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1.
Otol Neurotol ; 45(6): 696-702, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38769078

RESUMO

OBJECTIVE: To investigate the microbial changes of long-term hearing aid use culture independently. STUDY DESIGN: Cross-sectional study. PATIENTS: Fifty long-term hearing aid users and 80 volunteer controls with asymptomatic ears. INTERVENTION: External auditory canal (EAC) sampling with DNA-free swabs. MAIN OUTCOME MEASURES: Microbial communities in the samples were investigated with amplicon sequencing of the 16S rRNA gene. RESULTS: The final analysis contained 48 hearing aid users, 59 controls. Twenty-four samples were excluded because of low sequence count, recent use of antimicrobials and/or corticosteroids, recent cold, or missing health status. The groups showed significant differences in bacterial diversity (beta div., p = 0.011), and hearing aid users showed lower species richness than the control group (alpha div., p < 0.01). The most frequent findings in both groups were Staphylococcus auricularis , Alloiococcus otitis , Cutibacterium acnes , Corynebacterium otitidis , and Staphylococcus unclassified sp. Hearing aid users' samples presented more Corynebacterium tuberculostearicum than the control samples. Common EAC pathogens, such as Staphylococcus aureus or Pseudomonas aeruginosa were rare. CONCLUSION: Long-term hearing aid use lowers bacterial diversity and modulates the EAC microbiome. The changes mostly affect commensals. Lowered diversity may predispose individuals to EAC conditions and needs more research.


Assuntos
Meato Acústico Externo , Auxiliares de Audição , Microbiota , Humanos , Masculino , Meato Acústico Externo/microbiologia , Idoso , Feminino , Pessoa de Meia-Idade , Estudos Transversais , RNA Ribossômico 16S/genética , Idoso de 80 Anos ou mais , Adulto , Bactérias/genética , Bactérias/isolamento & purificação
2.
Am J Audiol ; 33(2): 455-464, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38564491

RESUMO

OBJECTIVE: The aim of this study was to explore the potential for bimodal auditory and noninvasive electrical stimulation at the ears to alleviate tonal, somatic tinnitus that was investigated in a small preliminary trial (11 participants). DESIGN: Auditory stimulation took the form of short "notched noise" bursts customized to each participant's tinnitus percept. Simultaneous pulsed electrical stimulation, intended to facilitate neuroplasticity, was delivered via hydrogel electrodes placed in opposite ears. RESULTS: After a 6-week intervention period, average Tinnitus Functional Index (TFI) and Tinnitus Primary Function Questionnaire (TPFQ) scores were consistent with clinically meaningful improvements in the study population. Magnitudes and effect sizes of improvements in TFI and TPFQ are comparable to those reported in other recent bimodal therapy studies using different auditory and electrical stimulation parameters. CONCLUSIONS: Our results should be considered preliminary given the small sample size, lack of crossover data, and small subject pool. When considered alongside other recent bimodal therapy results, we do believe that there are therapeutic benefits of bimodal stimulation for tinnitus sufferers that have the potential to help some with tinnitus, with a variety of stimulation parameters and electrode placements. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25444546.


Assuntos
Terapia por Estimulação Elétrica , Zumbido , Humanos , Zumbido/terapia , Zumbido/fisiopatologia , Zumbido/reabilitação , Feminino , Pessoa de Meia-Idade , Masculino , Terapia por Estimulação Elétrica/métodos , Adulto , Idoso , Meato Acústico Externo , Resultado do Tratamento , Estimulação Acústica/métodos
3.
Int J Pediatr Otorhinolaryngol ; 180: 111956, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38657426

RESUMO

OBJECTIVE: Trimming of perforation margins and external auditory canal (EAC) packing are basic procedures in underlay myringoplasty for repairing chronic perforations. The objective of this study was to compare the operation time, graft outcome, hearing improvement, and complications of endoscopic cartilage underlay myringoplasty with and without trimming of perforation margins and EAC packing in children. STUDY DESIGN: Prospective, randomized study. SETTING: Tertiary referral center. MATERIAL AND METHODS: Pediatric patients older than 12 years with chronic perforations were randomly divided into two groups: myringoplasty with trimming of perforation margin and EAC packing (TPME) group or no trimming of perforation margin and EAC packing (NTPME) group. The operation time, graft success rate, hearing improvement, and complications were compared between the two groups. RESULTS: Fifty-two patients were ultimately included in the study. The mean operation time was 31.4 ± 4.2 min in the TPME group and 23.6 ± 1.7 min in the NTPME group; the difference was significant (P < 0.01). The rate of aural fullness significantly differed between the TPME and NTPME groups (P = 0.000). All participants were followed up for 12 months; the graft success rate did not significantly differ between the groups (88.5% vs. 96.2%; P = 0.603). No patients developed adhesive otitis media. Between the preoperative and postoperative measurements, the mean air-bone gap improved by 10.2 ± 2.8 dB in the TPME group and 11.6 ± 0.7 dB in the NTPME group; this was significant (P < 0.001) in both groups. CONCLUSIONS: Endoscopic cartilage underlay myringoplasty NTPME shorted the operation time and avoided aural fullness and EAC discomfort compared with the TPME technique; however, graft success and hearing improvement were comparable between the two techniques for repairing large perforations in children.


Assuntos
Miringoplastia , Duração da Cirurgia , Perfuração da Membrana Timpânica , Humanos , Miringoplastia/métodos , Perfuração da Membrana Timpânica/cirurgia , Criança , Feminino , Masculino , Estudos Prospectivos , Resultado do Tratamento , Doença Crônica , Meato Acústico Externo/cirurgia , Endoscopia/métodos , Adolescente , Cartilagem/transplante , Audição
4.
J Acoust Soc Am ; 155(4): 2769-2785, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38662609

RESUMO

Assuming plane waves, ear-canal acoustic quantities, collectively known as wideband acoustic immittance (WAI), are frequently used in research and in the clinic to assess the conductive status of the middle ear. Secondary applications include compensating for the ear-canal acoustics when delivering stimuli to the ear and measuring otoacoustic emissions. However, the ear canal is inherently non-uniform and terminated at an oblique angle by the conical-shaped tympanic membrane (TM), thus potentially confounding the ability of WAI quantities in characterizing the middle-ear status. This paper studies the isolated possible confounding effects of TM orientation and shape on characterizing the middle ear using WAI in human ears. That is, the non-uniform geometry of the ear canal is not considered except for that resulting from the TM orientation and shape. This is achieved using finite-element models of uniform ear canals terminated by both lumped-element and finite-element middle-ear models. In addition, the effects on stimulation and reverse-transmission quantities are investigated, including the physical significance of quantities seeking to approximate the sound pressure at the TM. The results show a relatively small effect of the TM orientation on WAI quantities, except for a distinct delay above 10 kHz, further affecting some stimulation and reverse-transmission quantities.


Assuntos
Meato Acústico Externo , Análise de Elementos Finitos , Pressão , Membrana Timpânica , Humanos , Membrana Timpânica/fisiologia , Meato Acústico Externo/fisiologia , Som , Acústica , Estimulação Acústica , Simulação por Computador , Modelos Anatômicos , Emissões Otoacústicas Espontâneas/fisiologia , Orelha Média/fisiologia , Testes de Impedância Acústica/métodos
5.
Med Mycol ; 62(5)2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38684473

RESUMO

Malassezia yeasts belong to the normal skin microbiota of a wide range of warm-blooded animals. However, their significance in cattle is still poorly understood. In the present study, the mycobiota of the external ear canal of 20 healthy dairy Holstein cows was assessed by cytology, culture, PCR, and next-generation sequencing. The presence of Malassezia was detected in 15 cows by cytology and PCR. The metagenomic analysis revealed that Ascomycota was the predominant phylum but M. pachydermatis the main species. The Malassezia phylotype 131 was detected in low abundance. Nor M. nana nor M. equina were detected in the samples.


The mycobiota of the external ear canal of healthy cows was assessed by cytology, culture, PCR, and NGS. The presence of Malassezia was detected by cytology and PCR. Ascomycota was the main phylum and M. pachydermatis the main species. The Malassezia phylotype 131 was also detected in the samples.


Assuntos
Meato Acústico Externo , Malassezia , Micobioma , Animais , Bovinos , Meato Acústico Externo/microbiologia , Malassezia/isolamento & purificação , Malassezia/classificação , Malassezia/genética , Sequenciamento de Nucleotídeos em Larga Escala , Feminino , Metagenômica , Reação em Cadeia da Polimerase
6.
Artigo em Chinês | MEDLINE | ID: mdl-38686486

RESUMO

Trichoblastoma(TB) is a rare germ cell skin adnexal tumor of the hair, and it is a rare follicular tumor of the skin that differentiates from the hair germ epithelium and is often regarded as a benign skin tumorHowever, it is poorly confined and has a local infiltrative growth pattern. tb occurs in the head and neck region, especially in the face, and presents clinically as a slow growing, well-defined and elevated nodule. TB is routinely treated surgically. Due to the lack of universally accepted treatment guidelines or protocols, the recurrence rate after surgery is high, which makes clinical cure more difficult. In this study, a 65-year-old female patient was found to have a swelling with recurrent rupture and pus flow from the right external auditory canal opening and the auricular cavity. After initial misdiagnosis as otitis externa, she was treated with conventional anti-infective therapy, but her symptoms did not resolve and gradually worsened before coming to our hospital. The condition presented in this case is relativelyrare,therepre,timely and accurate diagnosis and treatment are crucial for prognosis improvement of such diseases.


Assuntos
Neoplasias Cutâneas , Humanos , Feminino , Idoso , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias da Orelha/patologia , Neoplasias de Anexos e de Apêndices Cutâneos/patologia , Neoplasias de Anexos e de Apêndices Cutâneos/diagnóstico , Meato Acústico Externo/patologia
7.
Otol Neurotol ; 45(5): 542-548, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38511274

RESUMO

OBJECTIVE: To compare recidivism rates, audiometric outcomes, and postoperative complication rates between soft-wall canal wall reconstruction (S-CWR) versus bony-wall CWR (B-CWR) with mastoid obliteration (MO) in patients with cholesteatoma. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary neurotologic referral center. PATIENTS: Ninety patients aged ≥18 years old who underwent CWR with MO, either S-CWR or B-CWR, for cholesteatoma with one surgeon from January 2011 to January 2022. Patients were followed postoperatively for at least 12 months with or without second-look ossiculoplasty. INTERVENTIONS: Tympanomastoidectomy with CWR (soft vs. bony material) and mastoid obliteration. MAIN OUTCOME MEASURES: Recidivism rates; conversion rate to CWD; pre- versus postoperative pure tone averages, speech reception thresholds, word recognition scores, and air-bone gaps; postoperative complication rates. RESULTS: Middle ear and mastoid cholesteatoma recidivism rates were not significantly different between B-CWR (17.3%) and S-CWR (18.4%, p = 0.71). There was no significant difference in pre- versus postoperative change in ABG (B-CWR, -2.1 dB; S-CWR, +1.6 dB; p = 0.91) nor in the proportion of postoperative ABGs <20 dB (B-CWR, 41.3%; S-CWR, 30.7%; p = 0.42) between B-CWR and S-CWR. Further, there were no significant differences in complication rates between B-CWR and S-CWR other than increased minor TM perforations/retractions in B-CWR (63% vs. 40%, p = 0.03). CONCLUSIONS: Analysis of recidivism rates, audiometric outcomes and postoperative complications between B-CWR with MO versus S-CWR with MO revealed no significant difference. Both approaches are as effective in eradicating cholesteatoma while preserving relatively normal EAC anatomy and hearing. Surgeon preference and technical skill level may guide the surgeon's choice in approach.


Assuntos
Colesteatoma da Orelha Média , Processo Mastoide , Mastoidectomia , Humanos , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Colesteatoma da Orelha Média/cirurgia , Adulto , Processo Mastoide/cirurgia , Mastoidectomia/métodos , Resultado do Tratamento , Timpanoplastia/métodos , Complicações Pós-Operatórias/epidemiologia , Procedimentos de Cirurgia Plástica/métodos , Idoso , Meato Acústico Externo/cirurgia , Adulto Jovem , Audiometria de Tons Puros , Recidiva
8.
Eur Arch Otorhinolaryngol ; 281(5): 2383-2394, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38499694

RESUMO

PURPOSE: Necrotizing otitis externa (OEN) is an aggressive and morbid infection of the external acoustic meatus. What are the risk factors for OEN extension? METHODS: French monocentric retrospective study (2004-2021), including patients with OEN defined by the association of an inflamed EAM, a positive nuclear imaging, the presence of a bacteriological sample and the failure of a well-followed local and/or general antibiotic treatment. OEN was extensive if it was associated with vascular or neurological deficits, if nuclear imaging fixation and/or bone lysis extended beyond the tympanic bone. RESULTS: Our population (n = 39) was male (74%), type 2 diabetic (72%), aged 75.2 years and pseudomonas aeruginosa was found in 88% of cases. Complications for 43% of patients were extensive fixation on nuclear imaging, for 21% of them the presence of extensive bone lysis, for 13% the appearance of facial palsy, for 5.3% the presence hypoglossal nerve palsy and for 2.5% the presence of thrombophlebitis or other nerves palsies. 59% of our population had extensive OEN. The diagnosis of the extensive OEN was made 22 days later (p = 0.04). The clinical presentation was falsely reassuring due to easier identification of the tympanic membrane (70% vs 46%, p = 0.17) but associated with periauricular oedema (42% vs 0%), bone exposure (16% vs 0%) and a temporomandibular joint pain (41% vs 12%). CONCLUSION: Delayed treatment of OEN, identification of clinical bone lysis, especially when the tympanic membrane is easily visualized, and the presence of unbalanced diabetes are potential risk factors for extension of OEN.


Assuntos
Otite Externa , Infecções por Pseudomonas , Humanos , Masculino , Otite Externa/epidemiologia , Otite Externa/diagnóstico , Estudos Retrospectivos , Meato Acústico Externo , Infecções por Pseudomonas/epidemiologia , Antibacterianos/uso terapêutico , Fatores de Risco
9.
Eur Arch Otorhinolaryngol ; 281(6): 3283-3287, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38530458

RESUMO

BACKGROUND: While mastoid obliteration techniques have received much attention in decreasing the disadvantages associated with the resultant mastoid cavity from canal wall down procedures, techniques for an anatomically normal looking ear canal reconstruction to increase the feasibility of hearing aid fitting are less commonly discussed as an alternative. METHODS: Our mastoidoplasty technique basically utilises an inferiorly based periosteal flap with or without temporalis muscles and fascia to obliterate the epitympanum and reconstruct the external auditory canal (EAC). Stay sutures are used to keep them in place. For larger cavities, demineralized bone matrix (DBM) is used to obliterate the mastoid cavity and support the neo-EAC. CONCLUSIONS: The concept of our mastoidoplasty potentially provides a very useful alternative in recreating a near normal ear canal anatomy avoiding cavity problems as well as facilitating hearing aid fitting with canal type hearing aids after canal wall down mastoidectomy.


Assuntos
Meato Acústico Externo , Processo Mastoide , Mastoidectomia , Retalhos Cirúrgicos , Humanos , Mastoidectomia/métodos , Meato Acústico Externo/cirurgia , Processo Mastoide/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade
10.
Med Image Anal ; 94: 103152, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38531210

RESUMO

Today, fitting bespoke hearing aids involves injecting silicone into patients' ears to produce ear canal molds. These are subsequently 3D scanned to create digital ear canal impressions. However, before digital impressions can be used they require a substantial amount of effort in manual 3D editing. In this article, we present computational methods to pre-process ear canal impressions. The aim is to create automation tools to assist the hearing aid design, manufacturing and fitting processes as well as normalizing anatomical data to assist the study of the outer ear canal's morphology. The methods include classifying the handedness of the impression into left and right ear types, orienting the geometries onto the same coordinate system sense, and removing extraneous artifacts introduced by the silicone mold. We investigate the use of convolutional neural networks for performing these semantic tasks and evaluate their accuracy using a dataset of 3000 ear canal impressions. The neural networks proved highly effective at performing these tasks with 95.8% adjusted accuracy in classification, 92.3% within 20° angular error in registration and 93.4% intersection over union in segmentation.


Assuntos
Meato Acústico Externo , Auxiliares de Audição , Humanos , Meato Acústico Externo/anatomia & histologia , Silicones , Redes Neurais de Computação
12.
Int Tinnitus J ; 27(2): 238-241, 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38507640

RESUMO

External Auditory Canal Cholesteatomas (EACC), is an exceptionally rare condition with a prevalence of only 0.1-0.5% among new patients1. EACC are known to possess bone eroding properties, causing a variety of complications, similar to the better-known attic cholesteatomas. We describe here the novel surgical management of a case of EACC. She is 38-year-old female who presented with otorrhea for 6 months. Clinical examination and radiological investigations suggested the diagnosis of an external auditory canal cholesteatoma. The patient underwent modified radical mastoidectomy with type 1 tympanoplasty with meatoplasty. Post-operatively, the patient showed marked clinical improvement.


Assuntos
Colesteatoma , Otopatias , Feminino , Humanos , Adulto , Meato Acústico Externo/cirurgia , Estudos Retrospectivos , Colesteatoma/diagnóstico , Colesteatoma/cirurgia , Miringoplastia
13.
Braz J Otorhinolaryngol ; 90(3): 101414, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38492307

RESUMO

OBJECTIVES: The internal acoustic meatus is an osseous canal that connects the inner ear to the posterior cranial fossa. It is located in the petrous portion of the temporal bone. A thin cribriform osseous plate known as the fundus is situated at the lateral end of the canal. This study assesses the structural and numerical variations of the fundus formations. METHODS: Fifty-four temporal bones of unknown gender and age were examined with the surgical microscope. RESULTS: The temporal bones analyzed were 46.2% right-sided and 53.7% left-sided. Only one temporal bone had two parallel transverse crests, while three had a single anterior crest that split into two branches posteriorly. The number of foramina at the transverse crest varied, with 29.6% having none, 48.1% having a single foramen, and 22.2% having several foramina. An anterior crest structure was seen in 53.7% of the temporal bones, with 5% having a slightly constricted entry to the facial canal. In cases with a single nerve foramen, 48.1% had one, while 51.8% had more than one, including examples with three or four foramina. A crest was found between the foramina of the single nerve in 7% of patients. Furthermore, a crest between the saccular nerve foramen and the high fiber foramina was seen in 25.9% of cases, and 5% had two saccular nerve foramina. CONCLUSION: We think that revealing the anatomical, structural and numerical variations in the fundus will be useful in explaining the disease-symptom relationship. LEVEL OF EVIDENCE: Level 4.


Assuntos
Osso Temporal , Humanos , Osso Temporal/anatomia & histologia , Variação Anatômica , Meato Acústico Externo/anatomia & histologia , Masculino , Feminino , Orelha Interna/anatomia & histologia , Orelha Interna/diagnóstico por imagem
14.
Kobe J Med Sci ; 69(4): E144-E150, 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38379276

RESUMO

The expression of EGFR and p16 in the external auditory canal squamous cell carcinoma (EACSCC) and their impacts on oncological outcomes were not well studied. Seventeen-one consecutive patients who were treated for EACSCC at Kobe University Hospital from 1995 to 2018 were enrolled in this study. The expression of EGFR, and p16 were evaluated and their impacts on oncological outcomes were statistically analyzed. Positive expression of EGFR was observed in 62 patients (87%). Strong positive expression of p16 were observed in 18 patients (32.4%), and weakly positive expression in 30 patients (42.3%), respectively. While the number of the patients with negative EGFR expression were limited, all the surgically treated patients with negative EGFR expression have been alive without disease. In the patients with T3 & T4a EACSCC, prognosis of the patients with positive p16 expression EACSCC tended to be better than those with negative p16 expression. These results suggest the clinical significance of EGFR and p16 expressions in the patients with advanced EACSCC to predict oncological outcomes.


Assuntos
Carcinoma de Células Escamosas , Meato Acústico Externo , Humanos , Meato Acústico Externo/metabolismo , Meato Acústico Externo/patologia , Receptores ErbB/metabolismo , Carcinoma de Células Escamosas/patologia , Prognóstico
15.
Eur Arch Otorhinolaryngol ; 281(4): 2031-2035, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38367073

RESUMO

PURPOSE: Achromobacter xylosoxidans is an emerging pathogen mainly associated with resistant nosocomial infections. This bacteria had been isolated in the ear together with other pathogens in cultures from patients with chronic otitis media, but it had never been reported as a cause of osteomyelitis of the external auditory canal. CASE PRESENTATION: We present a unique case of a healthy 81-year-old woman who presented with left chronic otorrhea refractory to topical and oral antibiotic treatment. Otomicroscopy revealed an erythematous and exudative external auditory canal (EAC) with scant otorrhea. The tympanic membrane was intact, but an area of bone remodeling with a small cavity anterior and inferior to the bony tympanic frame was observed. Otic culture isolated multi-drug-resistant A. xylosoxidans, only sensitive to meropenem and cotrimoxazole. Temporal bone computed tomography showed an excavation of the floor of the EAC compatible with osteomyelitis. Targeted antibiotherapy for 12 weeks was conducted, with subsequent resolution of symptoms and no progression of the bone erosion. CONCLUSIONS: Atypical pathogens such as A. xylosoxidans can be the cause of chronic otitis externa. Early diagnosis and specific antibiotherapy can prevent the development of further complications, such as osteomyelitis. In these cases, otic cultures play an essential role to identify the causal germ. This is the first case of EAC osteomyelitis due to A. xylosoxidans reported to date.


Assuntos
Achromobacter denitrificans , Otopatias , Osteomielite , Otite Externa , Feminino , Humanos , Idoso de 80 Anos ou mais , Meato Acústico Externo/diagnóstico por imagem , Otite Externa/diagnóstico , Otite Externa/tratamento farmacológico , Osteomielite/diagnóstico , Osteomielite/tratamento farmacológico , Osteomielite/complicações
16.
Eur J Cancer ; 201: 113922, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38364629

RESUMO

OBJECTIVES: To analyse prognostic factors and survival outcomes of malignant tumors of the external auditory canal, to investigate the role of regional surgery, and adjuvant radiotherapy in early stages and to investigate the role of surgery in operable T4 stage. SETTING: A retrospective analysis was conducted on all patients prospectively included in the national database of the French Expertize Network for Rare ENT Cancers (REFCOR) from January 2000 to December 2016. PARTICIPANTS: 103 patients from 19 reference centers were included. A propensity score matching analysis was applied to enable comparisons between treatments. MAIN OUTCOMES AND MEASURES: Event-free survival, overall survival and factors of poor prognosis of the cohort were described. The interest of local and regional surgery and postoperative radiotherapy were evaluated. RESULTS: The factors of poor prognosis on event-free survival were immunosuppression (p = 0.002), Karnofsky status less than 90% (p = 0.02), body mass index less than 19 Kg / m2 (p = 0.0009), peripheric facial palsy (p = 0.0016), and positive margin (p = 0.0006). In early stages, locoregional surgery was associated with an increase in event-free survival (p = 0.003, HR = 0.21) versus local surgery alone, while postoperative radiotherapy was not associated with an increase in event-free survival (p = 0.86, HR = 0.91) or overall (p = 0.86, HR = 0.91). In locally advanced stages, locoregional surgery followed by radiotherapy was associated with an increase in event-free survival (p = 0.03, HR = 0.39) and overall (p = 0.02, HR = 0.34) versus chemoradiotherapy alone. CONCLUSION AND RELEVANCE: Regional surgery is recommended for early stages of cancers of the external auditory canal. In operable cases, locoregional surgery followed by radiotherapy is recommended.


Assuntos
Carcinoma de Células Escamosas , Meato Acústico Externo , Humanos , Estudos Retrospectivos , Pontuação de Propensão , Meato Acústico Externo/patologia , Carcinoma de Células Escamosas/patologia , Radioterapia Adjuvante , Prognóstico
17.
Otol Neurotol ; 45(4): e342-e350, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38361347

RESUMO

HYPOTHESIS: Unilateral congenital conductive hearing impairment in ear canal atresia leads to atrophy of the gray matter of the contralateral primary auditory cortex or changes in asymmetry pattern if left untreated in childhood. BACKGROUND: Unilateral ear canal atresia with associated severe conductive hearing loss results in deteriorated sound localization and difficulties in understanding of speech in a noisy environment. Cortical atrophy in the Heschl's gyrus has been reported in acquired sensorineural hearing loss but has not been studied in unilateral conductive hearing loss. METHODS: We obtained T1w and T2w FLAIR MRI data from 17 subjects with unilateral congenital ear canal atresia and 17 matched controls. Gray matter volume and thickness were measured in the Heschl's gyrus using Freesurfer. RESULTS: In unilateral congenital ear canal atresia, Heschl's gyrus exhibited cortical thickness asymmetry (right thicker than left, corrected p = 0.0012, mean difference 0.25 mm), while controls had symmetric findings. Gray matter volume and total thickness did not differ from controls with normal hearing. CONCLUSION: We observed cortical thickness asymmetry in congenital unilateral ear canal atresia but no evidence of contralateral cortex atrophy. Further research is needed to understand the implications of this asymmetry on central auditory processing deficits.


Assuntos
Córtex Auditivo , Humanos , Córtex Auditivo/patologia , Perda Auditiva Condutiva/patologia , Meato Acústico Externo , Imageamento por Ressonância Magnética/métodos , Atrofia/patologia
18.
Artigo em Alemão | MEDLINE | ID: mdl-38412958

RESUMO

A 12-year-old male neutered European Shorthair cat was presented for pruritus in the right ear region, bleeding from ear canal and a suspected polyp-like mass in its lumen.After the diagnostic imaging a biopsy of the mass was taken and submitted for histopathological evaluation. Histopathologic examination led to the diagnosis of low grade mast cell tumor. The subsequent staging examinations included ultrasonography of the liver and spleen as well as a complete blood count. Total ear canal ablation was performed on the same day, and the removed ear canal was again submitted for histopathologic evaluation of the surgical margins. The excision incision margins were free from infiltrating tumor cells. The cat was euthanised 14 months after the surgery. It is unknown whether the reasons for this were associated to metastatic spread of the initial mast cell tumor.A mast cell tumor in the ear canal is an unusual and rare finding, however it should be included in the list of differential diagnoses for ear canal tumors.


Assuntos
Doenças do Gato , Neoplasias da Orelha , Masculino , Animais , Gatos , Meato Acústico Externo/diagnóstico por imagem , Meato Acústico Externo/cirurgia , Meato Acústico Externo/patologia , Mastócitos/patologia , Neoplasias da Orelha/diagnóstico por imagem , Neoplasias da Orelha/cirurgia , Neoplasias da Orelha/veterinária , Diagnóstico Diferencial , Biópsia/veterinária , Doenças do Gato/diagnóstico por imagem , Doenças do Gato/cirurgia
19.
Braz J Otorhinolaryngol ; 90(3): 101381, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38364523

RESUMO

OBJECTIVE: Compare thermal variation in the region of the External Acoustic Canal (EAC) and the Round Window (RW) using different rigid endoscopes and light sources in human temporal bones. METHOD: This is an analytical experimental study using human temporal bones. Thermal variation was assessed during ten minutes, using a thermometer in the region of the EAC and the RW of two temporal bones, right and left. We used three different endoscopes (0° 4-mm, 0° 3-mm and 30° 4-mm) and five intensity/type light source (Halogen 100%, LED 50%, LED 100%, Xenon 50% and Xenon 100% with the same endoscope light fiber. RESULTS: We found temperature elevations in the EAC and RW in all measurements. Larger caliber endoscopes (4-mm) and light sources at 100% intensity generated higher temperatures, slightly higher in halogen and xenon. The 30° endoscopes tended to put more heat on structures, with little difference in most measurements. We identified greater temperature variations in the EAC of the right and left temporal bones compared to the RW overall. The highest temperature acquired in the present study was in the EAC of the temporal bone with a 4-mm and 30° endoscope, using xenon light source (intensity of 100%), with an increase of 4.51 °C. CONCLUSION: The type of endoscope and light source can influence the thermal variation and the risk of tissue injury during endoscopic ear surgery. Larger endoscopes with xenon and halogen light sources at maximum intensity generate more heat.


Assuntos
Endoscópios , Osso Temporal , Humanos , Cadáver , Meato Acústico Externo , Janela da Cóclea , Endoscopia/instrumentação
20.
Head Neck Pathol ; 18(1): 5, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38334859

RESUMO

A 48-year-old man presented with a chief complaint of intermittent right ear otorrhea of several-month duration, occasional otalgia and progressive unilateral hearing impairment. He also reported frequent episodes of headache and pressure in the sinuses and maxilla. Previous systemic treatment with antibiotics failed to alleviate the symptoms. A head/neck CT showed completely normal mastoid, middle ear and external auditory canal regions without any evidence of opacification or bone erosion. Otoscopic examination of the right ear disclosed aggregates of dried, brown, fibrillar material and debris occluding the external auditory canal and obstructing the otherwise intact tympanic membrane. Dilation of the external auditory canal or thickening of the tympanic membrane were not appreciated. The canal was debrided and the fibrillar material was placed in formalin. Histopathologic examination revealed numerous branching, septated fungal hyphae organized in densely-packed clusters. In other areas, the fungal hyphae abutted or were attached to lamellated collections of orthokeratin. As highlighted by GMS staining, the fungi were morphologically compatible with Aspergillus species. The clinicopathologic findings supported a diagnosis of fungal otitis externa, while the numerous anucleate squamous cells were compatible with colonization of an underlying, probably developing, cholesteatoma. Culture of material isolated from the external auditory canal confirmed the presence of Aspergillus flavus. In this illustrative case, we present the main clinical and microscopic characteristics of Aspergillus-related otomycosis developing in the setting of a tautochronous cholesteatoma.


Assuntos
Colesteatoma , Otopatias , Otite Externa , Otomicose , Masculino , Humanos , Pessoa de Meia-Idade , Otomicose/microbiologia , Aspergillus flavus , Otite Externa/microbiologia , Meato Acústico Externo , Colesteatoma/diagnóstico
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