sigmoid sinus junction, ASTS and IMTS) can be used as a novel method to precisely locate the sinus junction during lateral skull base craniotomy.
METHODS
Forty-three dried adult skull samples (21 from males and 22 from females) were included in the study. A rectangular coordinate system on the lateral surface of the skull was defined to assist the analysis. According to sex and skull side, the data were divided into 4 groups: male&left, male&right, female&left and female&right. The distances from the ASTS and IMTS to the TMN were evaluated on the X-axis and Y-axis, symbolized as ASTS&TMN_x, ASTS&TMN_y, IMTS&TMN_x and IMTS&TMN_y.
RESULTS
Among the four groups, there was no significant difference in ASTS&TMN_x (p = 0.05) and ASTS&TMN_y (p = 0.3059), but there were significant differences in IMTS&TMN_x (p < 0.001) and IMTS&TMN_y (p = 0.01), and multiple comparisons indicated that there were significant differences between male&left and female&left both in IMTS&TMN_x (p = 0.0006) and in IMTS&TMN_y (p = 0.0081). In general, the ASTS was located 1.92 mm anterior to the TMN on the X-axis and 27.01 mm superior to the TMN on the Y-axis. For the male skulls, the IMTS was located 3.60 mm posterior to the TMN on the X-axis and 14.40 mm superior to the TMN on the Y-axis; for the female skulls, the IMTS was located 7.84 mm posterior to the TMN on the X-axis and 19.70 mm superior to the TMN on the Y-axis.
CONCLUSIONS
The TMN is a useful landmark for accurately locating the ASTS and IMTS.
Topics: Cadaver; Cranial Sinuses; Craniotomy; Female; Humans; Male; Mastoid
PubMed: 32220232
DOI: 10.1186/s12883-020-01688-2 -
The Journal of International Advanced... Apr 2020Liposarcoma is a soft tissue neoplasm that commonly develops in the lower extremities and rarely in the head and neck region. Herein, we report the case of a patient...
Liposarcoma is a soft tissue neoplasm that commonly develops in the lower extremities and rarely in the head and neck region. Herein, we report the case of a patient with primary liposarcoma that was detected in the mastoid antrum during staged tympanoplasty for cholesteatoma. The tumor adjacent to the attic cholesteatoma was resected completely, and the pathological diagnosis was that of myxoid-type liposarcoma. Because positron emission tomography after the surgery showed no signs of tumor remnants or systemic metastasis, a second-stage surgery was performed 8 months after the first surgery. After confirming that there was no recurrence, tympanoplasty type III with interposition between the stapes and malleus and canal reconstruction was performed. No recurrence was observed for 5 years, and to date, good hearing has been maintained. This is the first report on long-term follow-up of a patient with liposarcoma in the mastoid antrum.
Topics: Aged; Aged, 80 and over; Child, Preschool; Cholesteatoma, Middle Ear; Hearing; Humans; Liposarcoma, Myxoid; Magnetic Resonance Imaging; Male; Mastoid; Mastoidectomy; Middle Aged; Positron-Emission Tomography; Postoperative Care; Treatment Outcome; Tympanoplasty
PubMed: 31257194
DOI: 10.5152/iao.2019.6709 -
Journal of Neuro-ophthalmology : the... Sep 2023
Topics: Humans; Mastoiditis; Lateral Sinus Thrombosis; Petrositis; Sinus Thrombosis, Intracranial
PubMed: 34974488
DOI: 10.1097/WNO.0000000000001431 -
BMC Infectious Diseases Dec 2021Trichosporon asahii is an opportunistic fungus that causes infections in immunosuppressed patients. It is rarely seen in children and immunocompetent hosts. The...
BACKGROUND
Trichosporon asahii is an opportunistic fungus that causes infections in immunosuppressed patients. It is rarely seen in children and immunocompetent hosts. The mortality rates are still high despite early treatment with proper antifungal drugs. Trichosporon asahii mastoiditis in an immunocompetent child makes this case challenging.
CASE PRESENTATION
This report presents a case of Trichosporon asahii mastoiditis which was complicated by transverse sinus thrombosis, in an otherwise healthy 21-month-old girl, and successfully treated with voriconazole. Trichosporon asahii was isolated, in three different occasions, from ear discharge of an immunocompetent healthy child, who presented with prolonged history of fever and received appropriate dosages of multiple types of antimicrobials as an outpatient but without improvement. After 48 h of starting the Voriconzole; post auricular swelling and ear discharge improved significantly.
CONCLUSION
A high index of clinical and microbiological suspicion is needed for optimal diagnosis of Trichosporon infection. Trichosporon asahii can also cause infection in immunocompetent individual even without previous history of hospitalization or intervention. We emphasize the importance of early pediatric infectious evaluation and intervention.
Topics: Antifungal Agents; Basidiomycota; Child; Female; Humans; Infant; Mastoiditis; Trichosporon; Trichosporonosis
PubMed: 34876058
DOI: 10.1186/s12879-021-06915-w -
Ear, Nose, & Throat Journal Feb 2022
Topics: Arthritis, Infectious; Fatal Outcome; Humans; Magnetic Resonance Imaging; Male; Mastoiditis; Middle Aged; Osteomyelitis; Staphylococcus aureus; Substance-Related Disorders; Temporomandibular Joint; Tomography, X-Ray Computed
PubMed: 32720812
DOI: 10.1177/0145561320944648