A Rare Cause of Red Tympanic Membrane: Jugular Bulb Diverticulum.

SIGNIFICANCE STATEMENT: Pulsatile tinnitus with erythematous tympanic membrane mass suggests vascular pathologies such as dural arteriovenous fistula, glomus tympanicum, or aberrant carotid artery. Jugular bulb aneurysmatic diverticulum is rare but should be suspected in a case with the presence of aneurysm in other organs. An imaging study is mandatory to confirm the diagnosis. Patient must avoid digging ear as it can cause profuse bleeding. Treatment option can be open surgery or endovascular treatment.

Case series of tuberculous otitis media: Spectrum of clinical presentation and outcome.

OBJECTIVE: Tuberculous otitis media (TB OM) is a rare disease. We present here our experience of TB OM on its clinical presentation, investigation and treatment outcome. METHODS: A retrospective observational study was performed and clinical data of patients in whom TB OM was diagnosed at our center between 2008 and 2019 was analyzed. RESULTS: Five cases of TB OM were identified. Otorrhoea was the most consistent presenting chief complaint while one of the cases presented with right post-auricular swelling. All the cases were successfully treated with anti-tuberculous medication with outcome of dry middle ear but only one case achieved full recovery of hearing loss. CONCLUSION: Due to the disparity of presentations in all our patients, we would like to emphasize the high index of suspicion of TB OM in acute or chronic cases of otitis media with unusual presentation or poor response to standard treatment.

Serie de casos de otitis media tuberculosa: espectro de presentación clínica y resultado / Case series of tuberculous otitis media: Spectrum of clinical presentation and outcome

Objective: Tuberculous otitis media (TB OM) is a rare disease. We present here our experience of TB OM on its clinical presentation, investigation and treatment outcome. Methods: A retrospective observational study was performed and clinical data of patients in whom TB OM was diagnosed at our center between 2008 and 2019 was analyzed. Results: Five cases of TB OM were identified. Otorrhoea was the most consistent presenting chief complaint while one of the cases presented with right post-auricular swelling. All the cases were successfully treated with anti-tuberculous medication with outcome of dry middle ear but only one case achieved full recovery of hearing loss. Conclusion: Due to the disparity of presentations in all our patients, we would like to emphasize the high index of suspicion of TB OM in acute or chronic cases of otitis media with unusual presentation or poor response to standard treatment. (AU)

Objetivo: La otitis media tuberculosa (TB OM, por sus siglas en inglés) es una enfermedad infrecuente. Presentamos nuestra experiencia sobre la misma en cuanto a presentación clínica, investigación y resultado del tratamiento. Métodos: Se realizó un estudio retrospectivo observacional, analizándose los datos clínicos de los pacientes a quienes se diagnosticó de TB OM en nuestro centro entre 2008 y 2019. Resultados: Se identificaron 5 casos de TB OM, siendo otorrea la forma de presentación más consistente, mientras que uno de los casos presentó edema postauricular derecho. Todos los casos fueron exitosamente tratados con fármacos anti-tuberculosos con resultado de oído medio seco, aunque un caso logró la recuperación total de la hipoacusia. Conclusión: Debido a la disparidad de las presentaciones en todos nuestros pacientes, nos gustaría resaltar el elevado índice de sospecha de TB OM en casos agudos o crónicos de otitis media con presentación inusual o mala respuesta al tratamiento estándar. (AU)

Case series of tuberculous otitis media: Spectrum of clinical presentation and outcome.

OBJECTIVE: Tuberculous otitis media (TB OM) is a rare disease. We present here our experience of TB OM on its clinical presentation, investigation and treatment outcome. METHODS: A retrospective observational study was performed and clinical data of patients in whom TB OM was diagnosed at our center between 2008 and 2019 was analyzed. RESULTS: Five cases of TB OM were identified. Otorrhoea was the most consistent presenting chief complaint while one of the cases presented with right post-auricular swelling. All the cases were successfully treated with anti-tuberculous medication with outcome of dry middle ear but only one case achieved full recovery of hearing loss. CONCLUSION: Due to the disparity of presentations in all our patients, we would like to emphasize the high index of suspicion of TB OM in acute or chronic cases of otitis media with unusual presentation or poor response to standard treatment.

Association of Cobb angle progression and neuraxial abnormality on MRI in asymptomatic Adolescent Idiopathic Scoliosis

Background: Detection of neuraxial abnormality in neurologically asymptomatic adolescent idiopathic scoliosis (AIS) is crucial prior to surgery. It can only be detected on magnetic resonance imaging (MRI), which was not routinely done in this group of patient. On the other hand, whole spine radiographs for measurement of Cobb angle have been routinely included during clinic follow-up. This study aimed to determine the correlation between Cobb angle progression and neuraxial abnormality finding on MRI in asymptomatic AIS. Methods: A retrospective study was conducted in the Orthopaedic department of a tertiary hospital. Patients with asymptomatic AIS aged 10-20 years who attended scoliosis clinic from year 2007 to 2010 was reviewed. Patients who had whole spine MRI and two vertebral radiographs at least one year apart were further selected. Statistical analysis was done to see the association between Cobb angle progression and neuraxial abnormality on MRI. Results: The mean age at first presentation was 14.4 years old. Female (n=249) to male (n=50) ratio was 5:1. Only 19 patients fulfilled the selection criteria. There were 5 patients (26.3%) who had neuraxial abnormalities. The mean curve progression was 7.05° (range from -5° to 28°). Patients with and without neuroaxial abnormality showed mean curve progression of 0.6º and 9.36° respectively. There was no significant association between Cobb angle progression and neuroaxial abnormality (p=1.000). Conclusion: Cobb angle progression is not a reliable indicator for predicting neuroaxial abnormality in patients with asymptomatic AIS. However, this study stressed the need to perform MRI prior to operation to document any associated neuraxial abnormality in clinically asymptomatic AIS patients.