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Ear Canal (ear + canal)
Kinds of Ear Canal Selected AbstractsMicrobiological shifts in intra- and extraoral habitats following mechanical periodontal therapyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2004Thomas Beikler Abstract Objectives: The aim of the present study was to analyze the intra- and extraoral colonization dynamics of periodontal pathogens following supra- and subgingival debridement. Material and Methods: Thirty five patients with chronic periodontitis were enrolled in the study. Supra- and subgingival plaque samples, saliva, and swab samples from mucosa and extraoral sites were taken at baseline and 6 weeks, 3 months and 6 months after mechanical periodontal therapy. Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Eikenella corrodens (Ec), Tannerella forsythensis (Tf), Prevotella intermedia (Pi), Prevotella nigrescens (Pn), and Treponema denticola (Td) were identified by PCR. Results: Supra- and subgingival debridement decreased the number of subgingival sites infected with the analyzed pathogens only transiently, if at all. However, the detection frequencies of Tf, Td, Ec, Pi, and Pn in the supragingival region, of Pg, Td, and Pn at the oral mucosa sites (mostly the tongue), and of all pathogens except Aa in saliva increased over the 6-month observation period. Td was the only pathogen recorded in notable quantities in the extraoral habitat (external ear canal). Conclusion: The results indicate that supra- and subgingival debridement results in a dissemination of periodontal pathogens within the oral cavity. [source] Missed opportunities for a diagnosis of acute otitis media in Aboriginal childrenJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 7 2003KB Gibney Objective: Severe otitis media and its sequelae are common in rural and remote Aboriginal children. Identification of acute otitis media (AOM) is likely to reduce the number of children who go on to develop chronic suppurative otitis media and associated complications. The aim of this study was to compare the diagnoses made by researchers with that documented in the medical records of children admitted to the paediatric isolation ward of the Royal Darwin Hospital, Darwin, Northern Territory. Methods: Children aged <8 years admitted to Royal Darwin Hospital were eligible for assessment by pneumatic otoscopy, video-otoscopy and tympanometry. A diagnosis was made for each child according to the state of their worst ear. Comparisons were made between the researcher diagnoses of ear disease and those documented in the hospital notes by medical staff. Results: Thirty-one children were enrolled during 32 admissions. Most were aged <2 years, Aboriginal, and resided in remote communities. Sixty-one video-otoscopic assessments were attempted and sufficiently good images to allow diagnosis were obtained in 105 of 122 ears. Acute otitis media was diagnosed by the research team in 20 of 32 child admissions. Of 29 children who had ear examinations documented by hospital staff, only seven had a diagnosis of AOM recorded. Overall, the research team were almost three times more likely to make this diagnosis (relative risk 2.9, 95% confidence interval 1.6, 5.2). This difference was unlikely to have occurred by chance (P = 0.0002, McNemar's Chi-squared test). Conclusions: In this small study, young Aboriginal children with clear bulging of their tympanic membrane were not diagnosed with AOM by medical staff. Further training in diagnosis, including cleaning of the ear canal, may lead to more accurate assessment and appropriate recommendations for ongoing management. [source] Para-aural abscessation following traumatic ear canal separation in a dogJOURNAL OF SMALL ANIMAL PRACTICE, Issue 5 2001N. A. Connery Traumatic ear canal separation is rare in animals, with only eight dogs and one cat reported with the condition in the English language literature. Para-aural abscessation occurred in six of these nine animals. Diagnosis was made on otoscopic observation of a shortened, abruptly ending external ear canal that was free from advanced disease. Radiographs in those cases which have been described showed a disruption of the normal air opacity of the affected ear canal. Drainage, by creating a separate opening for the horizontal ear canal, or total ear canal ablation and lateral bulla osteotomy (TECA/LBO), have led to resolution of the clinical signs. This report adds a further case to the literature in which TECA/LBO was employed successfully. [source] Difficult paediatric intubation when fibreoptic laryngoscopy failsPEDIATRIC ANESTHESIA, Issue 9 2002Agnes Ng Summary We report an unusual problem with fibreoptic bronchoscopy in an 8-year-old girl with Negar syndrome. She had a history of difficult airway since birth, and had undergone mandibular distraction for severe obstructive sleep apnoea when she was aged 2 years. Nagar syndrome is a Treacher,Collins like syndrome with normal intelligence, conductive bone deafness and problems with articulation. The patients have malar hypoplasia with down slanting palpebral fissures, high nasal bridge, micrognathia, absence of lower eyelashes, low set posteriorly rotated ears, preauricular tags, atresia of external ear canal, cleft palate, hypoplasia of thumb, with or without radius, and limited elbow extension. Protracted attempts with a fibreoptic bronchoscope failed to visualize the glottis, and this was only possible when the tube was guided to the larynx by blind nasal intubation. Apparently, the healing of the wounds for the mandibular distraction in the mandibular space on the inside of the rami of the mandible had caused differential fibrosis on either side of the hyoid, leading to a triplane distortion of the larynx with a left shift, clockwise rotation to a 2,8 o'clock direction and a slight tilt towards the left pharyngeal wall. The large epiglottis overlying this had precluded a view of the larynx. Finally, the older technique of breathguided intubation facilitated fibreoptic bronchoscopy to achieve tracheal intubation. [source] Osteotome Technique for Removal of Symptomatic Ear Canal ExostosesTHE LARYNGOSCOPE, Issue S113 2007Douglas G. Hetzler MD Abstract Objectives/Hypothesis: This study was undertaken to assess a transcanal osteotome technique for removing symptomatic ear canal exostoses. Outcome measures included healing rates and the rate of complications. Study Design: Prospective study in a private practice. Methods: A straight 1-mm osteotome and a curved 1-mm osteotome were used by way of a transcanal approach to incrementally remove obstructive ear canal exostoses. If anterior or superior bone growths were closely approximating the tympanic membrane, they were partially removed with a 1.5 mm cylindrical end- and side-cutting burr. Healing rates were monitored with weekly postoperative visits. Results: Two hundred twenty-one ear canals (140 patients) were consecutively treated with this technique. Healing was achieved at 2 to 8 (average 3.50) weeks, with 90% healed by 4 weeks. There were 4 mobilizations of a full-thickness segment of anterior bony canal wall; 3 exposures of periosteum anterior to the anterior bony wall; 1 tear of the tympanic membrane requiring a tympanoplasty; 18 anterior and 11 posterior tympanic membrane tears that healed spontaneously; 3 instances of sensorineural hearing decrease; 3 cases of new-onset postoperative tinnitus; and 1 instance of postoperative positioning vertigo. There were no lacerations of the tympanic membrane by an osteotome, no facial nerve injuries, no soft tissue stenoses of an ear canal, and no skin grafting of an ear canal. Conclusions: The described technique of using osteotomes transcanal for removal of symptomatic obstructive ear canal exostoses promoted rapid healing and was effective and safe. [source] Acute Otitis Externa: Efficacy and Tolerability of N-Chlorotaurine, a Novel Endogenous Antiseptic Agent,THE LARYNGOSCOPE, Issue 5 2004Andreas Neher MD Abstract Objective: The study's objective was to test the tolerability and efficacy of the endogenous antiseptic N-chlorotaurine (NCT) in comparison with a standard clinical treatment according to a phase IIb clinical trial protocol. Study Design: The antimicrobial agent NCT was compared with the antibiotic component drops Otosporin (containing neomycin, polymyxin B, and hydrocortisone) for topical treatment of acute otitis externa in a randomized and rater-blinded clinical study. Methods: Fifty patients suffering from acute otitis externa were divided into two groups according to a randomized list. The test group was treated with 1 mL of 1% aqueous NCT solution, the reference group with 1 mL of Otosporin. The substances were applied to the external ear canal at one daily session until the signs of infection disappeared. Efficacy and tolerability were evaluated daily by visual analogue scale and a six-step infection score. In addition, smears were analyzed to identify the causative pathogens. Results: Both medications were equally well tolerated by the patients. The treatment was successful for all patients of the NCT group, whereas in one patient from the reference group, the infection did not disappear. The inflammation score improved more rapidly in the NCT group, which resulted in an earlier termination of the therapy. This difference became highly significant on days 4 to 7 (P < .01 each). Time needed for disappearance of inflammation (score 0) was 5.6 ± 1.6 (mean ± SD, range 3,9) days in the NCT group and 7.4 ± 1.6 (range 4,10) days in the Otosporin group (P < .001). As expected, micro-biologic cultures from ear swabs revealed Pseudomonas aeruginosa (58%) followed by Staphylococcus aureus (18%) as the main causative pathogens. Conclusions: NCT appears to be well tolerated and more effective than the therapy using antibiotic component drops. Because of its endogenous nature and its higher efficacy, NCT appears to be a good choice for topical treatment of acute otitis externa. [source] Optimum Tension for Partial Ossicular Replacement Prosthesis Reconstruction in the Human Middle Ear,THE LARYNGOSCOPE, Issue 2 2004David P. Morris BSc Abstract Objective: Hearing results from ossiculoplasty are unpredictable. There are many potentially modifiable parameters. One parameter that has not been adequately investigated in the past is the effect of tension on the mechanical functioning of the prosthesis. Our goal was to investigate this parameter further, with the hypothesis that the mechanical functioning of partial ossicular replacement prostheses (PORP) from the stapes head to the eardrum will be affected by the tension that they are placed under. Methods: Fresh temporal bones were used to reconstruct a missing incus defect with a PORP-type prosthesis. Three different lengths of PORP were used, and the stapes vibrations were measured with a laser Doppler vibrometer using a calibrated standard sound in the ear canal. Eight temporal bones were used. Results: Tension had a very significant effect on stapes vibration. In general, loose prostheses resulted in the best overall vibration transmission. The effects were most marked at the lower frequencies. There was a slight advantage to tight prostheses in the higher frequencies, but much less than the decrement in lower frequencies with tight prostheses. Conclusion: In ossicular reconstruction, best stapes vibration results in our model are achieved by shorter prostheses, which result in lower tension. [source] Canal Wall Reconstruction with Mimix Hydroxyapatite Cement: Results in an Animal Model and Case Study,THE LARYNGOSCOPE, Issue 12 2003John Dornhoffer MD Abstract Objective/Hypothesis To assess Mimix hydroxyapatite cement for its applicability in canal wall reconstruction using the gerbil as a canal wall model. A case is presented to illustrate a novel technique of canal wall reconstruction using Mimix on the basis of the findings of our animal research. Study Design This was a preclinical study. Methods Ten Mongolian gerbils were implanted with Mimix, with the left side used to simulate mastoid obliteration and the right side used to simulate canal wall reconstruction. Pre- and postsurgery auditory-evoked brainstem responses were used to assess ototoxicity, and hematoxylin-eosin staining of histologic sections was used to assess inflammatory and foreign-body response and new bone formation. Results Rapid wound healing was achieved with each of the nine animals evaluated, with no erythema, edema, or drainage. Inspection of the ear canal at the time of sacrifice revealed no signs of otitis media and no middle ear effusions. Microscopic examination showed no inflammatory response or foreign-body reaction, good mucosalization on the side of the implant facing the bulla, and minimal fibrosis adjacent to the skin. Eight of nine specimens showed new woven bone ingrowth at the bone implant interface, with active osteoblasts and viable lacunae cells. There were no apparent fractures in the implanted material. Conclusions Mimix hydroxyapatite cement is biocompatible and suitable for canal wall reconstruction in the animal model. The characteristics of this cement, namely its ability to set quickly in a moist environment, offer advantages over previously used cements for canal wall reconstruction. [source] Malignancies of the external auditory canal and temporal bone: A reviewANZ JOURNAL OF SURGERY, Issue 2 2002P. Yeung Background: Malignancies of the external auditory canal and temporal bone are uncommon. A retrospective review was conducted of a large series treated at the Prince of Wales hospital between 1974 and 1995. Methods: Retrospective review of 59 cases of ear canal and temporal bone malignancies. These were analysed according to histopathology, disease extent, surgery, margin status and survival. A TNM-type staging system was applied to 51 cases and Kaplan,Meier survival analysis applied to this group. Results: The 5-year cancer-specific survival (CSS) for the series was 54%. For stages 1, 2, 3 and 4 disease, the CSS were 90, 45, 40 and 19%, respectively. Survival was significantly higher where clear surgical margins were achieved (80 vs 35%). Conclusions: Carcinoma of the external ear canal is rare and, in Australia, is often related to recurrence of periauricular cutaneous malignancy. Surgical extirpation with clear margins provides the best survival. [source] Alloiococcus otitidis,otitis media pathogen or normal bacterial flora?,APMIS, Issue 9 2008KRISTER TANO During the last decade a new potential otitis media pathogen, Alloiococcus otitidis, has been studied. It is still not clear whether this bacterium really is a pathogen, although it has been found in a high percentage of middle ear effusions in children. The present study aimed to investigate the presence of A. otitidis in the nasopharynx and outer ear canals, and to develop a culture method that would make it possible to isolate A. otitidis from these locations. Nasopharyngeal samples (n=129) from children below 6 years were investigated by conventional culture on blood agar plates with 6% saline and rabbit antisera against A. otitidis, and by a PCR method. In the same way, we investigated 10 samples from vestibulum nasi of healthy persons, 68 samples from outer ear canals of patients with acute or chronic ear problems, and 24 samples from outer ear canals of healthy persons. In a rat model of acute otitis media, we instilled living A. otitidis into rat middle ears through the tympanic bulla and evaluated the outcome clinically by otomicroscopy at days 3, 6 and 14. Of the 129 nasopharyngeal cultures, 9 were positive for A. otitidis by PCR, but none by the culture method. Of the 68 samples from patients with running ears, 4 were positive for A. otitidis by PCR, but none by the culture method. Of the 24 healthy ear canals, 7 were positive for A. otitidis by PCR and 3 of them also by the culture method. No A. otitidis could be found from the vestibulum nasi. The rat experiment showed that the reactions in the middle ears were mild; we could not provoke a purulent acute otitis media in any of the rats. There was a 7% prevalence of A. otitidis in children below 6 years. The highest prevalence (29%) was found in outer ear canals of healthy persons, which strongly suggests that A. otitidis is part of the normal bacterial flora of the outer ear canal. The doubtful pathogenicity is also confirmed by the fact that,in the rat model,A. otitidis elicited only a mild response in the middle ear. It was possible to isolate A. otitidis using a blood agar plate with 6% saline. [source] Secondary effects induced by the colon carcinogen azoxymethane in BDIX rats,APMIS, Issue 6 2004MORTEN KOBĘK-LARSEN Azoxymethane (AOM) is claimed to be a colon-specific carcinogen. In our studies, AOM was administered to adult BDIX/OrlIco rats by four weekly subcutaneous injections of 15 mg/kg body weight each , two periods of 2 weeks of AOM treatment separated by a one-week break. This treatment schedule resulted in colon carcinomas with a high frequency (75,100%) and with a high reproducibility. However, some serious side effects are associated with this carcinogen treatment. In addition to the colorectal tumours, we found small intestinal tumours, hepatic lesions and a high frequency of mesenchymal renal tumours which increased with longer latency periods. The renal tumours were only found in female rats, and this indicates a possible relation to sex hormones. We therefore analyzed both male and female kidneys for the expression of estrogen and progesterone receptors by immunohistochemical methods. A positive nuclear reaction for estrogen receptor was present in most tumour cells in all tumours and occasionally in nuclei of entrapped tubular cells, but never in glomeruli. Normal appearing renal tissue from female rats showed no positive reaction, but in male rats a slight nuclear reaction was seen in tubuli in the peripheral part of the medulla. A similar pattern was seen for progesterone receptors, but less pronounced. No rats developed tumours in the external ear canal, which is in contrast to studies performed in other rat strains. This may therefore be strain related. In order to reduce the secondary effects of the induction of colon cancer by AOM, it is advisable to use male rats only and a maximum latency period of 32 weeks. [source] Cochlear delays measured with distortion product otoacoustic emissionsCLINICAL OTOLARYNGOLOGY, Issue 4 2000S. Schneider Objective. To investigate the generation place and mechanism of distortion product otoacoustic emissions (DPOAEs) by measuring their delays. Materials and methods. Two tones with the frequencies f1 and f2 (f1 < f2) were presented to the ear canal of a guinea-pig by two telephones. The frequency of one of the tones was varied while the other was kept constant. The amplitude and phase of four DPOAEs (2f1,f2, 3f1,2f2, 4f1,3f2 and 2f2,f1) were measured as a function of frequency. From the phase vs. frequency relation of the DPOAE the cochlear delay is calculated, which is related to the place where the emission is generated. Results. Delays that were determined by varying the f1 frequency appear to be equal for all four distortion products. When the f2 frequency is varied, the delays of the DPOAEs with frequencies 2f1,f2, 3f1,2f2, 4f1,3f2 and 2f2,f1 are significantly larger than the delays of the DPOAE with frequency 2f2,f1. Conclusion. The DPOAEs 2f1,f2, 3f1,2f2 and 4f1,3f2 are generated at the same cochlear place, close to the characteristic place of the f2 frequency. The DPOAE with frequency 2f2,f1 comes from a more basal location in the cochlea. [source] Osteotome Technique for Removal of Symptomatic Ear Canal ExostosesTHE LARYNGOSCOPE, Issue S113 2007Douglas G. Hetzler MD Abstract Objectives/Hypothesis: This study was undertaken to assess a transcanal osteotome technique for removing symptomatic ear canal exostoses. Outcome measures included healing rates and the rate of complications. Study Design: Prospective study in a private practice. Methods: A straight 1-mm osteotome and a curved 1-mm osteotome were used by way of a transcanal approach to incrementally remove obstructive ear canal exostoses. If anterior or superior bone growths were closely approximating the tympanic membrane, they were partially removed with a 1.5 mm cylindrical end- and side-cutting burr. Healing rates were monitored with weekly postoperative visits. Results: Two hundred twenty-one ear canals (140 patients) were consecutively treated with this technique. Healing was achieved at 2 to 8 (average 3.50) weeks, with 90% healed by 4 weeks. There were 4 mobilizations of a full-thickness segment of anterior bony canal wall; 3 exposures of periosteum anterior to the anterior bony wall; 1 tear of the tympanic membrane requiring a tympanoplasty; 18 anterior and 11 posterior tympanic membrane tears that healed spontaneously; 3 instances of sensorineural hearing decrease; 3 cases of new-onset postoperative tinnitus; and 1 instance of postoperative positioning vertigo. There were no lacerations of the tympanic membrane by an osteotome, no facial nerve injuries, no soft tissue stenoses of an ear canal, and no skin grafting of an ear canal. Conclusions: The described technique of using osteotomes transcanal for removal of symptomatic obstructive ear canal exostoses promoted rapid healing and was effective and safe. [source] Alloiococcus otitidis,otitis media pathogen or normal bacterial flora?,APMIS, Issue 9 2008KRISTER TANO During the last decade a new potential otitis media pathogen, Alloiococcus otitidis, has been studied. It is still not clear whether this bacterium really is a pathogen, although it has been found in a high percentage of middle ear effusions in children. The present study aimed to investigate the presence of A. otitidis in the nasopharynx and outer ear canals, and to develop a culture method that would make it possible to isolate A. otitidis from these locations. Nasopharyngeal samples (n=129) from children below 6 years were investigated by conventional culture on blood agar plates with 6% saline and rabbit antisera against A. otitidis, and by a PCR method. In the same way, we investigated 10 samples from vestibulum nasi of healthy persons, 68 samples from outer ear canals of patients with acute or chronic ear problems, and 24 samples from outer ear canals of healthy persons. In a rat model of acute otitis media, we instilled living A. otitidis into rat middle ears through the tympanic bulla and evaluated the outcome clinically by otomicroscopy at days 3, 6 and 14. Of the 129 nasopharyngeal cultures, 9 were positive for A. otitidis by PCR, but none by the culture method. Of the 68 samples from patients with running ears, 4 were positive for A. otitidis by PCR, but none by the culture method. Of the 24 healthy ear canals, 7 were positive for A. otitidis by PCR and 3 of them also by the culture method. No A. otitidis could be found from the vestibulum nasi. The rat experiment showed that the reactions in the middle ears were mild; we could not provoke a purulent acute otitis media in any of the rats. There was a 7% prevalence of A. otitidis in children below 6 years. The highest prevalence (29%) was found in outer ear canals of healthy persons, which strongly suggests that A. otitidis is part of the normal bacterial flora of the outer ear canal. The doubtful pathogenicity is also confirmed by the fact that,in the rat model,A. otitidis elicited only a mild response in the middle ear. It was possible to isolate A. otitidis using a blood agar plate with 6% saline. [source] | ||||||||||