Evaluation of hearing level in patients on long term aspirin therapy.

Introduction: Aspirin is a routinely prescribed drug, most notably for cardiovascular diseases, such as myocardial ischemia. This cross sectional, comparative study study aims to explore differences in hearing status between the cardiovascular disease patients on aspirin therapy and age matched controls. Methods: The study population consisted of 182 patients with heart disease taking long term aspirin (i.e., for more than one year). The control population consisted of 221 age matched controls who were not taking aspirin. Results: It was found that age of patient, not aspirin intake, was more important risk factor contributing to hearing loss.  Conclusions: When confounding factors like age of the patient, hypertension and diabetes were taken into account, aspirin in its antiplatelet dose was not found to be the cause of any audiological problems like tinnitus and hearing loss.

Managing a wooden foreign body in the neck.

An interesting case is presented of a wooden foreign body in the neck entering through the right lower vestibule of the mouth. The foreign body traveled subcutaneously in the neck and got stuck in the clavicle, without damaging any vital structures. In this case, the authors highlight the mode of entry of the foreign body, the peculiarity of the wooden foreign body, the management protocol and the outcomes of the penetrating neck injury by the wooden stick.

Penetrating injury of parotid gland and external auditory canal: a unique combination.

A unique case is presented of a penetrating injury of the parotid gland and complete transection of the cartilaginous portion of the external auditory canal by a tree branch. A subsequent superficial parotidectomy along with end-to-end anastomosis of the external auditory canal and appropriate antimicrobial therapy was successful. A review of the literature did not reveal any previous similar cases.

Cancer of the oral cavity- a growing concern in the Micronesia: a case report from the Marshall Islands.

Cancer of the oral cavity is of growing concern worldwide. In the Micronesia, there has been a recent increase in use of betel nut and tobacco chewing in addition to already existing problem of smoking and alcohol drinking. These deleterious habits have further added the risk for development of oral cancers in the Marshall Islands. The oral cancers have good prognosis, which is directly related to the early diagnosis and treatment. Advanced staged cancers need mutilating surgery in addition to radiotherapy and carry high mortality rate. The epidemiology, etiology and recent approaches in the management of oral cavity cancer has been discussed along with a case report of advanced cancer of the floor of the mouth from the Marshall Islands.

Malignant otitis externa: a review.

Malignant otitis externa is a rare but potentially fatal disease of the external auditory canal seen mostly among elderly, diabetic or immunocompramised patients. The causative organism is mainly Pseudomonas aeruginosa. The disease spreads rapidly, invading surrounding soft tissues, cartilage and bones causing their necrosis and even spreading to the cranial nerves. The disease can be fatal if treatment is not aggressive and timely, especially if it spreads outside the auditory canal with involvement of the cranial nerves. Treatment is mainly medical with antipseudomonal drugs like the third generation cephalosporin and the fluoroquinolones and local debridement. With aggressive treatment the mortality rate from this disease, which used to be 50% in the past has now been reduced to 10-20%. The pathophysiology of the disease, clinical presentation, diagnosis, treatment and the outcome has been discussed and reviewed.