Finite element modelling of sound transmission from outer to inner ear.

PubMed

Areias, Bruno; Santos, Carla; Natal Jorge, Renato M; Gentil, Fernanda; Parente, Marco Pl

2016-11-01

The ear is one of the most complex organs in the human body. Sound is a sequence of pressure waves, which propagates through a compressible media such as air. The pinna concentrates the sound waves into the external auditory meatus. In this canal, the sound is conducted to the tympanic membrane. The tympanic membrane transforms the pressure variations into mechanical displacements, which are then transmitted to the ossicles. The vibration of the stapes footplate creates pressure waves in the fluid inside the cochlea; these pressure waves stimulate the hair cells, generating electrical signals which are sent to the brain through the cochlear nerve, where they are decoded. In this work, a three-dimensional finite element model of the human ear is developed. The model incorporates the tympanic membrane, ossicular bones, part of temporal bone (external auditory meatus and tympanic cavity), middle ear ligaments and tendons, cochlear fluid, skin, ear cartilage, jaw and the air in external auditory meatus and tympanic cavity. Using the finite element method, the magnitude and the phase angle of the umbo and stapes footplate displacement are calculated. Two slightly different models are used: one model takes into consideration the presence of air in the external auditory meatus while the other does not. The middle ear sound transfer function is determined for a stimulus of 60 dB SPL, applied to the outer surface of the air in the external auditory meatus. The obtained results are compared with previously published data in the literature. This study highlights the importance of external auditory meatus in the sound transmission. The pressure gain is calculated for the external auditory meatus.

Gain affected by the interior shape of the ear canal.

PubMed

Yu, Jen-Fang; Chen, Yen-Sheng; Cheng, Wei-De

2011-06-01

This study investigated the correlation of gain distribution and the interior shape of the human external ear canal. Cross-sectional study of gain measurement at the first bend and second bend. Chang Gung Memorial Hospital and Chang Gung University. There were 15 ears in patients aged between 20 and 30 years (8 men/7 women) with normal hearing and middle ears. Stimulus frequencies of 500, 1000, 2000, 3000, and 4000 Hz were based on the standard clinical hearing test. Measurements closer to the tympanic membrane and the positions at the first and second bends were confirmed by using otoscope. Real ear measurement to analyze the canal resonance in human external ears was adopted. This study found that gain at stimulus frequencies of 4000 Hz was affected by the interior shape of the ear canal (P < .005), particularly at the first and second bends, whereas gain was only affected by the length of the ear canal for stimulus frequencies of 2000 Hz (P < .005). This study found that gain was affected not only by the length of the external auditory canal (EAC) but also by the interior shape of the EAC significantly. The findings of this study may have potential clinical applications in canalplasty and congenital aural atresia surgery and may be used to guide surgeries that attempt to reshape the ear canal to achieve more desirable hearing outcomes.

Anatomical study of the pigs temporal bone by microdissection.

PubMed

Garcia, Leandro de Borborema; Andrade, José Santos Cruz de; Testa, José Ricardo Gurgel

2014-01-01

Initial study of the pig`s temporal bone anatomy in order to enable a new experimental model in ear surgery. Dissection of five temporal bones of Sus scrofa pigs obtained from UNIFESP - Surgical Skills Laboratory, removed with hole saw to avoid any injury and stored in formaldehyde 10% for better conservation. The microdissection in all five temporal bone had the following steps: inspection of the outer part, external canal and tympanic membrane microscopy, mastoidectomy, removal of external ear canal and tympanic membrane, inspection of ossicular chain and middle ear. Anatomically it is located at the same position than in humans. Some landmarks usually found in humans are missing. The tympanic membrane of the pig showed to be very similar to the human, separating the external and the middle ear. The middle ear`s appearance is very similar than in humans. The ossicular chain is almost exactly the same, as well as the facial nerve, showing the same relationship with the lateral semicircular canal. The temporal bone of the pigs can be used as an alternative for training in ear surgery, especially due the facility to find it and its similarity with temporal bone of the humans.

Perichondritis

MedlinePlus

... Ear piercing (especially piercing of the cartilage) Contact sports Trauma to the side of the head Ear ... external ear. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology . 6th ed. Philadelphia, ...

21 CFR 524.1484c - Neomycin sulfate, isoflupredone acetate, tetracaine hydrochloride ointment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... conditions of the external ear canal, a quantity of ointment sufficient to fill the external ear canal may be... cleansed, and a small amount of the ointment applied and spread or rubbed in gently. The involved area may...

21 CFR 524.1484c - Neomycin sulfate, isoflupredone acetate, tetracaine hydrochloride ointment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... conditions of the external ear canal, a quantity of ointment sufficient to fill the external ear canal may be... cleansed, and a small amount of the ointment applied and spread or rubbed in gently. The involved area may...

Swimmer's Ear (External Otitis)

MedlinePlus

... t help, your doctor might prescribe a stronger pain reliever. You'll use this only for a short time — until the ear drops and antibiotics begin to work. To protect your ear while it heals, your ...

Active middle ear implant after lateral petrosectomy and radiotherapy for ear cancer.

PubMed

Cristalli, Giovanni; Sprinzl, Georg M; Wolf-Magele, Astrid; Marchesi, Paolo; Mercante, Giuseppe; Spriano, Giuseppe

2014-04-01

Tumor of the temporal bone is a rare disease with a very poor prognosis. Surgery and postoperative radiotherapy are usually the recommended treatments for squamous cell carcinoma (SCC) of the external and middle ear, which may cause conductive hearing loss. The purpose of this study was to evaluate the audiologic results and compliance of active middle ear implant (AMEI) and establish the feasibility of the procedure in a patient treated for middle ear cancer. A 73-year-old patient treated with lateral petrosectomy, neck dissection, reconstruction/obliteration by pedicled pectoralis major myocutaneous flap, and postoperative full dose radiotherapy for external and middle ear SCC was selected for AMEI. Preoperative audiometric and speech audiometry tests were performed on both ears before and after the activation. Pure tone free field audiometry. Binaural free field speech audiogram. Aided pure tone free field audiometry AMEI results show an increase in air conduction. Speech audiogram showed better discrimination scores in AMEI-aided situations. No complications were observed. AMEI after surgery followed by radiotherapy for middle ear cancer is feasible. Acoustic results in obliterated ear are satisfactory.

Klippel-Feil syndrome and associated ear anomalies.

PubMed

Yildirim, Nadir; Arslanoğlu, Atilla; Mahiroğullari, Mahir; Sahan, Murat; Ozkan, Hüseyin

2008-01-01

Klippel-Feil syndrome (KFS) is a congenital segmentation anomaly of the cervical vertebrae that manifests as short neck, low hair line, and limited neck mobility. Various systemic malformations may also accompany the syndrome including wide variety of otopathologies affecting all 3 compartments of the ear (external, middle, and inner ear) as well as internal acoustic canal and vestibular aqueduct. We aimed to investigate these involvements and their clinical correlates in a group of patients with KFS. We present 20 KFS cases, of which 12 (% 60) displayed most of the reported ear abnormalities such as microtia, external ear canal stenosis, chronic ear inflammations and their sequels, anomalies of the tympanic cavity and ossicles, inner ear dysplasies, deformed internal acoustic canal, and wide vestibular aqueduct, which are demonstrated using the methods of otoscopy, audiologic testing, and temporal bone computed tomography. This series represents one of the highest reported rate of ear involvement in KFS. We found no correlation between the identified ear pathologies and the skeletal and extraskeletal malformations. The genetic nature of the syndrome was supported by the existence of affected family members in 4 (20%) of the cases.

Infantile inflammatory pseudotumor of the facial nerve as a complication of epidermal nevus syndrome with cholesteatoma.

PubMed

Hato, Naohito; Tsujimura, Mika; Takagi, Taro; Okada, Masahiro; Gyo, Kiyofumi; Tohyama, Mikiko; Tauchi, Hisamichi

2013-12-01

The first reported case of facial paralysis due to an inflammatory pseudotumor (IPT) of the facial nerve as a complication of epidermal nevus syndrome (ENS) is herein presented. A 10-month-old female patient was diagnosed with ENS at 3 months of age. She was referred to us because of moderate left facial paralysis. Epidermal nevi of her left auricle extended deep into the external ear canal. Otoscopy revealed polypous nevi and cholesteatoma debris filling the left ear. Computed tomography showed a soft mass filling the ear canal, including the middle ear, and an enormously enlarged facial nerve. Surgical exploration revealed numerous polypous nevi, external ear cholesteatoma, and tumorous swelling of the facial nerve. The middle ear ossicles were completely lost. The facial paralysis was improved after decompression surgery, but recurred 5 months later. A second operation was conducted 10 months after the first. During this operation, facial nerve decompression was completed from the geniculate ganglion to near the stylomastoid foramen. Histological diagnosis of the facial nerve tumor was IPT probably caused by chronic external ear inflammation induced by epidermal nevi. The facial paralysis gradually improved to House-Blackmann grade III 5 years after the second operation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Traumatic neuroma: a late complication of otoplasty.

PubMed

Lwin, Christine T-T; Birch, Jeremy; Giele, Henk

2007-01-01

We report on the development of traumatic ear lobe neuromas as a late complication of bilateral otoplasty performed 16 years previously. To our knowledge, this is the first and only described case of traumatic neuromas arising as a late complication of otoplasty in the English literature. Traumatic neuroma should be considered in the differential diagnosis of any nodular lesions that develop within the external ear in patients who have had otoplasty or any other form of external ear surgery or trauma.

Ear abnormalities in patients with oculo-auriculo-vertebral spectrum (Goldenhar syndrome).

PubMed

Rosa, Rafael Fabiano Machado; Silva, Alessandra Pawelec da; Goetze, Thayse Bienert; Bier, Bianca de Almeida; Almeida, Sheila Tamanini de; Paskulin, Giorgio Adriano; Zen, Paulo Ricardo Gazzola

2011-01-01

Oculo-auriculo-vertebral spectrum (OAVS) is a rare condition characterized by the involvement of the first branchial arches. To investigate the ear abnormalities of a sample of patients with OAVS. The sample consisted of 12 patients with OAVS seen at the Clinical Genetics Unit, UFCSPA/CHSCPA. The study included only patients who underwent mastoid computed tomography and with normal karyotype. We performed a review of its clinical features, giving emphasis to the ear findings. Nine patients were male, the ages ranged from 1 day to 17 years. Ear abnormalities were observed in all patients and involved the external (n = 12), middle (n = 10) and inner ear (n = 3). Microtia was the most frequent finding (n = 12). The most common abnormalities of the middle ear were: opacification (n = 2), displacement (n = 2) and malformation of the ossicular chain. Agenesis of the internal auditory canal (n = 2) was the most frequent alteration of the inner ear. Ear abnormalities are variable in patients with OAVS and often there is no correlation between findings in the external, middle and inner ear. The evaluation of these structures is important in the management of individuals with OAVS.

A comparison of patterns of disease extension in keratosis obturans and external auditory canal cholesteatoma.

PubMed

Shinnabe, Akihiro; Hara, Mariko; Hasegawa, Masayo; Matsuzawa, Shingo; Kanazawa, Hiromi; Yoshida, Naohiro; Iino, Yukiko

2013-01-01

To investigate the different pathways of progression to the middle ear in keratosis obturans (KO) and external auditory canal cholesteatoma (EACC). Retrospective case review. Referral hospital otolaryngology department. Patients with KO or EACC and middle ear disease who underwent surgical management were included. Four ears of 4 patients (mean age, 41.25 yr) were the KO group, and 5 ears of 4 patients (mean age, 49.5 yr) were the EACC group. Intraoperative findings of the middle ear cavity were investigated in KO and EACC groups. In the KO group, 3 patients had a perforated tympanic membrane and cholesteatoma in the tympanic cavity. The other patient had preoperative right facial palsy. Removal of the keratin plug revealed an adherent tympanic membrane. In intraoperative findings, the tympanic segment of the fallopian canal was found to be eroded because of inflammation. No case initially progressed to the mastoid cavity. Four patients had external auditory canal cholesteatoma with middle ear disease. In EACC group, all patients had initial progression to the mastoid cavity. KO tends to progress initially to the tympanic cavity via a diseased tympanic membrane. EACC tends to progress to the mastoid cavity via destruction of the posterior bony canal. This is the first report to investigate differences in pathway of progression to the middle ear cavity in these 2 diseases.

Adenoid cystic carcinoma of the external ear: a population based study.

PubMed

Green, Ross W; Megwalu, Uchechukwu C

2016-01-01

To determine the incidence of adenoid cystic carcinoma of the external ear in the United States, and to evaluate the clinical characteristics and survival outcomes associated with the disease. Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) 18 Database of the National Cancer Institute. The study cohort included patients diagnosed with adenoid cystic carcinoma of the external ear from 1973 to 2012. The incidence of adenoid cystic carcinoma of the external ear was 0.004 per 100,000. The SEER database identified 66 patients meeting the inclusion criteria. Nodal metastasis was noted in 13.1% of patients, while 7.9% had distant metastasis. Distant metastasis was associated with worse overall survival (HR 10.18). However, nodal metastasis had no impact on overall survival (HR 0.15, p = 0.09). Surgery alone was associated with improved overall survival (HR 0.26), compared with combination surgery and radiotherapy, while radiotherapy alone was associated with worse overall survival (HR 20.12). Increasing age (HR 1.12) and black race (HR 6.83) were associated with worse overall survival, while female sex (HR 0.26) was associated with improved overall survival. ACC of the external ear is rare. Distant metastasis is a poor prognostic factor. However, nodal metastasis does not appear to impact survival. Advanced age, black race, and male sex are also poor prognostic factors. Surgical resection alone is associated with better survival than combination surgical resection and radiation, or radiotherapy alone. Copyright © 2016 Elsevier Inc. All rights reserved.

First branchial cleft sinus presenting with cholesteatoma and external auditory canal atresia.

PubMed

Yalçin, Sinasi; Karlidağ, Turgut; Kaygusuz, Irfan; Demirbağ, Erhan

2003-07-01

First branchial cleft abnormalities are rare. They may involve the external auditory canal and middle ear. We describe a 6-year-old girl with congenital external auditory canal atresia, microtia, and cholesteatoma of mastoid and middle ear in addition to the first branchial cleft abnormalities. Clinical features of the patient are briefly described and the embryological relationship between first branchial cleft anomaly and external auditory canal atresia is discussed. The surgical management of these lesions may be performed, both the complete excision of the sinus and reconstructive otologic surgery.

Anthropometry of external auditory canal by non-contactable measurement.

PubMed

Yu, Jen-Fang; Lee, Kun-Che; Wang, Ren-Hung; Chen, Yen-Sheng; Fan, Chun-Chieh; Peng, Ying-Chin; Tu, Tsung-Hsien; Chen, Ching-I; Lin, Kuei-Yi

2015-09-01

Human ear canals cannot be measured directly with existing general measurement tools. Furthermore, general non-contact optical methods can only conduct simple peripheral measurements of the auricle and cannot obtain the internal ear canal shape-related measurement data. Therefore, this study uses the computed tomography (CT) technology to measure the geometric shape of the ear canal and the shape of the ear canal using a non-invasive method, and to complete the anthropometry of external auditory canal. The results of the study show that the average height and width of ear canal openings, and the average depth of the first bend for men are generally longer, wider and deeper than those for women. In addition, the difference between the height and width of the ear canal opening is about 40% (p < 0.05). Hence, the circular cross-section shape of the earplugs should be replaced with an elliptical cross-section shape during manufacturing for better fitting. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Three cases of successful microvascular ear replantation after bite avulsion injury.

PubMed

Schonauer, Fabrizio; Blair, James W; Moloney, Dominique M; Teo, T C; Pickford, Mark A

2004-01-01

We present three cases of sub-total amputation of the external ear caused by bite avulsion injury. The ears were all successfully replanted despite us being unable to perform a venous anastomosis in one case. These outcomes support attempted microsurgical replantation for total or sub-total amputations of the ear, as successful replantation is the most effective surgical option.

Rerouting the external auditory canal. A method of correcting congenital stenosis.

PubMed

Baron, S H

1975-04-01

An hourglass or funnel-shaped, stenosed, external auditory meatus with a normal tympanic membrane, middle and inner ear is one of the congenital anomalies that occasionally occurs. Such abnormality was present in both ears of a woman and caused chromic otitis externa and deafness. A routine meatoplasty on the right ear failed because of an unusual cephalad position of the drumhead in relation to a "downhill" position of the stenosed outer meatus. Rerouting the ear canal to a horizontal position by removing bone of the canal superiorly, posteriorly, and inferiorly, and grafting the now horizontal canal with skin taken from the postauricular fold produced a good result. This is a satisfactory procedure for a woman, but would be cosmetically unacceptable for a man.

[Genetic deafness].

PubMed

Marcolla, A; Bouchetemble, P; Lerosey, Y; Marie, J-P; Dehesdin, D

2006-06-01

The aim of this study was to review the different types of genetic deafness. We describe syndromic and isolated sensorineural deafness and transmission deafness. Genetic sensorineural syndromic deafness represents 30% of cases of genetic deafness. A frequent cause is Pendred syndrome, which associates congenital sensorineural deafness with goitre and malformations of the inner ear which can be identified on computed tomography scan. Isolated deafness which is responsible for 70% of cases of genetic deafness is then outlined. Among the different types of isolated deafness, 80% are autosomal recessive disorders. A frequent form of autosomal recessive deafness is due to mutations in the connexin 26 gene. Lastly, we detail transmission deafness dominated by aplasia. Major aplasia is characterized by a malformation of the external ear associated with malformations of the middle ear whereas, minor aplasia corresponds to a malformation of the middle ear, sometimes associated with minor external ear malformations. For each type of deafness we propose a systematic assessment.

Optical measurement of the weak non-linearity in the eardrum vibration response to auditory stimuli

NASA Astrophysics Data System (ADS)

Aerts, Johan

The mammalian hearing organ consists of the external ear (auricle and ear canal) followed by the middle ear (eardrum and ossicles) and the inner ear (cochlea). Its function is to convert the incoming sound waves and convert them into nerve pulses which are processed in the final stage by the brain. The main task of the external and middle ear is to concentrate the incoming sound waves on a smaller surface to reduce the loss that would normally occur in transmission from air to inner ear fluid. In the past it has been shown that this is a linear process, thus without serious distortions, for sound waves going up to pressures of 130 dB SPL (˜90 Pa). However, at large pressure changes up to several kPa, the middle ear movement clearly shows non-linear behaviour. Thus, it is possible that some small non-linear distortions are also present in the middle ear vibration at lower sound pressures. In this thesis a sensitive measurement set-up is presented to detect this weak non-linear behaviour. Essentially, this set-up consists of a loud-speaker which excites the middle ear, and the resulting vibration is measured with an heterodyne vibrometer. The use of specially designed acoustic excitation signals (odd random phase multisines) enables the separation of the linear and non-linear response. The application of this technique on the middle ear demonstrates that there are already non-linear distortions present in the vibration of the middle ear at a sound pressure of 93 dB SPL. This non-linear component also grows strongly with increasing sound pressure. Knowledge of this non-linear component can contribute to the improvement of modern hearing aids, which operate at higher sound pressures where the non-linearities could distort the signal considerably. It is also important to know the contribution of middle ear non-linearity to otoacoustic emissions. This are non-linearities caused by the active feedback amplifier in the inner ear, and can be detected in the external and middle ear. These signals are used for diagnostic purposes, and therefore it is important to have an estimate the non-linear middle ear contribution to these emissions.

Experimental research on preventing mechanical phlebitis arising from indwelling needles in intravenous therapy by external application of mirabilite

PubMed Central

Lu, Yanyan; Hao, Chunyan; He, Wubin; Tang, Can; Shao, Zhenya

2018-01-01

Various types of complications arising from intravenous indwelling needles have become a challenge in clinical care. It is urgent to seek a simple and cost-effective method for prevention and treatment of phlebitis. We investigated the roles of mirabilite in preventing and treating phlebitis caused by intravenous indwelling needles and provide guidance for prevention and treatment of mechanical phlebitis caused by intravenous indwelling needles. A total of 57 healthy congeneric big-eared New Zealand rabbits were randomly divided into 3 groups: blank control, indwelling needle, and group with external application of mirabilite. The ear vein of each rabbit was punctured with an intravenous indwelling needle. The ear vein specimens were taken at 3, 5, and 7 days after indwelling. The hematoxylin and eosin stained pathological tissue sections of the ear veins of the rabbits in each group were observed. The expression levels of IL-1 and IL-6, and tumour necrosis factor-α (TNF-α) in the vascular tissue of the ear veins of the rabbits in each group were detected with the immunofluorescence method. In the blank control group, there was no inflammatory cellular infiltration and no proliferation of fibrous tissue around the vascular wall. With the increase of the indwelling time, proliferation of fibrous tissue in vascular wall, increased inflammatory cellular infiltration and organized thrombus in the vascular tissue occurred in the ear veins of the rabbits in the indwelling needle group and group with external application of mirabilite. Compared with the indwelling needle group, the group with external application of mirabilite had significantly decreased fibrous tissue in the vascular wall and significantly decreased inflammatory cellular infiltration. At the same point in indwelling time, the expression levels of IL-1, IL-6, and TNF-α in the indwelling needle and group with external application of mirabilite were significantly higher than that in the blank control group (P<0.05). The expression levels of IL-1, IL-6, and TNF-α in the group with external application of mirabilite were lower than that in the indwelling needle group (P<0.05). The expression levels of IL-1, IL-6, and TNF-α are positively correlated with the indwelling time within the same group at different points in time. In conclusion, external application of mirabilite can significantly decrease infiltration of venous inflammatory cells of the rabbit ear margin, proliferation of fibrous tissue and thrombosis in the vascular wall, significant decrease the expression levels of IL-1, IL-6, and TNF-α in the mechanical phlebitis caused by intravenous indwelling needles, and decrease the inflammatory responses of the ear veins of rabbits. PMID:29250150

Experimental research on preventing mechanical phlebitis arising from indwelling needles in intravenous therapy by external application of mirabilite.

PubMed

Lu, Yanyan; Hao, Chunyan; He, Wubin; Tang, Can; Shao, Zhenya

2018-01-01

Various types of complications arising from intravenous indwelling needles have become a challenge in clinical care. It is urgent to seek a simple and cost-effective method for prevention and treatment of phlebitis. We investigated the roles of mirabilite in preventing and treating phlebitis caused by intravenous indwelling needles and provide guidance for prevention and treatment of mechanical phlebitis caused by intravenous indwelling needles. A total of 57 healthy congeneric big-eared New Zealand rabbits were randomly divided into 3 groups: blank control, indwelling needle, and group with external application of mirabilite. The ear vein of each rabbit was punctured with an intravenous indwelling needle. The ear vein specimens were taken at 3, 5, and 7 days after indwelling. The hematoxylin and eosin stained pathological tissue sections of the ear veins of the rabbits in each group were observed. The expression levels of IL-1 and IL-6, and tumour necrosis factor-α (TNF-α) in the vascular tissue of the ear veins of the rabbits in each group were detected with the immunofluorescence method. In the blank control group, there was no inflammatory cellular infiltration and no proliferation of fibrous tissue around the vascular wall. With the increase of the indwelling time, proliferation of fibrous tissue in vascular wall, increased inflammatory cellular infiltration and organized thrombus in the vascular tissue occurred in the ear veins of the rabbits in the indwelling needle group and group with external application of mirabilite. Compared with the indwelling needle group, the group with external application of mirabilite had significantly decreased fibrous tissue in the vascular wall and significantly decreased inflammatory cellular infiltration. At the same point in indwelling time, the expression levels of IL-1, IL-6, and TNF-α in the indwelling needle and group with external application of mirabilite were significantly higher than that in the blank control group (P<0.05). The expression levels of IL-1, IL-6, and TNF-α in the group with external application of mirabilite were lower than that in the indwelling needle group (P<0.05). The expression levels of IL-1, IL-6, and TNF-α are positively correlated with the indwelling time within the same group at different points in time. In conclusion, external application of mirabilite can significantly decrease infiltration of venous inflammatory cells of the rabbit ear margin, proliferation of fibrous tissue and thrombosis in the vascular wall, significant decrease the expression levels of IL-1, IL-6, and TNF-α in the mechanical phlebitis caused by intravenous indwelling needles, and decrease the inflammatory responses of the ear veins of rabbits.

Ewing Sarcoma of the External Ear Canal

PubMed Central

Kecelioglu Binnetoglu, Kiymet; Gerin, Fatma; Sari, Murat

2016-01-01

Background. Ewing sarcoma (ES) is a high-grade malignant tumor that has skeletal and extraskeletal forms and consists of small round cells. In the head and neck region, reported localization of extraskeletal ES includes the larynx, thyroid gland, submandibular gland, nasal fossa, pharynx, skin, and parotid gland, but not the external ear canal. Methods. We present the unique case of a 2-year-old boy with extraskeletal ES arising from the external ear canal, mimicking auricular hematoma. Results. Surgery was performed and a VAC/IE (vincristine, adriamycin, cyclophosphamide alternating with ifosfamide, and etoposide) regimen was used for adjuvant chemotherapy for 12 months. Conclusion. The clinician should consider extraskeletal ES when diagnosing tumors localized in the head and neck region because it may be manifested by a nonspecific clinical picture mimicking common otorhinolaryngologic disorders. PMID:27313930

Inverted u-shaped purse and rotation flaps: correcting the inferoposterior deformity of reconstructed ears after canaloplasty of the external auditory meatus.

PubMed

Ji, Chenyang; Zhang, Jinming; An, Geng; Liang, Weiqiang; Pan, Shujuan; Chen, Yuhong; Wei, Zhe; Zhang, Ganlin

2012-06-01

After patients with congenital microtia receive external ear canal plasty, the mastoid area usually has insufficient space for ear reconstruction. Hence, after ear reconstruction, an inferoposterior position deformity of the ear appears to some extent. Using inverted U-shaped purse and rotation flaps can correct this deformity effectively. From May of 2009 to September of 2011, five patients received the described procedures in the authors' department. Inverted U-shaped purse and rotation flaps were used for all the patients. The inverted U-shaped purse flap was used to reduce the area of the canal orifice and to lower the position, and the rotation flap was applied to turn the ear in a more superoposterior position. Two patients also received full-thickness skin grafting to cover the secondary wound. In four patients, V-Y-plasty or Z-plasty was used to adjust the flap transition. For the five patients, the distances between the ear antihelix and canal orifice were shortened, and the areas of the canal orifice were diminished. The retroversion of the auricle was corrected in various degrees, and the angles of the long axis of the auricle and the horizontal line were increased an average of 14.4°. The vertical distance between the top of the helix and the center of the canal orifice was increased an average of 15.2 mm. A slight dog ear deformity in front of the crus of the helix was left after the operation, but it was alleviated in the follow-up period. By using inverted U-shaped purse and rotation flaps, the inferoposterior position deformity of the reconstructed ear after external ear canal plasty in congenital microtia can be resolved effectively. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.

Preventing Cauliflower Ear with a Modified Tie-Through Technique.

ERIC Educational Resources Information Center

Dimeff, Robert J.; Hough, David O.

1989-01-01

Describes a quick, simple tie-through suture technique (in which a collodion packing is secured to the auricle with two buttons) for preventing cauliflower ear following external ear trauma in wrestlers and boxers. The technique ensures constant compression; multiple treatments for fluid reaccumulation are rarely necessary. (SM)

Redefinition of the helical rim in cauliflower-ear surgery.

PubMed

Schonauer, F; La Rusca, I; Pereira, J A; Molea, G

2002-01-01

Cauliflower ear is a serious deformity of the auricle induced by single or repeated injury to the external ear. Few papers deal with surgical techniques for correcting this deformity. We describe the use of ipsilateral excess cartilage to restore the helical rim. Copyright 2002 The British Association of Plastic Surgeons.

A systematic review on external ear melanoma.

PubMed

Toia, Francesca; Garbo, Giuseppe; Tripoli, Massimiliano; Rinaldi, Gaetana; Moschella, Francesco; Cordova, Adriana

2015-07-01

External ear melanoma accounts for only 1% of all cutaneous melanomas, and data on its optimal management and prognosis are limited. We aim to review the literature on external ear melanoma to guide surgeons in the treatment of this uncommon and peculiar pathology. A systematic review of English language studies on ear melanoma published from 1993 to 2013 was performed using the PubMed electronic database. Data on epidemiology, oncological treatment (tumor resection and regional lymph nodes management), and reconstruction were extrapolated from selected papers. The total number of patients was 858 (30 studies). The helix was the most common location (57%); superficial spreading melanoma was the most common histopathological subtype (41%). The mean Breslow thickness was 2.01 mm, with 88% of stage I-II patients. Sentinel lymph node biopsy was performed in 45% of patients, with 8% of positive nodes. Available data on its prognosis are fragmentary and contrasting, but the Breslow thickness appears to be the main prognostic factor. There is a tendency towards reduced resection margins and preservation of the underlying perichondrium and cartilage. Local flaps are the most popular reconstructive option. To the best of our knowledge, this systematic review presents the largest data series on external ear melanoma. There is no general agreement on its surgical management, but a favorable prognosis seems to justify the tendency towards conservative treatments. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Why Cannot We have an Etiological Classification for the Patients with Granular Myringitis?

PubMed

Bansal, Mohan

2017-09-01

Though granular myringitis (GM) is not a very rare disease it does not have any classification. Its exact etiology is not known. The granulations on tympanic membrane also occur in association with other lesions of external auditory canal (EAC) and middle ear. The aims of this study were to know the etiological factors of GM and classify the disease according to its etiological factors and associated disorders of EAC and middle ear. Data were retrieved from the search of four electronic databases: PubMed, EMBASE, Cochrane Library, and Google scholar. Relevant articles were also sought by a hand search review of reference books. The databases were searched using the key words otitis externa, external otitis, granular myringitis, granular otitis externa and myringitis. Data were extracted using a pre-defined data-extraction form. The following data were recorded (1) etiological and predisposing conditions; (2) pathological features; (3) associated disorders of external and middle ear. The study proposes the etiological classification of GM. It suggests two major groups: primary and secondary. The primary GM is basically idiopathic and these patients do no have evidences of any other types of otitis media and otitis externa. In the secondary GM the cause is obvious and the patients usually have associated otitis media and/or lesions of external ear canal. Author speculates that habit of self ear cleaning/scratching is a specific etiological factor in cases of primary GM but more studies are required to confirm this theory.

External ear anomalies and hearing impairment in Noonan Syndrome.

PubMed

van Trier, Dorothée C; van Nierop, Josephine; Draaisma, Jos M Th; van der Burgt, Ineke; Kunst, Henricus; Croonen, Ellen A; Admiraal, Ronald J C

2015-06-01

This is the first cohort in which hearing impairment and external ear anomalies in Noonan Syndrome are described extensively. Retrospective analysis of the otorhinolaryngological and clinical genetic data from 97 Noonan Syndrome (NS) patients. Forty-four NS patients were seen by an otorhinolaryngologist for the analysis of hearing impairment. In our cohort 80 of the 97 patients were genetically tested. In 71 of these mutations were found: in 48 patients a mutation in PTPN11, in 10 patients in SOS1, in 5 patients in SHOC2, in 5 patients in RAF1, in 1 patient in MAP2K2, in 1 patient in KRAS and in 1 patient in A2ML1. External ear anomalies were reported in 75 NS patients (77%). In 69 patients the ears were low-set, 28 patients had posteriorly rotated ears, 14 patients showed protruding ears and 18 had thickened helices. Hearing impairment was detected in 34 NS patients. Nine patients had sensorineural hearing impairment, two a permanent conductive hearing impairment, two other patients had mixed hearing impairment and 20 patients had conductive hearing impairment in the past, caused by otitis media with effusion. Their temporary conductive hearing impairment resolved between the ages of 2 and 18 years. Sensorineural hearing impairment varied between mild high-frequency hearing impairment and profound (uni- and bilateral) hearing impairment and was progressive in three patients. Four NS patients received cochlear implants for their severe sensorineural hearing impairment. The cohort is small for genotype-phenotype correlations, but sensorineural hearing impairment, especially the bilateral severe hearing impairment, was only seen in patients with a PTPN11 mutation. NS is characterized by dysmorphic external ear anomalies and both sensorineural and conductive hearing impairment. Audiological examinations are recommended in all patients with Noonan Syndrome. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

21 CFR 344.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Definitions. 344.3 Section 344.3 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE... impairment. (d) Ear drying aid. A drug used in the external ear canal to help dry water-clogged ears. [51 FR...

Inner ear dysplasia is common in children with Down syndrome (trisomy 21).

PubMed

Blaser, Susan; Propst, Evan J; Martin, Daniel; Feigenbaum, Annette; James, Adrian L; Shannon, Patrick; Papsin, Blake C

2006-12-01

Middle and external ear anomalies are well recognized in Down syndrome (DS, trisomy 21). Inner ear anomalies are much less frequently described. This study reviews inner ear morphology on imaging to determine the prevalence of cochlear and vestibular anomalies in children with DS. The authors conducted a retrospective review of imaging features of (DS) inner ear structures. Fifty-nine sequential patients with DS with imaging of the inner ear were identified by a radiology report text search program. Quantitative biometric assessment of the inner ear was performed on patients with high-resolution computed tomography or magnetic resonance images of the petrous bone. Petrous imaging was performed for evaluation of inflammatory disease or hearing loss. Spinal imaging, which included petrous views, was performed in most cases to exclude C1 to 2 dislocation, a potential complication of DS. Measurements were compared with normative data. Inner ear dysplasia is much more common in DS than previously reported. Inner ear structures are universally hypoplastic. Vestibular malformations are particularly common and a small bony island of the lateral semicircular canal (<3 mm in diameter) appears highly typical. Additional findings in some patients were persistent lateral semicircular anlage with fusion of the lateral semicircular canal and vestibule into a single cavity, vestibular aqueduct and endolymphatic sac fossa enlargement, cochlear nerve canal hypoplasia, and stenosis or duplication of the internal auditory canal. Stenosis of the external meatus, poor mastoid pneumatization, middle ear and mastoid opacification, and cholesteatoma were common, as expected.

Cauliflower ear dissection.

PubMed

Fujiwara, Masao; Suzuki, Ayano; Nagata, Takeshi; Fukamizu, Hidekazu

2011-11-01

Cauliflower ear (CE) is caused by repeated direct trauma to the external ear. Surgical correction of an established CE is one of the most challenging problems in ear reconstruction. However, no reports have clarified the dissection of an established CE in detail. In this report, the dissection of a CE is described based on macroscopic, microscopic and imaging features. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Extended lateral thoracic fasciocutaneous biosynthetic flap for reconstruction of full-thickness partial external ear defects: an experimental study.

PubMed

Kuvat, Samet Vasfi; Taşkın, Ümit; Yücebaş, Kadir; Tansuker, Hasan Deniz; Oktay, Mehmet Faruk; Kozanoğlu, Erol; Aydın, Salih

2017-01-01

External ear reconstruction is a controversial topic in reconstructive plastic surgery. Here, we prepared a pedicled biosynthetic flap for full-thickness, partial ear defects in rabbits. We operated on six adult female New Zealand rabbits weighing 3-4 kg. The dimensions of the lateral thoracic fasciocutaneous flap were 7 × 6 cm. The flap was elevated based on one of the bilaterally located internal thoracic arteries, which were dissected proximally. The pedicled flap was folded in two, and polypropylene mesh was sandwiched in the middle. The flap was adapted to a defect of 3.5 × 3 cm in diameter. In fact, the defect was created before elevation of the flap. Rabbits were followed up for 4 weeks, at the end of which they were killed and their ears were evaluated histopathologically. The survival rate of the rabbits was 100 %. All pedicled biosynthetic flaps were viable, but one showed partial (20 %) necrosis (1/6) and one was partially detached (1/6). Macroscopic (color, thickness, texture) and histological (polymorphonuclear leukocyte invasion in the skin, subcutaneous tissue, and at the junction between the polypropylene mesh and the flap) features of the flap were compared to the ipsilateral ear. A new technique was developed for partial external ear reconstruction with sufficient inner skeletal support and outer skin lining. Level of evidence Level NA.

Reconstruction following traumatic partial amputation of the ear.

PubMed

Pearl, Robert A; Sabbagh, Walid

2011-02-01

Reconstruction following traumatic amputation of the external ear remains a unique challenge to the plastic surgeon. The authors report a series of ear reconstructions with autologous costal cartilage in patients following traumatic partial amputation of the ear. Technical points regarding the carving of the cartilage framework and methods of skin coverage are discussed. Fifty partial ear reconstructions with autologous costal cartilage were performed over a 4-year period. All patients had suffered previous traumatic amputation of part of the external auricle due to bite injuries (n = 36), road traffic accidents (n = 6), burns (n = 5), or torture (n = 3). A two-stage technique of reconstruction with autologous cartilage graft was used based on Nagata's adaptations of Brent's original technique. In nine cases, skin shortage or extensive scarring required preoperative tissue expansion (n = 4) or a temporoparietal fascial flap (n = 5) to provide adequate coverage of the cartilage framework. Forty-seven patients had a successful surgical outcome without complication. Two patients developed small areas of skin necrosis resulting in exposure of the cartilage framework. These healed with conservative management with minor loss of definition. One case of wound infection resulted in significant loss of definition of the construct, which required a further surgical procedure with additional costal cartilage graft. Reconstruction of the external ear with autologous costal cartilage following traumatic amputation can produce high-quality auricles consistently and is becoming the treatment of choice for such injuries, given access to a specialist center with exposure to a high volume of cases.

Unusual extension of the first branchial cleft anomaly.

PubMed

Ada, Mehmet; Korkut, Nazim; Güvenç, M Güven; Acioğlu, Engin; Yilmaz, Süleyman; Cevikbaş, Uğur

2006-03-01

First branchial cleft is the only branchial structure that persists as the external ear canal, while all other clefts are resorbed. Incomplete obliteration and the degree of closure cause the varied types of first branchial cleft anomalies. They were classified based on the anatomical and histological features. We present an unusual type of first branchial cleft anomaly involving the external auditory canal, the middle ear and the nasopharynx through the eustachian tube.

Design and preliminary testing of a novel skin expander for total ear reconstruction in a rabbit model.

PubMed

Xiong, Wu; Yan, Yu; Hu, Feng; Liu, Can; Wang, Shaohua; Chen, Jia; Wang, Xueqi; Zhou, Jianda

2016-01-01

Ear reconstruction is one of the most complicated and challenging techniques in plastic surgery because of the histologic and anatomic properties of the ear. Success depends on fitting the auriform cartilage scaffold into the overlying skin, but current approaches can just give results that are not lifelike and can lead to complications. A novel double-capsule, double-valve plastic ear expander was designed and implanted subcutaneously on either side of the dorsum of six New Zealand white rabbits (two expanders per rabbit). The outer capsule was expanded by injecting approximately 120 mL of physiological saline, then withdrawing the liquid on two occasions. Next, the ear-shaped inner capsule was filled with high-hardness plaster, and the external capsule was emptied such that the expanded skin flap and external capsule responded to the negative pressure and closed over the ear-shaped inner capsule. As a result, the skin flap adopted an ear shape. The ear expander was left in place for 4 wk, removed with the help of a mini-incision, and stripped of its fibrous capsule. To simulate human ear reconstruction, the expander was replaced with an auriform silicone prosthesis, and the effects of auricular reconstruction were observed dynamically. All 12 skin flaps maintained abundant blood supply, created a clear outline of the ear framework, and produced a lifelike result. No complications were observed during the 4-wk observation period. The expanded skin flaps described here can mold to the desired contours and appear lifelike, as well as maintain abundant blood supply. This may provide a simpler approach to total ear reconstruction that reduces risk of complications. Copyright © 2016 Elsevier Inc. All rights reserved.

A practical use of a 16-gauge peripheral angiocatheter as an aspiration cautery in endoscopic ear surgery.

PubMed

Ozdek, Ali; Keseroglu, Kemal

2014-08-01

To define a technique for the practical use of a 16-gauge peripheral venous catheter as an insulated aspiration cautery in endoscopic ear surgery. Retrospective case review. Tertiary referral center. A 16-gauge intravenous catheter was prepared as a cauterization instrument with aspiration. After simple rearrangement of the exterior plastic portion, it was connected to a suction system. With the help of an unipolar cautery, aspiration of the blood and homeostasis was achieved. Hemorrhage of the external ear canal skin after incision can be easily coagulated with this instrument. During follow-up, there were no wound infection, facial nerve paresis, scar formation, and inadvertent burn of the external canal and auricular skin. With the help of this instrument, bleeding control during incision can be easily maintained. It is a simple, easily prepared, and alternative homeostasis technique in endoscopic ear surgery.

Occurrence and distribution of Malassezia species on skin and external ear canal of horses.

PubMed

Shokri, Hojjatollah

2016-01-01

The aim of this study was to investigate the prevalence of Malassezia species from the body skin and external ear canal of healthy horses. The samples were obtained by scraping the skin surface from the nose, groin and dorsum and swabbing from the external ear canal of 163 animals, and then incubated on sabouraud dextrose agar and modified Dixon agar. Malassezia species were isolated from 34.9% of horses. The percentages of Malassezia species were 64.3% for Arab, 35.7% for Persian, 35.4% for Thoroughbred and 27.1% for Turkmen breeds. The greatest abundance of Malassezia species was found in the external ear canal (47.7%, representing significant difference with other sites), followed by nose (26.3%), groin (15.8%) and dorsum (10.5%) (P < 0.05). A total of 57 strains from six Malassezia species were detected with a frequency rate as follows: M. pachydermatis (33.3%), M. globosa (26.3%), M. sympodialis (14.1%), M. restricta (10.5%), M. obtusa (8.8%) and M. furfur (7%). The most common age-group affected was 1-3 years (59.4%). This study confirmed that cutaneous Malassezia microbiota in healthy horses varies by body site and age but not by breed and gender, representing M. pachydermatis as the most prevalent species on horse skin. © 2015 Blackwell Verlag GmbH.

Management of Acquired Atresia of the External Auditory Canal.

PubMed

Bajin, Münir Demir; Yılmaz, Taner; Günaydın, Rıza Önder; Kuşçu, Oğuz; Sözen, Tevfik; Jafarov, Shamkal

2015-08-01

The aim was to evaluate surgical techniques and their relationship to postoperative success rate and hearing outcomes in acquired atresia of the external auditory canal. In this article, 24 patients with acquired atresia of the external auditory canal were retrospectively evaluated regarding their canal status, hearing, and postoperative success. Acquired stenosis occurs more commonly in males with a male: female ratio of 2-3:1; it seems to be a disorder affecting young adults. Previous ear surgery (13 patients, 54.2%) and external ear trauma (11 patients, 45.8%) were the main etiological factors of acquired ear canal stenosis. Mastoidectomy (12/13) and traffic accidents (8/11) comprise the majority of these etiological factors. Endaural incision is performed in 79.2% and postauricular incision for 20.8% of cases during the operation. As types of surgical approach, transcanal (70.8%), transmastoid (20.8%), and combined (8.4%) approaches are chosen. The atretic plate is generally located at the bony-cartilaginous junction (37.5%) and in the cartilaginous canal (33.3%); the bony canal is involved in a few cases only. Preserved healthy canal skin, split- or full-thickness skin grafts, or pre- or postauricular skin flaps are used to line the ear canal, but preserved healthy canal skin is preferred. The results of surgery are generally satisfactory, and complications are few if surgical principles are followed.

Congenital atresia of the external ear and tinnitus: a new syndrome.

PubMed

Shulman, Abraham; Strashun, Arnold M; Goldstein, Barbara; Lenhardt, Martin L

2006-01-01

Congenital atresia of the external ears and severe tinnitus has been reported by two patients to be contralateral to the atretic ear. The use of the nuclear medicine imaging technique of single-photon emission computed tomography (SPECT) of brain has demonstrated hypoperfusion in brain areas supplied by the middle cerebral artery on the side of the atretic ear. Ultrahigh-frequency audiometry (UHFA) has revealed a bilateral loss of hearing greater than expected for the age of affected patients. Quantitative electroencephalography (QEEG) has shown a significant central nervous system electrical dysfunction correlated with the SPECT of brain findings. One case is reported in detail at this time. Completion of the medical audiological tinnitus patient protocol, including SPECT of brain, UHFA, and QEEG, accurately established the clinical tinnitus diagnosis of predominantly a central-type tinnitus, a clinical hypothesis that the medical significance of the tinnitus is a "soft" sign of cerebrovascular disease, and provided a rationale for treatment directed to a presumed ischemia of brain based on a receptor-targeted therapy targeted to the GABA-A receptor, resulting in significant tinnitus relief. Questions that have arisen include (1) the incidence of occurrence of hypoperfusion of the middle cerebral artery in congenital atresia patients; (2) implications and long-term consequences of this finding in this patient population for development of cerebrovascular disease; (3) brain plasticity for tinnitus relief (i.e., neuronal reprogramming, particularly in response to treatment recommendations for complaints of the cochleovestibular system in general and specifically for tinnitus); (4) the clinical significance of the UHFA thresholds of bilateral hearing loss greater than expected for the age of the patient; and (5) whether congenital atresia of the external ear may be part of a syndrome that includes hypoperfusion in brain areas supplied by the middle cerebral artery on the side of the atretic ear, ultra-high-frequency bilateral loss of hearing greater than expected for the age of the patient, and significant central nervous system electrical dysfunction. As far as we can determine, these findings, highlighted by the brain SPECT, have not previously been reported in patients with congenital atresia of the external ear.

Shaping magnetic fields to direct therapy to ears and eyes.

PubMed

Shapiro, B; Kulkarni, S; Nacev, A; Sarwar, A; Preciado, D; Depireux, D A

2014-07-11

Magnetic fields have the potential to noninvasively direct and focus therapy to disease targets. External magnets can apply forces on drug-coated magnetic nanoparticles, or on living cells that contain particles, and can be used to manipulate them in vivo. Significant progress has been made in developing and testing safe and therapeutic magnetic constructs that can be manipulated by magnetic fields. However, we do not yet have the magnet systems that can then direct those constructs to the right places, in vivo, over human patient distances. We do not yet know where to put the external magnets, how to shape them, or when to turn them on and off to direct particles or magnetized cells-in blood, through tissue, and across barriers-to disease locations. In this article, we consider ear and eye disease targets. Ear and eye targets are too deep and complex to be targeted by a single external magnet, but they are shallow enough that a combination of magnets may be able to direct therapy to them. We focus on how magnetic fields should be shaped (in space and time) to direct magnetic constructs to ear and eye targets.

External auditory canal atresia of probable congenital origin in a dog.

PubMed

Schmidt, K; Piaia, T; Bertolini, G; De Lorenzi, D

2007-04-01

A nine-month-old Labrador retriever was referred to the Clinica Veterinaria Privata San Marco because of frequent headshaking and downward turning of the right ear. Clinical examination revealed that there was no external acoustic meatus in the right ear. Computed tomography confirmed that the vertical part of the right auditory canal ended blindly, providing a diagnosis of external auditory canal atresia. Cytological examination and culture of fluid from the canal and the bulla revealed only aseptic cerumen; for this reason, it was assumed that the dog was probably affected by a congenital developmental deformity of the external auditory canal. Reconstructive surgery was performed using a "pull-through" technique. Four months after surgery the cosmetic and functional results were satisfactory.

A new method for selecting auricle positions in skull base reconstruction for temporal bone cancer.

PubMed

Tanaka, Kentaro; Yano, Tomoyuki; Homma, Tsutomu; Tsunoda, Atsunobu; Aoyagi, Masaru; Kishimoto, Seiji; Okazaki, Mutsumi

2018-03-25

In advanced temporal bone carcinoma cases, we attempted to preserve as much of the auricle as possible from a cosmetic and functional perspective. Difficulties are associated with selecting an adequate position for reconstructed auricles intraoperatively. We improved the surgical procedure to achieve a good postoperative auricle position. Nine patients were included in this study. All patients underwent subtotal removal of the temporal bone and resection of the external auditory canal while preserving most of the external ear, and lateral skull base reconstruction was performed with anterolateral thigh flaps. We invented a new device, the auricle localizer, to select the correct position for the replaced external ear. The head skin incision line and two points of three-point pin fixation were used as criteria, and a Kirschner wire was shaped as a basic line to match these criteria. Another Kirschner wire was shaped by wrapping it around the inferior edge of the external ear as the positioning line, and these two lines were then combined. To evaluate the postoperative auricle position, the auricle inclination angle was measured using head frontal cephalogram imaging. The external ear on the affected side clearly drooped postoperatively in nonlocalizer cases, whereas this was not obvious in localizer cases. Auricle inclination angles 1 year after surgery significantly differed between these two cases (P = 0.018). The surgical device, the auricle localizer, is useful for selecting intraoperative accurate auricle positions. The assessment index, the auricle inclination angle, is useful for quantitatively evaluating postoperative results. 4 Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

Surgical management of 2 different presentations of ear canal atresia in dogs

PubMed Central

Béraud, Romain

2012-01-01

A 6-year-old French spaniel and a 14-month-old German shepherd dog were diagnosed with ear canal atresia. Based on presentation, computed tomography, and auditory function evaluation, the first dog underwent excision of the horizontal ear canal and bulla curettage, and the second underwent re-anastomosis of the vertical canal to the external meatus. Both dogs had successful outcomes. PMID:23024390

Underwater hearing and sound localization with and without an air interface.

PubMed

Shupak, Avi; Sharoni, Zohara; Yanir, Yoav; Keynan, Yoav; Alfie, Yechezkel; Halpern, Pinchas

2005-01-01

Underwater hearing acuity and sound localization are improved by the presence of an air interface around the pinnae and inside the external ear canals. Hearing threshold and the ability to localize sound sources are reduced underwater. The resonance frequency of the external ear is lowered when the external ear canal is filled with water, and the impedance-matching ability of the middle ear is significantly reduced due to elevation of the ambient pressure, the water-mass load on the tympanic membrane, and the addition of a fluid-air interface during submersion. Sound lateralization on land is largely explained by the mechanisms of interaural intensity differences and interaural temporal or phase differences. During submersion, these differences are largely lost due to the increase in underwater sound velocity and cancellation of the head's acoustic shadow effect because of the similarity between the impedance of the skull and the surrounding water. Ten scuba divers wearing a regular opaque face mask or an opaque ProEar 2000 (Safe Dive, Ltd., Hofit, Israel) mask that enables the presence of air at ambient pressure in and around the ear made a dive to a depth of 3 m in the open sea. Four underwater speakers arranged on the horizontal plane at 90-degree intervals and at a distance of 5 m from the diver were used for testing pure-tone hearing thresholds (PTHT), the reception threshold for the recorded sound of a rubber-boat engine, and sound localization. For sound localization, the sound of the rubber boat's engine was randomly delivered by one speaker at a time at 40 dB HL above the recorded sound of a rubber-boat engine, and the diver was asked to point to the sound source. The azimuth was measured by the diver's companion using a navigation board. Underwater PTHT with both masks were significantly higher for frequencies of 250 to 6000 Hz when compared with the thresholds on land (p <0.0001). No differences were found in the PTHT or the reception threshold for the recorded sound of a rubber-boat engine for dry or wet ear conditions. There was no difference in the sound localization error between the regular mask and the ProEar 2000 mask. The presence of air around the pinna and inside the external ear canal did not improve underwater hearing sensitivity or sound localization. These results support the argument that bone conduction plays the main role in underwater hearing.

Effects of topical oxiconazole and boric acid in alcohol solutions to rat inner ears.

PubMed

Özdemir, Süleyman; Tuncer, Ülkü; Tarkan, Özgür; Akar, Funda; Sürmelioğlu, Özgür

2013-06-01

The aim of this study is to evaluate the ototoxicity of topical oxiconazole and boric acid in alcohol solutions. Prospective controlled animal study. Research laboratory. Fifty adult Wistar albino rats were divided into 5 groups consisting of 10 animals each. The right tympanic membranes were perforated, and baseline and posttreatment distortion product otoacoustic emission (DPOAE) measurements were performed. The solutions were applied through the external ear canal to the middle ear twice a day for 14 days. The rats in group I and group II received 0.1 mL of oxiconazole-containing solution drops and 4% boric acid in alcohol solution drops, respectively. Group III received gentamicin solution (40 mg/mL) (ototoxic control), group IV received saline solution, and group V was followed without any medication. The baseline DPOAE results of the right ears of all animals tested were normal. Animals in groups I, II, IV, and V showed no statistically significant change in the DPOAE amplitudes. The rats in the gentamicin group showed a significant decrease. This study demonstrates that topically used oxiconazole and boric acid in alcohol solutions to the middle ear appear to be safe on the inner ear of rats. The safety of these drugs has not yet been confirmed in humans. Caution should be taken when prescribing these drugs, especially to patients who had tympanic membrane perforation. Ear drops should be chosen more carefully in an external ear infection for patients with tympanic membrane perforation to avoid ototoxicity.

Fibrous Dysplasia of the Temporal Bone with External Auditory Canal Stenosis and Secondary Cholesteatoma.

PubMed

Liu, Yu-Hsi; Chang, Kuo-Ping

2016-04-01

Fibrous dysplasia is a slowly progressive benign fibro-osseous disease, rarely occurring in temporal bones. In these cases, most bony lesions developed from the bony part of the external auditory canals, causing otalgia, hearing impairment, otorrhea, and ear hygiene blockade and probably leading to secondary cholesteatoma. We presented the medical history of a 24-year-old woman with temporal monostotic fibrous dysplasia with secondary cholesteatoma. The initial presentation was unilateral conductive hearing loss. A hard external canal tumor contributing to canal stenosis and a near-absent tympanic membrane were found. Canaloplasty and type I tympanoplasty were performed, but the symptoms recurred after 5 years. She received canal wall down tympanomastoidectomy with ossciculoplasty at the second time, and secondary cholesteatoma in the middle ear was diagnosed. Fifteen years later, left otorrhea recurred again and transcanal endoscopic surgery was performed for middle ear clearance. Currently, revision surgeries provide a stable auditory condition, but her monostotic temporal fibrous dysplasia is still in place.

A new skin flap method for total auricular reconstruction in microtia patients with a reconstructed ear canal: extended scalp and extended mastoid postauricular skin flaps.

PubMed

Hwang, Euna; Kim, Young Soo; Chung, Seum

2014-06-01

Before visiting a plastic surgeon, some microtia patients may undergo canaloplasty for hearing improvement. In such cases, scarred tissues and the reconstructed external auditory canal in the postauricular area may cause a significant limitation in using the posterior auricular skin flap for ear reconstruction. In this article, we present a new method for auricular reconstruction in microtia patients with previous canaloplasty. By dividing a postauricular skin flap into an upper scalp extended skin flap and a lower mastoid extended skin flap at the level of a reconstructed external auditory canal, the entire anterior surface of the auricular framework can be covered with the two extended postauricular skin flaps. The reconstructed ear shows good color match and texture, with the entire anterior surface of the reconstructed ear being resurfaced with the skin flaps. Clinical question/level of evidence; therapeutic level IV. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Optical-fiber-coupled inferometric measurement of tympanic membrane temperature: a new diagnostic tool for acute otitis media

NASA Astrophysics Data System (ADS)

DeRowe, Ari; Ophir, Eyal; Sade, Sharon; Fishman, Gadi; Ophir, Dov; Grankin, Mila; Katzir, Abraham

1998-07-01

A novel infrared (IR) transparent optical fiber coupled to a hand held otoscope and a radiometer was constructed and used to measure the temperatures of the tympanic membrane (TM) and to distinguish between diseased and healthy middle ears. A greater temperature difference between TM readings was found when Acute Otitis Media (AOM) existed in one of the ears examined. This supports the hypothesis that acute inflammation of the middle ear will result in elevated local temperature when measured in such a way that the reading is taken only from the TM without interference of the external canal. The use of an optical fiber enabled temperature measurements of the TM with high spatial resolution eliminating the external ear canal interference. A small patient population was examined and the initial results were statistically significant. In the hands of the primary care physician, this tool would prevent misdiagnosis of AOM preventing indiscriminate use of antibiotics and avoiding complications by early diagnosis.

The ototoxic effect of intratympanic terbinafine applied in the middle ear of rats

PubMed Central

2013-01-01

Background Otomycosis is defined as an infection of the external ear canal with fungal agents. The treatment of the disease is cleansing and drying of the external ear canal, identification and treatment of any predisposing factors and application of topical antifungal agents. Terbinafine is used as an antifungal agent to treat otomycosis. We proposed to investigate the probable ototoxic effect of terbinafine solution on auditory brain stem response (ABR) and distortion product otoacoustic emission (DPOAE) when applied intratympanically in the middle ear of rats. Methods The experiment was performed on 30 female Wistar albino rats. Thirty animals were divided into three groups of 10 animals each. 1% terbinafine solution was administered to the first group (group T). The second group (group G) was administered 40 mg/ml gentamicin solution (ototoxic control). The third group (group S) was administered saline solution (negative control). Baseline DPOAE measurements and ABR testing from the left ears were obtained from the animals in all groups under general anesthesia. Ear solutions were applied in the middle ear intratympanically with a dental needle. Treatment was initiated after baseline measurements and repeated once every two days for fifteen days. Results Pre and post-treatment DPOAE responses for all tested frequencies of group T and Group S showed no statistically significant difference. However, the group G demonstrated a significant change in ABR thresholds and DPOAE responses. Conclusions Terbinafine solution is a broad spectrum antifungal agent effective in the treatment of otomycosis. The present study demonstrated that its direct administration in the middle ear of rats does not affect inner ear function as measured by ABR and DPOAE responses. PMID:23663536

Surgical management of polyotia.

PubMed

Pan, Bo; Qie, Shuyan; Zhao, Yanyong; Tang, Xiaojun; Lin, Lin; Yang, Qinghua; Zhuang, Hongxing; Jiang, Haiyue

2010-08-01

Polyotia is an extremely rare type of congenital external ear malformation, which is defined as an accessory ear that is large enough to resemble an additional pinna. The terms 'mirror ear' or 'accessory ear' are sometime used. We present our methods in correcting this malformation and summarise the aetiology. The posterior part of the polyotia may presents with a normal ear, a constricted ear or a microtic ear. Free auricular composite tissue transplantation was used to correct the constricted ear. Ear reconstruction was applied in cases of microtia. The anterior auricle was mainly used to form the tragus. 7 cases polyotia were treated between 2004 and 2008. After free auricular composite tissue transplantation the size of the constricted ear and the contralateral ear was similar. In microtia cases the reconstructed ears were natural looking and had a satisfactory three-dimensional contour. The extra tissue of the anterior ear was excised and the tragus was reconstructed. Through operative intervention tailored to the individual case natural-looking and symmetric ears were acquired. The aetiology of polyotia probably relates to abnormal migration of neural crest cell. Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Epidemiology of subclinical ovine psoroptic otoacariasis in Great Britain.

PubMed

Bates, P G

1996-04-20

Seven sheep flocks with subclinical psoroptic otoacariasis were investigated. Psoroptes species mites were isolated from 3.1 per cent of the 2676 sheep examined and the prevalence in the flocks ranged between 1.3 and 23.9 per cent, with the highest infestations in pedigree flocks. Unilateral or bilateral infestations were found in sheep of all ages. Adult and shearling rams, with prevalences of 21.5 and 14.2 per cent, respectively, were the most affected and two lambs, two and eight days old, were the youngest to be infested. There was no evidence of vertical transmission. The infestation affected several breeds of sheep. No other known hosts for Psoroptes species present on the premises were shown to be infested. Non-parasitic for-age mites were also isolated from the ear canals of the sheep and may have contributed to the clinical signs which, in adult sheep, ranged from aural haematomas/fibrosis (cauliflower ears), and violent head shaking and ear rubbing leading to excoriation and wounding of the ear and base of the ear. The signs in lambs included plaques of scab (often bloody) on the external ear cleft, excoriation of the base of the ear, ear scratching with the hind feet and inflammation of the external aspects of the horizontal canal. In all cases the internal pinnae were clear of typical psoroptic scabs. Psoroptes mites were isolated from 28.6 per cent of the damaged ears and from 7.8 per cent of the undamaged ears. There was no evidence of classical sheep scab in any of the flocks. Plunge dipping in diazinon, propetamphos or flumethrin, or the use of synthetic pyrethroid pour-on preparations and an oral drench of ivermectin had little effect because ear mite infestations were detected in the flocks after these treatments. An injection of ivermectin at 200 micrograms/kg bodyweight effectively eradicated the infestations when it was administered to these infested flocks.

Preventing Cauliflower Ear With a Modified Tie-Through Technique.

PubMed

Dimeff, R J; Hough, D O

1989-03-01

In brief: Hematoma following trauma to the external ear is a common problem among wrestlers and boxers. If the hematoma is not treated promptly, infection, fibrosis, scarring, and calcification may develop, leading to the gross deformity known as cauliflower ear or wrestler's ear. Evacuation of the hematoma followed by compression of the auricle is commonly regarded as the treatment of choice. However, fluid frequently reaccumulates after this procedure. The authors describe a tie-through suture technique in which a collodion packing is secured to the auricle with two buttons. Multiple treatments for fluid reaccumulation are rarely necessary when this technique is used.

21 CFR 874.5800 - External nasal splint.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false External nasal splint. 874.5800 Section 874.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5800 External nasal splint. (a...

21 CFR 874.5800 - External nasal splint.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External nasal splint. 874.5800 Section 874.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5800 External nasal splint. (a...

21 CFR 874.5800 - External nasal splint.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false External nasal splint. 874.5800 Section 874.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5800 External nasal splint. (a...

21 CFR 874.5800 - External nasal splint.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false External nasal splint. 874.5800 Section 874.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5800 External nasal splint. (a...

21 CFR 874.5800 - External nasal splint.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false External nasal splint. 874.5800 Section 874.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5800 External nasal splint. (a...

Transcultural adaptation to Spanish of the instrument "Effectiveness of Auditory Rehabilitation" for the assessment of quality of life in patients using hearing aids.

PubMed

Cardemil, Felipe; Esquivel, Patricia; Aguayo, Lorena; Barría, Tamara; Fuente, Adrian; Carvajal, Rocío; Fromín, Rose; Villalobos, Iván; Yueh, Bevan

2013-01-01

It is becoming increasingly important to have reliable and valid questionnaires. This becomes especially important when evaluating hearing loss. the "Effectiveness of Auditory Rehabilitation" (EAR) questionnaire for the Spanish-speaking population. This instrument assesses quality of life and hearing aspects in patients using hearing aids. Cross-sectional validation study. A cultural adaptation through the use of English to Spanish translations and re-translations was carried out. The validity and reliability of the newly adapted instrument were evaluated. A total of 69 individuals (44 older adults and 25 younger adults) were examined. The pure-tone averages (PTA, 500, 1,000 and 2,000 Hz) were 47.3 dB HL and 47.1 dB HL for the left and right ears, respectively. The mean maximum speech discrimination in silence for monosyllables were 83.3% and 82.9% for the left and right ears, respectively. Internal consistency presented Cronbach alpha values of 0.85 and 0.77 for the internal and external dimensions, respectively. The intraclass correlation coefficients were 0.80 for the internal module and 0.85 for the external module. Construct validity reported a correlation coefficient of 0.71 at baseline and 0.76 at 3 months after the initial assessment for the internal module, and 0.62 at baseline and 0.74 at 3 months after the initial assessment for the external module. The size effects were 1.3 and 1.1 for the internal and external modules, respectively. The Spanish version of the EAR questionnaire seems to be a reliable and valid instrument. The evaluation of audiological aspects, as well as aspects relating to aesthetics and comfort are the main strengths of this instrument. Finally, the EAR scale is more sensitive to change than other scales. Copyright © 2013 Elsevier España, S.L. All rights reserved.

[Basics of Ear Surgery].

PubMed

Lailach, S; Zahnert, T

2016-12-01

The present article about the basics of ear surgery is a short overview of current indications, the required diagnostics and surgical procedures of common otologic diseases. In addition to plastic and reconstructive surgery of the auricle, principles of surgery of the external auditory canal, basics of middle ear surgery and the tumor surgery of the temporal bone are shown. Additionally, aspects of the surgical hearing rehabilitation (excluding implantable hearing systems) are presented considering current study results. Georg Thieme Verlag KG Stuttgart · New York.

Anteverted internal auditory canal as an inner ear anomaly in patients with craniofacial microsomia.

PubMed

L'Heureux-Lebeau, Bénédicte; Saliba, Issam

2014-09-01

Craniofacial microsomia involves structure of the first and second branchial arches. A wide range of ear anomalies, affecting external, middle and inner ear, has been described in association with this condition. We report three cases of anteverted internal auditory canal in patients presenting craniofacial microsomia. This unique internal auditory canal orientation was found on high-resolution computed tomography of the temporal bones. This internal auditory canal anomaly is yet unreported in craniofacial anomalies. Copyright © 2014. Published by Elsevier Ireland Ltd.

Treatment of Recurrent Eczematous External Otitis with Honey Eardrops: A Proof-of-Concept Study.

PubMed

Henatsch, Darius; Nabuurs, Cindy H; van de Goor, Rens M; Wolffs, Petra F; Stokroos, Robert J

2017-10-01

Eczematous external otitis is a chronic inflammatory disease and often difficult to treat. Our objective was to investigate the clinical effect and in vitro antibacterial potential of medical honey eardrops as treatment of eczematous external otitis. In a prospective study, 15 patients diagnosed with recurrent eczematous external otitis were treated with medical honey eardrops for 2 weeks. The following clinical outcomes were evaluated: visual analog scale of ear complaints, score of eczema, and eradication of bacterial infection. Furthermore, the antibacterial effect of honey eardrops against different bacterial strains was tested in vitro. Treatment resulted in less discomfort and itching and decreased signs of eczema, with high patient satisfaction and without adverse reactions. Honey eardrops showed a strong in vitro inhibitory activity against all tested strains but did not eradicate Staphylococcus aureus infection in vivo. The results of this preliminary study indicate a possible role of honey eardrops in eczematous ear disease.

21 CFR 344.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Definitions. 344.3 Section 344.3 Food and Drugs... TOPICAL OTIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE General Provisions § 344.3 Definitions. As used... external ear canal that aids in the removal of excessive earwax. (c) Water-clogged ears. The retention of...

Otoplasty: sequencing the operation for improved results.

PubMed

Hoehn, James G; Ashruf, Salman

2005-01-01

: After studying this article, the participant should be able to: 1. Understand the anatomy and embryology of the external ear. 2. Understand the anatomic causes of the prominent ear. 3. Understand the operative maneuvers used to shape the external ear. 4. Be able to sequence the otoplasty for consistent results. 5. Understand the possible complications of the otoplasty procedure. Correction of prominent ears is a common plastic surgical procedure. Proper execution of the surgical techniques is dependent on the surgeon's understanding of the surgical procedure. This understanding is best founded on an understanding of the historical bases for the operative steps and the execution of these operative steps in a logical fashion. This article describes the concept of sequencing the operation of otoplasty to produce predictable results combining the technical contributions from many authors. The historical, embryological, and anatomic bases for the operation are also discussed. Finally, the authors' preferred techniques are presented. Sequencing the steps in the preoperative assessment, preoperative planning, patient management, operative technique, and postoperative care will produce reproducible results for the attentive surgeon. Careful attention to the details of the operation of otoplasty will avoid many postoperative problems.

Computational Modeling of Blast Wave Transmission Through Human Ear.

PubMed

Leckness, Kegan; Nakmali, Don; Gan, Rong Z

2018-03-01

Hearing loss has become the most common disability among veterans. Understanding how blast waves propagate through the human ear is a necessary step in the development of effective hearing protection devices (HPDs). This article presents the first 3D finite element (FE) model of the human ear to simulate blast wave transmission through the ear. The 3D FE model of the human ear consisting of the ear canal, tympanic membrane, ossicular chain, and middle ear cavity was imported into ANSYS Workbench for coupled fluid-structure interaction analysis in the time domain. Blast pressure waveforms recorded external to the ear in human cadaver temporal bone tests were applied at the entrance of the ear canal in the model. The pressure waveforms near the tympanic membrane (TM) in the canal (P1) and behind the TM in the middle ear cavity (P2) were calculated. The model-predicted results were then compared with measured P1 and P2 waveforms recorded in human cadaver ears during blast tests. Results show that the model-derived P1 waveforms were in an agreement with the experimentally recorded waveforms with statistic Kurtosis analysis. The FE model will be used for the evaluation of HPDs in future studies.

The effects of alterations in the osseous external auditory canal on perceived sound quality.

PubMed

van Spronsen, Erik; Brienesse, Patrick; Ebbens, Fenna A; Waterval, Jerome J; Dreschler, Wouter A

2015-10-01

To evaluate the perceptual effect of the altered shape of the osseous external auditory canal (OEAC) on sound quality. Prospective study. Twenty subjects with normal hearing were presented with six simulated sound conditions representing the acoustic properties of six different ear canals (three normal ears and three cavities). The six different real ear unaided responses of these ear canals were used to filter Dutch sentences, resulting in six simulated sound conditions. A seventh unfiltered reference condition was used for comparison. Sound quality was evaluated using paired comparison ratings and a visual analog scale (VAS). Significant differences in sound quality were found between the normal and cavity conditions (all P < .001) using both the seven-point paired comparison rating and the VAS. No significant differences were found between the reference and normal conditions. Sound quality deteriorates when the OEAC is altered into a cavity. This proof of concept study shows that the altered acoustic quality of the OEAC after radical cavity surgery may lead to a clearly perceived deterioration in sound quality. Nevertheless, some questions remain about the extent to which these changes are affected by habituation and by other changes in middle ear anatomy and functionality. 4 © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Air and Bone Conduction Frequency-specific Auditory Brainstem Response in Children with Agenesis of the External Auditory Canal

PubMed Central

Sleifer, Pricila; Didoné, Dayane Domeneghini; Keppeler, Ísis Bicca; Bueno, Claudine Devicari; Riesgo, Rudimar dos Santos

2017-01-01

Introduction  The tone-evoked auditory brainstem responses (tone-ABR) enable the differential diagnosis in the evaluation of children until 12 months of age, including those with external and/or middle ear malformations. The use of auditory stimuli with frequency specificity by air and bone conduction allows characterization of hearing profile. Objective  The objective of our study was to compare the results obtained in tone-ABR by air and bone conduction in children until 12 months, with agenesis of the external auditory canal. Method  The study was cross-sectional, observational, individual, and contemporary. We conducted the research with tone-ABR by air and bone conduction in the frequencies of 500 Hz and 2000 Hz in 32 children, 23 boys, from one to 12 months old, with agenesis of the external auditory canal. Results  The tone-ABR thresholds were significantly elevated for air conduction in the frequencies of 500 Hz and 2000 Hz, while the thresholds of bone conduction had normal values in both ears. We found no statistically significant difference between genders and ears for most of the comparisons. Conclusion  The thresholds obtained by bone conduction did not alter the thresholds in children with conductive hearing loss. However, the conductive hearing loss alter all thresholds by air conduction. The tone-ABR by bone conduction is an important tool for assessing cochlear integrity in children with agenesis of the external auditory canal under 12 months. PMID:29018492

Prenatal evaluation of the middle ear and diagnosis of middle ear hypoplasia using MRI.

PubMed

Katorza, Eldad; Nahama-Allouche, Catherine; Castaigne, Vanina; Gonzales, Marie; Galliani, Eva; Marlin, Sandrine; Jouannic, Jean-Marie; Rosenblatt, Jonathan; le Pointe, Hubert Ducou; Garel, Catherine

2011-05-01

Analysis of the middle ear with fetal MRI has not been previously reported. To show the contribution of fetal MRI to middle ear imaging. The tympanic cavity was evaluated in 108 fetal cerebral MRI examinations (facial and/or cerebral malformation excluded) and in two cases, one of Treacher Collins syndrome (case 1) and the other of oculo-auriculo-vertebral (OUV) spectrum (case 2) with middle ear hypoplasia identified by MRI at 27 and 36 weeks' gestation, respectively. In all 108 fetuses (mean gestational age 32.5 weeks), the tympanic cavity and T2 hypointensity related to the ossicles were well visualised on both sides. Case 1 had micro/retrognathia and bilateral external ear deformity and case 2 had retrognathism with a left low-set and deformed ear. MRI made it possible to recognize the marked hypoplasia of the tympanic cavity, which was bilateral in case 1 and unilateral in case 2. Both syndromes are characterized by craniofacial abnormalities including middle ear hypoplasia, which cannot be diagnosed with US. The middle ear cavity can be visualized with fetal MRI. We emphasize the use of this imaging modality in the diagnosis of middle ear hypoplasia.

Preventing collapse of external auditory meatus during audiometry.

PubMed

Pearlman, R C

1975-11-01

Occlusion of the external auditory meatus resulting from earphone pressure can produce a pseudoconductive hearing loss. I describe a method for detecting ear canal collapse by otoscopy and I suggest a method of correcting the problem with a polyethylene tube prosthesis.

[Antimycotic therapy in otomycosis with tympanic membrane perforation].

PubMed

Dyckhoff, G; Hoppe-Tichy, T; Kappe, R; Dietz, A

2000-01-01

Especially after prolonged antibiotic ototopic therapy otomycosis is not rare. An inoculation of fungi into the tympanic cavity however may have serious sequelae. Therefore an eradication of fungi from the external auditory canal is imperative before surgery. In addition to thorough cleaning of the outer ear canal antimycotic preparations are recommended in treating otomycosis. However, all of the commercially available ear drops contain ototoxic agents. In the case of defects of the tympanic membrane a damage of the inner ear may result. Alternatively, we suggest an aqueous solution of Miconazol 0,5%.

Micro-endoscopic ear anatomy of guinea pig applied to experimental surgery.

PubMed

Barros, Bruno Borges de Carvalho; Andrade, José Santos Cruz de; Garcia, Leandro Borborema; Pifaia, Gustavo Ribeiro; Cruz, Oswaldo Laércio Mendonça; Onishi, Ektor Tsuneo; Penido, Norma de Oliveira

2014-01-01

To describe topographic and endoscopic anatomy of guinea pig ear for development of surgical approaches in experimental studies. Experimental study. Eight adult guinea pigs (Cavia porcellus) were used in this study. Four animals were described through endoscopic view and four animals were used to describe topographic anatomy. The main structures of middle ear were well identified through endoscopy view: oval and round window, ossicles and vascular structures. Temporal bone position, landmarks and its relations to skull are perceived with topographic description. Topographic anatomic description allowed exposition of temporal bone relations for external surgical approaches. Alternatively, grooves and middle ear structures were identified and may be used to transcanal accesses.

Turicella otitidis and Corynebacterium auris: 20 years on.

PubMed

von Graevenitz, A; Funke, G

2014-02-01

Turicella otitidis and Corynebacterium auris, described as new species 20 years ago, have been isolated mainly from the external ear canal and middle ear fluid. While their taxonomic position has been clearly established, their diagnosis in the routine laboratory is difficult. The question of their pathogenic potential in otitis is still open but might be elucidated better if corynebacteria are speciated more often.

Carcinoma of the middle ear and external auditory canal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hahn, S.S.; Kim, J.A.; Goodchild, N.

1983-07-01

Thirty-one patients with malignant tumors of the middle ear and external auditory canal (EAC) were observed at the University of Virginia Hospital from 1956 through 1980. Of 27 patients with carcinoma, 21 had squamous cell carcinoma, 4 had basal cell carcinoma and 2 had adenoid cystic carcinoma. The 27 patients with carcinoma are reviewed with regard to clinical presentation, treatment modality, results and complications. The majority (67%) of patients had a history of chronic ear drainage, 22% had a previous mastoidectomy or polypectomy and 7% had an associated cholesteatoma. Eighty percent of patients with carcinoma limited to EAC were alivemore » and well at 5 years, compared to 43% of patients with involvement of the middle ear. Fifty-six percent of patients without invasion of the petrous bone were alive at 5 years compared to only 20% of patients with petrous bone involvement. The data strongly suggest that survival depends on the extent of disease. The corrected disease free 5 year survival rates were 14% for patients who had surgery alone and 50% for those who had surgery and radiotherapy. Of the three patients with advanced disease who received radiotherapy alone, none survived five years.« less

Challenges in fitting a hearing aid to a severely collapsed ear canal and mixed hearing loss.

PubMed

Oeding, Kristi; Valente, Michael; Chole, Richard

2012-04-01

Collapsed ear canals typically occur when an outside force, such as a headset for audiometric testing, is present. However, when a collapsed ear canal occurs without external pressure, this creates a challenge not only for performing audiometric testing but also for coupling a hearing aid to the ear canal. This case report highlights the challenges associated with fitting a hearing aid on a patient with a severe anterior-posterior collapsed ear canal with a mixed hearing loss. A 67-yr-old female originally presented to Washington University in St. Louis School of Medicine in 1996 with a long-standing history of bilateral otosclerosis. She had chronic ear infections in the right ear and a severely collapsed ear canal in the left ear and was fit with a bone anchored hearing aid (BAHA®) on the right side in 2003. However, benefit from the BAHA started to decrease due to changes in hearing, and a different hearing solution was needed. It was proposed that a hearing aid be fit to her collapsed left ear canal; however, trying to couple a hearing aid to the collapsed ear canal required unique noncustom earmold solutions. This case study highlights some of the obstacles and potential solutions for coupling a hearing aid to a severely collapsed ear canal. American Academy of Audiology.

External unit for a semi-implantable middle ear hearing device.

PubMed

Garverick, S L; Kane, M; Ko, W H; Maniglia, A J

1997-06-01

A miniaturized, low-power external unit has been developed for the clinical trials of a semi-implantable middle ear electromagnetic hearing device (SIMEHD) which uses radio-frequency telemetry to couple sound signals to the internal unit. The external unit is based on a commercial hearing aid which provides proven audio amplification and compression. Its receiver is replaced by an application-specific integrated circuit (ASIC) which: 1) adjusts the direct-current bias of the audio input according to its peak value; 2) converts the audio signal to a one-bit digital form using sigma-delta modulation; 3) modulates the sigma-delta output with a radio-frequency (RF) oscillator; and 4) drives the external RF coil and tuning capacitor using a field-effect transistor operated in class D. The external unit functions as expected and has been used to operate bench-top tests to the SIMEHD. Measured current consumption is 1.65-2.15 mA, which projects to a battery lifetime of about 15 days. Bandwidth is 6 kHz and harmonic distortion is about 2%.

Morphological Variations and Biometrics of Ear: An Aid to Personal Identification.

PubMed

Verma, Pradhuman; Sandhu, Harpreet Kaur; Verma, Kanika Gupta; Goyal, Sharry; Sudan, Madhu; Ladgotra, Amit

2016-05-01

The morphological characteristics and dimensions of external ear vary in different human ethnic races which can be utilized in forensics for personal identification of living or deceased. To determine uniqueness of morphological and biometric variations of both ears for individualization among North East (NE) and North West (NW) subpopulation of India. The study was conducted on randomly selected 80 students, 40 from each subgroup. Nine ear parameters were recorded twice using digital Vernier's caliper by single investigator and two indices (Ear Index and Lobule Index) were calculated for both the ears. Morphological ear shapes and lobule attachment were also noted. Pearson's coefficient correlation test was performed on cross-tabulations to evaluate significant relationship between different variables. Of the total 35% free and 65% attached ear lobes were noted in both population groups. Oval ear shape was most commonly noted followed by triangular, rectangular and round in both populations. On comparing anthropometric measurements of ears in two populations it was found that except the tragus length and lobule index all other values were noted more in NW population. No statistical difference was found in ear and lobular indices of males and females although the left ear index and lobule index were found to be higher than right in both populations except in NW females where right lobule index was recorded more than left. The results obtained can be used in anthropological and forensic sciences for the inclusion and exclusion of persons for identification on the basis of ear variations.

Histologic characterization of the cat middle ear: in sickness and in health.

PubMed

Sula, M M; Njaa, B L; Payton, M E

2014-09-01

The purpose of this study was to establish microscopic normal in the middle ear of the cat while concurrently characterizing gross and microscopic lesions reflecting spontaneous otitis media. Both ears from 50 cats were examined grossly and processed for histologic examination of the external, middle, and internal ear on a single slide. Gross lesions of the middle ear were present in 14 of 100 (14%) and included turbid fluid, frank pus, hemorrhage, and fibrous thickening of the auricular mucoperiosteum. Histologically, 48 of 100 (48%) ears had evidence of ongoing or previous inflammatory middle ear disease, including proteinaceous fluid; vascular ectasia; expansion of the auricular mucoperiosteum by neutrophils, lymphocytes, and macrophages; cholesterol clefts; hemorrhage; fibrin; granulation tissue; membranous pseudo-glands; fibrosis; proliferation and/or osteolysis of the tympanic and septum bullae. Histologic lesions were identified in 34 of 100 ears (34%) lacking gross evidence of disease. Ears were classified histologically as either normal (52/100 [52%]) or diseased (48/100 [48%]). Diseased ears were further classified as mild to moderate (37/100 [37%]) or severely (11/100 [11%]) affected. Internal ear involvement was present in 11 of 100 (11%) ears. Histologic evidence of middle ear disease in cats is far greater than gross lesions or clinical literature suggests; further investigation and correlation of clinical and histologic disease are warranted. With minimal additional preparation, diagnostic specimens may be readily prepared and evaluated for this integral sensing organ. © The Author(s) 2013.

[Plastic surgery to correct deformities of the ear].

PubMed

Naumann, A

2005-08-18

For the plastic-surgical correction of mild deformities of the ears, well-proven incisional and suturing techniques are available. Only in exceptional cases is skin grafting or the use of cartilage ersatz material required. In the plastic surgical treatment of moderate to severe ear deformities, in contrast, not only incisional and suturing techniques, but also free skin grafts and ersatz materials are needed. At the ENT Department of the Ludwig-Maximilian University in Munich, plastic reconstruction of moderate to severe deformities of the external ear using porous polyethylene implants instead of rib cartilage grafts has been practiced with success for the past two years or so. Porous polyethylene implants provide good results and may help to avoid pre- and postoperative morbidity at donor site defects.

Finite element modeling of sound transmission with perforations of tympanic membrane

PubMed Central

Gan, Rong Z.; Cheng, Tao; Dai, Chenkai; Yang, Fan; Wood, Mark W.

2009-01-01

A three-dimensional finite element (FE) model of human ear with structures of the external ear canal, middle ear, and cochlea has been developed recently. In this paper, the FE model was used to predict the effect of tympanic membrane (TM) perforations on sound transmission through the middle ear. Two perforations were made in the posterior-inferior quadrant and inferior site of the TM in the model with areas of 1.33 and 0.82 mm2, respectively. These perforations were also created in human temporal bones with the same size and location. The vibrations of the TM (umbo) and stapes footplate were calculated from the model and measured from the temporal bones using laser Doppler vibrometers. The sound pressure in the middle ear cavity was derived from the model and measured from the bones. The results demonstrate that the TM perforations can be simulated in the FE model with geometrical visualization. The FE model provides reasonable predictions on effects of perforation size and location on middle ear transfer function. The middle ear structure-function relationship can be revealed with multi-field coupled FE analysis. PMID:19603881

KGFR as a possible therapeutic target in middle ear cholesteatoma.

PubMed

Yamamoto-Fukuda, Tomomi; Akiyama, Naotaro; Shibata, Yasuaki; Takahashi, Haruo; Ikeda, Tohru; Kohno, Michiaki; Koji, Takehiko

2014-11-01

We demonstrated that repression of keratinocyte growth factor (KGF) receptor (KGFR) could be a potentially useful strategy in the conservative treatment of middle ear cholesteatoma. Recently, the use of a selective inhibitor of the KGFR, SU5402, in an in vitro experiment resulted in the inhibition of the differentiation and proliferation of epithelial cells through KGF secretion by fibroblasts isolated from the cholesteatoma. In this study, we investigated the effects of the KGFR inhibitor during middle ear cholesteatoma formation in vivo. Based on the role of KGF in the development of cholesteatoma, Flag-hKGF cDNA driven by CMV14 promoter was transfected through electroporation into the external auditory canal of rats five times on every fourth day. Ears transfected with empty vector were used as controls. KGFR selective inhibitor (SU5402) or MEK inhibitor (PD0325901) was administered in the right ear of five rats after vector transfection. In the control, 2% DMSO in PBS was administered in the other ears after vector transfection. The use of a selective KGFR inhibitor, SU5402, completely prevented middle ear cholesteatoma formation in the rats.

Experiments and improvements of ear recognition based on local texture descriptors

NASA Astrophysics Data System (ADS)

Benzaoui, Amir; Adjabi, Insaf; Boukrouche, Abdelhani

2017-04-01

The morphology of the human ear presents rich and stable information embedded on the curved 3-D surface and has as a result attracted considerable attention from forensic scientists and engineers as a biometric recognition modality. However, recognizing a person's identity from the morphology of the human ear in unconstrained environments, with insufficient and incomplete training data, strong person-specificity, and high within-range variance, can be very challenging. Following our previous work on ear recognition based on local texture descriptors, we propose to use anatomical and embryological information about the human ear in order to find the autonomous components and the locations where large interindividual variations can be detected. Embryology is particularly relevant to our approach as it provides information on the possible changes that can be observed in the external structure of the ear. We experimented with three publicly available databases, namely: IIT Delhi-1, IIT Delhi-2, and USTB-1, consisting of several ear benchmarks acquired under varying conditions and imaging qualities. The experiments show excellent results, beyond the state of the art.

Aviation Fuel Exposure Resulting in Otitis Externa with Vertigo.

PubMed

Long, Robert J; Charles, Reese A

2018-07-01

Otitis externa secondary to irritant or chemical exposure is well documented; however, specifically secondary to jet fuel exposure and its associated toxicology is not. Over 2 million military and civilian personnel per year are occupationally exposed to aviation fuels. An aircraft maintainer presented with noninfectious acute otitis externa secondary to external ear canal exposure to JP-5 jet fuel. Proper exposure guidelines were followed, but it was not realized that the external ear canal was involved. The first symptoms to emerge were vertigo, dizziness, and disequilibrium; however, on physical exam it appeared that there was no middle ear involvement. Otitis externa normally does not present with vestibular symptoms as the pathology affects the external ear canal dermal tissue. Upon review of JP-5's toxicology profile, dermal absorption is a route of entry and can cause general neurological symptoms, including loss of coordination. This case highlights potential deficiencies in the standardized safety data sheets that are used after exposure. Without mention of possible auricular exposure one may focus on the logical protection of the eyes, mouth, and visible skin. This is concerning due to potential delayed exposure symptoms, dermal absorption, high level of dermal destruction, and the close proximity to the sensory system. The goal of this case report is to improve the knowledge of providers caring for personnel who may be exposed and to suggest possible revisions to the Safety Data Sheets for jet fuel.Long RJ, Charles RA. Aviation fuel exposure resulting in otitis externa with vertigo. Aerosp Med Hum Perform. 2018; 89(7):661-663.

Ear-body lift and a novel thrust generating mechanism revealed by the complex wake of brown long-eared bats (Plecotus auritus)

NASA Astrophysics Data System (ADS)

Johansson, L. Christoffer; Håkansson, Jonas; Jakobsen, Lasse; Hedenström, Anders

2016-04-01

Large ears enhance perception of echolocation and prey generated sounds in bats. However, external ears likely impair aerodynamic performance of bats compared to birds. But large ears may generate lift on their own, mitigating the negative effects. We studied flying brown long-eared bats, using high resolution, time resolved particle image velocimetry, to determine the aerodynamics of flying with large ears. We show that the ears and body generate lift at medium to cruising speeds (3-5 m/s), but at the cost of an interaction with the wing root vortices, likely reducing inner wing performance. We also propose that the bats use a novel wing pitch mechanism at the end of the upstroke generating thrust at low speeds, which should provide effective pitch and yaw control. In addition, the wing tip vortices show a distinct spiraling pattern. The tip vortex of the previous wingbeat remains into the next wingbeat and rotates together with a newly formed tip vortex. Several smaller vortices, related to changes in circulation around the wing also spiral the tip vortex. Our results thus show a new level of complexity in bat wakes and suggest large eared bats are less aerodynamically limited than previous wake studies have suggested.

Ultrasound characterization of middle ear effusion.

PubMed

Seth, Rahul; Discolo, Christopher M; Palczewska, Grazyna M; Lewandowski, Jan J; Krakovitz, Paul R

2013-01-01

To further enhance and assess the ability to characterize middle ear effusion (MEE) using non-invasive ultrasound technology. This is a prospective unblinded comparison study. Fifty-six children between the ages of 6 months and 17 years scheduled to undergo bilateral myringotomy with pressure equalization tube placement were enrolled. With the child anesthetized, the probe was placed into the external ear canal after sterile water was inserted. Ultrasound recordings of middle ear contents were analyzed by computer algorithm. Middle ear fluid was collected during myringotomy and analyzed for bacterial culture and viscosity. Ultrasound waveforms yielded a computer algorithm interpretation of middle ear contents in 66% of ears tested. When a result was obtained, the sensitivity and specificity for successfully characterizing middle ear fluid content as either void of fluid, thick fluid (mucoid), or thin fluid (serous or purulent) were at least 94%. Mucoid effusions had higher measured viscosity values (P=.002). Viscosity measures were compared to culture result, and those with low viscosity (thin consistency) had a higher likelihood of having a positive culture (P=.048). The device sensitivity and specificity for fluid detection were 94% or greater among interpretable waveforms (66% of those tested). Although this technology provides important information of the middle ear effusion presence and characteristic, further technological improvements are needed. Copyright © 2013 Elsevier Inc. All rights reserved.

Ultrasound Characterization of Middle Ear Effusion

PubMed Central

Seth, Rahul; Discolo, Christopher M; Palczewska, Grazyna M; Lewandowski, Jan J; Krakovitz, Paul R

2012-01-01

Purpose To further enhance and assess the ability to characterize middle ear effusion (MEE) using non-invasive ultrasound technology. Materials and Methods This is a prospective unblinded comparison study. Fifty-six children between the ages of 6 months and 17 years scheduled to undergo bilateral myringotomy with pressure equalization tube placement were enrolled. With the child anesthetized, the probe was placed into the external ear canal after sterile water was inserted. Ultrasound recordings of middle ear contents were analyzed by computer algorithm. Middle ear fluid was collected during myringotomy and analyzed for bacterial culture and viscosity. Results Ultrasound waveforms yielded a computer algorithm interpretation of middle ear contents in 66% of ears tested. When a result was obtained, the sensitivity and specificity for successfully characterizing middle ear fluid content as either void of fluid, thick fluid (mucoid), or thin fluid (serous or purulent) was at least 94%. Mucoid effusions had higher measured viscosity values (P=0.002). Viscosity measures were compared to culture result, and those with low viscosity (thin consistency) had a higher likelihood of having a positive culture (P=0.048). Conclusion The device sensitivity and specificity for fluid detection was 94% or greater among interpretable waveforms (66% of those tested). Although this technology provides important information of the middle ear effusion presence and characteristic, further technological improvements are needed. PMID:23084430

In vitro tympanic membrane position identification with a co-axial fiber-optic otoscope

NASA Astrophysics Data System (ADS)

Sundberg, Mikael; Peebo, Markus; Strömberg, Tomas

2011-09-01

Otitis media diagnosis can be assisted by measuring the shape of the tympanic membrane. We have developed an ear speculum for an otoscope, including spatially distributed source and detector optical fibers, to generate source-detector intensity matrices (SDIMs), representing the curvature of surfaces. The surfaces measured were a model ear with a latex membrane and harvested temporal bones including intact tympanic membranes. The position of the tympanic membrane was shifted from retracted to bulging by air pressure and that of the latex membrane by water displacement. The SDIM was normalized utilizing both external (a sheared flat plastic cylinder) and internal references (neutral position of the membrane). Data was fitted to a two-dimensional Gaussian surface representing the shape by its amplitude and offset. Retracted and bulging surfaces were discriminated for the model ear by the sign of the Gaussian amplitude for both internal and external reference normalization. Tympanic membranes were separated after a two-step normalization: first to an external reference, adjusted for the distance between speculum and the surfaces, and second by comparison with an average normally positioned SDIM from tympanic membranes. In conclusion, we have shown that the modified otoscope can discriminate between bulging and retracted tympanic membranes in a single measurement, given a two-step normalization.

Prevalence of clinical abnormalities in cats found to have nonneoplastic middle ear disease at necropsy: 59 cases (1991-2007).

PubMed

Schlicksup, Michael D; Van Winkle, Thomas J; Holt, David E

2009-10-01

To determine the prevalence of nonneoplastic middle ear disease among cats undergoing necropsy and the prevalence of clinical abnormalities in cats in which nonneoplastic middle ear disease was identified. Retrospective case series. 59 cats that underwent necropsy between January 1991 and August 2007. Medical records were searched to identify cats in which nonneoplastic middle ear disease was identified at necropsy. For cats included in the study, data that were recorded included signalment, initial complaint, whether the cat had any clinical signs of middle or external ear disease, whether the cat had upper respiratory tract disease, necropsy diagnosis, gross appearance of the bullae, and reason for euthanasia. Signs of middle ear disease that were considered included unilateral peripheral vestibular disease without motor deficits, Horner syndrome, and facial nerve paralysis. Of the 3,442 cats that underwent necropsy during the study period, 59 (1.7%) had nonneoplastic middle ear disease. Six of the 59 (10%) cats, including 1 cat that was affected bilaterally, had clinical signs of middle ear disease. Of these, 5 had signs of unilateral peripheral vestibular disease, and 1 had Horner syndrome. Results suggested that most cats with nonneoplastic middle ear disease did not have associated clinical signs. Findings may be of clinical relevance for cats in which middle ear disease is identified as an incidental finding during computed tomography or magnetic resonance imaging for unrelated diseases.

Cauliflower ear - a minimally invasive treatment method in a wrestling athlete: a case report.

PubMed

Haik, Josef; Givol, Or; Kornhaber, Rachel; Cleary, Michelle; Ofir, Hagit; Harats, Moti

2018-01-01

Acute auricular hematoma can be caused by direct blunt trauma or other injury to the external ear. It is typically seen in those who practice full contact sports such as boxing, wrestling, and rugby. "Cauliflower ear" deformity, fibrocartilage formation during scarring, is a common complication of auricular hematomas. Therefore, acute drainage of the hematoma and postprocedural techniques for preventing recurrence are necessary for preventing the deformity. There are many techniques although no superior method of treatment has been found. In this case report, we describe a novel method using needle aspiration followed by the application of a magnet and an adapted disc to the affected area of the auricular. This minimally invasive, simple, and accessible method could potentially facilitate the treatment of cauliflower ear among full contact sports athletes.

Phylogenetic and functional implications of the ear region anatomy of Glossotherium robustum (Xenarthra, Mylodontidae) from the Late Pleistocene of Argentina

NASA Astrophysics Data System (ADS)

Boscaini, Alberto; Iurino, Dawid A.; Billet, Guillaume; Hautier, Lionel; Sardella, Raffaele; Tirao, German; Gaudin, Timothy J.; Pujos, François

2018-04-01

Several detailed studies of the external morphology of the ear region in extinct sloths have been published in the past few decades, and this anatomical region has proved extremely helpful in elucidating the phylogenetic relationships among the members of this mammalian clade. Few studies of the inner ear anatomy in these peculiar animals were conducted historically, but these are increasing in number in recent years, in both the extinct and extant representatives, due to wider access to CT-scanning facilities, which allow non-destructive access to internal morphologies. In the present study, we analyze the extinct ground sloth Glossotherium robustum and provide a description of the external features of the ear region and the endocranial side of the petrosal bone, coupled with the first data on the anatomy of the bony labyrinth. Some features observable in the ear region of G. robustum (e.g., the shape and size of the entotympanic bone and the morphology of the posteromedial surface of the petrosal) are highly variable, both intraspecifically and intraindividually. The form of the bony labyrinth of G. robustum is also described, providing the first data from this anatomical region for the family Mylodontidae. The anatomy of the bony labyrinth of the genus Glossotherium is here compared at the level of the superorder Xenarthra, including all available extant and extinct representatives, using geometric morphometric methods. In light of the new data, we discuss the evolution of inner ear anatomy in the xenarthran clade, and most particularly in sloths, considering the influence of phylogeny, allometry, and physiology on the shape of this highly informative region of the skull. These analyses show that the inner ear of Glossotherium more closely resembles that of the extant anteaters, and to a lesser extent those of the giant ground sloth Megatherium and euphractine armadillos, than those of the extant sloths Bradypus and Choloepus, further demonstrating the striking morphological convergence between the two extant sloth genera.

Phylogenetic and functional implications of the ear region anatomy of Glossotherium robustum (Xenarthra, Mylodontidae) from the Late Pleistocene of Argentina.

PubMed

Boscaini, Alberto; Iurino, Dawid A; Billet, Guillaume; Hautier, Lionel; Sardella, Raffaele; Tirao, German; Gaudin, Timothy J; Pujos, François

2018-03-27

Several detailed studies of the external morphology of the ear region in extinct sloths have been published in the past few decades, and this anatomical region has proved extremely helpful in elucidating the phylogenetic relationships among the members of this mammalian clade. Few studies of the inner ear anatomy in these peculiar animals were conducted historically, but these are increasing in number in recent years, in both the extinct and extant representatives, due to wider access to CT-scanning facilities, which allow non-destructive access to internal morphologies. In the present study, we analyze the extinct ground sloth Glossotherium robustum and provide a description of the external features of the ear region and the endocranial side of the petrosal bone, coupled with the first data on the anatomy of the bony labyrinth. Some features observable in the ear region of G. robustum (e.g., the shape and size of the entotympanic bone and the morphology of the posteromedial surface of the petrosal) are highly variable, both intraspecifically and intraindividually. The form of the bony labyrinth of G. robustum is also described, providing the first data from this anatomical region for the family Mylodontidae. The anatomy of the bony labyrinth of the genus Glossotherium is here compared at the level of the superorder Xenarthra, including all available extant and extinct representatives, using geometric morphometric methods. In light of the new data, we discuss the evolution of inner ear anatomy in the xenarthran clade, and most particularly in sloths, considering the influence of phylogeny, allometry, and physiology on the shape of this highly informative region of the skull. These analyses show that the inner ear of Glossotherium more closely resembles that of the extant anteaters, and to a lesser extent those of the giant ground sloth Megatherium and euphractine armadillos, than those of the extant sloths Bradypus and Choloepus, further demonstrating the striking morphological convergence between the two extant sloth genera.

The Existence of a Natural Plica at the Anatomical Base of the Antihelix and its Surgical Importance to Address Protruding Ears: An Anatomicosurgical Study.

PubMed

Oliveira, Miguel Marques; Oliveira, Daniel Sousa Marques; Oliveira, Gustavo Sousa Marques

2017-04-01

Protruding ears represent the main abnormality of the external ear, which has required numerous anatomic and surgical studies. Most studies give attention to the absence of the antihelix as the anatomic defect responsible for the clinical deformity of the lateral aspect of the ear that leads to its anteversion. The reason for this study is the controversial origin of the fold of the antihelix within the auricle framework, a field of interest for aesthetic otoplasty. The current study examined the medial surface of the cartilaginous ear frame from cadaver specimens with right morphology to investigate the starting point of the fold of the antihelix. This allowed for verification of a natural plica at the anatomic base of this antihelical fold, which to date has not had its topography described morphologically. It is acknowledged that relevant literature makes no reference to this innominate natural plica at the origin of the antihelix, whose anatomic and surgical importance is related in this report. This study aimed to show that the existence of a natural plica at the base of the antihelix in ear framing represents a landmark between normal and protruding ear morphology. For 8 years, 118 ears were carefully investigated within rigid ethical principles based on a thorough review of the pertinent literature. The study investigated 16 selected cadaver specimens and 102 protruding ears dissected by the senior author including 49 bilateral cases (26 males and 23 females) and 4 unilateral cases (2 males and 2 females). Bifacial anthropometric measurements by calipers were used for documentation. A natural plica at the base of the antihelix was found in all cadaver ears selected with right morphology, whereas it was totally absent in every surgically treated protruding ear irrespective of color, gender, age, or ethnic origin. Ambilateral measures of the antihelix eminence certify the study object in normal specimens as well as its lack in abnormal ones. Technical and topographic knowledge that a natural plica exists at the anatomic base of the antihelix is a valuable key point in recognizing the normal external ear. In addition, the making of a natural plica is the first and most effective factor in the reconstruction of the antihelical fold and its absolute absence results in the pathologic condition for protruding ears. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the A3 online Instructions to Authors. http://www.springer.com/00266 .

Type II first branchial cleft anomaly.

PubMed

Al-Mahdi, Akmam H; Al-Khurri, Luay E; Atto, Ghada Z; Dhaher, Ameer

2013-01-01

First branchial cleft anomaly is a rare disease of the head and neck. It accounts for less than 8% of all branchial abnormalities. It is classified into type I, which is thought to arise from the duplication of the membranous external ear canal and are composed of ectoderm only, and type II that have ectoderm and mesoderm. Because of its rarity, first branchial cleft anomaly is often misdiagnosed and results in inappropriate management. A 9-year-old girl presented to us with fistula in the submandibular region and discharge in the external ear. Under general anesthesia, complete surgical excision of the fistula tract was done through step-ladder approach, and the histopathologic examination confirmed the diagnosis of type II first branchial cleft anomaly.

Continuous 24-hour measurement of middle ear pressure.

PubMed

Tideholm, B; Jönsson, S; Carlborg, B; Welinder, R; Grenner, J

1996-07-01

A new method was developed for continuous measurement of the middle ear pressure during a 24-h period. The equipment consisted of a piezo-electric pressure device and a digital memory. To allow continuous pressure recordings during normal every-day activities the equipment was made light and portable. The measurement accuracy of the equipment as well as the base-line and temperature stability were tested and found to meet to our requirements satisfactorily. In 4 volunteers with different middle ear conditions, a small perforation was made through the tympanic membrane. A rubber stopper containing a small polyethylene tube was fitted into the external ear canal. Tubal function tests were made to establish the equipment's ability to monitor fast pressure changes. The tests were well in accordance with other methods of direct pressure measurements. The equipment was carried by the volunteers for 24 h to monitor any slow or rapid dynamic pressure changes in the middle ear. Four continuous 24-h measurements are presented. The method was found to be suitable for valid measurements of dynamic pressure changes in the middle ear during normal every-day activities. It may become a useful instrument in the search for a better understanding of the development of chronic middle ear disease.

Isolated Sensorineural Hearing Loss as a Sequela after Lightning Strike

PubMed Central

Turan, Mahfuz; Kalkan, Ferhat; Bozan, Nazım; Özçalimli, İsa; Zeki Erdem, Mehmet; Yalınkılıç, Abdülaziz; Garca, Mehmet Fatih

2015-01-01

In most of the surviving patients after a lightning strike, audiovestibular abnormalities have been reported. The most frequently reported type of abnormalities is a tympanic membrane perforation with hearing loss and external ear canal burn. However a sensor neural hearing loss and mixed type hearing loss can also occur, but these occur rarely. A nineteen-year-old female patient had, after a lightning strike, serious burns on the left ear, behind the ear, and on the chest and neck. She also had in her left ear 108 dB hearing loss with irregular central perforation and in her right ear 52 dB sensorineural hearing loss. There was no hearing loss before the strike. A hearing aid was recommended for the right ear and good care and follow-up were recommended for the left ear. A lightning strike can cause serious audiological damage. Therefore, it is necessary to make a careful audiovestibular evaluation of the patients. Although there exist rarely healed cases from sensorineural hearing loss after lightning strike in literature, in our case hearing loss occurred bilaterally and then it healed unilaterally. This condition is quite rare in literature. PMID:26161278

In vivo over-expression of KGF mimic human middle ear cholesteatoma.

PubMed

Yamamoto-Fukuda, Tomomi; Akiyama, Naotaro; Shibata, Yasuaki; Takahashi, Haruo; Ikeda, Tohru; Koji, Takehiko

2015-10-01

We reported previously that keratinocyte growth factor (KGF), a mesenchymal cell-derived paracrine growth factor, plays an important role in middle ear cholesteatoma formation, which is characterized by marked proliferation of epithelial cells. Here, we investigated whether KGF, the main factor that induces cholesteatoma, overexpression in vivo results in the formation of cholesteatoma. Flag-hKGF cDNA driven by CMV14 promoter was transfected through electroporation into the external auditory canal (EAC) of rats once (short-term model) or five times on every fourth day (long-term model). Ears transfected with empty vector were used as controls. Successful transfection of plasmids into epithelial and stromal cells was confirmed by Flag immunohistochemistry. In the short-term model, the intensity of KGF protein was the strongest in hKGF transfected ear at day 4. KGF expression induced epithelial cell proliferation, reaching a peak level at day 4 and then decreased later, while in the long-term model, KGF expression in the EAC led to middle ear cholesteatoma formation. In conclusion, we described here a new experimental model of human middle ear cholesteatoma, and demonstrated that KGF and KGF receptor paracrine action play an essential role in middle ear cholesteatoma formation in an in vivo model.

Numerical evaluation of implantable hearing devices using a finite element model of human ear considering viscoelastic properties.

PubMed

Zhang, Jing; Tian, Jiabin; Ta, Na; Huang, Xinsheng; Rao, Zhushi

2016-08-01

Finite element method was employed in this study to analyze the change in performance of implantable hearing devices due to the consideration of soft tissues' viscoelasticity. An integrated finite element model of human ear including the external ear, middle ear and inner ear was first developed via reverse engineering and analyzed by acoustic-structure-fluid coupling. Viscoelastic properties of soft tissues in the middle ear were taken into consideration in this model. The model-derived dynamic responses including middle ear and cochlea functions showed a better agreement with experimental data at high frequencies above 3000 Hz than the Rayleigh-type damping. On this basis, a coupled finite element model consisting of the human ear and a piezoelectric actuator attached to the long process of incus was further constructed. Based on the electromechanical coupling analysis, equivalent sound pressure and power consumption of the actuator corresponding to viscoelasticity and Rayleigh damping were calculated using this model. The analytical results showed that the implant performance of the actuator evaluated using a finite element model considering viscoelastic properties gives a lower output above about 3 kHz than does Rayleigh damping model. Finite element model considering viscoelastic properties was more accurate to numerically evaluate implantable hearing devices. © IMechE 2016.

Continuous long-term measurements of the middle ear pressure in subjects without a history of ear disease.

PubMed

Tideholm, B; Carlborg, B; Jönsson, S; Bylander-Groth, A

1998-06-01

A new method was used for continuous measurement of the middle ear (ME) pressure during a 24-h period. In 10 subjects without a history of ear disease a small perforation was made through the tympanic membrane. A tight rubber stopper containing a small polyethylene tube was fitted into the external ear canal. Conventional tubal function tests were performed. The equipment was then carried by the subjects for 24 h of normal activity to monitor any slow or rapid dynamic pressure change in the ME. Body position was found to be the most important factor affecting ME pressure variation, during the 24-h continuous pressure measurements. A significant pressure rise occurred in the recumbent position in all but one subject. Few rapid pressure equilibrations were seen during the recordings, indicating few tubal openings. This implies that the pressure changes in the ME seen in this study were mainly the result of gas exchange over the mucosa. The investigation might be a base for reference when investigating different kinds of pathologic conditions in the ear.

Tumbling cartilage flap and free auricular composite tissue transplantation for correcting mild and moderate forms of constricted ear.

PubMed

Pan, Bo; Zhao, Yanyong; Zhuang, Hongxing; Lin, Lin; Liu, Lei; Jiang, Haiyue

2010-01-01

To report a new surgical approach that results in a natural size and contour of the external malformed constricted ear. A total of 62 consecutive patients with constricted ear underwent surgery between July 1, 2005, and December 31, 2007. Depending on the features and severity of the deformity, the methods of tumbling cartilage flap (CF), free auricular composite graft, or a combination of these 2 techniques were applied. A total of 45 patients were treated with the method of tumbling CF. Twelve were treated with an auricular composite graft from the contralateral ear, and in 5 patients a combination of the 2 methods was used. In all cases, there was an improvement in the size, shape, and symmetry of the ears, and most patients were satisfied with the outcome. Complications were rare, and there was no donor site deformity. The technique of tumbling CF and free auricular composite graft provides a simple and promising treatment for constricted ears. Furthermore, this technique is easy to apply with a predictable good outcome.

Efficacy of naturopathic extracts in the management of ear pain associated with acute otitis media.

PubMed

Sarrell, E M; Mandelberg, A; Cohen, H A

2001-07-01

To determine the efficacy and tolerance of Otikon Otic Solution (Healthy-On Ltd, Petach-Tikva, Israel), a naturopathic herbal extract (containing Allium sativum, Verbascum thapsus, Calendula flores, and Hypericum perforatum in olive oil), compared with Anaesthetic (Vitamed Pharmaceutical Ltd, Benyamina, Israel) ear drops (containing ametocaine and phenazone in glycerin) in the management of ear pain associated with acute otitis media (AOM). Children between the ages of 6 and 18 years who experienced ear pain (otalgia) and who were diagnosed with eardrum problems associated with AOM were randomly assigned to be treated with Otikon or Anaesthetic ear drops, which were instilled into the external canal(s) of the affected ear(s). Ear pain was assessed using 2 visual analog scales: a linear scale and a color scale. Pain assessment took place throughout the course of 3 days. The mean score of pain reduction was used to measure outcome. Primary pediatric community ambulatory centers. One hundred three children aged 6 to 18 years who were diagnosed with otalgia associated with AOM. Each of the 2 treatment groups were comparable on the basis of age, sex, laterality of AOM, and the effectiveness of ameliorating symptoms of otalgia. The 2 groups were also comparable to each other in the initial ear pain score and in the scores at each application of Otikon or Anaesthetic drops. There was a statistically significant improvement in ear pain score throughout the course of the study period (P =.007). Otikon, an ear drop formulation of naturopathic origin, is as effective as Anaesthetic ear drops and was proven appropriate for the management of AOM-associated ear pain.

Comparison of Microbiological Flora in the External Auditory Canal of Normal Ear and an Ear with Acute Otitis Externa.

PubMed

Ghanpur, Asheesh Dora; Nayak, Dipak Ranjan; Chawla, Kiran; Shashidhar, V; Singh, Rohit

2017-09-01

Acute Otitis Externa (AOE) is also known as swimmer's ear. Investigations initiated during World War II firmly established the role of bacteria in the aetiology of Acute Otitis Externa. To culture the microbiological flora of the normal ear and compare it with the flora causing AOE and to know the role of normal ear canal flora and anaerobes in the aetiology. A prospective observational study was conducted on 64 patients clinically diagnosed with unilateral AOE. Ear swabs were taken from both the ears. Microbiological flora was studied considering diseased ear as test ear and the normal ear as the control. Aerobic and anaerobic cultures were done. Severity of the disease was assessed by subjective and objective scores. Effect of topical treatment with ichthammol glycerine pack was assessed after 48 hours and scores were calculated again. Patients with scores < 4 after pack removal were started on systemic antibiotics and were assessed after seven days of antibiotics course. Data was analysed using Paired t-test, Wilcoxon signed ranks test and Chi-square test. A p-value < 0.05 was considered significant. Pseudomonas aeruginosa (33%) was the most common bacteria cultured from the ear followed by Methicillin Resistant Staphylococcus aureus (MRSA) (18%). Patients with anaerobic organism in the test ear had severe symptoms and needed systemic antibiotic therapy. Most of the cases may respond to empirical antibiotic therapy. In cases with severe symptoms and the ones refractory to empirical treatment, a culture from the ear canal will not be a tax on the patient. This helps in giving a better understanding about the disease, causative organisms and helps in avoiding the use of inappropriate antibiotics that usually result in developing resistant strains of bacteria.

Proposal of a Classification System for the Assessment and Treatment of Prominent Ear Deformity.

PubMed

Lee, Youngdae; Kim, Young Seok; Lee, Won Jai; Rha, Dong Kyun; Kim, Jiye

2018-06-01

Prominent ear is the most common external ear deformity. To comprehensively treat prominent ear deformity, adequate comprehension of its pathophysiology is crucial. In this article, we analyze cases of prominent ear and suggest a simple classification system and treatment algorithm according to pathophysiology. We retrospectively reviewed a total of 205 Northeast Asian patients' clinical data who underwent an operation for prominent ear deformity. Follow-up assessments were conducted 3, 6, and 12 months after surgery. Prominent ear deformities were classified by diagnostic checkpoints. Class I (simple prominent ear) includes prominent ear that developed with the absence of the antihelix without conchal hypertrophy. Class II (mixed-type prominent ear) is defined as having not only a flat antihelix, but also conchal excess. Class III (conchal-type prominent ear) has an enlarged conchal bowl with a well-developed antihelix. Among the three types of prominent ear, class I was most frequent (162 patients, 81.6%). Class II was observed in 28 patients (13.6%) and class III in 10 patients (4.8%). We used the scaphomastoid suture method for correction of antihelical effacement, the anterior approach conchal resection for correction of conchal hypertrophy, and Bauer's squid incision for lobule prominence. The complication rate was 9.2% including early hematoma, hypersensitivity, and suture extrusion. Unfavorable results occurred in 4% including partial recurrence, overcorrection, and undercorrection. To reduce unfavorable results and avoid recurrence, we propose the use of a classification and treatment algorithm in preoperative evaluation of prominent ear. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Chronological changes in microbial profiles in external and middle ear diseases: a 20-year study in Korea.

PubMed

Kim, Hantai; Choo, Oak-Sung; Jang, Jeong Hun; Park, Hun Yi; Choung, Yun-Hoon

2017-03-01

Microbial infection is one of the most significant causes of ear diseases, but microbial profiles are very diverse according to the diseases and change over time. The purpose of the study was to clarify differences and chronological changes in causative pathogens among infectious ear diseases over the last 20 years, and to identify antibiotic resistance. In total, 1191 isolates were included from patients diagnosed with chronic otitis media without cholesteatoma (COM), cholesteatomatous otitis media (Chole), middle ear effusion (MEE), including acute otitis media and otitis media with effusion, and external otitis (EO). Data were collected periodically for the years 1995, 2000, 2004, 2009, and 2013. Culture results and antibiotic resistance were assessed. The most common microorganism identified was S. aureus. The microbial profiles differed significant among the COM, Chole, and MEE groups (p < 0.001). In contrast, there was no distinct difference between COM and EO (p = 0.332). COM, Chole, and MEE also showed significant chronological changes in microbial profiles over time. The frequency of CNS increased markedly in COM and Chole (p = 0.029 and 0.028, respectively); however, S. pneumoniae infection decreased significantly in MEE (p = 0.016). Methicillin-resistant S. aureus (MRSA) demonstrated a constant trend (p = 0.564), whereas ciprofloxacin-resistant P. aeruginosa increased over time (p < 0.001). Microbial profiles have changed over a 20-year period. Increases in the frequency of coagulase-negative Staphylococcus (CNS) and bacterial resistance to ciprofloxacin, used widely in treating ear infections, are noteworthy.

[2000-year history of the ear syringe and its relationship to the enema. Images from the history of otorhinolaryngology, represented by instruments from the collection of the Ingolstadt Medical History Museum].

PubMed

Feldmann, H

1999-08-01

SYRINGES WITH A PISTON AND THEIR USE AS "CLYSTER ORICULARIUS" IN THE ANCIENT ROME: Syringes with a piston were already known in ancient times and have been mentioned as a device for spraying rose water (Philon of Byzantium, about 230 BC), and for fighting fires (Heron of Alexandria about 110 AD). Celsus mentions it several times in his grand opus "De Medicina" (1st century AD) in the treatment of purulent discharge from the ear and for removing foreign bodies from the external ear canal. He always calls it "clyster oricularius", i.e. ear syringe, even when he describes its use in applications other than otological, such as in urology. Later the ear syringe fell from favor for a very long time and was reinvented only at the beginning of the 19th century. IRRIGATION OF THE BOWELS, FROM THE BAG SYRINGE TO THE PISTON SYRINGE: Irrigations of the bowels, clysters, were performed from ancient times to the 18th century with a baglike syringe using the bladder of animals as a pouch. Syringes with a piston were used by barbers and surgeons only for cleansing wounds or irrigating natural cavities of the body. Irrigation of the external ear canal had completely fallen from favor. In France in the 18th century large syringes with a piston made of tin oder brass came into use for enemas and replaced the old baglike devices. THE REINVENTION OF THE EAR SYRINGE AFTER THE PROTOTYPE OF THE ENEMA SYRINGE: Itard, an otologist in France in 1821, was the first to describe irrigating the ear with a syringe to remove hard wax. He recommended using an enema syringe ("seringue à lavement") for the procedure. Soon after his publication special ear syringes of appropriate size were developed and described by Beck in Freiburg, Germany, in 1827; by Fabrizi in Modena, Italy, 1839; and Schmalz in Dresden, Germany, 1846, who also introduced the kidney-shaped bowel for catching the water. Apart from that, small baglike syringes made of rubber were devised especially for use by the patient himself (Kramer, Berlin, 1860). This historical development is described in detail and illustrated by numerous figures.

Mozart Ear Deformity: a Rare Diagnosis in the Ear Reconstruction Clinic.

PubMed

Telich-Tarriba, Jose E; Victor-Baldin, Andre; Apellaniz-Campo, Armando

2017-07-01

Mozart ear is a rare auricular deformity; clinically the auricle is characterized by the bulging appearance of the anterosuperior portion of the auricle due to fusion of the crura of the antihelix, an inversion in the normal form of the cavum conchae resulting in its convexity and a slit-like narrowing of the orifice of the external auditory meatus.A retrospective review of clinical and photographic records of patients attended at the ear reconstruction clinic of our hospital between June of 2010 and May 2016 was performed; out of 576 consecutive patients only 3 fulfilled the inclusion criteria, with a prevalence of 0.5%. The authors present these patients.Surgical interventions mainly focus on the correction of the convex concha; however, the procedure should be tailored to the severity of the deformity and the wishes of the patient.

Mirror ear: a reconstructive technique for substantial tragal anomalies or polyotia.

PubMed

Gore, Sinclair M; Myers, Simon R; Gault, David

2006-01-01

Polyotia (mirror ear) is an extremely rarely reported congenital anomaly of the external ear. The aetiology of this condition is unclear, and there are few descriptions of surgical techniques used. We aimed to review our experience with this condition by performing a retrospective review of the cases treated in our unit. Eight cases of polyotia treated at a referral centre for ear reconstruction in a 12 year period (1992-2004) were reviewed. Patient demographic data and associated syndromes were recorded. Operative techniques used in the cases were studied. There was an equal number of males and females. Four patients had abnormal contralateral ears and two patients were formally diagnosed as suffering from a congenital developmental syndrome. Five main components of surgical technique were found to be particularly relevant to these cases. These relate to deconstruction of the defect, management of extra cartilage, management of skin, proximity of the facial nerve and the timing of surgery. The authors conclude that a structured surgical approach can lead to successful reconstruction of these difficult abnormalities.

Novel regulatory loci controlling oxygen- and pH-regulated gene expression in Salmonella typhimurium.

PubMed Central

Aliabadi, Z; Park, Y K; Slonczewski, J L; Foster, J W

1988-01-01

Three new loci were discovered, each of which participates in the regulation of anaerobic gene expression. The regulatory gene earA negatively regulates the expression of the anaerobiosis-inducible gene aniG as well as that of at least three other genes, as determined by two-dimensional polyacrylamide gel electrophoresis. The earA locus maps at 86 min. The expression of aniG was also shown to be controlled by changes in external pH under aerobic and anaerobic conditions. Maximal expression was observed under anaerobic conditions at an external pH of 6.0. Significant transcriptional activity was also observed under aerobic conditions at pH 6.0. This was in contrast to hyd, whose expression was dependent upon anaerobiosis and varied with external pH. The pH dependence disappeared under fully aerobic conditions. Mutations in earA had no effect upon hyd expression. The two other regulators identified were oxrF, which controls aniH, and oxrG, which, in concert with oxrA and oxrB, controls aniC and aniI. The oxrG locus was mapped to 88 min and appears to code for a positive regulator. Various oxr mutants were subjected to two-dimensional polyacrylamide electrophoretic analysis of anaerobiosis-inducible proteins. Several pathways of anaerobic control were observed by means of these techniques. Images PMID:3276666

Effect of Diving and Diving Hoods on the Bacterial Flora of the External Ear Canal and Skin

DTIC Science & Technology

1982-05-01

in parentheses itidicate number of sites tested. b One strain isolated from skin laceration exposed to water. "Diver developed external otitis media 5... otitis media (11), skin infections skin of wearing diving hoods in and out of the (6), and diarrheal diseases (10). One aspect of water. We

Sound-power collection by the auditory periphery of the Mongolian gerbil Meriones unguiculatus. I: Middle-ear input impedance.

PubMed

Ravicz, M E; Rosowski, J J; Voigt, H F

1992-07-01

This is the first paper of a series dealing with sound-power collection by the auditory periphery of the gerbil. The purpose of the series is to quantify the physiological action of the gerbil's relatively large tympanic membrane and middle-ear air cavities. To this end the middle-ear input impedance ZT was measured at frequencies between 10 Hz and 18 kHz before and after manipulations of the middle-ear cavity. The frequency dependence of ZT is consistent with that of the middle-ear transfer function computed from extant data. Comparison of the impedance and transfer function suggests a middle-ear transformer ratio of 50 at frequencies below 1 kHz, substantially smaller than the anatomical value of 90 [Lay, J. Morph. 138, 41-120 (1972)]. Below 1 kHz the data suggest a low-frequency acoustic stiffness KT for the middle ear of 970 Pa/mm3 and a stiffness of the middle-ear cavity of 720 Pa/mm3 (middle-ear volume V MEC of 195 mm3); thus the middle-ear air spaces contribute about 70% of the acoustic stiffness of the auditory periphery. Manipulations of a middle-ear model suggest that decreases in V MEC lead to proportionate increases in KT but that further increases in middle-ear cavity volume produce only limited decreases in middle-ear stiffness. The data and the model point out that the real part of the middle-ear impedance at frequencies below 100 Hz is determined primarily by losses within the middle-ear cavity. The measured impedance is comparable in magnitude and frequency dependence to the impedance in several larger mammalian species commonly used in auditory research. A comparison of low-frequency stiffness and anatomical dimensions among several species suggests that the large middle-ear cavities in gerbil act to reduce the middle-ear stiffness at low frequencies. A description of sound-power collection by the gerbil ear requires a description of the function of the external ear.

[The pharmacodynamic research on fuxiye, a Chinese herbal lotion for external wash].

PubMed

Chen, Xue-Qi; Ge, Bei-Fen; Shen, Wei; Liu, Pei; Cao, Jun-Ming; Chen, Zhe

2013-05-01

To observe antisepsis, anti-swelling, and therapeutic effects of Fuxiye (FXY), a Chinese medical lotion for external wash in treating vaginitis model rats. The cervicitis rat model was induced by agar plate diffusion, ear auricle swelling induced by dimethylbenzene, and chemical stimulus. The in vitro antibiotic actions of FXY were observed. Besides, its effects on the swelling and inflammation in model rats were also observed. FXY at 25 mg/mL could completely inhibit the growth of Pseudomonas aeruginosa, Escherichia coli, pyogenic Streptococcus, and Streptococcus agalactiae. FXY at 50 mg/mL could completely inhibit the growth of Staphylococcus aureus and Candida albicans. It obviously restrained dimethylbenzene induced ear auricle swelling. It significantly alleviated cervicitis induced by chemical stiumli. FXY showed better effects on antisepsis, anti-inflammation, and treating cervicitis.

Surgical and Technical Modalities for Hearing Restoration in Ear Malformations.

PubMed

Dazert, Stefan; Thomas, Jan Peter; Volkenstein, Stefan

2015-12-01

Malformations of the external and middle ear often go along with an aesthetic and functional handicap. Independent of additional aesthetic procedures, a successful functional hearing restoration leads to a tremendous gain in quality of life for affected patients. The introduction of implantable hearing systems (bone conduction and middle ear devices) offers new therapeutic options in this field. We focus on functional rehabilitation of patients with malformations, either by surgical reconstruction or the use of different implantable hearing devices, depending on the disease itself and the severity of malformation as well as hearing impairment. Patients with an open ear canal and minor malformations are good candidates for surgical hearing restoration of middle ear structures with passive titanium or autologous implants. In cases with complete fibrous or bony atresia of the ear canal, the most promising functional outcome and gain in quality of life can be expected with an active middle ear implant or a bone conduction device combined with a surgical aesthetic rehabilitation in a single or multi-step procedure. Although the surgical procedure for bone conduction devices is straightforward and safe, more sophisticated operations for active middle ear implants (e.g., Vibrant Soundbridge, MED-EL, Innsbruck, Austria) provide an improved speech discrimination in noise and the ability of sound localization compared with bone conduction devices where the stimulation reaches both cochleae. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Finite element modelling of human auditory periphery including a feed-forward amplification of the cochlea.

PubMed

Wang, Xuelin; Wang, Liling; Zhou, Jianjun; Hu, Yujin

2014-08-01

A three-dimensional finite element model is developed for the simulation of the sound transmission through the human auditory periphery consisting of the external ear canal, middle ear and cochlea. The cochlea is modelled as a straight duct divided into two fluid-filled scalae by the basilar membrane (BM) having an orthotropic material property with dimensional variation along its length. In particular, an active feed-forward mechanism is added into the passive cochlear model to represent the activity of the outer hair cells (OHCs). An iterative procedure is proposed for calculating the nonlinear response resulting from the active cochlea in the frequency domain. Results on the middle-ear transfer function, BM steady-state frequency response and intracochlear pressure are derived. A good match of the model predictions with experimental data from the literatures demonstrates the validity of the ear model for simulating sound pressure gain of middle ear, frequency to place map, cochlear sensitivity and compressive output for large intensity input. The current model featuring an active cochlea is able to correlate directly the sound stimulus in the ear canal with the vibration of BM and provides a tool to explore the mechanisms by which sound pressure in the ear canal is converted to a stimulus for the OHCs.

Non-invasive biophysical measurement of travelling waves in the insect inner ear

PubMed Central

2017-01-01

Frequency analysis in the mammalian cochlea depends on the propagation of frequency information in the form of a travelling wave (TW) across tonotopically arranged auditory sensilla. TWs have been directly observed in the basilar papilla of birds and the ears of bush-crickets (Insecta: Orthoptera) and have also been indirectly inferred in the hearing organs of some reptiles and frogs. Existing experimental approaches to measure TW function in tetrapods and bush-crickets are inherently invasive, compromising the fine-scale mechanics of each system. Located in the forelegs, the bush-cricket ear exhibits outer, middle and inner components; the inner ear containing tonotopically arranged auditory sensilla within a fluid-filled cavity, and externally protected by the leg cuticle. Here, we report bush-crickets with transparent ear cuticles as potential model species for direct, non-invasive measuring of TWs and tonotopy. Using laser Doppler vibrometry and spectroscopy, we show that increased transmittance of light through the ear cuticle allows for effective non-invasive measurements of TWs and frequency mapping. More transparent cuticles allow several properties of TWs to be precisely recovered and measured in vivo from intact specimens. Our approach provides an innovative, non-invasive alternative to measure the natural motion of the sensilla-bearing surface embedded in the intact inner ear fluid. PMID:28573026

Bilateral tympanokeratomas (cholesteatomas) with bilateral otitis media, unilateral otitis interna and acoustic neuritis in a dog.

PubMed

Østevik, Liv; Rudlang, Kathrine; Holt Jahr, Tuva; Valheim, Mette; Njaa, Bradley Lyndon

2018-05-22

An aural cholesteatoma, more appropriately named tympanokeratoma, is an epidermoid cyst of the middle ear described in several species, including dogs, humans and Mongolian gerbils. The cyst lining consists of stratified, keratinizing squamous epithelium with central accumulation of a keratin debris. This case report describes vestibular ganglioneuritis and perineuritis in a dog with chronic otitis, bilateral tympanokeratomas and presumed extension of otic infection to the central nervous system. An 11-year-old intact male Dalmatian dog with chronic bilateral otitis externa and sudden development of symptoms of vestibular disease was examined. Due to the dog's old age the owner opted for euthanasia without any further examination or treatment and the dog was submitted for necropsy. Transection of the ears revealed grey soft material in the external ear canals and pearly white, dry material consistent with keratin in the tympanic bullae bilaterally. The brain and meninges were grossly unremarkable. Microscopical findings included bilateral otitis externa and media, unilateral otitis interna, ganglioneuritis and perineuritis of the spiral ganglion of the vestibulocochlear nerve and multifocal to coalescing, purulent meningitis. A keratinizing squamous epithelial layer continuous with the external acoustic meatus lined the middle ear compartments, consistent with bilateral tympanokeratomas. Focal bony erosion of the petrous portion of the temporal bone and squamous epithelium and Gram-positive bacterial cocci were evident in the left cochlea. The findings suggest that meningitis developed secondary to erosion of the temporal bone and ganglioneuritis and/or perineuritis of the vestibulocochlear nerve. Middle ear tympanokeratoma is an important and potentially life-threatening otic condition in the dog. Once a tympanokeratoma has developed expansion of the cyst can lead to erosion of bone and extension of otic infection to the inner ear, vestibulocochlear ganglion and nerve potentially leading to bacterial infection of the central nervous system.

[Computerized study of perioperative difficulties of stapedectomy].

PubMed

Cadavid Zink, R; Ballivian, H; Gamboa, F J; Olaizola, F

1993-01-01

A retrospective study of 1035 stapedectomies was performed to assess the incidence of intraoperative complications between 1972-1990. We found 45.89% of complications. We divided this alterations in 6 groups: 1) hemorrhage (20.67%), 2) stapes, foot plate, oval window (8.40%), 3) alterations in the middle ear (6.85%), 4) alterations in the incus (3.76%), 5) alterations in the external ear canal (3.57%) and 6) problems with protesis or graf (2.60%). We have analyzed these complications. We propose to carry out the solutions.

Technical devices in otoplasty to obtain a natural appearance.

PubMed

Zaoli, G

1997-07-01

This article outlines the importance given by plastic surgeons to correcting the external ear malformations. The objective is to create ears with a normal appearance. Despite more than 200 methods proposed by different authors, a procedure for otoplasty that gives constant and lasting surgical results has not yet been found. Following some critical remarks, both anatomical and surgical, the author proposes a method that, in his experience, gives good results, more natural and reliable, and is free from failures.

Sound transmission in archaic and modern whales: anatomical adaptations for underwater hearing.

PubMed

Nummela, Sirpa; Thewissen, J G M; Bajpai, Sunil; Hussain, Taseer; Kumar, Kishor

2007-06-01

The whale ear, initially designed for hearing in air, became adapted for hearing underwater in less than ten million years of evolution. This study describes the evolution of underwater hearing in cetaceans, focusing on changes in sound transmission mechanisms. Measurements were made on 60 fossils of whole or partial skulls, isolated tympanics, middle ear ossicles, and mandibles from all six archaeocete families. Fossil data were compared with data on two families of modern mysticete whales and nine families of modern odontocete cetaceans, as well as five families of noncetacean mammals. Results show that the outer ear pinna and external auditory meatus were functionally replaced by the mandible and the mandibular fat pad, which posteriorly contacts the tympanic plate, the lateral wall of the bulla. Changes in the ear include thickening of the tympanic bulla medially, isolation of the tympanoperiotic complex by means of air sinuses, functional replacement of the tympanic membrane by a bony plate, and changes in ossicle shapes and orientation. Pakicetids, the earliest archaeocetes, had a land mammal ear for hearing in air, and used bone conduction underwater, aided by the heavy tympanic bulla. Remingtonocetids and protocetids were the first to display a genuine underwater ear where sound reached the inner ear through the mandibular fat pad, the tympanic plate, and the middle ear ossicles. Basilosaurids and dorudontids showed further aquatic adaptations of the ossicular chain and the acoustic isolation of the ear complex from the skull. The land mammal ear and the generalized modern whale ear are evolutionarily stable configurations, two ends of a process where the cetacean mandible might have been a keystone character. 2007 Wiley-Liss, Inc.

Acoustic feedback margin improvements in hearing instruments using a prototype DFS (digital feedback suppression) system.

PubMed

Dyrlund, O; Bisgaard, N

1991-01-01

The properties of a prototype DFS (digital feedback suppression) system have been investigated. 21 ears fitted with behind-the-ear (BTE) hearing instruments and hard acrylic ear-moulds and 4 ears fitted with vented in-the-ear (ITE) hearing instruments were selected for the investigation. Two ITE instruments with different venting were employed to one of the ears. Complex loop gain has been measured in an anechoic room, and from these measurements the improvements in acoustic feedback margin due to the DFS system have been determined. For the BTE group, median values of 13.1 and 10.0 dB of improvement were established for two sets of measurements introducing a 180 degrees phase shift in connection with the last set of measurements. For the ITE group, values from 9.8 to 16.1 dB and from 13.7 to 16.3 dB of improvement were observed for the normal and the 180 degrees phase shift conditions respectively. Beyond this the DFS system may improve the sound quality to some extent, because the amplitude distortion, caused by the external feedback signal, is almost completely eliminated.

A prediction of the minke whale (Balaenoptera acutorostrata) middle-ear transfer function.

PubMed

Tubelli, Andrew A; Zosuls, Aleks; Ketten, Darlene R; Yamato, Maya; Mountain, David C

2012-11-01

The lack of baleen whale (Cetacea Mysticeti) audiograms impedes the assessment of the impacts of anthropogenic noise on these animals. Estimates of audiograms, which are difficult to obtain behaviorally or electrophysiologically for baleen whales, can be made by simulating the audiogram as a series of components representing the outer, middle, and inner ear (Rosowski, 1991; Ruggero and Temchin, 2002). The middle-ear portion of the system can be represented by the middle-ear transfer function (METF), a measure of the transmission of acoustic energy from the external ear to the cochlea. An anatomically accurate finite element model of the minke whale (Balaenoptera acutorostrata) middle ear was developed to predict the METF for a mysticete species. The elastic moduli of the auditory ossicles were measured by using nanoindentation. Other mechanical properties were estimated from experimental stiffness measurements or from published values. The METF predicted a best frequency range between approximately 30 Hz and 7.5 kHz or between 100 Hz and 25 kHz depending on stimulation location. Parametric analysis found that the most sensitive parameters are the elastic moduli of the glove finger and joints and the Rayleigh damping stiffness coefficient β. The predicted hearing range matches well with the vocalization range.

New HRCT-based measurement of the human outer ear canal as a basis for acoustical methods.

PubMed

Grewe, Johanna; Thiele, Cornelia; Mojallal, Hamidreza; Raab, Peter; Sankowsky-Rothe, Tobias; Lenarz, Thomas; Blau, Matthias; Teschner, Magnus

2013-06-01

As the form and size of the external auditory canal determine its transmitting function and hence the sound pressure in front of the eardrum, it is important to understand its anatomy in order to develop, optimize, and compare acoustical methods. High-resolution computed tomography (HRCT) data were measured retrospectively for 100 patients who had received a cochlear implant. In order to visualize the anatomy of the auditory canal, its length, radius, and the angle at which it runs were determined for the patients’ right and left ears. The canal’s volume was calculated, and a radius function was created. The determined length of the auditory canal averaged 23.6 mm for the right ear and 23.5 mm for the left ear. The calculated auditory canal volume (Vtotal) was 0.7 ml for the right ear and 0.69 ml for the left ear. The auditory canal was found to be significantly longer in men than in women, and the volume greater. The values obtained can be employed to develop a method that represents the shape of the auditory canal as accurately as possible to allow the best possible outcomes for hearing aid fitting.

External Auditory Canal Dimensions, Age, and Cerumen Retention or Impaction in Persons With Down Syndrome.

PubMed

Dy, Alexander Edward S; Lapeña, José Florencio F

2018-04-01

To investigate associations between age, external auditory canal (EAC) dimensions, and cerumen retention/impaction among persons with Down syndrome (DS). This cross-sectional study evaluated EAC dimensions, cerumen retention/impaction, and middle ear status with pneumatoscopy after extraction in 130 persons with DS. Descriptive and inferential statistics correlated age, presence of impacted/retained cerumen, and EAC diameter. Of 260 ears in 67 males and 63 females with average age of 9.48 years, 72.3% (188) had EAC of ≤4 mm. Those ≤1 year were 4.97 times more likely to have cerumen problems than those >1 year (95% CI, 1.45-17.02, P = .011). The odds of having cerumen problems with an EAC diameter of ≤4 mm were 3.31 times higher than with a diameter of 5 mm (95% CI, 1.46-7.50, P = .004), and odds of having cerumen impaction were as much as 6.19 times higher (95% CI, 2.38-16.08, P < .001). Male gender and low-lying external ear were also associated with increased odds of cerumen problems. There is a high prevalence of cerumen retention/impaction in persons with DS compared to the general Philippine population and a higher prevalence rate for EAC stenosis than elsewhere. A canal diameter of 4 mm and below and age 1 year or less are associated with a significantly higher likelihood of cerumen retention/impaction.

Middle and inner ear malformations in mutation-proven branchio-oculo-facial (BOF) syndrome: case series and review of the literature.

PubMed

Carter, Melissa T; Blaser, Susan; Papsin, Blake; Meschino, Wendy; Reardon, Willie; Klatt, Regan; Babul-Hirji, Riyana; Milunsky, Jeff; Chitayat, David

2012-08-01

Hearing impairment is common in individuals with branchio-oculo-facial (BOF) syndrome. The majority of described individuals have conductive hearing impairment due to malformed ossicles and/or external canal stenosis or atresia, although a sensorineural component to the hearing impairment in BOF syndrome is increasingly being reported. Sophisticated computed tomography (CT) of the temporal bone has revealed middle and inner ear malformations in three previous reports. We present middle and inner ear abnormalities in three additional individuals with mutation-proven BOF syndrome. We suggest that temporal bone CT imaging be included in the medical workup of a child with BOF syndrome, in order to guide management. Copyright © 2012 Wiley Periodicals, Inc.

Histological study of the external, middle and inner ear of horses.

PubMed

Blanke, A; Aupperle, H; Seeger, J; Kubick, C; Schusser, G F

2015-12-01

Clinical, anatomical and histological aspects of the equine acoustic organ have been poorly investigated and illustrated in literature so far. It is understood that an intact acoustic organ and hearing function are of vital importance for the well-being of flight animals like horses. The knowledge of the acoustic organ is usually transferred analogously from other mammals to horses. The purpose of this study was to provide a detailed and complete histological description of the healthy equine auditory organ, and to determine its congruity to other mammalians. Anatomical dissections and histological preparations were carried out on ten cadaver heads. Specimens of various parts of the equine acoustic organ were taken and evaluated histologically. The histological composition of external, middle and inner ear structures are predominantly congruent to those of other mammals, especially to human beings. Unique inwardly directed rete pegs within the osseous ear canal and the prominent tensor tympani muscle are described for the first time. Results obtained in this study can be employed as references for further research on the equine acoustic organ and improve the understanding of the clinical development of hearing loss, otitis externa/media/interna or tympanosclerosis. © 2014 Blackwell Verlag GmbH.

Ear malformations, hearing loss and hearing rehabilitation in children with Treacher Collins syndrome.

PubMed

Rosa, Francisco; Coutinho, Miguel Bebiano; Ferreira, João Pinto; Sousa, Cecilia Almeida

2016-01-01

The aim of this study was to assess the main ear malformations, hearing loss and auditory rehabilitation in children with Treacher Collins syndrome. We performed a retrospective study of 9 children with Treacher Collins syndrome treated in a central hospital between January 2003 and January 2013. This study showed a high incidence of malformations of the outer and middle ear, such as microtia, atresia or stenosis of the external auditory canal, hypoplastic middle ear cavity, dysmorphic or missing ossicular chain. Most patients had bilateral hearing loss of moderate or high degree. In the individuals studied, there was functional improvement in patients with bone-anchored hearing aids in relation to conventional hearing aids by bone conduction. Treacher Collins syndrome is characterized by bilateral malformations of the outer and middle ear. Hearing rehabilitation in these children is of utmost importance, and bone-anchored hearing aids is the method of choice. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Is Malassezia nana the main species in horses' ear canal microbiome?

PubMed

Aldrovandi, Ana Lúcia; Osugui, Lika; Acqua Coutinho, Selene Dall'

2016-01-01

The objective of this study was to characterize genotypically Malassezia spp. isolated from the external ear canal of healthy horses. Fifty-five horses, 39 (70.9%) males and 16 (29.1%) females, from different breeds and adults were studied. External ear canals were cleaned and a sterile cotton swab was introduced to collect cerumen. A total of 110 samples were cultured into Dixon medium and were incubated at 32°C for up to 15 days. Macro- and micromorphology and phenotypic identification were performed. DNA was extracted, strains were submitted to polymerase chain reaction technique, and the products obtained were submitted to Restriction Fragment Length Polymorphism using the restriction enzymes BstCI and HhaI. Strains were sent off to genetic sequencing of the regions 26S rDNA D1/D2 and ITS1-5.8S-ITS2 rDNA. Malassezia spp. were isolated from 33/55 (60%) animals and 52/110 (47%) ear canals. No growth on Sabouraud dextrose agar was observed, confirming the lipid dependence of all strains. Polymerase chain reaction-Restriction fragment length polymorphism permitted the molecular identification of Malassezia nana - 42/52 (81%) and Malassezia slooffiae - 10/52 (19%). Sequencing confirmed RFLP identification. It was surprising that M. nana represented over 80% of the strains and no Malassezia equina was isolated in this study, differing from what was expected. Copyright © 2016 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda. All rights reserved.

Temporal bone changes in patients with Goldenhar syndrome with special emphasis on inner ear abnormalities.

PubMed

Hennersdorf, Florian; Friese, Natascha; Löwenheim, Hubert; Tropitzsch, Anke; Ernemann, Ulrike; Bisdas, Sotirios

2014-06-01

Goldenhar syndrome is a developmental disorder presenting with orofacial and vertebral anomalies, which are also accompanied by abnormalities in other organs. We examined temporal bone changes with special emphasis on inner ear abnormalities in these patients. A retrospective review of 7 new cases in addition to a previously published series of 14 cases with clinically diagnosed Goldenhar syndrome was carried out to search for inner ear anomalies. In addition, temporal bone imaging studies from the literature were summarized and compared with our results. Departments of Neuroradiology and Otorhinolaryngology at a university hospital. In addition to the previous series of 14 patients, 7 new patients with Goldenhar syndrome were identified. Patients underwent otologic examination, audiometric studies, and high-resolution computed tomography (CT) or magnetic resonance imaging (MRI) of the temporal bone. Temporal bone changes and specifically inner ear malformations. Nineteen of 21 patients showed changes of the external and middle ear correlating with the literature. Seven of 21 patients showed inner ear abnormalities constituting one-third of all patients. These ranged from mild such as vestibular enlargement to severe defects such as cochlear hypoplasia and common cavity. Inner ear abnormalities were present in one-third of patients. Although in some cases, these might not be of clinical significance, some patients show severe defects of the inner ear requiring more complex hearing loss therapy. Therefore, imaging of the temporal bone structures is important in the care of these patients.

Reconstruction of partially amputated external ear with costal cartilage graft: case report.

PubMed

Brunelli, A; Bottini, D J; Cervelli, V; Cervelli, G; Grimaldi, M

2004-06-01

Many causes are responsible for secondary anomalies of the outer ear, such as: car accidents, sport- or work-related accidents, assaults, bites from animals or humans, benign or malignant tumours, burns and the effects of surgical interventions of the ear (plastic surgery on the ear or attempts at correction of primary malformations of the ear). The anatomical complexity of the ear makes its reconstruction particularly complicated with post-operative results that are often disappointing. The Authors describe their experience in the reconstruction of a partially amputated outer ear following a dog bite. The therapeutic protocol required various surgical stages. Initially, a cutaneous expander was applied at the level of the mastoid in order to ensure a sufficient quantity of local skin. The second stage was to remove cartilage from the ribs, followed by construction of a cartilaginous model of the ear and its insertion into the subcutaneous mastoid region after removal of the cutaneous expander and any residual ear cartilage. The last stage was to separate the neo-formed outer ear from the mastoid skin with the insertion of a cartilage graft to the posterior region of the reconstructed ear. This graft was covered by the occipital fascia rotated at 180 degrees and by a skin graft removed from the pubis. The postoperative result was satisfactory with recuperation of a good aesthetic appearance of the ear. Aim of the present report is to describe the surgical technique employed in the reconstruction of secondary anomalies of the ear and to highlight errors committed during this procedure. These considerations have allowed us to stress some fundamental elements in the reconstruction of the ear. In particular, the watershed was the awareness that we had to create a cartilaginous model that respected, as far as possible, the anatomy of the outer ear with all its ridges, trenches and cavities. This as well as ensuring a sufficient quantity of local skin in order to cover the cartilaginous graft and, therefore, reduce the risk of exposing the cartilage and subsequent infection, to guarantee an optimal end result.

External ear canal exostosis and otitis media in temporal bones of prehistoric and historic chilean populations. A paleopathological and paleoepidemiological study.

PubMed

Castro, Mario; Goycoolea, Marcos; Silva-Pinto, Verónica

2017-04-01

External ear canal exostosis is more prevalent in northern coastal groups than in the highlands, suggesting that ocean activities facilitate the appearance of exostosis. However, southern coastal groups exposed to colder ocean water have a lesser incidence of exostosis, possibly due to less duration of exposure. There was a high incidence of otitis media in all groups of native population in Chile. One coastal group had a higher incidence, presumably due to racial factors. This is a paleopathological and paleoepidemiological study in temporal bones which assesses external ear canal exostosis and otitis media in prehistoric and historic native populations in Chile. A total of 460 temporal bones were evaluated for exostosis (ex) and 542 temporal bones were evaluated for otitis media (om). The study involved four groups: (1) Prehistoric Coastal (400-1000 AD) populations in Northern Chile (Pisagua-Tiwanaku) (22 temporal bones ex; 28 om); (2) Prehistoric Highland (400-1000 AD) populations in Northern Chile (292 temporal bones ex; 334 om); (3) Pisagua-Regional Developments (coastal) in Northern Chile (1000-1450 AD) (66 temporal bones ex; 82 om); and (4) Historic (1500-1800 AD) coastal populations in Southern Chile (80 temporal bones ex: 18 Chonos, 62 Fuegians. 98 om: 22 Chonos, 76 Fuegians). Skulls were evaluated visually and with an operating microscope. In addition, the otitis media group was evaluated with Temporal bone radiology - -lateral XRays-Schuller view - to assess pneumatization as evidence of previous middle ear disease. Prehistoric northern coastal groups had an incidence of exostosis of 15.91%, the northern highlands group 1.37%, and the southern coastal group 1.25%. There were changes suggestive of otitis media in: Pisagua/Tiwanaku 53.57%; Pisagua/Regional Developments 70.73%; Northern Highlands population 47.90%; Chonos 63.64%; and Fuegian tribes 64.47%.

Genetics Home Reference: Czech dysplasia

MedlinePlus

... for making a protein that forms type II collagen. This type of collagen is found mostly in the clear gel that ... in the nose and external ears. Type II collagen is essential for the normal development of bones ...

Genetics Home Reference: Kniest dysplasia

MedlinePlus

... for making a protein that forms type II collagen. This type of collagen is found mostly in the clear gel that ... in the nose and external ears. Type II collagen is essential for the normal development of bones ...

Genetics Home Reference: hypochondrogenesis

MedlinePlus

... for making a protein that forms type II collagen. This type of collagen is found mostly in the clear gel that ... in the nose and external ears. Type II collagen is essential for the normal development of bones ...

The application of direct current electrical stimulation of the ear and cervical spine kinesitherapy in tinnitus treatment.

PubMed

Mielczarek, Marzena; Konopka, Wieslaw; Olszewski, Jurek

2013-02-01

The aim of the study was to evaluate the effectiveness of electrical stimulations of the hearing organ in tinnitus treatment adapting the frequency of stimulation according to tinnitus frequency, to assess the influence of cervical spine kinesitherapy on tinnitus, as well as to evaluate hearing after electrical stimulations alone and together with cervical spine kinesitherapy. The study comprised 80 tinnitus, sensorineural hearing loss patients (119 tinnitus ears) divided into two groups. In group I (n - 58 tinnitus ears) electrical stimulation of the hearing organ was performed, in group II (n - 61 tinnitus ears) electrical stimulation together with cervical spine kinesitherapy. Hydrotransmissive, selective electrical stimulations were conducted using direct, rectangular current. The passive electrode was placed on the forehead, the active--a silver probe--was immersed in the external ear canal in 0.9% saline solution. The treatment involved fifteen applications of electrical stimulations (each lasted for 4 min) administered three or four times a week (whole treatment lasted approximately 30 days). The evaluation of the results considered a case history (change from permanent to temporary tinnitus), questionnaires (the increase/decrease of the total points) and the audiometric evaluation of hearing level. Before the treatment, group I comprised 51 ears (87.93%) with permanent, and 7 ears (12.07%) with temporary tinnitus; group II - 55 ears (90.17%) with permanent and 6 ears (9.83%) with temporary tinnitus. After the treatment, in both groups the number of ears with permanent tinnitus decreased considerably obtaining the pauses or disappearing of tinnitus. Directly after the treatment, group I comprised 25 ears (43.11%) with permanent, and 10 ears (17.24%) with temporary tinnitus, in 23 ears (39.65%) tinnitus disappeared; group II - 33 ears (54.1%) with permanent and 11 ears (18.03%) with temporary tinnitus, in 17 ears (27.87%) tinnitus disappeared. Regarding questionnaires, improvement was observed in group I - in 43.11% of ears, in group II - 32.8%. In both groups audiometric improvement of hearing was recognized. (1) Electrical stimulation of the hearing organ, with the application of current frequencies according to tinnitus frequencies (selective electrical stimulation), was an efficient method in severe tinnitus treatment. (2) Cervical spine kinesitherapy in the treatment of tinnitus, using electrical stimulation, did not have any supporting influence. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

A Study to Determine the Feasibility of Establishing an Ambulatory Surgery Program at Keller Army Community Hospital, West Point, New York

DTIC Science & Technology

1987-05-01

18.79 Other plastic repair of external ear Otoplasty; Postauricular skin graft ; Repair of lop ear 19.4 Myringoplasty Epitympanic, type I; Myringoplasty...of lip 27.53 Closure of fistula of mouth * 27.54 Repair of cleft lip * 27.55 Bill-thickness skin graft to lip and mouth * 27.56 Other skin graft to...structure 86.60 Free skin graft , not otherwise specified *d :935 Empire Blue Cross and Blue Shield- New York Dvisior 56 INTEGUMENTARY SYSTIA continued

Krazy Glue® in the ear: A case report of child abuse.

PubMed

Sorichetti, Brendan D; Fandiño, Marcela; Kozak, Frederick K

2018-06-01

Krazy Glue ® or cyanoacrylate glue is an acrylic resin that polymerizes in less than a minute when in contact with moisture or water. We present a case of a one month old referred to our tertiary pediatric otolaryngology clinic from an outside emergency department with a history of application of cyanoacrylate glue in the external ear canals. This report presents the management of this case along with the medical and legal outcomes surrounding this case of child abuse. Copyright © 2018. Published by Elsevier B.V.

Broadened population-level frequency tuning in the auditory cortex of tinnitus patients.

PubMed

Sekiya, Kenichi; Takahashi, Mariko; Murakami, Shingo; Kakigi, Ryusuke; Okamoto, Hidehiko

2017-03-01

Tinnitus is a phantom auditory perception without an external sound source and is one of the most common public health concerns that impair the quality of life of many individuals. However, its neural mechanisms remain unclear. We herein examined population-level frequency tuning in the auditory cortex of unilateral tinnitus patients with similar hearing levels in both ears using magnetoencephalography. We compared auditory-evoked neural activities elicited by a stimulation to the tinnitus and nontinnitus ears. Objective magnetoencephalographic data suggested that population-level frequency tuning corresponding to the tinnitus ear was significantly broader than that corresponding to the nontinnitus ear in the human auditory cortex. The results obtained support the hypothesis that pathological alterations in inhibitory neural networks play an important role in the perception of subjective tinnitus. NEW & NOTEWORTHY Although subjective tinnitus is one of the most common public health concerns that impair the quality of life of many individuals, no standard treatment or objective diagnostic method currently exists. We herein revealed that population-level frequency tuning was significantly broader in the tinnitus ear than in the nontinnitus ear. The results of the present study provide an insight into the development of an objective diagnostic method for subjective tinnitus. Copyright © 2017 the American Physiological Society.

A prediction of the minke whale (Balaenoptera acutorostrata) middle-ear transfer functiona)

PubMed Central

Tubelli, Andrew A.; Zosuls, Aleks; Ketten, Darlene R.; Yamato, Maya; Mountain, David C.

2012-01-01

The lack of baleen whale (Cetacea Mysticeti) audiograms impedes the assessment of the impacts of anthropogenic noise on these animals. Estimates of audiograms, which are difficult to obtain behaviorally or electrophysiologically for baleen whales, can be made by simulating the audiogram as a series of components representing the outer, middle, and inner ear (Rosowski, 1991; Ruggero and Temchin, 2002). The middle-ear portion of the system can be represented by the middle-ear transfer function (METF), a measure of the transmission of acoustic energy from the external ear to the cochlea. An anatomically accurate finite element model of the minke whale (Balaenoptera acutorostrata) middle ear was developed to predict the METF for a mysticete species. The elastic moduli of the auditory ossicles were measured by using nanoindentation. Other mechanical properties were estimated from experimental stiffness measurements or from published values. The METF predicted a best frequency range between approximately 30 Hz and 7.5 kHz or between 100 Hz and 25 kHz depending on stimulation location. Parametric analysis found that the most sensitive parameters are the elastic moduli of the glove finger and joints and the Rayleigh damping stiffness coefficient β. The predicted hearing range matches well with the vocalization range. PMID:23145610

Detailed assessment of the ear in Cornelia de Lange syndrome: comparison with a control sample using the new dysmorphology guidelines.

PubMed

Hunter, Alasdair G W; Collins, Julianne S; Deardorff, Matthew A; Krantz, Ian D

2009-10-01

The literature abounds with reports of malformation syndromes in which human external ears are variously described as dysplastic, abnormal, large/small, low set, typical, or in some way unusual. Rarely is the ear well illustrated or described in meaningful detail. With few exceptions, such as Down syndrome, there is no real understanding of the degree to which ear morphology is affected in a specific syndrome. This paper describes a retrospective attempt to apply the recently published Morphological Definitions of the ear to compare a control sample of convenience with a group of patients with Cornelia de Lange syndrome (CdLS) (all six papers in this issue are available online, open access at http://www3.interscience.wiley.com/journal/121641055/issue). Although this study has a number of limitations, it demonstrates that the method can be successfully applied and is capable of producing data that can be subjected to statistical analysis. The ears of the patients with CdLS were significantly different from the controls over a number of descriptors, the most significant of which included more frequent apparent posterior rotation, a shorter more serpiginous antihelical stem and sharper antihelical to inferior crus angle, a shorter crus helix, a more V-shaped incisura, and a smaller lobe.

[Administration of vaccine against myxomatosis using live MXT by means of external ear puncture with a special needle].

PubMed

Cupera, Z; Krupka, V; Jiran, E

1982-01-01

A new application method was developed and tested for the immunoprophylaxis of rabbits against myxomatosis using a live MXT vaccine. This new application method--injection of the ear with a special double needle--is very simple and easy. Its use enables a five-fold increase in vaccination doses as compared with subcutaneous application while the amount of vaccine remains the same. In laboratory this method with the MXT vaccine secured a 98.2% protection of the vaccinated animals. One vaccination dose contains 18.1 to 37.2 PD50. Eleven months from a single vaccination by injecting the ear, 83% of the rabbits still remained protected against experimental infection. With the use of the new application method of injecting the ear with the special double needle, the live MXT vaccine against myxomatosis in rabbits represents an effective, easily practicable and economically advantageous direction in the immunoprophylaxis of rabbits against myxomatosis.

Otosclerosis surgery: approaches, profits and complications.

PubMed

Japaridze, Sh; Lomidze, L; Jashi, M; Kekelidze, I; Gegenava, Kh

2009-05-01

A systematic analysis of stapedoplasty output in otosclerosis cases was carried out. The operations were done during the period of 2005-2008 years at the Department of Otorhinolaryngology of the Tbilisi State Medical University. From the overall number of 107 patients, 78 were females and 29 males, 72.9% and 27.1%, respectively. The ages ranged from 16 to 57 years. The mean age was 35 years. The conductive and mixed forms of hearing losses were diagnosed in 70 and 37 cases, 65.4% and 34.6%, respectively. Right ear was operated in 46 patients, left ear in 57, and both ears in four, 43.3%, 53.0%, and 3.7%, respectively. 111 ears have been cured thus in sum. Intumescences of external ear tube were observed during the operation in 22 patients, 20.6%. In 7, 6.5%, the facial nerve was located downward. Particularly abnormal placement of the facial nerve was the case in two patients, 1.9%. The endaural approach has been proved to own advantages over the transmeatal one. The data generally confirmed that stapedotomy, as compared to stapedectomy, is a better choice for the surgery output. In beneficial cases the air/bone gaps after the operation closed totally or nearly totally. Such a proper outcome was reached in 93 out of 111 ears operated, 83.8%. In most of remainder ears the gaps after the operation narrowed significantly but far not completely. The definite surgery failure happened in one case only, 0.9%. To balance the preserved middle-ear problems in non-perfect surgery cases, the hearing aids of bone-conduction types have been recommended. In mixed otosclerosis cases, conversely, the aids of air-conduction types were advised to overcome the coexisted inner-ear pathologies.

Relative size of auditory pathways in symmetrically and asymmetrically eared owls.

PubMed

Gutiérrez-Ibáñez, Cristián; Iwaniuk, Andrew N; Wylie, Douglas R

2011-01-01

Owls are highly efficient predators with a specialized auditory system designed to aid in the localization of prey. One of the most unique anatomical features of the owl auditory system is the evolution of vertically asymmetrical ears in some species, which improves their ability to localize the elevational component of a sound stimulus. In the asymmetrically eared barn owl, interaural time differences (ITD) are used to localize sounds in azimuth, whereas interaural level differences (ILD) are used to localize sounds in elevation. These two features are processed independently in two separate neural pathways that converge in the external nucleus of the inferior colliculus to form an auditory map of space. Here, we present a comparison of the relative volume of 11 auditory nuclei in both the ITD and the ILD pathways of 8 species of symmetrically and asymmetrically eared owls in order to investigate evolutionary changes in the auditory pathways in relation to ear asymmetry. Overall, our results indicate that asymmetrically eared owls have much larger auditory nuclei than owls with symmetrical ears. In asymmetrically eared owls we found that both the ITD and ILD pathways are equally enlarged, and other auditory nuclei, not directly involved in binaural comparisons, are also enlarged. We suggest that the hypertrophy of auditory nuclei in asymmetrically eared owls likely reflects both an improved ability to precisely locate sounds in space and an expansion of the hearing range. Additionally, our results suggest that the hypertrophy of nuclei that compute space may have preceded that of the expansion of the hearing range and evolutionary changes in the size of the auditory system occurred independently of phylogeny. Copyright © 2011 S. Karger AG, Basel.

Ototoxicity of boric acid powder in a rat animal model.

PubMed

Salihoglu, Murat; Dogru, Salim; Cesmeci, Enver; Caliskan, Halil; Kurt, Onuralp; Kuçukodaci, Zafer; Gungor, Atila

2017-04-22

Boric acid, which has antiseptic and acidic properties, is used to treat external and middle ear infections. However, we have not found any literature about the effect of boric acid powder on middle ear mucosa and inner ear. The purpose of this study is to investigate possible ototoxic effects of boric acid powder (BAP) on cochlear outer hair cell function and histological changes in middle ear mucosa in a rat animal model. Twenty healthy, mature Wistar albino rats were used in this study. The rats were divided into two groups, Group A and Group B, each of which consisted of 10 rats. Initially, the animals in each group underwent distortion product otoacoustic emissions (DPOAE) testing of their right and left ears. After the first DPOAE test, a surgical microscope was used to make a small perforation in both ears of the rats in each group, and a second DPOAE test was used to measure both ears in all of the rats. BAP was applied to the right middle ear of the rats using tympanic membrane perforation, and the DPOAEs were measured immediately after the BAP application. The histological changes and DPOAEs were evaluated three days later in Group A and 40 days later in Group B. No significant differences were found at all of the DPOAE frequencies. In Group A, mild inflammation of the middle ear mucosa was found on the third day after BAP application. In Group B, BAP caused mild inflammatory changes on the 40th day, which declined over time. Those changes did not lead to significant fibrosis within the mucosa. In rats, BAP causes mild inflammation in middle ear mucosa and it has no ototoxic effects on cochlear outer hair cell function in the inner ear of rats. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Computed tomographic findings in 205 dogs with clinical signs compatible with middle ear disease: a retrospective study.

PubMed

Belmudes, Audrey; Pressanti, Charline; Barthez, Paul Y; Castilla-Castaño, Eloy; Fabries, Lionel; Cadiergues, Marie C

2018-02-01

Computed tomography (CT) is considered to be the reference method to evaluate middle ear structures. To evaluate the presence and severity of CT changes in the middle ear and establish if any specific clinical presentations are associated with otitis media. Medical records of animals referred for CT with history and clinical signs consistent with middle ear disease. Retrospective evaluation of CT examinations of tympanic bullae performed over a six year period. Medical records were reviewed for signalment, clinical signs and cytological evaluation of the external ear canal. Dogs were divided into three clinical groups: chronic otitis externa (Group 1), peripheral vestibular disorder (Group 2) and other clinical presentations (Group 3). Group 1 - Of 214 ears, 87 (40.7%) had CT abnormalities: 38 of 87 (17.7%) had material-filled bullae, 42 of 87 (19.6%) had thickened bullae walls and seven of 87 (3.2%) had lysis of the bulla. Abnormalities were significantly more frequent in dogs with suppurative otitis than in erythemato-ceruminous otitis (57% and 23%, respectively; P = 0.003). Proliferative otitis, particularly in French bulldogs, was associated with severe otitis media. Group 2 - Of the 106 ears, 91 (85.8%) had normal tympanic bullae. Group 3 - Of the 26 ears from deaf dogs, 17 had filled bullae; all nine affected dogs were Cavalier King Charles spaniels. All dogs with Claude Bernard Horner syndrome or head tilt had normal tympanic bullae. CT is useful for canine chronic otitis externa, particularly in suppurative or proliferative otitis, even in the absence of associated neurological signs. © 2017 ESVD and ACVD.

External and middle ear sound pressure distribution and acoustic coupling to the tympanic membrane

PubMed Central

Bergevin, Christopher; Olson, Elizabeth S.

2014-01-01

Sound energy is conveyed to the inner ear by the diaphanous, cone-shaped tympanic membrane (TM). The TM moves in a complex manner and transmits sound signals to the inner ear with high fidelity, pressure gain, and a short delay. Miniaturized sensors allowing high spatial resolution in small spaces and sensitivity to high frequencies were used to explore how pressure drives the TM. Salient findings are: (1) A substantial pressure drop exists across the TM, and varies in frequency from ∼10 to 30 dB. It thus appears reasonable to approximate the drive to the TM as being defined solely by the pressure in the ear canal (EC) close to the TM. (2) Within the middle ear cavity (MEC), spatial variations in sound pressure could vary by more than 20 dB, and the MEC pressure at certain locations/frequencies was as large as in the EC. (3) Spatial variations in pressure along the TM surface on the EC-side were typically less than 5 dB up to 50 kHz. Larger surface variations were observed on the MEC-side. PMID:24606269

Postoperative Intensity-Modulated Radiotherapy for Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear: Treatment Outcomes, Marginal Misses, and Perspective on Target Delineation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, Wan-Yu; Kuo, Sung-Hsin; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

Purpose: To report outcomes of the rare disease of squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear treated with surgery and postoperative intensity-modulated radiotherapy (IMRT). Failure patterns related to spatial dose distribution were also analyzed to provide insight into target delineation. Methods and Materials: A retrospective review was conducted of the records of 11 consecutive patients with SCC of the EAC and middle ear who were treated with curative surgery and postoperative IMRT at one institution between January 2007 and February 2010. The prescribed IMRT dose was 60 to 66 Gy at 2 Gy permore » fraction. Three patients also received concurrent cisplatin-based chemotherapy, and 1 patient received concurrent oral tegafur/uracil. The median follow-up time was 19 months (range, 6-33 months). Results: Four patients had locoregional recurrence, yielding an estimated 2-year locoregional control rate of 70.7%. Among them, 1 patient had persistent disease after treatment, and 3 had marginal recurrence. Distant metastasis occurred in 1 patient after extensive locoregional recurrence, yielding an estimated 2-year distant control rate of 85.7%. The estimated 2-year overall survival was 67.5%. The three cases of marginal recurrence were near the preauricular space and glenoid fossa of the temporomandibular joint, adjacent to the apex of the ear canal and glenoid fossa of the temporomandibular joint, and in the postauricular subcutaneous area and ipsilateral parotid nodes, respectively. Conclusions: Marginal misses should be recognized to improve target delineation. When treating SCC of the EAC and middle ear, care should be taken to cover the glenoid fossa of the temporomandibular joint and periauricular soft tissue. Elective ipsilateral parotid irradiation should be considered. The treatment planning procedure should also be refined to balance subcutaneous soft-tissue dosimetry and toxicity.« less

Postoperative intensity-modulated radiotherapy for squamous cell carcinoma of the external auditory canal and middle ear: treatment outcomes, marginal misses, and perspective on target delineation.

PubMed

Chen, Wan-Yu; Kuo, Sung-Hsin; Chen, Yu-Hsuan; Lu, Szu-Huai; Tsai, Chiao-Ling; Cheng, Jason Chia-Hsien; Hong, Ruey-Long; Chen, Ya-Fang; Hsu, Chuan-Jen; Lin, Kai-Nan; Ko, Jenq-Yuh; Lou, Pei-Jen; Wang, Cheng-Ping; Chong, Fok-Ching; Wang, Chun-Wei

2012-03-15

To report outcomes of the rare disease of squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear treated with surgery and postoperative intensity-modulated radiotherapy (IMRT). Failure patterns related to spatial dose distribution were also analyzed to provide insight into target delineation. A retrospective review was conducted of the records of 11 consecutive patients with SCC of the EAC and middle ear who were treated with curative surgery and postoperative IMRT at one institution between January 2007 and February 2010. The prescribed IMRT dose was 60 to 66 Gy at 2 Gy per fraction. Three patients also received concurrent cisplatin-based chemotherapy, and 1 patient received concurrent oral tegafur/uracil. The median follow-up time was 19 months (range, 6-33 months). Four patients had locoregional recurrence, yielding an estimated 2-year locoregional control rate of 70.7%. Among them, 1 patient had persistent disease after treatment, and 3 had marginal recurrence. Distant metastasis occurred in 1 patient after extensive locoregional recurrence, yielding an estimated 2-year distant control rate of 85.7%. The estimated 2-year overall survival was 67.5%. The three cases of marginal recurrence were near the preauricular space and glenoid fossa of the temporomandibular joint, adjacent to the apex of the ear canal and glenoid fossa of the temporomandibular joint, and in the postauricular subcutaneous area and ipsilateral parotid nodes, respectively. Marginal misses should be recognized to improve target delineation. When treating SCC of the EAC and middle ear, care should be taken to cover the glenoid fossa of the temporomandibular joint and periauricular soft tissue. Elective ipsilateral parotid irradiation should be considered. The treatment planning procedure should also be refined to balance subcutaneous soft-tissue dosimetry and toxicity. Copyright © 2012 Elsevier Inc. All rights reserved.

Crouzon’s Syndrome with Life-Threatening Ear Bleed: Ruptured Jugular Vein Diverticulum Treated by Endovascular Embolization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mondel, Prabath Kumar, E-mail: prabathmondel@gmail.com; Anand, Sunanda, E-mail: sunandaanand@gmail.com; Limaye, Uday S., E-mail: uslkem@gmail.com

Crouzon’s syndrome is the commonest variety of syndromic craniosynostosis. Life-threatening ear bleed due to ruptured jugular venous diverticulum in Crouzon’s syndrome has not been described previously. In patients with syndromic craniosynostosis, definitive repair of jugular diverticulum by open surgery is fraught with high risk of bleeding, poor functional outcomes, and even death. A 24-year-old woman with Crouzon’s syndrome presented with conductive hearing loss and recurrent episodes of torrential bleeding from her left ear. On computed tomography, a defect in the roof of jugular fossa containing jugular venous diverticulum immediately inferior to the bony external auditory canal was seen. The clinicalmore » presentation, imaging features, and endovascular management of Crouzon’s syndrome due to a ruptured jugular venous diverticulum is described.« less

Cauliflower ear – a minimally invasive treatment method in a wrestling athlete: a case report

PubMed Central

Haik, Josef; Givol, Or; Kornhaber, Rachel; Cleary, Michelle; Ofir, Hagit; Harats, Moti

2018-01-01

Acute auricular hematoma can be caused by direct blunt trauma or other injury to the external ear. It is typically seen in those who practice full contact sports such as boxing, wrestling, and rugby. “Cauliflower ear” deformity, fibrocartilage formation during scarring, is a common complication of auricular hematomas. Therefore, acute drainage of the hematoma and postprocedural techniques for preventing recurrence are necessary for preventing the deformity. There are many techniques although no superior method of treatment has been found. In this case report, we describe a novel method using needle aspiration followed by the application of a magnet and an adapted disc to the affected area of the auricular. This minimally invasive, simple, and accessible method could potentially facilitate the treatment of cauliflower ear among full contact sports athletes. PMID:29403318

21 CFR 524.1484f - Neomycin sulfate, prednisolone acetate, tetracaine hydrochloride eardrops.

Code of Federal Regulations, 2010 CFR

2010-04-01

...-susceptible organisms and/or allergy. In otitis externa, 2 to 6 drops may be placed in the external ear canal... hypersensitivity or allergy. If such signs are noted, therapy should be stopped.1 (3) Federal law restricts this...

Estimation of sex from the anthropometric ear measurements of a Sudanese population.

PubMed

Ahmed, Altayeb Abdalla; Omer, Nosyba

2015-09-01

The external ear and its prints have multifaceted roles in medico-legal practice, e.g., identification and facial reconstruction. Furthermore, its norms are essential in the diagnosis of congenital anomalies and the design of hearing aids. Body part dimensions vary in different ethnic groups, so the most accurate statistical estimations of biological attributes are developed using population-specific standards. Sudan lacks comprehensive data about ear norms; moreover, there is a universal rarity in assessing the possibility of sex estimation from ear dimensions using robust statistical techniques. Therefore, this study attempts to establish data for normal adult Sudanese Arabs, assessing the existence of asymmetry and developing a population-specific equation for sex estimation. The study sample comprised 200 healthy Sudanese Arab volunteers (100 males and 100 females) in the age range of 18-30years. The physiognomic ear length and width, lobule length and width, and conchal length and width measurements were obtained by direct anthropometry, using a digital sliding caliper. Moreover, indices and asymmetry were assessed. Data were analyzed using basic descriptive statistics and discriminant function analyses employing jackknife validations of classification results. All linear dimensions used were sexually dimorphic except lobular lengths. Some of the variables and indices show asymmetry. Ear dimensions showed cross-validated sex classification accuracy ranging between 60.5% and 72%. Hence, the ear measurements cannot be used as an effective tool in the estimation of sex. However, in the absence of other more reliable means, it still can be considered a supportive trait in sex estimation. Further, asymmetry should be considered in identification from the ear measurements. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Sheep as a large animal ear model: Middle-ear ossicular velocities and intracochlear sound pressure.

PubMed

Péus, Dominik; Dobrev, Ivo; Prochazka, Lukas; Thoele, Konrad; Dalbert, Adrian; Boss, Andreas; Newcomb, Nicolas; Probst, Rudolf; Röösli, Christof; Sim, Jae Hoon; Huber, Alexander; Pfiffner, Flurin

2017-08-01

Animals are frequently used for the development and testing of new hearing devices. Dimensions of the middle ear and cochlea differ significantly between humans and commonly used animals, such as rodents or cats. The sheep cochlea is anatomically more like the human cochlea in size and number of turns. This study investigated the middle-ear ossicular velocities and intracochlear sound pressure (ICSP) in sheep temporal bones, with the aim of characterizing the sheep as an experimental model for implantable hearing devices. Measurements were made on fresh sheep temporal bones. Velocity responses of the middle ear ossicles at the umbo, long process of the incus and stapes footplate were measured in the frequency range of 0.25-8 kHz using a laser Doppler vibrometer system. Results were normalized by the corresponding sound pressure level in the external ear canal (P EC ). Sequentially, ICSPs at the scala vestibuli and tympani were then recorded with custom MEMS-based hydrophones, while presenting identical acoustic stimuli. The sheep middle ear transmitted most effectively around 4.8 kHz, with a maximum stapes velocity of 0.2 mm/s/Pa. At the same frequency, the ICSP measurements in the scala vestibuli and tympani showed the maximum gain relative to the P EC (24 dB and 5 dB, respectively). The greatest pressure difference across the cochlear partition occurred between 4 and 6 kHz. A comparison between the results of this study and human reference data showed middle-ear resonance and best cochlear sensitivity at higher frequencies in sheep. In summary, sheep can be an appropriate large animal model for research and development of implantable hearing devices. Copyright © 2017 Elsevier B.V. All rights reserved.

Growth Factor Stimulation Improves the Structure and Properties of Scaffold-Free Engineered Auricular Cartilage Constructs

PubMed Central

Rosa, Renata G.; Joazeiro, Paulo P.; Bianco, Juares; Kunz, Manuela; Weber, Joanna F.; Waldman, Stephen D.

2014-01-01

The reconstruction of the external ear to correct congenital deformities or repair following trauma remains a significant challenge in reconstructive surgery. Previously, we have developed a novel approach to create scaffold-free, tissue engineering elastic cartilage constructs directly from a small population of donor cells. Although the developed constructs appeared to adopt the structural appearance of native auricular cartilage, the constructs displayed limited expression and poor localization of elastin. In the present study, the effect of growth factor supplementation (insulin, IGF-1, or TGF-β1) was investigated to stimulate elastogenesis as well as to improve overall tissue formation. Using rabbit auricular chondrocytes, bioreactor-cultivated constructs supplemented with either insulin or IGF-1 displayed increased deposition of cartilaginous ECM, improved mechanical properties, and thicknesses comparable to native auricular cartilage after 4 weeks of growth. Similarly, growth factor supplementation resulted in increased expression and improved localization of elastin, primarily restricted within the cartilaginous region of the tissue construct. Additional studies were conducted to determine whether scaffold-free engineered auricular cartilage constructs could be developed in the 3D shape of the external ear. Isolated auricular chondrocytes were grown in rapid-prototyped tissue culture molds with additional insulin or IGF-1 supplementation during bioreactor cultivation. Using this approach, the developed tissue constructs were flexible and had a 3D shape in very good agreement to the culture mold (average error <400 µm). While scaffold-free, engineered auricular cartilage constructs can be created with both the appropriate tissue structure and 3D shape of the external ear, future studies will be aimed assessing potential changes in construct shape and properties after subcutaneous implantation. PMID:25126941

Titanium as a biomaterial for ossicular replacement: results after implantation in the middle ear of the rabbit.

PubMed

Schwager, K

1998-01-01

The middle ear poses unique challenges when finding suitable materials for ossicular reconstruction, primarily because of its link to the external environment via the eustachian tube and, hence, its greater exposure to infectious agents. In this study, the biocompatability of titanium was examined in the middle ear of rabbits by using light and scanning electron microscopy. Implants were placed as middle ear prostheses or as free implants. These were inspected at 28 days, 84 days, 168 days, 336 days and 504 days following implantation for mucosal coverage, percent epithelization and any sign of foreign-body reaction. After 28 days, the prostheses were covered by regular mucosa. Although a majority of the free implants took up to 336 days for complete epithelialization, some of the free implants were not epithelialized even at day 504. There were no inflammatory cells observed on the surface of the material, nor were unusual amounts of fibrous tissue seen. In addition, the titanium material exhibited an affinity toward bone. The results of this animal experiment indicate that titanium is a favorable material for ossicular replacement prostheses.

Insecticidal activity of common reagents for insect foreign bodies of the ear.

PubMed

Antonelli, P J; Ahmadi, A; Prevatt, A

2001-01-01

Insects commonly present as painful and distressing foreign bodies of the external ear canal. Removing live insects can be challenging, especially for primary care physicians who have limited equipment. The purpose of this study is to compare the insecticidal activity of commonly available preparations for insects that are most frequently recovered from ear canals: cockroaches (German and American), ticks, beetles, and honeybees. Prospective, blinded. One hundred seventy insects of each species were placed in test tubes and submerged in 17 test preparations (10 tubes per preparation, 1 insect per test tube). Insect activity was stimulated by agitation of the test tube. Responses were monitored, and the time until death was measured. Most test preparations exhibited some insecticidal activity against most insect species. Ticks were completely resistant to all of the test reagents. Ethanol killed the American cockroaches (mean time, 32.6 s), German cockroaches (mean time, 29.6 s), and honeybees (mean time, 19.6 s) the most rapidly. Many commonly available reagents may be used to kill or immobilize insect foreign bodies of the ear.

Fetal development of the elastic-fiber-mediated enthesis in the human middle ear.

PubMed

Takanashi, Yoshitaka; Shibata, Shunichi; Katori, Yukio; Murakami, Gen; Abe, Shinichi; Rodríguez-Vázquez, Jose Francisco; Kawase, Tetsuaki

2013-10-01

In the human middle ear, the annular ligament of the incudostapedial joint and the insertions of the tensor tympani and stapedius muscles contain abundant elastic fibers; i.e., the elastic-fiber-mediated entheses. Hyaluronan also coexists with the elastic fibers. In the present study using immunohistochemistry, we demonstrated the distribution of elastin not only in the incudostapedial joint but also in the other two joints of the middle ear in adults and fetuses. In adults, the expression of elastin did not extend out of the annular ligament composed of mature elastic fibers but clearly overlapped with it. Electron microscopic observations of the annular ligament demonstrated a few microfibrils along the elastic fibers. Thus, in contrast to the vocal cord, the middle ear entheses seemed not to contain elaunin and oxytalan fibers. In mid-term fetuses (at approximately 15-16 weeks of gestation) before opening of the external acoustic meatus, the incudostapedial joint showed abundant elastic fibers, but the incudomalleolar and stapediovestibular joints did not. At this stage, hyaluronan was not colocalized, but distributed diffusely in loose mesenchymal tissues surrounding the ear ossicles. Therefore, fetal development of elastin and elastic fibers in the middle ear entheses is unlikely to require acoustic oscillation. In late-stage fetuses (25-30 weeks), whose ear ossicles were almost the same size as those in adults, we observed bundling and branching of elastic fibers. However, hyaluronan expression was not as strong as in adults. Colocalization between elastic fibers and hyaluronan appeared to be a result of postnatal maturation of the entheses. Copyright © 2013 Elsevier GmbH. All rights reserved.

Contralateral Occlusion Test: The effect of external ear canal occlusion on hearing thresholds.

PubMed

Reis, Luis Roque; Fernandes, Paulo; Escada, Pedro

Bedside testing with tuning forks may decrease turnaround time and improve decision making for a quick qualitative assessment of hearing loss. The purpose of this study was to quantify the effects of ear canal occlusion on hearing, in order to decide which tuning fork frequency is more appropriate to use for quantifying hearing loss with the Contralateral Occlusion Test. Twenty normal-hearing adults (forty ears) underwent sound field pure tone audiometry with and without ear canal occlusion. Each ear was tested with the standard frequencies. The contralateral ear was suppressed with by masking. Ear occlusion was performed by two examiners. Participants aged between 21 and 30 years (25.6±3.03 years) showed an increase in hearing thresholds with increasing frequencies from 19.94dB (250Hz) to 39.25dB (2000Hz). The threshold difference between occluded and unoccluded conditions was statistically significant and increased from 10.69dB (250Hz) to 32.12dB (2000Hz). There were no statistically significant differences according to gender or between the examiners. The occlusion effect increased the hearing thresholds and became more evident with higher frequencies. The occlusion method as performed demonstrated reproducibility. In the Contralateral Occlusion Test, 256Hz or 512Hz tuning forks should be used for diagnosis of mild hearing loss, and a 2048Hz tuning fork should be used for moderate hearing loss. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

[The acoustics of the open mastoid cavity (so-called "radical cavity") and its modification by surgical measures. II. Clinical studies].

PubMed

Hartwein, J

1992-09-01

The acoustic resonance of a severely altered outer ear channel (radical mastoid cavity) is investigated in a series of 18 patients who underwent revision surgery by means of in-situ measurements of the sound-pressure-level near the tympanic membrane. While the average volume of the open cavity differs from the normal ear channel for the factor 2.5, the size of the external meatus is--in average--only 20% larger. This leads to an average frequency in patients with open cavity of 1939 Hz, more than 1000 Hz less than in a series (n = 20) of normal ears (average resonance frequency: 2942 Hz). The altered acoustic behaviour of the open cavity leads to partial extensive discrepancies of the resonance-caused sound-pressure augmentation in the frequencies of 3 and 4 kHz, which are important for speech perception. The average difference is more than 10 dB (SPL). Proved surgical techniques of cavity obliteration and meatoplasty can lead to a nearly normalized acoustic behaviour of the outer ear in a statistic significant way. Due to these surgical procedures, an average postoperative resonance frequency of 2421 Hz could be reached in our patients. Especially, the resonance-caused sound-pressure augmentation in 3-4 kHz could nearly be equalized to such of a normal outer ear. Differences in the acoustic behaviour of the outer ear as can be found between patients with an open mastoid cavity and normal ears can almost be eliminated surgically.(ABSTRACT TRUNCATED AT 250 WORDS)

Békésy's contributions to our present understanding of sound conduction to the inner ear.

PubMed

Puria, Sunil; Rosowski, John J

2012-11-01

In our daily lives we hear airborne sounds that travel primarily through the external and middle ear to the cochlear sensory epithelium. We also hear sounds that travel to the cochlea via a second sound-conduction route, bone conduction. This second pathway is excited by vibrations of the head and body that result from substrate vibrations, direct application of vibrational stimuli to the head or body, or vibrations induced by airborne sound. The sensation of bone-conducted sound is affected by the presence of the external and middle ear, but is not completely dependent upon their function. Measurements of the differential sensitivity of patients to airborne sound and direct vibration of the head are part of the routine battery of clinical tests used to separate conductive and sensorineural hearing losses. Georg von Békésy designed a careful set of experiments and pioneered many measurement techniques on human cadaver temporal bones, in physical models, and in human subjects to elucidate the basic mechanisms of air- and bone-conducted sound. Looking back one marvels at the sheer number of experiments he performed on sound conduction, mostly by himself without the aid of students or research associates. Békésy's work had a profound impact on the field of middle-ear mechanics and bone conduction fifty years ago when he received his Nobel Prize. Today many of Békésy's ideas continue to be investigated and extended, some have been supported by new evidence, some have been refuted, while others remain to be tested. Copyright © 2012 Elsevier B.V. All rights reserved.

Tinnitus--Current Concepts in Diagnosis and Management.

ERIC Educational Resources Information Center

Epstein, Stephen

1997-01-01

This article discusses the causes of tinnitus, sound or noise in the ears or head without any external stimulation. Classification of tinnitus, the essentials of medical evaluation of a patient with tinnitus, essential test procedures, and current concepts in the management of tinnitus are addressed. (CR)

First branchial cleft anomaly, a case for misdiagnosis.

PubMed

Lanisnik, Bostjan; Didanovic, Vojko; Cizmarevic, Bogdan

2004-01-01

First branchial cleft anomaly is a rare condition that is often misdiagnosed and falsely mistreated before complete and definitive surgical treatment. Its origin is uncertain and the presence of ectodermal and sometimes also mesodermal elements has led some authors to the conclusion that it represents buried nests of cells forming the first branchial cleft and the underlying mesoderm. First branchial cleft anomaly can be presented as a cystic lesion, fistula or sinus extending towards the membranous external ear canal. The sinus tract runs through the parotid gland in close association with the facial nerve. There is no imaging method capable of identifying a first branchial cleft anomaly with certainty. The danger of facial nerve injury during surgery and the failure to identify the sinus tract running to the external ear canal are the main reasons for incomplete excision. The facial nerve must be identified and preserved and the lesion completely excised. Facial nerve injury is more common in attempts to remove recurrent branchial cleft lesions.

The human otitis media with effusion: a numerical-based study.

PubMed

Areias, B; Parente, M P L; Santos, C; Gentil, F; Natal Jorge, R M

2017-07-01

Otitis media is a group of inflammatory diseases of the middle ear. Acute otitis media and otitis media with effusion (OME) are its two main types of manifestation. Otitis media is common in children and can result in structural alterations in the middle ear which will lead to hearing losses. This work studies the effects of an OME on the sound transmission from the external auditory meatus to the inner ear. The finite element method was applied on the present biomechanical study. The numerical model used in this work was built based on the geometrical information obtained from The visible ear project. The present work explains the mechanisms by which the presence of fluid in the middle ear affects hearing by calculating the magnitude, phase and reduction of the normalized umbo velocity and also the magnitude and phase of the normalized stapes velocity. A sound pressure level of 90 dB SPL was applied at the tympanic membrane. The harmonic analysis was performed with the auditory frequency varying from 100 Hz to 10 kHz. A decrease in the response of the normalized umbo and stapes velocity as the tympanic cavity was filled with fluid was obtained. The decrease was more accentuated at the umbo.

A rare case of petrified ear.

PubMed

Buikema, Kathryn E; Adams, Erin G

2012-01-01

Calcification or ossification of the auricle, also referred to as petrified ear, is a rare diagnosis in dermatology. In medical literature, it has most often been attributed to trauma, hypothermia and frostbite, or hypercalcemia secondary to a metabolic or endocrine disorder, such as Addison's disease. Here, we report the clinical and radiologic findings of a 79-year-old African American male whose unilateral petrified auricle was an incidental finding. He had a preceding history of hyperparathyroidism and subsequent hypercalcemia treated with a subtotal parathyroidectomy three years prior to presentation. In addition to laboratory analysis, a history and physical examination was performed which revealed no other signs of hypercalcemia. Radiologic studies demonstrated partial ossification of the external auricular cartilage on the left side. The patient was diagnosed with the rare occurrence of a petrified ear. In light of this case, we provide a discussion concerning the possible etiologies of this diagnosis including appropriate patient evaluation and possible treatment recommendations.

A Rare Case of Petrified Ear

PubMed Central

Buikema, Kathryn E.; Adams, Erin G.

2012-01-01

Calcification or ossification of the auricle, also referred to as petrified ear, is a rare diagnosis in dermatology. In medical literature, it has most often been attributed to trauma, hypothermia and frostbite, or hypercalcemia secondary to a metabolic or endocrine disorder, such as Addison's disease. Here, we report the clinical and radiologic findings of a 79-year-old African American male whose unilateral petrified auricle was an incidental finding. He had a preceding history of hyperparathyroidism and subsequent hypercalcemia treated with a subtotal parathyroidectomy three years prior to presentation. In addition to laboratory analysis, a history and physical examination was performed which revealed no other signs of hypercalcemia. Radiologic studies demonstrated partial ossification of the external auricular cartilage on the left side. The patient was diagnosed with the rare occurrence of a petrified ear. In light of this case, we provide a discussion concerning the possible etiologies of this diagnosis including appropriate patient evaluation and possible treatment recommendations. PMID:23259082

Biomedical Simulation Models of Human Auditory Processes

NASA Technical Reports Server (NTRS)

Bicak, Mehmet M. A.

2012-01-01

Detailed acoustic engineering models that explore noise propagation mechanisms associated with noise attenuation and transmission paths created when using hearing protectors such as earplugs and headsets in high noise environments. Biomedical finite element (FE) models are developed based on volume Computed Tomography scan data which provides explicit external ear, ear canal, middle ear ossicular bones and cochlea geometry. Results from these studies have enabled a greater understanding of hearing protector to flesh dynamics as well as prioritizing noise propagation mechanisms. Prioritization of noise mechanisms can form an essential framework for exploration of new design principles and methods in both earplug and earcup applications. These models are currently being used in development of a novel hearing protection evaluation system that can provide experimentally correlated psychoacoustic noise attenuation. Moreover, these FE models can be used to simulate the effects of blast related impulse noise on human auditory mechanisms and brain tissue.

PPARD is an Inhibitor of Cartilage Growth in External Ears.

PubMed

Zhang, Zhen; Duan, Yanyu; Wu, Zhongping; Zhang, Hui; Ren, Jun; Huang, Lusheng

2017-01-01

Peroxisome proliferator-activated receptor beta/delta (PPARD) is an important determinant of multiple biological processes. Our previous studies identified a missense mutation in the PPARD gene that significantly reduces its transcription activity, and consequently causes enlarged external ears in pigs. However, the mechanisms underlying the causality has remained largely unknown. Here, we show that PPARD retards the development of auricular cartilage by accelerating the apoptosis of cartilage stem/progenitor cells (CSPCs), the terminal differentiation of cartilage cells and the degradation of cartilage extracellular matrix in the auricle. At the transcription level, PPARD upregulates a set of genes that are associated with CSPCs apoptosis and chondrogenic differentiation, chondroblast differentiation and extracellular matrix degradation. ChIP-seq identified direct target genes of PPARD, including a well-documented gene for cartilage development: PPARG . We further show that compared to wild-type PPARD, the G32E mutant up-regulates the expression of PPARG and subsequently leads to the downregulation of critical genes that inhibit cartilage growth. These findings allow us to conclude that PPARD is an inhibitor of auricular cartilage growth in pigs. The causative mutation (G32E) in the PPARD gene attenuates the PPARD-mediated retardation of cartilage growth in the auricle, contributing to enlarged ears in pigs. The findings advance our understanding of the mechanisms underlying auricular development in mammals, and shed insight into the studies of innate pinna disorders and cartilage regeneration medicine in humans.

Primary Synovial Sarcoma of External Auditory Canal: A Case Report.

PubMed

Devi, Aarani; Jayakumar, Krishnannair L L

2017-07-20

Synovial sarcoma is a rare malignant tumor of mesenchymal origin. Primary synovial sarcoma of the ear is extremely rare and to date only two cases have been published in English medical literature. Though the tumor is reported to have an aggressive nature, early diagnosis and treatment may improve the outcome. Here, we report a rare case of synovial sarcoma of the external auditory canal in an 18-year-old male who was managed by chemotherapy and referred for palliation due to tumor progression.

A randomised controlled trial of active chronic otitis media comparing courses of eardrops versus one-off topical treatments suitable for primary, secondary and tertiary healthcare settings.

PubMed

Loock, J W

2012-08-01

Primary: to compare one-off administration of boric acid powder with courses of 1% acetic acid and ciprofloxacin eardrops in treating active chronic otitis media. Secondary: to evaluate the effectiveness of Quadriderm® cream in resistant active chronic otitis media; and to document side effects of these treatments, especially hearing loss. Randomised controlled trial. Outpatient department of a tertiary ENT unit. Hundred and fifty-nine patients over 6 years old with active chronic mucosal (without cholesteatoma) otitis media randomised to receive one of the three primary agents. All techniques employed were suitable for primary healthcare givers as well as specialists. After confirming eligibility, patients were randomly allocated to treatment. All ears underwent toilet with irrigation using clean water, a syringe and ambient light, with or without dry mopping, until the perforation was visible. The randomised solution was flushed through the middle ear and eustachian tube using a 'tragal pump' technique: saline was used as the solution for flushing in the boric acid powder arm. Patients allocated topical ear medication were given a bottle of eardrops to administer (six drops twice daily, 'pumped in') until finished. Those allocated boric acid powder had the external ear canals filled as a one-off treatment. Patients were followed up monthly thereafter. Primary: Dry (inactive) middle ears as assessed by the doctor. Secondary: Patient assessment of success; microbiologic culture and sensitivity; audiologic changes because of treatment; complications of treatment; costs of therapies. Ciprofloxacin eardrops and boric acid powder were statistically superior to 1% acetic acid eardrops in rendering active chronic otitis media inactive (73% dry ears for ciprofloxacin; 67% for boric acid powder; and 24% for acetic acid). There was no difference between the success rates of ciprofloxacin eardrops and boric acid powder. Quadriderm cream was effective in 85% of patients failing first-line therapy. No agent caused significant complications and specifically no hearing loss. This study showed a single application of boric acid powder following external auditory canal irrigation until the perforation was visible to be as effective as the current best practice of topical quinolone eardrops in active chronic otitis media. Boric acid powder is inexpensive and does not require patient compliance. Boric acid powder is a viable, less costly alternative to topical antibiotic/steroid ear drops in the developing world for active chronic otitis media. Acetic acid eardrops 1% are ineffective. Quadriderm cream, given as a one-off therapy, also appears to be effective. © 2012 Blackwell Publishing Ltd.

Otologic Manifestations of Autosomal Recessive Congenital Ichthyosis in Children.

PubMed

Martín-Santiago, A; Rodríguez-Pascual, M; Knöpfel, N; Hernández-Martín, Á

2015-11-01

Few studies have investigated ear involvement in nonsyndromic autosomal recessive congenital ichthyosis (ARCI). To assess the type and frequency of otologic manifestations of ARCI in patients under follow-up at the pediatric dermatology department of our hospital. We prospectively studied the presence of ear pain, ear itching, tinnitus, otitis, cerumen impaction, accumulation of epithelial debris, and hearing loss. Daily hygiene measures, topical treatments, medical-surgical interventions, and frequency of visits to an ear, nose, and throat (ENT) specialist were noted in the patients' medical records. Ear examination and hearing tests were performed in all cases. Ten patients were studied: 2 had a self-healing collodion baby phenotype and 8 had ichthyosis. There was mention of otologic manifestations in the records of all 8 patients with ichthyosis (100%); 6 of these patients (75%) had abnormalities in the external auditory canal examination and 2 (25%) had conductive hearing loss. Our findings are limited by the small number of patients studied, all of whom were younger than 19 years. The involvement of both dermatologists and ENT specialists in the management of patients with ichthyosis is crucial to ensure the application of the best therapeutic and preventive measures. More studies are needed to assess the prevalence and impact on quality of life of ear involvement in patients with ichthyosis and to determine the optimal interval between ENT visits for these patients. Copyright © 2015 Elsevier España, S.L.U. and AEDV. All rights reserved.

Hair band retained prosthetic reconstruction of bilaterally missing ears: a case of congenital atresia of external auditory canals and pinna.

PubMed

Minati, C; Shanmuganathan, N; Jain, Bhakti S; Padmanabhan, T V

2014-01-01

Auricular defects present reconstructive challenges, especially if they are bilateral. Surgical reconstruction provides effective results for defects; however for some patients surgical intervention is contraindicated. This case report describes an easy clinical technique to rehabilitate a patient with auricular defects. The prime purpose of this treatment rendered was to restore the lost auricular structure to the patient's satisfaction in an elegant, comfortable and cost effective manner. A thirteen year old female patient, who had bilaterally missing ears, was referred with a chief complaint of discomfort caused due to her existing hair band prosthesis and unsatisfactory esthetics. There was constant formation of ulcers at the site where the prosthesis came in contact with the skin. Considering the patient's age, ease of use and economic status, hair band retained ear prosthesis was selected. Silicone ear prostheses were fabricated on acrylic substructure to ensure fit, esthetics. Beneath the acrylic plates, a thin layer of soft silicone material was attached. The ear prostheses of both sides were connected with a metal hair band to retain. The newly fabricated prosthesis overcame the limitations of the existing one. The patient and her parents were satisfied with the results. The hair band retained silicone ear prosthesis is esthetic, economical and easy to use as a facial prosthesis. The addition of soft liner provided a cushion-like effect, thus reducing the formation of any ulcers due to pressure. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

21 CFR 874.3375 - Battery-powered artificial larynx.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Battery-powered artificial larynx. 874.3375... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3375 Battery-powered artificial larynx. (a) Identification. A battery-powered artificial larynx is an externally applied device...

21 CFR 874.3375 - Battery-powered artificial larynx.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Battery-powered artificial larynx. 874.3375... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3375 Battery-powered artificial larynx. (a) Identification. A battery-powered artificial larynx is an externally applied device...

21 CFR 874.3375 - Battery-powered artificial larynx.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Battery-powered artificial larynx. 874.3375... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3375 Battery-powered artificial larynx. (a) Identification. A battery-powered artificial larynx is an externally applied device...

21 CFR 874.3375 - Battery-powered artificial larynx.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Battery-powered artificial larynx. 874.3375... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3375 Battery-powered artificial larynx. (a) Identification. A battery-powered artificial larynx is an externally applied device...

21 CFR 874.3375 - Battery-powered artificial larynx.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Battery-powered artificial larynx. 874.3375... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3375 Battery-powered artificial larynx. (a) Identification. A battery-powered artificial larynx is an externally applied device...

Ear diseases among secondary school students in Xi'an, China: the role of portable audio device use, insomnia and academic stress.

PubMed

Chen, Yang; Li, Xu; Xu, Zhan; Li, Zonghua; Zhang, Pengzhi; He, Ya; Wang, Fangyuan; Qiu, Jianhua

2011-06-08

Hearing impairment negatively impacts students' development of academic, language and social skills. Even minimal unilateral hearing loss can hinder educational performance. We investigated the prevalence of ear diseases among secondary school students in the city of Xi'an, China in order to provide a foundation for evidence-based hearing healthcare. A stratified random sampling survey was conducted in 29 secondary schools. Demographics and medical histories were collected, and otologic examinations were performed. Questionnaires were administered to assess insomnia, academic stress and use of portable audio devices. Logistic regression analysis was used to identify factors associated with hearing impairment, and the association of sensorineural hearing loss with insomnia, academic stress and the use of portable audio devices was analyzed with the chi-square test. The percentage of students with some form of ear disease was 3.32%. External ear disease, middle ear disease and sensorineural hearing loss occurred in 1.21%, 0.64% and 1.47% of the students, respectively. Boys had a relatively higher prevalence of ear disease than girls. According to our survey, the prevalence of sensorineural hearing loss increased significantly among the students with insomnia and extended use of portable audio devices, but not among those with elevated levels of academic stress. Hearing aids and surgical treatment were needed in 1.47% and 0.89% of the students, respectively. There is a high prevalence of ear disease among secondary school students, and this should be given more attention. Insomnia and the excessive use of portable audio devices may be related to adolescent sensorineural hearing loss. It is important to establish and comply with an evidence-based preventive strategy.

Non-ossicular signal transmission in human middle ears: Experimental assessment of the “acoustic route” with perforated tympanic membranes

PubMed Central

Voss, Susan E.; Rosowski, John J.; Merchant, Saumil N.; Peake, William T.

2008-01-01

Direct acoustic stimulation of the cochlea by the sound-pressure difference between the oval and round windows (called the “acoustic route”) has been thought to contribute to hearing in some pathological conditions, along with the normally dominant “ossicular route.” To determine the efficacy of this acoustic route and its constituent mechanisms in human ears, sound pressures were measured at three locations in cadaveric temporal bones [with intact and perforated tympanic membranes (TMs)]: (1) in the external ear canal lateral to the TM, PTM; (2) in the tympanic cavity lateral to the oval window, POW; and (3) near the round window, PRW. Sound transmission via the acoustic route is described by two concatenated processes: (1) coupling of sound pressure from ear canal to middle-ear cavity, HPCAV≡PCAV/PTM, where PCAV represents the middle-ear cavity pressure, and (2) sound-pressure difference between the windows, HWPD≡(POW−PRW)/PCAV. Results show that: HPCAV depends on perforation size but not perforation location; HWPD depends on neither perforation size nor location. The results (1) provide a description of the window pressures based on measurements, (2) refute the common otological view that TM perforation location affects the “relative phase of the pressures at the oval and round windows,” and (3) show with an intact ossicular chain that acoustic-route transmission is substantially below ossicular-route transmission except for low frequencies with large perforations. Thus, hearing loss from TM perforations results primarily from reduction in sound coupling via the ossicular route. Some features of the frequency dependence of HPCAV and HWPD can be interpreted in terms of a structure-based lumped-element acoustic model of the perforation and middle-ear cavities. PMID:17902851

Prevention of meatal stenosis in conchal setback otoplasty.

PubMed

Small, A

1975-10-01

The conchal setback is a useful technique for correcting many prominent ear deformities. A disadvantage of the technique in some cases is meatal stenosis of the external auditory canal. By excising a portion of meatal cartilage, this problem is prevented. The technique is illustrated and post-operative result is shown.

Management of Irradiated and Contaminated Casualty Victims

DTIC Science & Technology

1984-08-01

such as those that appear to be "dirty," should have the contamination brushed away or wiped away. At this point the patient should be surveyed for...contamination. Hair should be shampooed with a mild shampoo . Should contamination be present within the external ear canals, the nose, or the mouth, these

Intracochlear drug injections through the round window membrane: Measures to improve drug retention

PubMed Central

Plontke, Stefan K.; Hartsock, Jared J.; Gill, Ruth M.; Salt, Alec N.

2016-01-01

The goal of this study was to develop appropriate methodology to apply drugs quantitatively to perilymph of the ear. Intratympanic applications of drugs to the inner ear often result in variable drug levels in perilymph and can only be used for molecules that readily permeate the round window (RW) membrane. Direct intracochlear and intralabyrinthine application procedures for drugs, genes or cell-based therapies by-pass the tight boundaries at the round window, oval window, otic capsule and the blood-labyrinth barrier. However, perforations can release inner ear pressure, allowing cerebrospinal fluid to enter through the cochlear aqueduct, displacing the injected drug solution into the middle ear. Two markers, fluorescein or fluorescein isothiocyanate (FITC)-labeled dextran, were used to quantify how much of an injected substance was retained in cochlear perilymph following an intracochlear injection. We evaluated whether procedures to mitigate fluid leaks improved marker retention in perilymph. Almost all procedures to reduce volume efflux, including the use of gel for internal sealing and glue for external sealing of the injection site, resulted in improved retention of the marker in perilymph. Adhesive on the RW membrane effectively prevented leaks but also influenced fluid exchange between CSF and perilymph. We conclude that drugs can be delivered to the ear in a consistent, quantitative manner using intracochlear injections if care is taken to control the fluid leaks that result from cochlear perforation. PMID:26905306

Pressure equilibration in the penguin middle ear.

PubMed

Sadé, Jacob; Handrich, Yves; Bernheim, Joelle; Cohen, David

2008-01-01

King penguins have a venous structure in the form of a corpus cavernosum (CC) in their middle ear (ME) submucosa. The CC may be viewed as a special organelle that can change ME volume for pressure equilibration during deep-sea diving it is a pressure regulating organelle (PRO). A similar CC and muscles also surround the external ear (EE) and may constrict it, isolating the tympanic membrane from the outside. A CC was previously found also in the ME of marine diving mammals and can be expected to exist in other deep diving animals, such as marine turtles. Marine animals require equalization of middle ear (ME) pressure when diving hundreds or thousands of meters to catch prey. We investigated what mechanism enables king penguins to protect their ME when they dive to great depths. Biopsies and serial sections of the ME and the EE of the deep diving king penguin (Aptenodytes patagonicus) were examined microscopically. It was demonstrated that the penguin ME has an extensive network of small and large submucosal venous sinuses. This venous formation, a corpus cavernosum, can expand and potentially 'flood' the ME almost completely on diving, thus elevating ME pressure and reducing the ME space. The EE has a similar protective mechanism.

Otomycosis: prevalence, clinical symptoms, therapeutic procedure.

PubMed

Kurnatowski, P; Filipiak, A

2001-12-01

Local lesions observed in otitis, create favourable conditions for the growth of fungi and development of mycoses both in the external and middle ear, as well as in post-operative cavities, especially in cases of open-type surgery. The objective of this study was: (1) to determine the prevalence of mycotic infections in inflammatory conditions of the ear; (2) to evaluate the relationship between the presence of fungi and clinical symptoms of inflammation; and (3) to construct a model of therapeutic procedure. The study concerned 345 individuals, including 295 patients (381 ears) who presented with symptoms of otitis. The mycological examinations revealed presence of fungi in 30.4% cases (116 ears). Positive culture results were obtained predominantly in patients with post-operative suppuration (52.8%). Otomycosis was more often associated with fungi of the genus Candida (3/5) than with fungi of the genus Aspergillus (2/5). The analysis of symptoms in otomycoses showed that in bacteria-induced otitis, pruritus, discharge, post-operative defective hearing and headaches are most common; the analysis of signs showed that reddened epidermis and lining of the tympanic cavity are statistically more frequent. The therapeutic protocol adopted in otomycoses yields good results: 89%--complete cure.

Comparison of clinical outcomes of three different packing materials in the treatment of severe acute otitis externa.

PubMed

Demir, D; Yılmaz, M S; Güven, M; Kara, A; Elden, H; Erkorkmaz, Ü

2018-06-13

To analyse the clinical outcomes of biodegradable synthetic polyurethane foam versus ribbon gauze and ear wick in the treatment of severe acute otitis externa. Ninety-two adults with severe acute otitis externa were randomly assigned to groups receiving ear wick (n = 28), ribbon gauze (n = 34) or biodegradable synthetic polyurethane foam (n = 30). Clinical efficacy, in terms of otalgia, oedema, erythema and tenderness of the external auditory canal, was assessed before packing was applied and at follow up on the 3rd and 7th days of presentation. All packing materials were associated with improved otalgia and oedema on the 3rd day; however, there were significant differences between biodegradable synthetic polyurethane foam and the other packing materials, and there was no significant reduction in tenderness in the biodegradable synthetic polyurethane foam group on the 3rd day. In the ribbon gauze and ear wick groups, improvements in all clinical efficacy scores were statistically significant for all pairwise comparisons. The three packing materials were all quite effective in treating severe acute otitis externa, but ear wick and ribbon gauze were superior to biodegradable synthetic polyurethane foam for relieving signs and symptoms, especially on the 3rd day.

Use of oral fluralaner for the treatment of Psoroptes cuniculi in 15 naturally infested rabbits.

PubMed

Sheinberg, Galia; Romero, Camilo; Heredia, Rafael; Capulin, Miguel; Yarto, Enrique; Carpio, Juan

2017-08-01

Psoroptes cuniculi, a nonburrowing ear mite, is a common ectoparasite of rabbits. Constant irritation of the auditory canal by the presence of this mite can lead to otitis externa or otoacariasis. The goal of this study was to evaluate the effect of fluralaner on rabbits naturally infested with P. cuniculi and exhibiting clinical signs. Fifteen female New Zealand domestic rabbits with otitis due to naturally occurring infestation with P. cuniculi. The external ears and ear canals of each individual were examined; samples of otic exudate were extracted with cotton swabs and examined microscopically for identification of the ectoparasite. Each animal was treated with a single 25 mg/kg oral dose of fluralaner. The amount of otic exudate/cerumen was assessed and samples were obtained from the ears to evaluate for presence or absence of mites at 4, 8, 12, 16, 20, 40 and 90 days after receiving treatment. Post-treatment, the amount of otic exudate decreased rapidly in all animals; by Day 12 and until the end of the study all rabbits were judged to have low amount of exudate with normally visible canals. The percentage of ears positive for P. cuniculi decreased to 13.3% of ears sampled by Day 4, and by Day 12 all rabbits were negative for the parasite. Administration of a single oral dose of fluralaner was effective for the treatment of naturally occurring P. cuniculi infestation in rabbits during a 90 day period. © 2017 ESVD and ACVD.

Prevention and management of vascular complications in middle ear and cochlear implant surgery.

PubMed

Di Lella, Filippo; Falcioni, Maurizio; Piccinini, Silvia; Iaccarino, Ilaria; Bacciu, Andrea; Pasanisi, Enrico; Cerasti, Davide; Vincenti, Vincenzo

2017-11-01

The objective of this study is to illustrate prevention strategies and management of vascular complications from the jugular bulb (JB) and internal carotid artery (ICA) during middle ear surgery or cochlear implantation. The study design is retrospective case series. The setting is tertiary referral university hospital. Patients were included if presented pre- or intraoperative evidence of high-risk anatomical anomalies of ICA or JB during middle ear or cochlear implant surgery, intraoperative vascular injury, or revision surgery after the previous iatrogenic vascular lesions. The main outcome measures are surgical outcomes and complications rate. Ten subjects were identified: three underwent cochlear implant surgery and seven underwent middle ear surgery. Among the cochlear implant patients, two presented with anomalies of the JB impeding access to the cochlear lumen and one underwent revision surgery for incorrect positioning of the array in the carotid canal. Subtotal petrosectomy was performed in all cases. Anomalies of the JB were preoperatively identified in two patients with attic and external auditory canal cholesteatoma, respectively. In a patient, a high and dehiscent JB was found during myringoplasty, while another underwent revision surgery after iatrogenic injury of the JB. A dehiscent ICA complicated middle ear effusion in one case, while in another case, a carotid aneurysm determined a cholesterol granuloma. Rupture of a pseudoaneurysm of the ICA occurred in a child during second-stage surgery and required permanent balloon occlusion without neurological complications. Knowledge of normal anatomy and its variants and preoperative imaging are the basis for prevention of vascular complications during middle ear or cochlear implant surgery.

Was Cheselden's One-Century-Long Otological Writings Concordant With His Time?

PubMed

Corrales, C Eduardo; Mudry, Albert

2015-08-01

William Cheselden's famous anatomical treatise spanned the entire 18th century period with its 15 editions. The aim of this study is to analyze the otological knowledge described in all these editions, to identify key 18th century otological advancements, and to study their concordance.In the first edition (1713), Cheselden notably mentioned four middle ear ossicles: malleus, incus, fourth ossicle, and stapes; four auditory muscles: "external tympani," "external oblique," tensor tympani, and stapedial; and a small opening in the tympanic membrane. In subsequent editions, minimal changes appeared, except for nomenclature changes and the proposal of an artificial opening of the tympanic membrane. Virtually no changes were performed up to the last edition (1806). All Cheselden's Editions confirm the uncertain presence of a fourth ossicle, the disputable presence of a tympanic membrane opening and the "usual" accepted presence of three muscles to the malleus. Key otologic advancements, not found in any of Cheselden's writings, were catherization of the Eustachian tube, presence of fluid in the inner ear, and the surgical opening of the mastoid.This study demonstrates that Cheselden, and his subsequent editors, were unaware of some important otologic developments that revolutionized the field of otology. Description of key advancements lacking in his treatise includes catherization of the Eustachian tube, the presence of fluid in the inner ear, and the surgical opening of the mastoid. Nevertheless, Cheselden is first in proposing to artificially open the tympanic membrane in humans.

3D fiber deposited polymeric scaffolds for external auditory canal wall.

PubMed

Mota, Carlos; Milazzo, Mario; Panetta, Daniele; Trombi, Luisa; Gramigna, Vera; Salvadori, Piero A; Giannotti, Stefano; Bruschini, Luca; Stefanini, Cesare; Moroni, Lorenzo; Berrettini, Stefano; Danti, Serena

2018-05-07

The external auditory canal (EAC) is an osseocartilaginous structure extending from the auricle to the eardrum, which can be affected by congenital, inflammatory, and neoplastic diseases, thus reconstructive materials are needed. Current biomaterial-based approaches for the surgical reconstruction of EAC posterior wall still suffer from resorption (biological) and extrusion (synthetic). In this study, 3D fiber deposited scaffolds based on poly(ethylene oxide terephthalate)/poly(butylene terephthalate) were designed and fabricated to replace the EAC wall. Fiber diameter and scaffold porosity were optimized, leading to 200 ± 33 µm and 55% ± 5%, respectively. The mechanical properties were evaluated, resulting in a Young's modulus of 25.1 ± 7.0 MPa. Finally, the EAC scaffolds were tested in vitro with osteo-differentiated human mesenchymal stromal cells (hMSCs) with different seeding methods to produce homogeneously colonized replacements of interest for otologic surgery. This study demonstrated the fabrication feasibility of EAC wall scaffolds aimed to match several important requirements for biomaterial application to the ear under the Tissue Engineering paradigm, including shape, porosity, surface area, mechanical properties and favorable in vitro interaction with osteoinduced hMSCs. This study demonstrated the fabrication feasibility of outer ear canal wall scaffolds via additive manufacturing. Aimed to match several important requirements for biomaterial application to ear replacements under the Tissue Engineering paradigm, including shape, porosity and pore size, surface area, mechanical properties and favorable in vitro interaction with osteo-differentiated mesenchymal stromal cells.

Primary Synovial Sarcoma of External Auditory Canal: A Case Report

PubMed Central

Jayakumar, Krishnannair l L

2017-01-01

Synovial sarcoma is a rare malignant tumor of mesenchymal origin. Primary synovial sarcoma of the ear is extremely rare and to date only two cases have been published in English medical literature. Though the tumor is reported to have an aggressive nature, early diagnosis and treatment may improve the outcome. Here, we report a rare case of synovial sarcoma of the external auditory canal in an 18-year-old male who was managed by chemotherapy and referred for palliation due to tumor progression. PMID:28948118

Auricular syncope.

PubMed

Thakar, A; Deepak, K K; Kumar, S Shyam

2008-10-01

To describe a previously unreported syndrome of recurrent syncopal attacks provoked by light stimulation of the external auditory canal. A 13-year-old girl had been receiving treatment for presumed absence seizures, with inadequate treatment response. Imaging was normal. Careful history taking indicated that the recurrent syncopal attacks were precipitated by external auditory canal stimulation. Targeted autonomic function tests confirmed a hyperactive vagal response, with documented significant bradycardia and lightheadedness, provoked by mild stimulation of the posterior wall of the left external auditory canal. Abstinence from ear scratching led to complete alleviation of symptoms without any pharmacological treatment. Reflex syncope consequent to stimulation of the auricular branch of the vagus nerve is proposed as the pathophysiological mechanism for this previously undocumented syndrome.

21 CFR 524.1195 - Ivermectin otic suspension.

Code of Federal Regulations, 2011 CFR

2011-04-01

....1195 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Ivermectin otic suspension. (a) Specifications. Each tube contains 0.5 milliliter (mL) of a 0.01 percent...—(1) Amount. Administer the contents of one 0.5-mL tube topically into each external ear canal. (2...

21 CFR 524.1195 - Ivermectin otic suspension.

Code of Federal Regulations, 2010 CFR

2010-04-01

....1195 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Ivermectin otic suspension. (a) Specifications. Each tube contains 0.5 milliliter (mL) of a 0.01 percent...—(1) Amount. Administer the contents of one 0.5-mL tube topically into each external ear canal. (2...

[Equivalent Lever Principle of Ossicular Chain and Amplitude Reduction Effect of Internal Ear Lymph].

PubMed

Zhao, Xiaoyan; Qin, Renjia

2015-04-01

This paper makes persuasive demonstrations on some problems about the human ear sound transmission principle in existing physiological textbooks and reference books, and puts forward the authors' view to make up for its literature. Exerting the knowledge of lever in physics and the acoustics theory, we come up with an equivalent simplified model of manubrium mallei which is to meet the requirements as the long arm of the lever. We also set up an equivalent simplified model of ossicular chain--a combination of levers of ossicular chain. We disassemble the model into two simple levers, and make full analysis and demonstration on them. Through the calculation and comparison of displacement amplitudes in both external auditory canal air and internal ear lymph, we may draw a conclusion that the key reason, which the sound displacement amplitude is to be decreased to adapt to the endurance limit of the basement membrane, is that the density and sound speed in lymph is much higher than those in the air.

The RetroX auditory implant for high-frequency hearing loss.

PubMed

Garin, P; Genard, F; Galle, C; Jamart, J

2004-07-01

The objective of this study was to analyze the subjective satisfaction and measure the hearing gain provided by the RetroX (Auric GmbH, Rheine, Germany), an auditory implant of the external ear. We conducted a retrospective case review. We conducted this study at a tertiary referral center at a university hospital. We studied 10 adults with high-frequency sensori-neural hearing loss (ski-slope audiogram). The RetroX consists of an electronic unit sited in the postaural sulcus connected to a titanium tube implanted under the auricle between the sulcus and the entrance of the external auditory canal. Implanting requires only minor surgery under local anesthesia. Main outcome measures were a satisfaction questionnaire, pure-tone audiometry in quiet, speech audiometry in quiet, speech audiometry in noise, and azimuth audiometry (hearing threshold in function of sound source location within the horizontal plane at ear level). : Subjectively, all 10 patients are satisfied or even extremely satisfied with the hearing improvement provided by the RetroX. They wear the implant daily, from morning to evening. We observe a statistically significant improvement of pure-tone thresholds at 1, 2, and 4 kHz. In quiet, the speech reception threshold improves by 9 dB. Speech audiometry in noise shows that intelligibility improves by 26% for a signal-to-noise ratio of -5 dB, by 18% for a signal-to-noise ratio of 0 dB, and by 13% for a signal-to-noise ratio of +5 dB. Localization audiometry indicates that the skull masks sound contralateral to the implanted ear. Of the 10 patients, one had acoustic feedback and one presented with a granulomatous reaction to the foreign body that necessitated removing the implant. The RetroX auditory implant is a semi-implantable hearing aid without occlusion of the external auditory canal. It provides a new therapeutic alternative for managing high-frequency hearing loss.

Reconstruction of anterior auricular conchal defect after malignancy excision: revolving-door flap versus full-thickness skin graft.

PubMed

Dessy, Luca Andrea; Figus, Andrea; Fioramonti, Paolo; Mazzocchi, Marco; Scuderi, Nicolò

2010-05-01

Skin tumours of the anterior auricular concha are not uncommon. Wider excision and immediate reconstruction are required to reduce the risks of recurrence of the disease, cartilage infection and external ear distortion. Many surgical methods have been described for reconstruction of conchal defects. Post-auricular island flaps, such as the revolving-door (RD) flap, and full-thickness skin grafts (FTSGs) are the most-performed procedures. Although the RD flap has been fully described, it is not widely accepted and many surgeons, in their daily practice, prefer to use FTSG. It is a common experience that FTSGs are more subjected to centripetal contraction, decreasing the structural firmness of the conchal cavity and affecting functional and aesthetic outcomes. Furthermore, FTSGs are more prone to delay in wound healing due to the difficult access to this region that hinders adequate tie-over dressings. Between March 2003 and January 2007, 40 patients affected by T1 and T2 non-melanotic skin cancer and T1 melanoma of the anterior conchal surface of the external ear were included in a prospective study and randomly assigned to the RD reconstructed group or to the FTSG reconstructed group to investigate, compare and define advantages and disadvantages of both the techniques. Visual Analogue Scale (VAS) was used to evaluate the overall outcome and the colour and texture match. No flap or skin graft total loss was observed. Six patients (30%) showed partial failure of FTSG. The RD group demonstrated excellent cosmetic outcome, ideal colour match, adequate structure of external ear, projection and shape. Wilcoxon matched-pairs rank-sum test demonstrated statistically significant higher scores for the RD group compared to the FTSG group (p<0.0001). The RD harvesting technique is easy and quicker than the FTSG technique. RD flap should be considered as the first choice for reconstruction of anterior auricular conchal defects following wider excision of skin tumours. Copyright (c) 2009. Published by Elsevier Ltd.

Transcanal endoscopic resection for leiomyoma of the external auditory canal and a review of the literature.

PubMed

Ikeda, Ryoukichi; Tateda, Masaru; Okoshi, Akira; Morita, Shinkichi; Suzuki, Hiroyoshi; Hashimoto, Sho

2016-02-01

Leiomyoma usually originates from the uterus and alimentary tract, but in extremely rare cases leiomyoma can appear in the external auditory canal. Here we present a 37-year-old man with right auricular fullness. Preoperative findings suggested benign tumor or cholesteatoma in the right external auditory canal. We performed total resection using an endoauricular approach with transcanal endoscopic ear surgery. Histopathological and immunohistochemistry examination confirmed the diagnosis of leiomyoma of external auditory canal. Leiomyoma arising from soft tissue, including that in the external auditory canal, is classified into two types: that from the arrectores pilorum muscles and that from the muscle coats of blood vessels. Only four cases of leiomyoma of external auditor canal have been published in the English literature. The other four cases demonstrated vascular leiomyomas. This is the first report of leiomyoma of the EAC arising from arrectores pilorum muscles. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Hands-free device control using sound picked up in the ear canal

NASA Astrophysics Data System (ADS)

Chhatpar, Siddharth R.; Ngia, Lester; Vlach, Chris; Lin, Dong; Birkhimer, Craig; Juneja, Amit; Pruthi, Tarun; Hoffman, Orin; Lewis, Tristan

2008-04-01

Hands-free control of unmanned ground vehicles is essential for soldiers, bomb disposal squads, and first responders. Having their hands free for other equipment and tasks allows them to be safer and more mobile. Currently, the most successful hands-free control devices are speech-command based. However, these devices use external microphones, and in field environments, e.g., war zones and fire sites, their performance suffers because of loud ambient noise: typically above 90dBA. This paper describes the development of technology using the ear as an output source that can provide excellent command recognition accuracy even in noisy environments. Instead of picking up speech radiating from the mouth, this technology detects speech transmitted internally through the ear canal. Discreet tongue movements also create air pressure changes within the ear canal, and can be used for stealth control. A patented earpiece was developed with a microphone pointed into the ear canal that captures these signals generated by tongue movements and speech. The signals are transmitted from the earpiece to an Ultra-Mobile Personal Computer (UMPC) through a wired connection. The UMPC processes the signals and utilizes them for device control. The processing can include command recognition, ambient noise cancellation, acoustic echo cancellation, and speech equalization. Successful control of an iRobot PackBot has been demonstrated with both speech (13 discrete commands) and tongue (5 discrete commands) signals. In preliminary tests, command recognition accuracy was 95% with speech control and 85% with tongue control.

Hearing rehabilitation with single-stage bilateral vibroplasty in a child with Franceschetti syndrome.

PubMed

Sargsyan, Sona; Rahne, Torsten; Kösling, Sabrina; Eichler, Gerburg; Plontke, Stefan K

2014-05-01

Hearing is of utmost importance for normal speech and social development. Even children who have mild or unilateral permanent hearing loss may experience difficulties with understanding speech, as well as problems with educational and psycho-social development. The increasing advantages of middle-ear implant technologies are opening new perspectives for restoring hearing. Active middle-ear implants can be used in children and adolescents with hearing loss. In addition to the well-documented results for improving speech intelligibility and quality of hearing in sensorineural hearing loss active middle-ear implants are now successfully used in patients with conductive and mixed hearing loss. In this article we present a case of successful, single-stage vibroplasty, on the right side with the fixation of the FMT on the stapes and PORP CLiP vibroplasty on the left side in a 6-year-old girl with bilateral mixed hearing loss and multiple dyslalia associated with Franceschetti syndrome (mandibulofacial dysostosis). CT revealed bilateral middle-ear malformations as well as an atretic right and stenotic left external auditory canal. Due to craniofacial dysmorphia airway and (post)operative, management is significantly more difficult in patients with a Franceschetti syndrome which in this case favoured a single-stage bilateral procedure. No intra- or postoperative surgical complications were reported. The middle-ear implants were activated 4 weeks after surgery. In the audiological examination 6 months after surgery, the child showed 100% speech intelligibility with activated implants on each side.

The ototoxic effect of boric acid solutions applied into the middle ear of guinea pigs.

PubMed

Oztürkcan, Sedat; Dündar, Riza; Katilmis, Hüseyin; Ilknur, Ali Ekber; Aktaş, Sinem; Haciömeroğlu, Senem

2009-05-01

This study analyzed the ototoxic effects of boric acid solutions. Boric acid solutions have been used as otologic preparations for many years. Boric acid is commonly found in solutions prepared with alcohol or distilled water but can also be found in a powder form. These preparations are used for both their antiseptic and acidic qualities in external and middle ear infections. We investigated the ototoxic effect of boric acid solutions on guinea pigs. We are unaware of any similar, previously published study of this subject in English. The study was conducted on 28 young albino guinea pigs. Prior to application of the boric acid solution under general anesthesia, an Auditory Brainstem Response (ABRs) test was applied to the right ear of the guinea pigs. Following the test, a perforation was created on the tympanic membrane of the right ear of each guinea pig and small gelfoam pieces were inserted into the perforated area. Test solutions were administered to the middle ear for 10 days by means of a transcanal route. Fifteen days after inserting the gelfoams in all of the guinea pigs, we anasthesized the guinea pigs and removed the gelfoams from the perforated region of the ear and then performed an ABRs on each guinea pig. The ABRs were within the normal range before the applications. After the application, no significant changes were detected in the ABRs thresholds in neither the saline group nor the group administered boric acid and distilled water solution; however, significant changes were detected in the ABRs thresholds of the Gentamicine and boric acid and alcohol solution groups. We believe that a 4% boric acid solution prepared with distilled water can be a more reliable preparation than a 4% boric acid solution prepared with alcohol.

High-resolution x-ray computed tomography to understand ruminant phylogeny

NASA Astrophysics Data System (ADS)

Costeur, Loic; Schulz, Georg; Müller, Bert

2014-09-01

High-resolution X-ray computed tomography has become a vital technique to study fossils down to the true micrometer level. Paleontological research requires the non-destructive analysis of internal structures of fossil specimens. We show how X-ray computed tomography enables us to visualize the inner ear of extinct and extant ruminants without skull destruction. The inner ear, a sensory organ for hearing and balance has a rather complex three-dimensional morphology and thus provides relevant phylogenetical information what has been to date essentially shown in primates. We made visible the inner ears of a set of living and fossil ruminants using the phoenix x-ray nanotom®m (GE Sensing and Inspection Technologies GmbH). Because of the high absorbing objects a tungsten target was used and the experiments were performed with maximum accelerating voltage of 180 kV and a beam current of 30 μA. Possible stem ruminants of the living families are known in the fossil record but extreme morphological convergences in external structures such as teeth is a strong limitation to our understanding of the evolutionary history of this economically important group of animals. We thus investigate the inner ear to assess its phylogenetical potential for ruminants and our first results show strong family-level morphological differences.

[Severe Bleeding from the Middle Ear Cavity after Myringotomy: Review Based on a Case Report].

PubMed

Hofmann, Veit M; Niehues, Stefan M; Albers, Andreas E; Pudszuhn, Annett

2017-03-01

Report of a rare case of severe bleeding from the middle ear cavity after myringotomy. On the basis of the case report, the procedure for such bleeding is discussed in the context of the literature. A 6-year-old boy received a revision myringotomy in an ambulant setting. During the procedure a severe bleeding occurred. The external auditory canal was adequately packed. The patient was extubated and transferred to the clinic as an emergency. Computer tomography of the temporal bone showed the anatomical variant of a dehiscent high jugular bulb, which had been injured. Because no rebleeding occurred, the packing of the ear canal was removed and an explorative tympanoscopy was performed on the third postoperative day. When the tympanomeatal flap was lifted, the defect in the jugular bulb was found. The lesion was covered with Tutopatch ® pads and fibrin glue and the auditory canal was packed again. After removal of the packing three weeks postoperatively a properly healed situs was found. No further measures were taken. The injury of a dehiscent jugular bulb in the course of ear surgeries leads to a massive hemorrhage. The case describes the diagnostic and therapeutic procedure for this relatively rare but severe complication. © Georg Thieme Verlag KG Stuttgart · New York.

Retrofacial approach to access the round window for cochlear implantation of malformed ears.

PubMed

Rizk, Habib; O'Connell, Brendan; Stevens, Shawn; Meyer, Ted

2015-03-01

To report the use of the retrofacial approach for cochlear implantation in three cases of malformed ears with inaccessible round windows through the standard facial recess. Two children with bilateral profound sensorineural hearing loss who were cochlear implant candidates. One patient had bilateral sequential cochlear implantations and the other a unilateral implant. Retrofacial approach to access the posterior mesotympanum and visualize the round window. Ability to complete the surgery with full insertion of the implant and no complications such as facial nerve injury. We implanted three ears in two patients with multiple external and middle ear malformations with an aberrant facial nerve or a posteriorly displaced round window niche. The standard facial recess approach did not allow visualization of the round window. We resorted to a retrofacial approach to access the posterior mesotympanum and proceeded with the surgery through an anterior and inferior cochleostomy or through the round window. In cases with an aberrant facial nerve or inaccessible round window through the facial recess, the retrofacial approach is a good alternative but requires a certain level of expertise and familiarity with temporal bone anatomy. The decision to use an unconventional approach should be considered before surgery, but the ultimate decision may require intraoperative assessment.

Molecular biology of hearing

PubMed Central

Stöver, Timo; Diensthuber, Marc

2012-01-01

The inner ear is our most sensitive sensory organ and can be subdivided into three functional units: organ of Corti, stria vascularis and spiral ganglion. The appropriate stimulus for the organ of hearing is sound, which travels through the external auditory canal to the middle ear where it is transmitted to the inner ear. The inner ear houses the hair cells, the sensory cells of hearing. The inner hair cells are capable of mechanotransduction, the transformation of mechanical force into an electrical signal, which is the basic principle of hearing. The stria vascularis generates the endocochlear potential and maintains the ionic homeostasis of the endolymph. The dendrites of the spiral ganglion form synaptic contacts with the hair cells. The spiral ganglion is composed of neurons that transmit the electrical signals from the cochlea to the central nervous system. In recent years there has been significant progress in research on the molecular basis of hearing. An increasing number of genes and proteins related to hearing are being identified and characterized. The growing knowledge of these genes contributes not only to greater appreciation of the mechanism of hearing but also to a deeper understanding of the molecular basis of hereditary hearing loss. This basic research is a prerequisite for the development of molecular diagnostics and novel therapies for hearing loss. PMID:22558056

Abnormal vessel of the ear associated with congenital arteriovenous malformation in the postauricular region.

PubMed

Dixit, Shilpi Gupta; Dixit, Rakesh

2013-08-01

Variations in the branching pattern of the common, external, and internal carotid arteries can present as arteriovenous malformations, and their basis can be explained embryologically. Our case was a rare variation presenting as a congenital, very gradually increasing bluish painless swelling at the region of the left lobule of the ear arising from an abnormal vessel (from the postauricular artery) which was explored under general anesthesia through a postauricular curved incision. The abnormal vessel and other feeding vessels were ligated and a sclerosing agent injected. Anomalies of pharyngeal arch arteries like our case can be found resulting from the persistence of channels that normally disappear, and prior knowledge of these anomalies is essential before surgeries like mastoidectomy to prevent alarming hemorrhage.

[Identification of human papilloma viruses (HPV) in inflammatory states and ear neoplasms].

PubMed

Rydzewski, Bogdan; Goździcka-Józefiak, Anna; Sokalski, Jerzy; Matusiak, Monika; Durzyński, Lukasz

2007-01-01

Human Papilloma Virus has a strong relation to oropharyngeal mucosa and is considered to be responsible for a wide range of upper respiratory tract pathologies, like laryngeal papilloma. There's a hypothesis, that it plays a significant role in middle ear chronic inflammations and neoplasm's. MATERIAL AND METHODIC. The examination was carried on a group of 53 patients, 39 of which was suffering from granulation tissue chronic otitis media, 7-cholesteatomatous otitis media, 6--middle ear malignant neoplasm, and 1 middle and/or external ear benign neoplasm. The control group consisted of 5 patients operated on: otosclerosis--4 cases and post-traumatic tympanic membrane perforation--1 case. The material was postoperative tissue, like polyps, inflammatory granulation tissue, cholesteatoma masses and malignant neoplasm's tissue. In the whole group of 53 examined cases, HPV DNA was confirmed in 22 cases (41.5%), in that group oncogenic types 16 or 18 in 12 cases (22.6%), and in 14 cases (26.4%) types 6 or 11. In a group of chronic granulomatous otitis media DNA characteristic for Papilloma was identified in 12 cases (25.6%), in it in 9 cases DNA HPV type 6 or 11 was confirmed, and in 7 cases type 16 or 18. Among cholesteatomatous chronic otitis media HPV DNA types 6 or 11 was identified in 70%. In every case of middle ear malignant neoplasm a presence of high-risk DNA Papilloma types 16 or 18 was confirmed. In any case of control group HPV DNA was detected. The results has been compared with other authors examinations and it is claimed that they confirm the observation, that Human Papilloma Viruses may be a factor, that might play an important role in pathology of chronic otitis media and ear neoplasm's. It is concluded, that differences in percentages of HPV presence in chronic inflammations (70%) and ear neoplasm's may be explained by viral co-infection during bacterial c. o. m. Viral infection probably evolves carcinogenesis, which leads to a neoplastic growth.

Wideband reflectance in Down syndrome.

PubMed

Soares, Jordana Costa; Urosas, Juliana Granja; Calarga, Karenina Santos; Pichelli, Tathiany Silva; Limongi, Suelly Cecília Olivan; Shahnaz, Navid; Carvallo, Renata Mota Mamede

2016-08-01

Children with Down syndrome (DS) have a high incidence of middle ear disorders and congenital abnormalities of the external, middle and inner ear. Energy reflectance (ER), a wideband acoustic immittance (WAI) measurement parameter, can measure the sound energy reflected or absorbed in the ear canal over a wider range of frequencies more efficiently and faster than conventional single-tone 226 Hz tympanometry. The aim of the present study was to compare the WAI measurements of children with DS with those of typically developing, normal-hearing children according to their tympanometric findings. Four groups of children with Down syndrome (age range: 2 years and 4 months to 16 years and 3 months; mean age: 8.5 yr) with normal tympanograms (19 ears), flat tympanograms (13 ears), mild negative pressure tympanograms (6 ears between -100 and -199 daPa at the admittance peak) and severe negative pressure tympanograms (4 ears at -200 daPa or lower at the admittance peak) were assessed. All findings were compared with data obtained from 21 ears of a healthy control group (age range: 3 years and 1 month to 13 years and 11 months; mean age: 7.9 yr). The subjects underwent tympanometry with a 226-Hz probe tone frequency and ER measurements along the 200-6,000 Hz range with a chirp stimulus using the Middle-Ear Power Analyzer (MEPA3 - HearID) by Mimosa Acoustics (Champaign, IL), software, version 3.3 [38]. Statistically significant differences were observed in the ER curves for some comparisons between the studied groups. There was also a negative correlation between the static acoustic admittance at the tympanic membrane level and ER measured with a chirp stimulus at 500 and 1,000 Hz. The discriminant analysis technique, which used a chirp stimulus at 1,000 and 1,600 Hz to classify the participants' data based on ER values, achieved a correct classification rate of 59.52% for participants with DS. While groups with abnormal middle ear status, as indicated by tympanometry, showed higher ER values compared to the DS tymp A group and the control group, similar reflectance curves were observed between control group and the DS tymp A group. WAI shows promise as a clinical diagnostic tool in investigating the impact of middle ear disorders in DS group. However, further research is required to investigate this issue in narrower age range group and a larger sample size. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Identifying the Optimal Water-Occluding Earplugs: A Scientific Simulation Study.

PubMed

Kovoor, Joshua; Al Hussaini, Ali; Backhouse, Steven

2016-12-01

Numerous types of water-occluding earplugs are available as a means of preventing infection in patients with external and middle ear disease. However, little is known about the comparative efficacies of these earplugs with prolonged water exposure. In this study, we assessed the water impermeability of various earplug materials to prolonged water exposure. Nine earplugs were tested: cotton wool mixed with petroleum jelly, cotton wool externally coated with petroleum jelly, Blu-Tack, foam earplugs, silicone putty, silicone earplugs, flanged earplugs, and hard and soft silicone custom-moulds. Precision-engineered cups were filled with 30 mL water and sealed with lids that contained a 10 mm diameter hole to simulate the ear canal. The aperture was occluded with different earplugs, and the cup was inverted. Computer software was used to record the water loss to the nearest 10 milligrams 720 times over a three-hour period. The test was repeated five times for each material. The water permeability onset, rate, and total amount of water loss varied markedly between the materials; cotton wool mixed with petroleum jelly demonstrated the fastest onset of leak and the highest rate of water loss (p < 0.00001), as well as the largest amount of cumulative water loss (p = 0.00213). The soft silicone custom-mould plugs, hard silicone custom-mould plugs, foam plugs, and silicone putty demonstrated no leaks. This study demonstrates a wide range of water permeabilities of commonly used ear-occluding materials during prolonged water exposure. We found that the generally suggested regimen of cotton wool mixed with petroleum jelly may be inefficacious for substantial periods of water exposure.

Responses of the ear to low frequency sounds, infrasound and wind turbines.

PubMed

Salt, Alec N; Hullar, Timothy E

2010-09-01

Infrasonic sounds are generated internally in the body (by respiration, heartbeat, coughing, etc) and by external sources, such as air conditioning systems, inside vehicles, some industrial processes and, now becoming increasingly prevalent, wind turbines. It is widely assumed that infrasound presented at an amplitude below what is audible has no influence on the ear. In this review, we consider possible ways that low frequency sounds, at levels that may or may not be heard, could influence the function of the ear. The inner ear has elaborate mechanisms to attenuate low frequency sound components before they are transmitted to the brain. The auditory portion of the ear, the cochlea, has two types of sensory cells, inner hair cells (IHC) and outer hair cells (OHC), of which the IHC are coupled to the afferent fibers that transmit "hearing" to the brain. The sensory stereocilia ("hairs") on the IHC are "fluid coupled" to mechanical stimuli, so their responses depend on stimulus velocity and their sensitivity decreases as sound frequency is lowered. In contrast, the OHC are directly coupled to mechanical stimuli, so their input remains greater than for IHC at low frequencies. At very low frequencies the OHC are stimulated by sounds at levels below those that are heard. Although the hair cells in other sensory structures such as the saccule may be tuned to infrasonic frequencies, auditory stimulus coupling to these structures is inefficient so that they are unlikely to be influenced by airborne infrasound. Structures that are involved in endolymph volume regulation are also known to be influenced by infrasound, but their sensitivity is also thought to be low. There are, however, abnormal states in which the ear becomes hypersensitive to infrasound. In most cases, the inner ear's responses to infrasound can be considered normal, but they could be associated with unfamiliar sensations or subtle changes in physiology. This raises the possibility that exposure to the infrasound component of wind turbine noise could influence the physiology of the ear. Copyright (c) 2010 Elsevier B.V. All rights reserved.

Popularity and Harms of Aural Foreign Bodies: A Descriptive Study of Patients in Baqiyatallah University Hospital, Tehran, Iran.

PubMed

Taheri, Abolfazl; Mehmandari, Sina Navaei; Shahidi, Mojtaba; Mehdizadeh, Hamidreza; Mirlohi, Seyyed Mohammad Javad; Aref, Nasrin Mohammadi; Avanaki, Mahsa Alborzi; Khosravi, Mohammad Hossein

2017-12-01

To evaluate the prevalence of external ear complications among Iranian aural foreign body users attending to otolaryngology clinic of our hospital. In this cross-sectional study patients attending to Otolaryngology clinics of Baqiyatallah hospital were enrolled regardless of their age, gender and reason of attending. Patients between 15 and 60 years of age were included in the present study. Those with positive history of chronic ear diseases, ear surgery, congenital ear disorders, trauma to ear or head and neck region or shock wave trauma were excluded from the study. Demographic information as well as data on chief complaint, educational level, frequency and type of used foreign body and findings of physical examination and Otoscopy by a single otolaryngologist were recorded in a predesigned checklist. Eventually 362 patients (232 male and 130 female) with a mean age of 40.32 ± 16.90 years underwent analysis. Of all patients 244 (67.2%) were using a kind of aural foreign body frequently and Cotton bud was the most popular (63.5%) used foreign body among patients. Drying ear canal was the most common (54.9%) reason of using AFBs among study individuals followed by itching (29.5%) and pyorrhea (11.06%). Also 11 (4.5%) patients were using AFBs as a habit with no specific reason. Itching was the most prevalent symptom reported by both aural foreign body users (78%) and non-users (45.5%); however it was significantly higher among AFB users (p = 0.026). Also hearing loss was significantly more reported by AFB users (p = 0.033). A majority of patients had normal physical examination in both AFB users and non-users group. Inflammation of ear canal was significantly more detected in AFB users (p = 0.004). In addition, rate of right ear wax impaction was higher among AFB users (p = 0.016). In conclusion we realized that 67.2% of patients attending to Otolaryngology clinic of our hospital were using a kind of aural foreign bodies and itching was the most common chief complaint of these patients.

JPRS Report, Science & Technology, USSR: Life Sciences.

DTIC Science & Technology

1987-06-29

tested included kohlrabi, cauliflower , Brussels sprouts, and red and white cabbages. Results indicated that Savoy cabbage retained the highest water...variations in radioactive substance retention were noted. The highest levels were found in cauliflower , along with Vienna Early Savoy cabbage...conchae, larynx and the external ear . Coagulation by the Nd:YAG laser was attained with fiber optics with infiltrating anesthesia in the case of

A distal 594 bp ECR specifies Hmx1 expression in pinna and lateral facial morphogenesis and is regulated by the Hox-Pbx-Meis complex

DOE PAGES

Rosin, Jessica M.; Li, Wenjie; Cox, Liza L.; ...

2016-07-19

Hmx1 encodes a homeodomain transcription factor expressed in the developing lateral craniofacial mesenchyme, retina and sensory ganglia. Mutation or mis-regulation of Hmx1 underlies malformations of the eye and external ear in multiple species. Deletion or insertional duplication of an evolutionarily conserved region (ECR) downstream of Hmx1 has recently been described in rat and cow, respectively. Here, we demonstrate that the impact of Hmx1 loss is greater than previously appreciated, with a variety of lateral cranioskeletal defects, auriculofacial nerve deficits, and duplication of the caudal region of the external ear. Using a transgenic approach, we demonstrate that a 594 bp sequencemore » encompassing the ECR recapitulates specific aspects of the endogenous Hmx1 lateral facial expression pattern. Moreover, we show that Hoxa2, Meis and Pbx proteins act cooperatively on the ECR, via a core 32 bp sequence, to regulate Hmx1 expression. In conclusion, these studies highlight the conserved role for Hmx1 in BA2-derived tissues and provide an entry point for improved understanding of the causes of the frequent lateral facial birth defects in humans.« less

Sensitivity to feature displacement in familiar and unfamiliar faces: beyond the internal/external feature distinction.

PubMed

Brooks, Kevin R; Kemp, Richard I

2007-01-01

Previous studies of face recognition and of face matching have shown a general improvement for the processing of internal features as a face becomes more familiar to the participant. In this study, we used a psychophysical two-alternative forced-choice paradigm to investigate thresholds for the detection of a displacement of the eyes, nose, mouth, or ears for familiar and unfamiliar faces. No clear division between internal and external features was observed. Rather, for familiar (compared to unfamiliar) faces participants were more sensitive to displacements of internal features such as the eyes or the nose; yet, for our third internal feature-the mouth no such difference was observed. Despite large displacements, many subjects were unable to perform above chance when stimuli involved shifts in the position of the ears. These results are consistent with the proposal that familiarity effects may be mediated by the construction of a robust representation of a face, although the involvement of attention in the encoding of face stimuli cannot be ruled out. Furthermore, these effects are mediated by information from a spatial configuration of features, rather than by purely feature-based information.

A distal 594 bp ECR specifies Hmx1 expression in pinna and lateral facial morphogenesis and is regulated by the Hox-Pbx-Meis complex

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rosin, Jessica M.; Li, Wenjie; Cox, Liza L.

Hmx1 encodes a homeodomain transcription factor expressed in the developing lateral craniofacial mesenchyme, retina and sensory ganglia. Mutation or mis-regulation of Hmx1 underlies malformations of the eye and external ear in multiple species. Deletion or insertional duplication of an evolutionarily conserved region (ECR) downstream of Hmx1 has recently been described in rat and cow, respectively. Here, we demonstrate that the impact of Hmx1 loss is greater than previously appreciated, with a variety of lateral cranioskeletal defects, auriculofacial nerve deficits, and duplication of the caudal region of the external ear. Using a transgenic approach, we demonstrate that a 594 bp sequencemore » encompassing the ECR recapitulates specific aspects of the endogenous Hmx1 lateral facial expression pattern. Moreover, we show that Hoxa2, Meis and Pbx proteins act cooperatively on the ECR, via a core 32 bp sequence, to regulate Hmx1 expression. In conclusion, these studies highlight the conserved role for Hmx1 in BA2-derived tissues and provide an entry point for improved understanding of the causes of the frequent lateral facial birth defects in humans.« less

To analyze the impact of intracavitary brachytherapy as boost radiation after external beam radiotherapy in carcinoma of the external auditory canal and middle ear: a retrospective analysis.

PubMed

Badakh, Dinesh K; Grover, Amit H

2014-01-01

The purpose of this study was to analyze the impact of intra-cavitary brachytherapy (ICBT) as boost radiation after external beam radiotherapy (EBRT) in carcinoma of the external auditory canal and middle ear (EACMA): A retrospective analysis. A retrospective study of 18 patients with carcinoma of the EACMA who were treated with a curative intent from the year 1998 to 2010 was carried out. The age of the patients ranged from 25 years to 67 years. There were 11 male patients (61.1%) and 7 female patients (38.9%). A total of 15 (88.2%) patients were treated with curative radiation alone after a biopsy and two patients received post-operative radiation therapy. The patients were initially treated with EBRT with cobalt 60 machine up to 60-64 Gy. In our department, all the patients who were technically suitable for ICBT received an ICBT boost. The overall survival (OS) in these patients ranged from 7 months to 151 months (9 out of 17 patients, no evidence of disease 53%). The OS in patients treated with a combination of EBRT with ICBT was (8 out of 11) 72.7%, P value statistically significant (P value: 0.0024). The multivariate analysis shows statistically significant difference only for patients who got an ICBT boost (P Value: 0.020). ICBT as a boost after EBRT has got a positive impact on the OS. In conclusion, our results demonstrate that radical radiation therapy (EBRT and ICBT) is the treatment of choice for stage T2, carcinoma of EACMA.

Estrus synchronization in sheep with synthetic progestagens.

PubMed

Awel, Hayatu; Eshetu, Lisanework; Tadesse, Gebrehiwot; Birhanu, Alemselam; Khar, S K

2009-10-01

Sixteen female sheep of Degua breed were assigned to receive either the full dose of norgestomet ear implant and injectable solution containing norgestomet and estradiol valerate (n = 8) or half the dose (n = 8). The ear implants were removed in both groups on day 12. All ewes received an intramuscular administration of 500 IU PMSG at implant withdrawal. Synchronized ewes were individually hand mated twice at 48 and 60 hours after implant removal. One ewe in each group however refused mating on both occasions. Pregnancy diagnosis was conducted by bimanual external palpation 90 to 100 days post mating. The conception rates (3/7, 42.85%) and (5/7, 71.42%) were recorded in the two treatment groups, respectively. All eight ewes lambed between 145 to 153 days post mating. In group I ewes carried only singletons (prolificity rate 1.0) whereas in group II two ewes delivered twins, producing 7 lambs with prolificity rate of 1.4 (N.S). From this preliminary investigation it appears that the lower dose of norgestomet ear implants offers better option for estrus synchronization accompanied by higher fertility.

Shape and 3D acoustically induced vibrations of the human eardrum characterized by digital holography

NASA Astrophysics Data System (ADS)

Khaleghi, Morteza; Furlong, Cosme; Cheng, Jeffrey Tao; Rosowski, John J.

2014-07-01

The eardrum or Tympanic Membrane (TM) transfers acoustic energy from the ear canal (at the external ear) into mechanical motions of the ossicles (at the middle ear). The acousto-mechanical-transformer behavior of the TM is determined by its shape and mechanical properties. For a better understanding of hearing mysteries, full-field-of-view techniques are required to quantify shape, nanometer-scale sound-induced displacement, and mechanical properties of the TM in 3D. In this paper, full-field-of-view, three-dimensional shape and sound-induced displacement of the surface of the TM are obtained by the methods of multiple wavelengths and multiple sensitivity vectors with lensless digital holography. Using our developed digital holographic systems, unique 3D information such as, shape (with micrometer resolution), 3D acoustically-induced displacement (with nanometer resolution), full strain tensor (with nano-strain resolution), 3D phase of motion, and 3D directional cosines of the displacement vectors can be obtained in full-field-ofview with a spatial resolution of about 3 million points on the surface of the TM and a temporal resolution of 15 Hz.

Clinical significance of stapedioplasty biomechanics: swimming, diving, flying after stapes surgery.

PubMed

Hüttenbrink, Karl-Bernd

2007-01-01

A piston prosthesis in stapedioplasty significantly modifies the function of the normal ossicular chain. Due to the fact that the ear works as a pressure receptor, a piston prosthesis will be displaced at ambient air pressure changes in a different way than the normal stapes. Our ear is constantly exposed to these pressure changes in daily live, for example during swallowing, with tubal opening, with wind gusts at the external ear, during flying, or diving. Temporal bone experiments showed that elevated static pressures, like in tympanometry, can displace a piston up to 0.5mm in the vestibule. These large movements, which are caused by the missing attachment of the piston to the annual ligament, may explain why a short piston can be lifted out of the footplate perforation (e.g. after sneezing) or a piston with excessive length might come into contact with the membranous labyrinth, causing vertigo with an inward movement. Flying or diving can be performed by the patients after stapedioplasty, provided that a test with tympanometry is tolerated without evoking vertigo.

Congenital middle ear abnormalities with absence of the oval window: diagnosis, surgery, and audiometric outcomes.

PubMed

Su, Yu; Yuan, Hu; Song, Yue-shuai; Shen, Wei-dong; Han, Wei-ju; Liu, Jun; Han, Dong-yi; Dai, Pu

2014-08-01

Congenital absence of the oval window (CAOW) is a rare condition in which the stapes footplate fails to develop, resulting in a significant conductive hearing loss in the affected ear. The purpose of this study was to describe the surgical management and outcomes of patients with CAOW undergoing the oval window drill-out (OWD) procedure. A retrospective chart review of patients with CAOW between 1996 and 2011 was performed. Clinical data of patients who underwent OWD were collected. Seventy-nine patients (103 ears) were confirmed using exploratory tympanotomy as having congenital stapes anomalies and CAOW without any anomalies of the tympanic membrane and external auditory canal. Demographic data, CT findings, operative findings, complications, and preoperative/postoperative audiometry data of patients who underwent OWD were collected. The preoperative and postoperative audiologic findings were analyzed in 42 patients (56 ears) with complete data. Hearing restoration surgery was aborted for various reasons in 14 cases. Six patients underwent revision operations for worsening hearing after their first surgery. The average preoperative 4 tone air conduction threshold was 67 dB; the average 6-month postoperative four tone air conduction threshold was 49 dB, and the average postoperative hearing gain was 18 dB. For the 56 ears, the average 4 tone air conduction threshold 6 months after surgery was significantly lower than the preoperative threshold. The oval window drill-out procedure is a viable operation for patients with congenital absence of the oval window, and it is important for surgeons to develop personalized treatment programs to improve patients' hearing with minimal complications.

Modeling sound transmission of human middle ear and its clinical applications using finite element analysis.

PubMed

Chen, Shou-I; Lee, Ming-Hsiao; Yao, Chih-Min; Chen, Peir-Rong; Chou, Yuan-Fang; Liu, Tien-Chen; Song, Yu-Lin; Lee, Chia-Fone

2013-03-01

We have developed a new finite element (FE) model of human right ear, including the accurate geometry of middle ear ossicles, external ear canal, tympanic cavity, and mastoid cavity. The FE model would be suitable to study the dynamic behaviors of pathological middle ear conditions, including changes of stapedial ligament stiffness, tensor tympani ligament (TTL), and tympanic membrane (TM) stiffness and thickness. Increasing stiffness of stapedial ligament has substantial effect on stapes footplate movement, especially at low frequencies, but less effect on umbo movement. Softer TTL will result in increasing umbo and stapes footplate displacement, especially at low frequencies (f<1000Hz). When the TTL was detached, the vibration amplitude of umbo increased by 6dB at 600Hz and two peaks (300 and 600Hz) were found in the vibration amplitude of stapes footplate. Increasing the stiffness of tensor tympani resulted in a slightly decreased umbo amplitude at very low frequencies (f<500Hz) and significantly decreased displacement up to 12dB at middle frequencies (1000Hz1500Hz. As (TM) thickness was increased, the umbo displacement was reduced, especially at very low frequencies (f<600Hz). Otherwise, the stapes displacement was reduced at all frequencies. Copyright © 2013. Published by Elsevier B.V.

The role of reverberation-related binaural cues in the externalization of speech.

PubMed

Catic, Jasmina; Santurette, Sébastien; Dau, Torsten

2015-08-01

The perception of externalization of speech sounds was investigated with respect to the monaural and binaural cues available at the listeners' ears in a reverberant environment. Individualized binaural room impulse responses (BRIRs) were used to simulate externalized sound sources via headphones. The measured BRIRs were subsequently modified such that the proportion of the response containing binaural vs monaural information was varied. Normal-hearing listeners were presented with speech sounds convolved with such modified BRIRs. Monaural reverberation cues were found to be sufficient for the externalization of a lateral sound source. In contrast, for a frontal source, an increased amount of binaural cues from reflections was required in order to obtain well externalized sound images. It was demonstrated that the interaction between the interaural cues of the direct sound and the reverberation strongly affects the perception of externalization. An analysis of the short-term binaural cues showed that the amount of fluctuations of the binaural cues corresponded well to the externalization ratings obtained in the listening tests. The results further suggested that the precedence effect is involved in the auditory processing of the dynamic binaural cues that are utilized for externalization perception.

Directional Receiver for Biomimetic Sonar System

NASA Astrophysics Data System (ADS)

Guarato, Francesco; Andrews, Heather; Windmill, James F.; Jackson, Joseph; Gachagan, Anthony

An ultrasonic localization method for a sonar system equipped with an emitter and two directional receivers and inspired by bat echolocation uses knowledge of the beam pattern of the receivers to estimate target orientation. Rousettus leschenaultii's left ear constitutes the model for the design of the optimal receiver for this sonar system and 3D printing was used to fabricate receiver structures comprising of two truncated cones with an elliptical external perimeter and a parabolic flare rate in the upper part. Measurements show one receiver has a predominant lobe in the same region and with similar attenuation values as the bat ear model. The final sonar system is to be mounted on vehicular and aerial robots which require remote control for motion and sensors for estimation of each robot's location.

Comparative effects of in ovo exposure to sodium perchlorate on development, growth, metabolism, and thyroid function in the common snapping turtle (Chelydra serpentina) and red-eared slider (Trachemys scripta elegans).

PubMed

Eisenreich, Karen M; Dean, Karen M; Ottinger, Mary Ann; Rowe, Christopher L

2012-11-01

Perchlorate is a surface and groundwater contaminant found in areas associated with munitions and rocket manufacturing and use. It is a thyroid-inhibiting compound, preventing uptake of iodide by the thyroid gland, ultimately reducing thyroid hormone production. As thyroid hormones influence metabolism, growth, and development, perchlorate exposure during the embryonic period may impact embryonic traits that ultimately influence hatchling performance. We topically exposed eggs of red-eared sliders (Trachemys scripta) and snapping turtles (Chelydra serpentina) to 200 and 177 μg/g of perchlorate (as NaClO(4)), respectively, to determine impacts on glandular thyroxine concentrations, embryonic growth and development, and metabolic rates of hatchlings for a period of 2 months post-hatching. In red-eared sliders, in ovo perchlorate exposure delayed hatching, increased external yolk size at hatching, increased hatchling mortality, and reduced total glandular thyroxine concentrations in hatchlings. In snapping turtles, hatching success and standard metabolic rates were reduced, liver and thyroid sizes were increased, and total glandular thyroxine concentrations in hatchlings were reduced after exposure to perchlorate. While both species were negatively affected by exposure, impacts on red-eared sliders were most severe, suggesting that the slider may be a more sensitive sentinel species for studying effects of perchlorate exposure to turtles. Copyright © 2012 Elsevier Inc. All rights reserved.

Pathogenesis of Middle Ear Cholesteatoma

PubMed Central

Yamamoto-Fukuda, Tomomi; Hishikawa, Yoshitaka; Shibata, Yasuaki; Kobayashi, Toshimitsu; Takahashi, Haruo; Koji, Takehiko

2010-01-01

Middle ear cholesteatoma is characterized by enhanced proliferation of epithelial cells with aberrant morphological characteristics. To investigate the origin of the cholesteatoma cells, we analyzed spontaneously occurring cholesteatomas associated with a new transplantation model in Mongolian gerbils (gerbils). Cholesteatomas were induced in gerbils with a transplanted tympanic membrane by using the external auditory canal (EAC) ligation method. After the pars flaccida of the tympanic membranes were completely removed from male gerbils, corresponding portions of tympanic membranes of female gerbils were transplanted to the area of defect, and then we ligated the EAC (hybrid-model group). As a control group, the EAC of normal male and female gerbils was ligated without myringoplasty. In all ears of each group, the induced cholesteatomas were seen. In situ PCR was then performed to detect the mouse X chromosome-linked phosphoglycerate kinase-1 (pgk-1) gene on the paraffin sections. One pgk-1 spot in the epithelial nuclei was detected in male cholesteatoma, and two pgk-1 spots were detected in female cholesteatoma, respectively. On the other hand, in the hybrid-model group, we detected not only one but also two pgk-1 spots in the epithelial nuclei of cholesteatoma. These results strengthened the evidence that the origin of epithelial cells in cholesteatoma is the tympanic membrane in this model, but not the residential middle ear epithelial cells or the skin of the EAC. PMID:20413684

Pathogenesis of middle ear cholesteatoma: a new model of experimentally induced cholesteatoma in Mongolian gerbils.

PubMed

Yamamoto-Fukuda, Tomomi; Hishikawa, Yoshitaka; Shibata, Yasuaki; Kobayashi, Toshimitsu; Takahashi, Haruo; Koji, Takehiko

2010-06-01

Middle ear cholesteatoma is characterized by enhanced proliferation of epithelial cells with aberrant morphological characteristics. To investigate the origin of the cholesteatoma cells, we analyzed spontaneously occurring cholesteatomas associated with a new transplantation model in Mongolian gerbils (gerbils). Cholesteatomas were induced in gerbils with a transplanted tympanic membrane by using the external auditory canal (EAC) ligation method. After the pars flaccida of the tympanic membranes were completely removed from male gerbils, corresponding portions of tympanic membranes of female gerbils were transplanted to the area of defect, and then we ligated the EAC (hybrid-model group). As a control group, the EAC of normal male and female gerbils was ligated without myringoplasty. In all ears of each group, the induced cholesteatomas were seen. In situ PCR was then performed to detect the mouse X chromosome-linked phosphoglycerate kinase-1 (pgk-1) gene on the paraffin sections. One pgk-1 spot in the epithelial nuclei was detected in male cholesteatoma, and two pgk-1 spots were detected in female cholesteatoma, respectively. On the other hand, in the hybrid-model group, we detected not only one but also two pgk-1 spots in the epithelial nuclei of cholesteatoma. These results strengthened the evidence that the origin of epithelial cells in cholesteatoma is the tympanic membrane in this model, but not the residential middle ear epithelial cells or the skin of the EAC.

Deflation opening pressure of the eustachian tube.

PubMed

Cohen, D

1989-03-01

Measurements derived from tests of the performance of the eustachian tube (ET) under a variety of normal and pathologic conditions are widely diffuse and overlap considerably. In this survey, the deflation opening pressure (DOP) of the ET was tested in 31 patients suffering either from recurrent otitis (these patients had ventilating tubes inserted) or from chronic otitis media. Oxygen was deflated from the external ear canal, through the middle ear to the pharyngeal end of the ET. The DOP was the pressure needed for the passing of the oxygen. This pressure was usually between 100 to 200 mm H2O. No difference was found in the DOP between infants and adults or between discharging ears and dry ones. A second measurement was obtained through measuring the deflation flow pressure (DFP) required for the continuous passage of oxygen through the ET. The DFP was less than the DOP by approximately 20 to 60 mm H2O, and again no difference was noted between age groups or between infected and noninfected ears. It was concluded that DOP and DFP measurements of the ET are similar in a variety of conditions and therefore cannot indicate whether the ET is normally or abnormally functioning. The existence of a linear connection between the health of the ET and its performance is not proven; hence the role of the ET in predicting the likely outcome of tympanoplasty should be assessed within a different context.

Tumor Stage-Related Role of Radiotherapy in Patients with an External Auditory Canal and Middle Ear Carcinoma.

PubMed

Choi, Jinhyun; Kim, Se-Heon; Koh, Yoon Woo; Choi, Eun Chang; Lee, Chang Geol; Keum, Ki Chang

2017-01-01

The purpose of this study was to evaluate the clinical outcomes of patients treated with radiotherapy (RT) for a carcinoma of the external auditory canal (EAC) and middle ear. The records of 32 patients who received RT from 1990 to 2013 were reviewed retrospectively. The Pittsburgh classification was used to stage all the cancers (early stage, T1/T2 [n=12]; advanced stage, T3/T4 or N positive [n=20]). Twenty-one patients (65.6%) were treated with postoperative RT and 11 patients (34.4%) were treated with definitive RT. The median radiation doses for postoperative and definitive RT were 60 Gy and 64.8 Gy, respectively. Chemotherapy was administered to seven patients (21.9%). The 5-year overall survival and disease-free survival rates for all patients were 57% and 52%, respectively. The disease control rates for the patients with early stage versus advanced stage carcinomawere 55.6% (5/9) and 50% (6/12) in the postoperative RT group and 66.7% (2/3) and 37.5% (3/8) in the definitive RT group, respectively. Overall, 15 cases (14 patients, 46.7%) experienced treatment failure; these failures were classified as local in four cases, regional in one case, and distant in 10 cases. The median follow-up period after RT was 51 months (range, 7 to 286 months). Patients with early stage carcinoma achieved better outcomes when definitive RT was used. Advanced stage carcinoma patients experienced better outcomes with postoperative RT. The high rate of distant failure after RT, with or without surgery, reflected the lack of a consensus regarding the best therapeutic approach for treating carcinoma of the EAC and middle ear.

Mimetic Muscles in a Despotic Macaque (Macaca mulatta) Differ from Those in a Closely Related Tolerant Macaque (M. nigra).

PubMed

Burrows, Anne M; Waller, Bridget M; Micheletta, Jérôme

2016-10-01

Facial displays (or expressions) are a primary means of visual communication among conspecifics in many mammalian orders. Macaques are an ideal model among primates for investigating the co-evolution of facial musculature, facial displays, and social group size/behavior under the umbrella of "ecomorphology". While all macaque species share some social behaviors, dietary, and ecological parameters, they display a range of social dominance styles from despotic to tolerant. A previous study found a larger repertoire of facial displays in tolerant macaque species relative to despotic species. The present study was designed to further explore this finding by comparing the gross morphological features of mimetic muscles between the Sulawesi macaque (Macaca nigra), a tolerant species, and the rhesus macaque (M. mulatta), a despotic species. Five adult M. nigra heads were dissected and mimetic musculature was compared to those from M. mulatta. Results showed that there was general similarity in muscle presence/absence between the species as well as muscle form except for musculature around the external ear. M. mulatta had more musculature around the external ear than M. nigra. In addition, M. nigra lacked a zygomaticus minor while M. mulatta is reported to have one. These morphological differences match behavioral observations documenting a limited range of ear movements used by M. nigra during facial displays. Future studies focusing on a wider phylogenetic range of macaques with varying dominance styles may further elucidate the roles of phylogeny, ecology, and social variables in the evolution of mimetic muscles within Macaca Anat Rec, 299:1317-1324, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Cold atmospheric plasma for local infection control and subsequent pain reduction in a patient with chronic post-operative ear infection

PubMed Central

Isbary, G; Shimizu, T; Zimmermann, J L; Thomas, H M; Morfill, G E; Stolz, W

2013-01-01

Following surgery of cholesteatoma, a patient developed a chronic infection of the external auditory canal, including extended-spectrum β-lactamase producing Escherichia coli, which caused severe pain. The application of cold atmospheric plasma resulted in a significant reduction in pain and clearance of bacterial carriage, allowing antibiotics and analgesics to be ceased. PMID:25356328

[Epidemiology of otomycoses at the University Hospital of Yopougon (Abidjan-Ivory Coast)].

PubMed

Adoubryn, K D; N'Gattia, V K; Kouadio-Yapo, G C; Nigué, L; Zika, D K; Ouhon, J

2014-06-01

Otomycosis is a fungal infection, which leads to a damage of the external auditory meatus. The disease is worldwide in distribution but is said to be more common in tropical countries. Though otomycosis presumably occurs frequently in Africa, reports on its incidence and etiology are rare from Côte d'Ivoire. The objective of this study was to evaluate the prevalence of the disease and to identify aetiological agents as well as the risk factors. A cross-sectional study was carried out in the Otorhinolaryngology Department of the University Teaching Hospital of Yopougon from September 2007 to February 2008. For laboratory investigation, specimens were collected by means of a sterile swab. Samples were inoculated on Sabouraud's Dextrose Agar with and without antibiotics and incubated at 30°C for a period of 1 to 2 weeks. Identification was performed by direct microscopic examination on Cotton Blue Mount preparation and slide culture examination was used for differentiation of morphology. Biotyping was performed using Carbohydrate Fermentation tests, Carbohydrate Assimilation Tests (galerie Api 20 CAux TM - Sanofi Pasteur), Germ tube Test, detection of chlamydospore formation on corn meal agar. A total of 110 patients (sex-ratio=1.2) with suspected cases of otomycosis were investigated. Itching, otalgia, and hypoacusis were the symptoms reported by the patients and the apparent signs were debris in the ear, scabs and inflammation of the external auditory meatus. Of these, 88 cases (80%) were confirmed specifically of mycotic etiology on the basis of positive culture with 92 isolates consisting of yeasts (65.2%) and moulds (34.8%). The predominant etiological agents were Aspergillus flavus (28.4%), Candida guilliermondii (19.3%) and Candida parapsilosis (18.2%). The predisposing factors included previous otological pathology (P=0.010), frequent scratching of the external ear canal and use of ear drops (RR=3.47; IC 95%=1.3-9.27). This study revealed the great prevalence of otomycosis in Abidjan, some predisposing factors and the aetiological agents. Management of otomycosis must include mycological examination for diagnosis and information for changing behaviour patterns leading to infection. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Progression of growth in the external ear from birth to maturity: a 2-year follow-up study in India.

PubMed

Purkait, Ruma

2013-06-01

This study aimed to follow the growth dynamics of auricular dimensions from birth to the age of 18 years. The norms of dimensions at different ages, the peak growth period and the maturity age of the dimensions are essential information to Physicians for early clinical diagnosis or for deciding the optimal time for surgery to correct abnormalities. For this study, 2,147 children belonging to central Indian population were measured in at least three sequential sessions. Eight dimensions including the physiognomic length and width of the ear and its morphologic width; conchal length, width, and depth; and lobular length and width were measured using anthropometric technique. Three new dimensions (tragal length and height and maximum width of the antihelix) were introduced in the study. Three indices (auricular, conchal, and lobular) also were derived. Most dimensions exhibited very rapid growth during the first 3-6 months of infancy and thereafter proceeded at a slow pace until adulthood. The smaller dimensions (conchal depth, tragal height, and maximum width of the antihelix) increased continuously throughout the growth period. At birth, most of the dimensions were 52-76 % of their adult size, while tragal length and height were less than half their adult size. Unlike the other dimensions, the lobule length was smaller in males, probably due to the higher frequency of hypoplastic and bow-shaped lobules among them. The width dimensions matured earlier, at 5.6-11 years, whereas the maturity age of lengths varied from 12 to 16 years. The data generated in the current study will be useful to Physicians as a guideline in correcting auricular deformity and in constructing age progression charts of the external ear. Knowledge concerning the maturation age of the ear will help law enforcement authorities in deciding when to use it for establishing personal identification. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Genetically-modified bone mesenchymal stem cells with TGF-β3 improve wound healing and reduce scar tissue formation in a rabbit model.

PubMed

Li, Mingyong; Qiu, Lin; Hu, Wei; Deng, Xiang; Xu, Hanfeng; Cao, Youhan; Xiao, Zijian; Peng, Liangyu; Johnson, Shawn; Alexey, Lyundup; Kingston, Paul A; Li, Qing; Zhang, Yuanyuan

2018-06-01

Extensive scar tissue formation often occurs after severe burn injury, trauma, or as one of complications after surgical intervention. Despite significant therapeutic advances, it is still a significant challenge to manage massive scar tissue formation while also promoting normal wound healing. The goal of this study was to investigate the therapeutic effect of bone mesenchymal stem cells (BMSCs) that were genetically modified to overexpress transforming growth factor-beta 3 (TGF-β 3 ), an inhibitor of myofibroblast proliferation and collagen type I deposition, on full-thickness cutaneous wound healing in a rabbit model. Twenty-four rabbits with surgically-induced full-thickness cutaneous wounds created on the external ear (1.5 × 1.5 cm, two wounds/ear) were randomized into four groups: (G1), wounds with no special treatment but common serum-free culture medium as negative controls; (G2), topically-applied recombinant adenovirus, expressing TGF-β 3 /GFP; (G3), topically-applied BMSCs alone; (G4), topically-applied BMSCs transfected with Ad-TGF-β 3 /GFP (BMSCs TGF-β3 ); and (G5), an additional normal control (n = 2) with neither wound nor treatment on the external ear skin. The sizes of wounds on the ear tissues were grossly examined, and the scar depth and density of wounds were histologically evaluated 21, 45, and 90 days after surgical wound creation. Our results demonstrated that G4 significantly reduced the wound scar depth and density, compared to G1~3. Numbers of cells expressing GFP significantly increased in G4, compared to G2. The protein expression of TGF-β 3 and type III collagen in G4 significantly increased, while the ratio of type I to type III collagen was also significantly reduced, which is similar to the tissue architecture found in G5, as compared the other treatment groups. In conclusion, transplantation of BMSCs TGF-β3 remarkably improves wound healing and reduces skin scar tissue formation in an animal model, which may potentially provide an alternative in the treatment of extensive scar tissue formation after soft tissue injury. Copyright © 2018. Published by Elsevier Inc.

Responses of the ear to low frequency sounds, infrasound and wind turbines

PubMed Central

Salt, Alec N.; Hullar, Timothy E.

2010-01-01

Infrasonic sounds are generated internally in the body (by respiration, heartbeat, coughing, etc) and by external sources, such as air conditioning systems, inside vehicles, some industrial processes and, now becoming increasingly prevalent, wind turbines. It is widely assumed that infrasound presented at an amplitude below what is audible has no influence on the ear. In this review, we consider possible ways that low frequency sounds, at levels that may or may not be heard, could influence the function of the ear. The inner ear has elaborate mechanisms to attenuate low frequency sound components before they are transmitted to the brain. The auditory portion of the ear, the cochlea, has two types of sensory cells, inner hair cells (IHC) and outer hair cells (OHC), of which the IHC are coupled to the afferent fibers that transmit “hearing” to the brain. The sensory stereocilia (“hairs”) on the IHC are “fluid coupled” to mechanical stimuli, so their responses depend on stimulus velocity and their sensitivity decreases as sound frequency is lowered. In contrast, the OHC are directly coupled to mechanical stimuli, so their input remains greater than for IHC at low frequencies. At very low frequencies the OHC are stimulated by sounds at levels below those that are heard. Although the hair cells in other sensory structures such as the saccule may be tuned to infrasonic frequencies, auditory stimulus coupling to these structures is inefficient so that they are unlikely to be influenced by airborne infrasound. Structures that are involved in endolymph volume regulation are also known to be influenced by infrasound, but their sensitivity is also thought to be low. There are, however, abnormal states in which the ear becomes hypersensitive to infrasound. In most cases, the inner ear’s responses to infrasound can be considered normal, but they could be associated with unfamiliar sensations or subtle changes in physiology. This raises the possibility that exposure to the infrasound component of wind turbine noise could influence the physiology of the ear. PMID:20561575

[Hearing screening at nursery schools: results of an evaluation study].

PubMed

Weichbold, Viktor; Rohrer, Monika; Winkler, Cornelia; Welzl-Müller, Kunigunde

2004-07-31

This study aimed to evaluate the hearing screening of pre-school children at nursery schools in Tyrol, Austria. 47 nursery schools with a total of 2199 enrolled children participated in the study. At the screening, the children were presented a series of tones at frequencies 0.5 kHz (25dB), 1 kHz, 2 kHz, 3 kHz, and 4 kHz (20 dB each) from portable audiometers. The tones were presented over headphones for each ear separately and at irregular intervals. Failure to respond to any of the frequencies was considered failure of the screening. Parents were then advised in written form to have the child examined by an ENT-specialist. 1832 individuals were screened (coverage: 83% of nursery school children; corresponding to at least 63% of all Tyrolean children aged 3 to 5 years). Of these, 390 failed the test (referral rate: 21% of all screened). Examination through an ENT-specialist occurred with 217 children, and this confirmed the positive test in 139 children (hit rate: 64%). In most cases, a temporary conductive hearing loss due to external or middle ear problems (glue ear, tube dysfunction, cerumen, otitis media) was diagnosed. A sensorineural hearing loss was found in 4 children (in 3 of them bilateral). The need for therapy was recognized in 81 children (4% of all screened). Pre-school hearing screening identifies children with ear and hearing problems that need therapeutical intervention. Although the hearing problems are mostly of a temporary nature, some may require monitoring over some period. Also some children with permanent sensorineural hearing loss may be detected through this measure. Hearing screening is an efficient means of assessing ear and hearing problems in pre-school children. However, the follow-up rate needs to be improved for optimizing the efficacy.

[Comparison of four different staining methods for ear cytology of dogs with otitis externa].

PubMed

Bouassiba, C; Osthold, W; Mueller, R S

2013-01-01

Cytological examination is crucial for the diagnosis and classification of canine otitis externa. Staining should reveal micro-organisms as perpetuating factors of otitis externa. The aim of the study was to compare four different staining methods (Diff-Quik®, Diff-Quik® after dipping in acetone, Gram Quick stain® and a commercial rapid stain for otitis externa) for ear cytology of dogs with otitis externa and to investigate the agreement of cytology and culture. In a study evaluating dogs with otitis externa, five ear swabs (one for culture and four for cytology) were taken from the horizontal part of the external auditory canal of 224 affected ears and compared semi-quantitatively. Diff-Quik® with and without prior dipping in acetone as well as the Gram Quick stain® displayed a high degree of agreement in the detection of micro-organisms (cocci p = 0.2366; rods p = 0.4832; yeasts p = 0.1574), while the commercial otitis rapid stain revealed significantly less micro-organisms (p < 0.001 for all comparisons). The results of the first three stains corresponded to the culture results by >  70%; the agreement was lower with the commercial otitis rapid stain. The quickest and easiest method was staining with Diff-Quik®. Diff-Quik® with or without prior dipping in acetone and the Gram Quick stain® had a high agreement in the detection of microorganisms and can thus be considered nearly equivalent for the diagnosis of otitis externa infectiosa. The commercial otitis rapid stain is less reliable. Based on this study Diff-Quik® can be recommended for the routine cytology of ear swabs. Additionally, a culture may be indicated and must be interpreted in the context of the cytology.

[Effects on hearing due to the occupational noise exposure of marble industry workers in the Federal District, Brazil].

PubMed

Harger, Marília Rabelo Holanda Camarano; Barbosa-Branco, Anadergh

2004-01-01

To evaluate the prevalence of hearing loss, its degree and type, among workers in the marble industry in the Brazilian Federal District (FD). Workers from eight marble industries in the FD were evaluated by means of a cross sectional epidemiological study. An audiometry screening test (air conduction) was performed. Workers with hearing loss were submitted to liminal tonal audiometry air & bone conduction and speech audiometry tests using an audiometer AD-28 (Interacoustics). All subjects studied were submitted to a visual inspection of the external acoustic meatus. One hundred and fifty two workers were examined; mean age was 32 years (SD = 8.6); average occupational noise exposure was of 8.3 years (SD = 6.8). Audiometries demonstrated that 48.0% (n = 73) had some type of hearing loss. Among the workers with hearing loss, 50.0% had results compatible with noise-induced hearing loss (NIHL); 41.0% with incipient noise induced hearing loss, 5.0% with sensorineural hearing loss (all except NIHL) and 4.0% with conductive and mixed hearing losses. Among workers with NIHL, 57.1% had bilateral involvement, 17.1% in the right ear and 25.7% in the left ear. Among those with incipient NIHL, 13.9% were bilateral, 19.4% were only in the right ear and 66.7% were only in the left ear. Abnormal audiograms were found in 48.0% of the sample. Among those with hearing loss, the predominant cause was NIHL, followed by those classified as having incipient noise induced hearing loss. Hearing loss usually started at 6 kHz, frequently in the left ear.

Tuberculosis of the ear, a professional disease?

PubMed

Sens, Patrícia Maria; Almeida, Clemente I R; Valle, Lupércio O do; Costa, Luís H C; Angeli, Miguel L S

2008-01-01

Tuberculosis is a rare cause of chronic suppurative otitis media and mastoiditis; the predisposing factors of this association, however, are not commonly described. There has been an alarming increase in the incidence of tuberculosis in Brazil, including tuberculous otitis media. These patients typically present multiple perforations of the tympanic membrane, an ear discharge, and progressive hearing loss. This diagnosis should be taken into account in patients that do not respond to routine therapy for fungal external otitis or bacterial otitis media. In this retrospective study, the authors describe four cases of patients with tuberculous otitis media. This sample consisted of two physicians, a chemical engineer and an underage child in whose family there were cases of active tuberculosis. Predisposing factors for tuberculous otitis were contact with family members that had tuberculosis, professional contact with patients and exposure to pathogenic microorganisms in airways.

[Seven cases of tuberculous otitis media].

PubMed

Nishiike, S; Irifune, M; Kubo, T

2000-12-01

Tuberculous otitis media (TOM) is a variable and puzzling infectious disease that is sometimes confused with other chronic middle ear diseases. A series of 7 cases (9 ears) of TOM recently treated at Osaka Prefectural Habikino Hospital is reviewed to assess the recent features of the disease. In most cases, the pathogenetic mechanism was probably aspiration of tubercle bacilli through the eustachian tube. In most cases, abundant granulations were observed in the middle and external ears, but multiple perforations of the tympanic membrane were not seen. The manifestations were variable, such as otorrhea from the perforation and otitis media with effusion. In their early stage, most cases of TOMs due to transmission via the eustachian tube are tend to resemble otitis media with effusion. Smear tests, culture, PCR, and histopathological examinations, each of which has advantages and disadvantages, must be repeated to achieve a definitive diagnosis. Tuberculin tests can be unreliable, but a chest x-ray is indispensable whenever TOM is suspected. Antitubercular chemotherapy and 2% kanamycin earwash yielded good results. Since the classical criteria for the diagnosis of TOM are no longer valid, we propose a new criterion for diagnosis in the early stage of the disease.

A case discussion on presbyacusis.

PubMed

Angadi, Savita S; Kotrannavar, Vijaykumar S

2013-01-01

Presbyacusis is one among the many socio-medical problems, which is considered as a hidden disability. The hearing impairment in elderly people is described as presbyacusis. Hearing problem among elderly people is a major issue and a person with hearing loss may be unable to hear doorbells and alarms, to respond while talking with anyone, etc. All this can make them feel frustrated, lonely, and depressed. It is the third most common chronic condition after arthritis and hypertensive diseases among elders. Hearing loss can be improved by using the hearing aids. Hearing aids work well for some while for others; it may not be a perfect solution due to many reasons such as some people do not buy aids that meet their needs, incorrect amplification adjustments, low custom design, etc. In classics of Ayurveda this ailment has been described as karnabaadhirya under the heading of ear diseases. Karnapurana (Instillation of medicated oil into the external auditory canal) is one of the major treatments for ear diseases explained in classics. Clinical observation has shown its effectiveness in the management of presbyacusis. A case report of 75-year-old male who presented with complaints of reduced hearing and tinnitus in both ears has been presented here.

Inflammation of the external ear in acute chikungunya infection: Experience from the outbreak in Johor Bahru, Malaysia, 2008.

PubMed

Javelle, Emilie; Tiong, Tee Hua; Leparc-Goffart, Isabelle; Savini, Hélène; Simon, Fabrice

2014-04-01

The re-emerging invalidating chikungunya disease has recently extended to temperate areas. Other alphaviruses can also present with febrile arthalgias. Dengue virus transmitted by the same species of mosquitoes may cocirculate, leading to dual infections and concurrent epidemics. Although these diseases share similar clinical features, their prognoses considerably differ. Prominent and prolonged articular disorders are more consistent with chikungunya virus, whereas haemorrhages make the gravity of dengue infection. Specific symptoms are required, especially when diagnostic tests are not available or performable at a large scale. Indeed, early clinical suspicion of a vector-borne disease is crucial to isolate the first cases in the course of an outbreak, and discrimination between arboviruses help to optimal management of patients. No specific chikungunya clinical sign has been yet reported. We highlight here the high prevalence (about 25%) of acute ear redness in infected people during the 2008 chikungunya outbreak in Jahor Bahru in Malaysia. Nine consenting patients are more precisely described. Ear chondritis could be sensitive diagnostic criterion of the acute stage of chikungunya, every physician - even in occidental non endemic areas - should be aware of. Copyright © 2014 Elsevier B.V. All rights reserved.

A case discussion on presbyacusis

PubMed Central

Angadi, Savita S.; Kotrannavar, Vijaykumar S.

2013-01-01

Presbyacusis is one among the many socio-medical problems, which is considered as a hidden disability. The hearing impairment in elderly people is described as presbyacusis. Hearing problem among elderly people is a major issue and a person with hearing loss may be unable to hear doorbells and alarms, to respond while talking with anyone, etc. All this can make them feel frustrated, lonely, and depressed. It is the third most common chronic condition after arthritis and hypertensive diseases among elders. Hearing loss can be improved by using the hearing aids. Hearing aids work well for some while for others; it may not be a perfect solution due to many reasons such as some people do not buy aids that meet their needs, incorrect amplification adjustments, low custom design, etc. In classics of Ayurveda this ailment has been described as karnabaadhirya under the heading of ear diseases. Karnapurana (Instillation of medicated oil into the external auditory canal) is one of the major treatments for ear diseases explained in classics. Clinical observation has shown its effectiveness in the management of presbyacusis. A case report of 75-year-old male who presented with complaints of reduced hearing and tinnitus in both ears has been presented here. PMID:23741163

Hernia of the tympanic membrane.

PubMed

Ikeda, Ryoukichi; Miyazaki, Hiromitsu; Kawase, Tetsuaki; Katori, Yukio; Kobayashi, Toshimitsu

2017-02-01

Although tympanic bulging is commonly encountered, tympanic herniation occupying the external auditory canal is extremely rare. A 66-year-old man was presented to our hospital with left aural fullness, bilateral hearing loss and otorrhea. Preoperative findings suggested tympanic membrane (TM) hernia located in the left external auditory canal. We performed total resection of the soft mass by a transcanal approach using endoscopy. Ventilation tubes were inserted into bilateral ears. Histopathological findings confirmed diagnosis of TM hernia. Passive opening pressure of this patient was higher than normal condition of the Eustachian tube, where active opening was not observed. Hernia of the TM most likely resulted from long-term excessive Valsalva maneuver. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Long-term Results of Troublesome CWD Cavity Reconstruction by Mastoid and Epitympanic Bony Obliteration (CWR-BOT) in Adults.

PubMed

Vercruysse, Jean-Philippe; van Dinther, Joost J S; De Foer, Bert; Casselman, Jan; Somers, Thomas; Zarowski, Andrzej; Cremers, Cor C; Offeciers, Erwin

2016-07-01

To present the long-term surgical outcome of the bony mastoid and epitympanic obliteration technique with canal wall reconstruction (CWR-BOT) in adults with an unstable cavity after previous canal wall-down surgery for extensive cholesteatoma. Retrospective study. Therapeutic. Tertiary referral center. Fifty consecutive adult patients undergoing a CWR-BOT between 1998 and 2009. (A) Recurrence and residual rates of cholesteatoma, (B) postoperative hygienic status of the ear, including postoperative aspect of the tympanic membrane and external ear canal integrity (EAC), (C) functional outcome, and (D) long-term safety issues. (A) The percentage of ears remaining safe without recurrent or residual disease after CWR-BOT was 96% after a mean follow-up time of 101.8 months. Recurrent cholesteatoma occurred in 2% (n = 1) and a residual cholesteatoma was detected in 2% (n = 1) of the patients. (B) A safe dry, and trouble-free graft and selfcleaning EAC was achieved in 94%. (C) The postoperative hearing results showed a gain of 1.7 dB on pure-tone average air-conduction. (D) Nonecho planar diffusion-weighted imaging (non-EP DW magnetic resonance imaging) documented the residual (n = 1) and recurrent cholesteatoma (n = 1). The 1- and 5-year imaging follow-up revealed no other recurrent or residual disease. The CWR-BOT is a safe and very effective option for treatment of problematic unstable canal wall-down mastoid cavities, resulting in dry trouble-free ears.

[History of the ear speculum. Images from the history of otorhinolaryngology, highlighted by instruments from the collection of the German Medical History Museum in Ingolstadt].

PubMed

Feldmann, H

1996-05-01

BACKGROUND. Inspection of or interventions in the external ear canal and the nostrils pose similar technical problems. This is the reason why early instruments devised for otoscopy and rhinoscopy were based on an identical principle. They were shaped like a pair of tongs, comparable to nasal specula of today. A similar type of instrument had been developed earlier by barber surgeons for inspecting narrow wound cavities. TONG-SHAPED SPECULA. The first description and illustration of an aural and nasal speculum was provided by Guy de Chauliac in Montpellier, France in 1363. Sophisticated models were presented by Fabricius Hildanus in Germany in 1646 and J.J. Perret in Paris in 1772, who offered them in his illustrated catalogue of surgical instruments at fixed prices. W. Kramer (1836) in Berlin improved this tong-shaped instrument and devised the ear speculum named after him that was generally favored during the first half of the 19th century. Further variations of this type were presented by Lincke and Schmalz (1846) in Germany. FUNNEL-SHAPED SPECULA. Ignaz Gruber in Vienna in 1838 devised the first tunnel-shaped ear specula made of metal. They had a simple conical shape, were not divided into separate jaws, and could not be spread. Gruber himself did not publish his invention, but he demonstrated his ear specula to W. R. Wilde from Dublin, who had paid a visit to his office in Vienna. Wilde reported on this in 1844, and subsequently systematically refined Gruber's specula. A. v. Tröltsch from Würzburg (Germany) had seen these instruments at Wilde's office and it was Wilde himself and v. Tröltsch who helped this type of ear speculum to gain acceptance on an international scale. A different type of bottle-shaped ear speculum was first used by Schmalz (1846) and Erhard (1859) in Germany, but it was only developed into a commercially available instrument by Josef Gruber in Vienna in 1870. The ear specula most in use today were first presented by A. Hartmann in Berlin in 1881. SUPPLEMENTARY INVENTIONS. An important supplementary invention was the pneumatic ear speculum by E. Siegle in Stuttgart (Germany) in 1864. It permitted not only inspecting the tympanic membrane but also examining its compliance and response to variations in air pressure in the ear canal. The importance of this instrument was recognized at once and has remained undisputed to this day. J. Bruton, an English military surgeon, presented his otoscope in 1862. It was the first device to incorporate interchangeable ear specula, illumination by a perforated mirror, and a magnifying lens into one handy instrument. It is the precursor of the modern diagnostic sets comprised of a battery-handle, various specula, and accessories for otoscopy, rhinoscopy, and ophthalmoscopy which started to come into use in the late twenties of this century. This historical development of the ear specula is described and illustrated in detail.

A Two-Magnet System to Push Therapeutic Nanoparticles

NASA Astrophysics Data System (ADS)

Shapiro, Benjamin; Dormer, Kenneth; Rutel, Isaac B.

2010-12-01

Magnetic fields can be used to direct magnetically susceptible nanoparticles to disease locations: to infections, blood clots, or tumors. Any single magnet always attracts (pulls) ferro- or para-magnetic particles towards it. External magnets have been used to pull therapeutics into tumors near the skin in animals and human clinical trials. Implanting magnetic materials into patients (a feasible approach in some cases) has been envisioned as a means of reaching deeper targets. Yet there are a number of clinical needs, ranging from treatments of the inner ear, to antibiotic-resistant skin infections and cardiac arrhythmias, which would benefit from an ability to magnetically "inject", or push in, nanomedicines. We develop, analyze, and experimentally demonstrate a novel, simple, and effective arrangement of just two permanent magnets that can magnetically push particles. Such a system might treat diseases of the inner ear; diseases which intravenously injected or orally administered treatments cannot reach due to the blood-brain barrier.

Comparison of Boric Acid and Combination Drug of Polymyxin, Neomycin and Hydrocortisone (polymyxin NH) in the Treatment of Acute Otitis Externa.

PubMed

Amani, Soroush; Moeini, Mohammad

2016-07-01

Acute otitis externa is an inflammation of the external auditory canal known as "swimmer's ear". Direct costs including medical treatment, painkillers, antibiotics, steroids or both and indirect costs are also remarkable. The aim of this study was to compare the effect of boric acid and polymyxin, neomycin and hydrocortisone composition in the treatment of acute otitis externa. This randomized clinical trial was carried out on 80 patients aged more than 17-year-old who were referred to Kashani hospital clinic with a diagnosis of acute otitis externa by otolaryngologist. The patients were randomly allocated to two groups (A: Boric acid and B: polymyxin NH ear drops) and Painkiller was prescribed and administered orally for all patients and in the presence of fever, cellulitis around the ears and neck adenopathy, broad-spectrum systemic antibiotics were used besides topical treatment. Symptoms of patients who were evaluated by a physician includes pain, discharge from the ear, swelling of the ear canal, auricle swelling, tenderness, and ear itching. In addition, pain was evaluated in patients and was recorded by Macgill Pain Questionnaire, in the first, third, seventh and tenth days. Results showed that itching on third day (p=0.007) and swelling of the ear canal in the examination of the third day (p=0.006) and the seventh day (p=0.001) in the polymyxin NH group was more than those of boric acid group. Overall mean pain based on McGill questionnaire was 11.10±1.49 in boric acid group in the examination on the first day and was 4.05±0.22 in the examination on the tenth day and in the polymyxin NH group, it was 10.9±0.99 on the first day and 4.20±0.40 on the tenth day. In both groups, pain relief was the same and there was no significant difference between two groups (p=0.075). The findings of this study showed slight differences in the effectiveness of the boric acid drug and combination of polymyxin, neomycin and hydrocortisone in the treatment of patients with acute otitis externa that is of clinical significance.

Comparison of Boric Acid and Combination Drug of Polymyxin, Neomycin and Hydrocortisone (polymyxin NH) in the Treatment of Acute Otitis Externa

PubMed Central

Moeini, Mohammad

2016-01-01

Introduction Acute otitis externa is an inflammation of the external auditory canal known as "swimmer’s ear". Direct costs including medical treatment, painkillers, antibiotics, steroids or both and indirect costs are also remarkable. Aim The aim of this study was to compare the effect of boric acid and polymyxin, neomycin and hydrocortisone composition in the treatment of acute otitis externa. Materials and Methods This randomized clinical trial was carried out on 80 patients aged more than 17-year-old who were referred to Kashani hospital clinic with a diagnosis of acute otitis externa by otolaryngologist. The patients were randomly allocated to two groups (A: Boric acid and B: polymyxin NH ear drops) and Painkiller was prescribed and administered orally for all patients and in the presence of fever, cellulitis around the ears and neck adenopathy, broad-spectrum systemic antibiotics were used besides topical treatment. Symptoms of patients who were evaluated by a physician includes pain, discharge from the ear, swelling of the ear canal, auricle swelling, tenderness, and ear itching. In addition, pain was evaluated in patients and was recorded by Macgill Pain Questionnaire, in the first, third, seventh and tenth days. Results Results showed that itching on third day (p=0.007) and swelling of the ear canal in the examination of the third day (p=0.006) and the seventh day (p=0.001) in the polymyxin NH group was more than those of boric acid group. Overall mean pain based on McGill questionnaire was 11.10±1.49 in boric acid group in the examination on the first day and was 4.05±0.22 in the examination on the tenth day and in the polymyxin NH group, it was 10.9±0.99 on the first day and 4.20±0.40 on the tenth day. In both groups, pain relief was the same and there was no significant difference between two groups (p=0.075). Conclusion The findings of this study showed slight differences in the effectiveness of the boric acid drug and combination of polymyxin, neomycin and hydrocortisone in the treatment of patients with acute otitis externa that is of clinical significance. PMID:27630871

Optimal Electromechanical Reshaping of the Auricular Ear and Long-term Outcomes in an In Vivo Rabbit Model

PubMed Central

Manuel, Cyrus T.; Tjoa, Tjoson; Nguyen, Tony; Su, Erica; Wong, Brian J. F.

2016-01-01

IMPORTANCE The prominent ear is a common external ear anomaly that is usually corrected through surgery. Electromechanical reshaping (EMR) may provide the means to reshape cartilage through the use of direct current (in milliamperes) applied percutaneously with needle electrodes and thus to reduce reliance on open surgery. OBJECTIVE To determine the long-term outcomes (shape change, cell viability, and histology) of a more refined EMR voltage and time settings for reshaping rabbit auricle. DESIGN, SETTING, AND SUBJECTS The intact ears of 14 New Zealand white rabbits were divided into 2 groups. Group 1 received 4 V for 5 minutes (5 ears), 5 V for 4 minutes (5 ears), or no voltage for 5 minutes (control; 4 ears). Group 2 received an adjusted treatment of 4 V for 4 minutes (7 ears) or 5 V for 3 minutes (7 ears). A custom mold with platinum electrodes was used to bend the pinna and to perform EMR. Pinnae were splinted for 6 months along the region of the bend. Rabbits were killed humanely and the ears were harvested the day after splint removal. Data were collected from March 14, 2013, to July 8, 2014, and analyzed from August 29, 2013, to March 1, 2015. MAIN OUTCOMES AND MEASURES Bend angle and mechanical behavior via palpation were recorded through photography and videography. Tissue was sectioned for histologic examination and confocal microscopy to assess changes to microscopic structure and cell viability. RESULTS Rabbits ranged in age from 6 to 8 months and weighed 3.8 to 4.0 g. The mean (SD) bend angles were 81° (45°) for the controls and, in the 5 EMR groups, 72° (29°) for 4 V for 4 minutes, 101° (19°) for 4 V for 5 minutes, 78° (18°) for 5 V for 3 minutes, and 126° (21°) for 5 V for 4 minutes. At 5 V, an increase in application time from 3 to 4 minutes provided significant shape change (78° [18°] and 126° [21°], respectively; P = .003). Pinnae stained with hematoxylin-eosin displayed localized areas of cell injury and fibrosis in and around electrode insertion sites. This circumferential zone of injury (range, 1.3–2.1 mm) corresponded to absence of red florescence on the cell viability assay. CONCLUSIONS AND RELEVANCE In this in vivo study, EMR produces shape changes in the intact pinnae of rabbits. A short application of 4 V or 5 V can achieve adequate reshaping of the pinnae. Tissue injury around the electrodes is modest in spatial distribution. This study provides a more optimal set of EMR variables and a critical step toward evaluation of EMR in clinical trials. LEVEL OF EVIDENCE NA. PMID:27101542

Multiple retentive means for prosthetic restoration of a large facial defect - a case report.

PubMed

Abdulhadi, Laith Mahmoud

2010-01-01

A 70-year-old man who suffered from extensive extra and intraoral defects was rehabilitated with a prosthesis using multiple retaining means. The treatment was performed in two parts: externally involving the construction of an episthesis supported only by the remaining intact boundaries of the defect and retained by mini-dental implants and spectacle frame with a modified ear hook; and intraorally by an acrylic resin obturator to restore the function of the hemi-sectioned hard and soft palate. The episthesis was securely retained with minimal movement and/or dislodgment of the prosthesis during function. Multiple retentive techniques may be used to fix heavy external prostheses as an alternative to conventional implants or biological adhesives.

Involvement of Ubiquitin-Editing Protein A20 in Modulating Inflammation in Rat Cochlea Associated with Silver Nanoparticle-Induced CD68 Upregulation and TLR4 Activation

NASA Astrophysics Data System (ADS)

Feng, Hao; Pyykkö, Ilmari; Zou, Jing

2016-05-01

Silver nanoparticles (AgNPs) were shown to temporarily impair the biological barriers in the skin of the external ear canal, mucosa of the middle ear, and inner ear, causing partially reversible hearing loss after delivery into the middle ear. The current study aimed to elucidate the molecular mechanism, emphasizing the TLR signaling pathways in association with the potential recruitment of macrophages in the cochlea and the modulation of inflammation by ubiquitin-editing protein A20. Molecules potentially involved in these signaling pathways were thoroughly analysed using immunohistochemistry in the rat cochlea exposed to AgNPs at various concentrations through intratympanic injection. The results showed that 0.4 % AgNPs but not 0.02 % AgNPs upregulated the expressions of CD68, TLR4, MCP1, A20, and RNF11 in the strial basal cells, spiral ligament fibrocytes, and non-sensory supporting cells of Corti's organ. 0.4 % AgNPs had no effect on CD44, TLR2, MCP2, Rac1, myosin light chain, VCAM1, Erk1/2, JNK, p38, IL-1β, TNF-α, TNFR1, TNFR2, IL-10, or TGF-β. This study suggested that AgNPs might confer macrophage-like functions on the strial basal cells and spiral ligament fibrocytes and enhance the immune activities of non-sensory supporting cells of Corti's organ through the upregulation of CD68, which might be involved in TLR4 activation. A20 and RNF11 played roles in maintaining cochlear homeostasis via negative regulation of the expressions of inflammatory cytokines.

3D-printed pediatric endoscopic ear surgery simulator for surgical training.

PubMed

Barber, Samuel R; Kozin, Elliott D; Dedmon, Matthew; Lin, Brian M; Lee, Kyuwon; Sinha, Sumi; Black, Nicole; Remenschneider, Aaron K; Lee, Daniel J

2016-11-01

Surgical simulators are designed to improve operative skills and patient safety. Transcanal Endoscopic Ear Surgery (TEES) is a relatively new surgical approach with a slow learning curve due to one-handed dissection. A reusable and customizable 3-dimensional (3D)-printed endoscopic ear surgery simulator may facilitate the development of surgical skills with high fidelity and low cost. Herein, we aim to design, fabricate, and test a low-cost and reusable 3D-printed TEES simulator. The TEES simulator was designed in computer-aided design (CAD) software using anatomic measurements taken from anthropometric studies. Cross sections from external auditory canal samples were traced as vectors and serially combined into a mesh construct. A modified tympanic cavity with a modular testing platform for simulator tasks was incorporated. Components were fabricated using calcium sulfate hemihydrate powder and multiple colored infiltrants via a commercial inkjet 3D-printing service. All components of a left-sided ear were printed to scale. Six right-handed trainees completed three trials each. Mean trial time (n = 3) ranged from 23.03 to 62.77 s using the dominant hand for all dissection. Statistically significant differences between first and last completion time with the dominant hand (p < 0.05) and average completion time for junior and senior residents (p < 0.05) suggest construct validity. A 3D-printed simulator is feasible for TEES simulation. Otolaryngology training programs with access to a 3D printer may readily fabricate a TEES simulator, resulting in inexpensive yet high-fidelity surgical simulation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Glass Particulate Contamination from Medications Aspirated from Glass Ampules: Comparison of Filtered Versus Non-Filtered Needles

DTIC Science & Technology

1994-09-01

with giant cells found in the spleen and lungs. A second experiment 3 (Brewer & Dunning, 1947) was conducted where 1,089 mice were injected...crystals, or starch. They conducted experiments where rabbits received I I.V. normal saline via the ear vein. Each rabbit received a different volume...conducted a similar experiment examining the incidence of drug contamination with particles from the external surface of glass ampules. Methylene blue

Congenital cholesteatoma of the infratemporal fossa with congenital aural atresia and mastoiditis: a case report.

PubMed

Abdel-Aziz, Mosaad

2012-06-25

Congenital cholesteatoma may be expected in abnormally developed ear, it may cause bony erosion of the middle ear cleft and extend to the infratemporal fossa. We present the first case of congenital cholesteatoma of the infratemporal fossa in a patient with congenital aural atresia that has been complicated with acute mastoiditis. A sixteen year old Egyptian male patient presented with congenital cholesteatoma of the infratemporal fossa with congenital aural atresia complicated with acute mastoiditis. Two weeks earlier, the patient suffered pain necessitating hospital admission, magnetic resonance imaging revealed a soft tissue mass in the right infratemporal fossa. On presentation to our institute, Computerized tomography was done as a routine, it proved the diagnosis of mastoiditis, pure tone audiometry showed an air-bone gap of 60 dB. Cortical mastoidectomy was done for treatment of mastoiditis, removal of congenital cholesteatoma was carried out with reconstruction of external auditory canal. Follow-up of the patient for 2 years and 3 months showed a patent, infection free external auditory canal with an air-bone gap has been reduced to 35db. One year after the operation; MRI was done and it showed no residual or recurrent cholesteatoma. Congenital cholesteatoma of the infratemporal fossa in cases of congenital aural atresia can be managed safely even if it was associated with mastoiditis. It is an original case report of interest to the speciality of otolaryngology.

Selective attention reduces physiological noise in the external ear canals of humans. I: Auditory attention

PubMed Central

Walsh, Kyle P.; Pasanen, Edward G.; McFadden, Dennis

2014-01-01

In this study, a nonlinear version of the stimulus-frequency OAE (SFOAE), called the nSFOAE, was used to measure cochlear responses from human subjects while they simultaneously performed behavioral tasks requiring, or not requiring, selective auditory attention. Appended to each stimulus presentation, and included in the calculation of each nSFOAE response, was a 30-ms silent period that was used to estimate the level of the inherent physiological noise in the ear canals of our subjects during each behavioral condition. Physiological-noise magnitudes were higher (noisier) for all subjects in the inattention task, and lower (quieter) in the selective auditory-attention tasks. These noise measures initially were made at the frequency of our nSFOAE probe tone (4.0 kHz), but the same attention effects also were observed across a wide range of frequencies. We attribute the observed differences in physiological-noise magnitudes between the inattention and attention conditions to different levels of efferent activation associated with the differing attentional demands of the behavioral tasks. One hypothesis is that when the attentional demand is relatively great, efferent activation is relatively high, and a decrease in the gain of the cochlear amplifier leads to lower-amplitude cochlear activity, and thus a smaller measure of noise from the ear. PMID:24732069

Rehabilitation of a missing ear with an implant retained auricular prosthesis

PubMed Central

Guttal, Satyabodh Sheshraj; Shanbhag, Shruti; Kulkarni, Sudhindra S.; Thakur, Srinath L.

2015-01-01

Burns can leave a patient with a severely debilitating disability even after treatment. The objectives of burn rehabilitation are to minimize the adverse effects caused by the injury while rehabilitating the patient's physical and psychological well-being, maximizing social integration. Long-term success of maxillofacial prostheses mainly depends on the retention. Extra oral implant retained prostheses have proved to be a predictable treatment option for maxillofacial rehabilitation. Replacement of a severely deformed external ear with burned tissues may be satisfactorily accomplished by a cosmetic prosthesis anchored by implants integrated in the skull. The use of such implants is now a well-recognized method for creating a stable result in maxillofacial rehabilitation. This case report describes a safe, simple and economical method for the rehabilitation of a patient with missing right auricle using an implant supported silicone prosthesis. The implant was placed in the mastoid region of the temporal bone. Reconstruction of the ear was done with auricular silicone prosthesis, retained using magnets incorporated in an autopolymerizing resin shim to decrease the weight of the prosthesis on a single implant. This method eliminates the need of tedious laboratory procedures and exact casting and fitting requirements of a metal substructure while minimizing the overall weight and cost of the prosthesis while maintaining adequate support, esthetics and retention of the prosthesis. PMID:26929490

Comparative study of carotenoids, catalase and radical formation in human and animal skin.

PubMed

Haag, S F; Bechtel, A; Darvin, M E; Klein, F; Groth, N; Schäfer-Korting, M; Bittl, R; Lademann, J; Sterry, W; Meinke, M C

2010-01-01

Animal skin is widely used in dermatological free radical research. Porcine ear skin is a well-studied substitute for human skin. The use of bovine udder skin is rare but its high carotenoid content makes it particularly appropriate for studying the redox state of the skin. Yet, information on the suitability of animal skin for the study of external hazard effects on the redox state of human skin has been lacking. In this study, we investigated the activity of the antioxidant enzyme catalase and the carotenoid content defining the redox status as well as UV-induced radical formation of human, porcine ear and bovine udder skin ex vivo. In human skin only low levels of radical formation were detected following UV irradiation, whereas bovine skin contains the highest amount of carotenoids but the lowest amount of catalase. Porcine ear skin does not exhibit a carotenoid signal but its catalase activity is close to human skin. Therefore, radical formation can neither be correlated to the amount of catalase nor to the amount of carotenoids in the skin. All skin types can be used for electron paramagnetic resonance-based detection of radicals, but porcine skin was found to be the most suitable type. Copyright 2010 S. Karger AG, Basel.

Saethre-Chotzen syndrome, Pro136His TWIST mutation, hearing loss, and external and middle ear structural anomalies: report on a Brazilian family.

PubMed

Lamônica, Dionísia A C; Maximino, Luciana P; Feniman, Mariza Ribeiro; Silva, Greyce K; Zanchetta, Sthella; Abramides, Dagma V M; Passos-Bueno, Maria Rita; Rocha, Kátia; Richieri-Costa, Antonio

2010-09-01

To describe the clinical, speech, hearing, and imaging findings in three members of a Brazilian family with Saethre-Chotzen syndrome (SCS) who presented some unusual characteristics within the spectrum of the syndrome. Clinical evaluation was performed by a multidisciplinary team. Direct sequencing of the polymerase chain reaction-amplified coding region of the TWIST1 gene, routine and electrophysiological hearing evaluation, speech evaluation, and imaging studies through computed tomography (CT) scan and magnetic resonance imaging (MRI) were performed. TWIST1 gene analysis revealed a Pro136His mutation in all patients. Hearing evaluation showed peripherial and mixed hearing loss in two of the patients, one of them with severe unilateral microtia. Computed tomography scan showed structural middle ear anomalies, and MRI showed distortion of the skull contour as well as some of the brain structures. We report a previously undescribed TWIST1 gene mutation in patients with SCS. There is evidence that indicates hearing loss (conductive and mixed) can be related both with middle ear (microtia, high jugular bulb, and enlarged vestibules) as well as with brain stem anomalies. Here we discuss the relationship between the gene mutation and the clinical, imaging, speech, and hearing findings.

Extensively remodeled, fractured cetacean tympanic bullae show that whales can survive traumatic injury to the ears.

PubMed

Yamato, Maya; Khidas, Kamal; Pyenson, Nicholas D; Fordyce, R Ewan; Mead, James G

2016-01-01

Underwater human activities and anthropogenic noise in our oceans may be a major source of habitat degradation for marine life. This issue was highlighted by the opening of the United States Eastern Seaboard for seismic oil and gas exploration in 2014, which generated massive media coverage and widespread concern that seismic surveys could kill or deafen whales. We discovered 11 new specimens of fractured and healed cetacean ear bones, out of a survey of 2127 specimens housed in museum collections. This rare condition has been previously reported only in two specimens of blue whales (Balaenoptera musculus) from the early 1900s, summarized by Fraser & Purves (1953). All of our new specimens are represented by species for which this condition had never been reported previously, including both baleen and toothed whales. The baleen whale specimens (Balaenoptera physalus, Balaenoptera borealis, Balaenoptera acutorostrata) were collected during Canadian commercial whaling operations in the Atlantic Ocean in the 1970s; the specimens include ear bones with well-healed fractures, demonstrating that baleen whales are capable of overcoming traumatic injury to the ears. The toothed whale specimens (Delphinus sp., Berardius bairdii) were found dead on beaches in 1972 and 2001, respectively, with less remodeled fractures. Thus, ear injuries may be more lethal to the echolocating toothed whales, which rely on hearing for navigation and foraging. We explore several hypotheses regarding how these injuries could have occurred, and conclude that the most parsimonious explanations appear to be both direct and indirect effects of lytic processes from disease or calcium depletion, or damage from external pressure waves. Although further research is required to confirm whether the fractures resulted from natural or human-induced events, this study underscores the importance of museum collections and the work of stranding networks in understanding the potential effects of modern human activities on marine mammal health. © 2015 Anatomical Society.

Comparative physiology of sound localization in four species of owls.

PubMed

Volman, S F; Konishi, M

1990-01-01

Bilateral ear asymmetry is found in some, but not all, species of owls. We investigated the neural basis of sound localization in symmetrical and asymmetrical species, to deduce how ear asymmetry might have evolved from the ancestral condition, by comparing the response properties of neurons in the external nucleus of the inferior colliculus (ICx) of the symmetrical burrowing owl and asymmetrical long-eared owl with previous findings in the symmetrical great horned owl and asymmetrical barn owl. In the ICx of all of these owls, the neurons had spatially restricted receptive fields, and auditory space was topographically mapped. In the symmetrical owls, ICx units were not restricted in elevation, and only azimuth was mapped in ICx. In the barn owl, the space map is two-dimensional, with elevation forming the second dimension. Receptive fields in the long-eared owl were somewhat restricted in elevation, but their tuning was not sharp enough to determine if elevation is mapped. In every species, the primary cue for azimuth was interaural time difference, although ICx units were also tuned for interaural intensity difference (IID). In the barn owl, the IIDs of sounds with frequencies between about 5 and 8 kHz vary systematically with elevation, and the IID selectivity of ICx neurons primarily encodes elevation. In the symmetrical owls, whose ICx neurons do not respond to frequencies above about 5 kHz, IID appears to be a supplementary cue for azimuth. We hypothesize that ear asymmetry can be exploited by owls that have evolved the higher-frequency hearing necessary to generate elevation cues. Thus, the IID selectivity of ICx neurons in symmetrical owls may preadapt them for asymmetry; the neural circuitry that underlies IID selectivity is already present in symmetrical owls, but because IID is not absolutely required to encode azimuth it can come to encode elevation in asymmetrical owls.

A new species of pine anole from the Sierra Madre del Sur in Oaxaca, Mexico (Reptilia, Squamata, Dactyloidae: Anolis).

PubMed

Köhler, Gunther; Pérez, Raúl Gómez Trejo; Petersen, Claus Bo P; de La Cruz, Fausto R Mendez

2014-01-09

We describe the new species Anolis peucephilus sp. nov. from the Pacific versant of southern Mexico. Anolis peucephilus differs from all congeners by having a combination of (1) smooth ventral scales; (2) usually a patch of three greatly enlarged supraocular scales; (3) extremely short hind legs, longest toe of adpressed hind leg reaching to a point between levels of axilla and ear opening, ratio shank length/snout-vent length 0.18-0.21; (4) circumnasal usually in contact with first supralabial; and (5) a large yellowish orange dewlap in males and a very small to small white dewlap in females. In external morphology, A. peucephilus is most similar to A. omiltemanus from which it differs by having even shorter hind legs with the longest toe of adpressed hind leg reaching to a point between levels of axilla and ear opening (versus usually to ear opening, occasionally to slightly beyond ear opening or to a point between shoulder and ear opening in A. omiltemanus), a slightly larger dewlap in females, to 64 mm2 (versus to 41 mm2 in A. omiltemanus), the circumnasal usually in contact with the first supralabial (versus those scales separated by the presence of a subnasal in A. omiltemanus), and 4-6 internasal scales in the new species (versus usually 6-7 in A. omiltemanus). Furthermore, A. peucephilus differs from A. omiltemanus in hemipenial morphology (no finger-like processus on asulcate side in A. peucephilus versus such a processus present in A. omiltemanus). Also, in a preliminary molecular genetic analysis of the mitochondrial CO1 gene fragment, A. peucephilus has a genetic distance of 11.5% from A. omiltemanus. Anolis peucephilus was collected at night while the lizards were sleeping in pine trees, 2-10 m above the ground.

First branchial cleft anomaly.

PubMed Central

Al-Fallouji, M. A.; Butler, M. F.

1983-01-01

A 15-year-old girl presented with a cystic swelling since birth behind the ramus of the right mandible and diagnosed clinically as a dermoid cyst. Surgical exploration, however, showed that it was closely related to the external auditory canal, with an extension running medially behind the parotid gland and ending in the bony middle ear. The facial nerve was closely related to the deep part of the cyst. Such an anatomical position indicates that this was a first branchial cleft anomaly. Surgical excision of the cyst was performed. PMID:6622327

Recovering faces from memory: the distracting influence of external facial features.

PubMed

Frowd, Charlie D; Skelton, Faye; Atherton, Chris; Pitchford, Melanie; Hepton, Gemma; Holden, Laura; McIntyre, Alex H; Hancock, Peter J B

2012-06-01

Recognition memory for unfamiliar faces is facilitated when contextual cues (e.g., head pose, background environment, hair and clothing) are consistent between study and test. By contrast, inconsistencies in external features, especially hair, promote errors in unfamiliar face-matching tasks. For the construction of facial composites, as carried out by witnesses and victims of crime, the role of external features (hair, ears, and neck) is less clear, although research does suggest their involvement. Here, over three experiments, we investigate the impact of external features for recovering facial memories using a modern, recognition-based composite system, EvoFIT. Participant-constructors inspected an unfamiliar target face and, one day later, repeatedly selected items from arrays of whole faces, with "breeding," to "evolve" a composite with EvoFIT; further participants (evaluators) named the resulting composites. In Experiment 1, the important internal-features (eyes, brows, nose, and mouth) were constructed more identifiably when the visual presence of external features was decreased by Gaussian blur during construction: higher blur yielded more identifiable internal-features. In Experiment 2, increasing the visible extent of external features (to match the target's) in the presented face-arrays also improved internal-features quality, although less so than when external features were masked throughout construction. Experiment 3 demonstrated that masking external-features promoted substantially more identifiable images than using the previous method of blurring external-features. Overall, the research indicates that external features are a distractive rather than a beneficial cue for face construction; the results also provide a much better method to construct composites, one that should dramatically increase identification of offenders.

[Otoacoustic emissions of full-term and preterm neonates].

PubMed

Kashiwamura, M; Ohwatari, R; Satoh, N; Kawanami, M; Chida, E; Sakamoto, T; Fukuda, S; Inuyama, Y

1996-01-01

Transiently evoked otoacoustic emission (TEOAE), distortion product otoacoustic emission (DPOAE), and spontaneous otoacoustic emission (SOAE) were measured in 45 full-term neonates (68 ears) and 12 preterm neonates (20 ears) with ILO88 & 92. Measurements were performed in the nursery of the obstetrics ward or NICU (not sound proof room) under natural sleeping condition after nursing. No sedating agent was used. TEOAEs were rated "good response" in 61 (89.7%) of 68 full-term neonate ears. DPOAEs were rated "good response" in 40 (71.4%) of 56 full-term neonate ears. SOAEs were detectable in 25 (62.5%) of 40 full-term neonate ears. Considering the high positive rate of TEOAE in full-term neonates and the easy and noninvasive method of measurement, we concluded that TEOAE is useful for auditory screening in neonates. There was failure to detect TEOAEs in 7 ears and the measurements were all performed within 6 days after birth. Some reports claim that residual amnion in the external auditory canal or the middle ear in the first few days after birth causes slight hearing loss. Thus, we expected that making the measurements more than 7 days after birth might yield higher "good response" rates. We sometimes found that the Total Echo Powers of TEOAEs were reduced by the poor condition of the ear probe. Thus, we must be very careful in regard to this technical problem in order to perform accurate examinations. Because of its lower "good response" rate, DPOAE was not as useful for screening as TEOAE. Because of the movements or respiratory noises of the newborn infants, it was hard to detect reliable DPOAEs, particularly in the low frequency range. On the other hand, because of its frequency specificity, particurally at high frequencies, DPOAE will be useful for detecting the partial hearing impairment such as congenital high-tone hearing impairment. It would be difficult to use SOAE as a clinical test. Because it is not an evoked response, its mechanism of generation is not well understood. We expect that following longitudinal changes in SOAE in neonates may yield some information about it. We measured mainly TEOAE in preterm neonates because we had to complete the measurements as soon as possible. High Total Echo Powers of TEOAEs were recorded in most infants over 38 weeks of PCA (post conceptional age). The earliest case showed reliable TEOAE at 35 weeks PCA. In most cases that could be measured twice on different days, the Total Echo Powers of TEOAE, were higher in the second time. We therefore concluded that TEOAE might serve as an examination for monitoring the maturation of preterm neonate hearing.

Preliminary Investigations on Therapy Thresholds for Laser Dosimetry, Cryogen Spray Cooling Duration, and Treatment Cycles for Laser Cartilage Reshaping in the New Zealand White Rabbit Auricle

PubMed Central

Chlebicki, Cara A.; Protsenko, Dmitry E.; Wong, Brian J.

2014-01-01

Previous studies have demonstrated the feasibility of laser irradiation (λ=1.45 μm) in tandem with cryogen spray cooling (CSC) to reshape rabbit auricular cartilage using total energy density of 14 J/cm2. The aim of this study was to further explore and identify the dosimetry parameter space for laser output energy, CSC duration, and treatment cycles required to achieve shape change while limiting skin and cartilage injury. Ten New Zealand white rabbits were treated with the 1.45 μm diode laser combined with cryogen spray cooling (Candela Smoothbeam™, Candela Co., Wayland, MA). The ear's central portion was bent around a cylindrical jig and irradiated in consecutive spots of 6 mm diameter (13 J/cm2 or 14 J/cm2 per spot) along 3 rows encompassing the bend. CSC was delivered during irradiation in cycles consisting of 25-35 ms. At thin and thick portions of the ear, 4-7 and 6-10 treatment cycles were delivered, respectively. After surgery, ears were examined and splinted for 6 weeks. Treatment parameters resulting in acceptable (Grades 1 & 2) and unacceptable (Grade 3) skin injuries for thick and thin regions were identified and shape change was observed. Confocal and histological analysis of cartilage tissue revealed several outcomes correlating to laser dosimetry, CSC duration, and treatment cycles. These outcomes included expansion of cartilage layers (thickening), partial cartilage injuries, and full thickness cartilage injuries. We determined therapy thresholds for laser output energy, cryogen spray cooling duration, and treatment cycles in the rabbit auricular model. These parameters are a starting point for future clinical procedures aimed at correcting external ear deformities. PMID:24202858

In vitro activity of an ear rinse containing tromethamine, EDTA, benzyl alcohol and 0.1% ketoconazole on Malassezia organisms from dogs with otitis externa.

PubMed

Cole, Lynette K; Luu, Dao H; Rajala-Schultz, Paivi J; Meadows, Cheyney; Torres, Audrey H

2007-04-01

The purpose of this study was to evaluate the in vitro activity of an ear rinse containing tromethamine, EDTA, benzyl alcohol and 0.1% ketoconazole in purified water on Malassezia organisms from dogs with otitis externa. Malassezia organisms were collected from ear swab samples from the external ear canal of 19 dogs with otitis externa plus one control strain of Malassezia pachydermatis. Three test solutions were evaluated: ER (EDTA, tromethamine, benzyl alcohol), ER + keto (EDTA, tromethamine, benzyl alcohol, ketoconazole), and H2O (purified water). Ten-millilitre aliquots of each test solution was transferred into 20 tubes and inoculated with one of the isolates (1 tube per isolate: 19 clinical and 1 control strain). Samples were retrieved from each tube at five time points (0, 15, 30, 45 and 60 min), transferred to Petri dishes, mixed with Sabouraud dextrose agar supplemented with 0.5% Tween 80 and incubated. Following incubation, the plates were examined for growth and colonies counted as colony-forming units per millilitre. The data were analysed using a repeated measures analysis, with pair-wise comparisons of solution-time combinations. There was a significant reduction in Malassezia growth in ER + keto at all time points (P < 0.0001) compared to time zero. Neither ER nor H2O had any effect on the growth of Malassezia. ER + keto was significantly more effective in reducing Malassezia growth (P < 0.0001) at all time points compared to both ER and H2O. ER + keto may be useful in the treatment of Malassezia otitis externa. Future studies should be performed to evaluate the in vivo efficacy of ER + keto as treatment for otic infections caused by Malassezia.

Preliminary investigations on therapy thresholds for laser dosimetry, cryogen spray cooling duration, and treatment cycles for laser cartilage reshaping in the New Zealand white rabbit auricle.

PubMed

Chlebicki, Cara A; Protsenko, Dmitry E; Wong, Brian J

2014-05-01

Previous studies have demonstrated the feasibility of laser irradiation (λ = 1.45 μm) in tandem with cryogen spray cooling (CSC) to reshape rabbit auricular cartilage using a total energy density of 14 J/cm(2). The aim of this study was to further explore and identify the dosimetry parameter space for laser output energy, CSC duration, and treatment cycles required to achieve shape change while limiting skin and cartilage injury. Ten New Zealand white rabbits were treated with the 1.45 μm diode laser combined with cryogen spray cooling (Candela Smoothbeam™, Candela Co., Wayland, MA, USA). The ear's central portion was bent around a cylindrical jig and irradiated in consecutive spots of 6 mm diameter (13 or 14 J/cm(2) per spot) along three rows encompassing the bend. CSC was delivered during irradiation in cycles consisting of 25-35 ms. At thin and thick portions of the ear, 4-7 and 6-10 treatment cycles were delivered, respectively. After surgery, ears were examined and splinted for 6 weeks. Treatment parameters resulting in acceptable (grades 1 and 2) and unacceptable (grade 3) skin injuries for thick and thin regions were identified, and shape change was observed. Confocal and histological analysis of cartilage tissue revealed several outcomes correlating to laser dosimetry, CSC duration, and treatment cycles. These outcomes included expansion of cartilage layers (thickening), partial cartilage injuries, and full-thickness cartilage injuries. We determined therapy thresholds for laser output energy, cryogen spray cooling duration, and treatment cycles in the rabbit auricular model. These parameters are a starting point for future clinical procedures aimed at correcting external ear deformities.

Tympanomastoid cholesterol granulomas: Immunohistochemical evaluation of angiogenesis.

PubMed

Iannella, Giannicola; Di Gioia, Cira; Carletti, Raffaella; Magliulo, Giuseppe

2017-08-01

This study investigates the immunohistochemical expression of vascular endothelial growth factor (VEGF) and CD34 in patients treated for middle ear and mastoid cholesterol granulomas to evaluate the angiogenesis and vascularization of this type of lesion. A correlation between the immunohistochemical data and the radiological and intraoperative evidence of temporal bone marrow invasion and blood source connection was performed to validate this hypothesis. Retrospective study. Immunohistochemical expression of VEGF and CD34 in a group of 16 patients surgically treated for cholesterol granuloma was examined. Middle ear cholesteatomas with normal middle ear mucosa and external auditory canal skin were used as the control groups. The radiological and intraoperative features of cholesterol granulomas were also examined. In endothelial cells, there was an increased expression of angiogenetic growth factor receptors in all the cholesterol granulomas in this study. The quantitative analysis of VEGF showed a mean value of 37.5, whereas the CD34 quantitative analysis gave a mean value of 6.8. Seven patients presented radiological or intraoperative evidence of bone marrow invasion, hematopoietic potentialities, or blood source connections that might support the bleeding theory. In all of these cases there was computed tomography or intraoperative evidence of bone erosion of the middle ear and/or temporal bone structures. The mean values of VEGF and CD34 were 41.1 and 7.7, respectively. High values of VEGF and CD34 are present in patients with cholesterol granulomas. Upregulation of VEGF and CD34 is indicative of a remarkable angiogenesis and a widespread vascular concentration in cholesterol granulomas. 3b. Laryngoscope, 127:E283-E290, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Malassezia pachydermatis and M nana predominate amongst the cutaneous mycobiota of Sphynx cats.

PubMed

Volk, Andrea V; Belyavin, Clare E; Varjonen, Katarina; Cadiergues, Marie-Christine; Stevens, Kim B; Bond, Ross

2010-12-01

Carriage of Malassezia species yeasts in healthy Sphynx cats was compared with that in Devon Rex cats (DRC), Cornish Rex cats (CRC) and domestic shorthair (DSH) cats. Swab samples from the external ear, anus and claw folds, and contact plate samples from the axillae and groins, were incubated on modified Dixon's agar at 32°C for 7 days. Malassezia species were isolated from all 18 Sphynx cats; M pachydermatis accounted for 118/140 isolates. Of 20 isolates of M nana, 16 were recovered from the ear canal. M slooffiae was isolated from the claw fold of one cat and the left groin of another. The high counts of M pachydermatis obtained from the axillae, groins and claw folds of the Sphynx cats exceeded those of healthy DSH, CRC and DRC; axillary populations were comparable to those of seborrhoeic DRC. These data support recent reports of high Malassezia species colonisation in Sphynx cats. Copyright © 2010 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

Assessment of edema volume in skin upon injury in a mouse ear model with optical coherence tomography

PubMed Central

Qin, Wan

2017-01-01

Accurate measurement of edema volume is essential for the investigation of tissue response and recovery following a traumatic injury. The measurements must be noninvasive and repetitive over time so as to monitor tissue response throughout the healing process. Such techniques are particularly necessary for the evaluation of therapeutics that are currently in development to suppress or prevent edema formation. In this study, we propose to use optical coherence tomography (OCT) technique to image and quantify edema in a mouse ear model where the injury is induced by a superficial-thickness burn. Extraction of edema volume is achieved by an attenuation compensation algorithm performed on the three-dimensional OCT images, followed by two segmentation procedures. In addition to edema volume, the segmentation method also enables accurate thickness mapping of edematous tissue, which is an important characteristic of the external symptoms of edema. To the best of our knowledge, this is the first method for noninvasively measuring absolute edema volume. PMID:27282161

Soft-tissue reactions following irradiation of primary brain and pituitary tumors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baglan, R.J.; Marks, J.E.

1981-04-01

One hundred and ninety-nine patients who received radiation therapy for a primary brain or pituitary tumor were studied for radiation-induced soft-tissue reactions of the cranium, scalp, ears and jaw. The frequency of these reactions was studied as a function of: the radiation dose 5 mm below the skin surface, dose distribution, field size and fraction size. Forty percent of patients had complete and permanent epilation, while 21% had some other soft-tissue complication, including: scalp swelling-6%, external otitis-6%, otitis media-5%, ear swelling-4%, etc. The frequency of soft-tissue reactions correlates directly with the radiation dose at 5 mm below the skin surface.more » Patients treated with small portals (<70 cm/sup 2/) had few soft-tissue reactions. The dose to superficial tissues, and hence the frequency of soft-tissue reactions can be reduced by: (1) using high-energy megavoltage beams; (2) using equal loading of beams; and (3) possibly avoiding the use of electron beams.« less

High-risk squamous cell carcinoma of the ear - A potential role for sentinel node biopsy.

PubMed

Beecher, Suzanne; Wrafter, Paula F; Joyce, Cormac W; Regan, Padraic J; Kelly, Jack L

2017-09-01

Squamous cell carcinomas (SCCs) of the external ear have a significant rate of metastasis. The purpose of this study was to present analyzed factors associated with auricular SCC metastasis in order to identify a group that may benefit from sentinel lymph node biopsy (SLNB). We performed a retrospective review of all operable SCCs between 2009 and 2014. The association between high-risk features and metastasis were analyzed. One hundred eighty-nine auricular SCCs were excised. Local recurrence was noted in 11% and 9.5% developed metastases. Cartilage, perineural, and lymphovascular invasion were significantly associated with metastasis, as were increased tumor depth and diameter (P < .001). All patients with metastasis developed nodal disease. Factors, including poor differentiation, perineural, cartilage, and lymphovascular invasion, are associated with auricular SCC metastasis. Patients with 2 or more high-risk features may benefit from SLNB in order to identify and treat early nodal disease and possibly reduce the risk of further spread. © 2017 Wiley Periodicals, Inc.

Thaumasioscolex didelphidis n. gen., n. sp. (Eucestoda: Proteocephalidae) from the black-eared opossum Didelphis marsupialis from Mexico, the first proteocephalidean tapeworm from a mammal.

PubMed

Cañeda-Guzmán, I C; de Chambrier, A; Scholz, T

2001-06-01

Thaumasioscolex didelphidis n. gen., n. sp. is described from the intestine of the black-eared opossum Didelphis marsupialis L. (Marsupialia: Didelphidae) from Los Tuxtlas, Veracruz, Mexico. The new genus differs from all proteocephalidean genera in the morphology of the scolex that is formed by 4 well separated lobes each containing 1 noncircular sucker opening laterally inside the exterolateral cavity, a large-sized body (length up to 1 m), a large number of testes, the shape of gravid proglottids that are inversely craspedote (the anterior border of a proglottid overlaps the posterior border of a preceding proglottid), eggs in groups mostly of 4-6 eggs each, and an embryophore bearing digitiform projections on its external surface. This is the first tapeworm of the Proteocephalidea, the members of which were previously reported exclusively from poikilotherm vertebrates (freshwater fishes, amphibians, and reptiles), found in a homoiotherm vertebrate.

Craniofacial abnormalities among patients with Edwards Syndrome

PubMed Central

Rosa, Rafael Fabiano M.; Rosa, Rosana Cardoso M.; Lorenzen, Marina Boff; Zen, Paulo Ricardo G.; Graziadio, Carla; Paskulin, Giorgio Adriano

2013-01-01

OBJECTIVE To determine the frequency and types of craniofacial abnormalities observed in patients with trisomy 18 or Edwards syndrome (ES). METHODS This descriptive and retrospective study of a case series included all patients diagnosed with ES in a Clinical Genetics Service of a reference hospital in Southern Brazil from 1975 to 2008. The results of the karyotypic analysis, along with clinical data, were collected from medical records. RESULTS: The sample consisted of 50 patients, of which 66% were female. The median age at first evaluation was 14 days. Regarding the karyotypes, full trisomy of chromosome 18 was the main alteration (90%). Mosaicism was observed in 10%. The main craniofacial abnormalities were: microretrognathia (76%), abnormalities of the ear helix/dysplastic ears (70%), prominent occiput (52%), posteriorly rotated (46%) and low set ears (44%), and short palpebral fissures/blepharophimosis (46%). Other uncommon - but relevant - abnormalities included: microtia (18%), orofacial clefts (12%), preauricular tags (10%), facial palsy (4%), encephalocele (4%), absence of external auditory canal (2%) and asymmetric face (2%). One patient had an initial suspicion of oculo-auriculo-vertebral spectrum (OAVS) or Goldenhar syndrome. CONCLUSIONS: Despite the literature description of a characteristic clinical presentation for ES, craniofacial alterations may be variable among these patients. The OAVS findings in this sample are noteworthy. The association of ES with OAVS has been reported once in the literature. PMID:24142310

Study of a temporal bone of Homo heildelbergensis.

PubMed

Urquiza, Rafael; Botella, Miguel; Ciges, Miguel

2005-05-01

The characteristic features of the Hh specimen conformed to those of other Pleistocene human fossils, indicating strong cranial structures and a heavy mandible. The mastoid was large and suggested a powerful sternocleidomastoid muscle. The inner ear and tympanic cavities were similar in size and orientation, suggesting that their functions were probably similar. Our observations suggest that the left ear of this Hh specimen was healthy. The large canaliculo-fenestral angle confirms that this ancestor was bipedal. It also strongly suggests that Hh individuals were predisposed to develop certain pathologies of the labyrinth capsule associated with bipedalism, in particular otosclerosis. We studied a temporal bone of Homo heidelbergensis (Hh) in order to investigate the clinical and physiological implications of certain morphological features, especially those associated with the evolutionary reorganization of the inner ear. The bone, found in a breach of a cave near MAáaga in southern Spain, together with Middle Upper Pleistocene faunal remains, is >300000 years old. Four analytical methods were employed. A 3D high-resolution surface laser scan was used for anatomical measurements. For the sectional analysis of the middle and inner ears of Hh we used high-resolution CT, simultaneously studying a normal temporal bone from Homo sapiens sapiens (Hss). To study the middle and inner ear spaces we used 3D reconstruction CT preceded by an intra-bone air shielding technique. To examine the tympanic cavities and measure the canaliculo fenestral angle, we used a special minimally invasive endoscopic procedure. The surface, sectional and 3D CT examinations showed that the Hh specimen was generally more robust and larger than the Hss specimen. It had a large glenoid fossa. The external meatus was wide and deep. The middle ear, and especially the mastoid, was large and widely pneumatized. There were no appreciable differences in the position and size of the labyrinthine spaces and tympanic cavity. The dimensions of the semicircular canals were similar to those of the Hss specimen. Endoscopy revealed normal, healthy tympanic walls and an ossicle fragment in the atticum that probably belonged to the body of the malleus. The diameters of the fallopian duct and the tympanic opening of the Eustachian tube were large. The canaliculo-fenestral angle was approximately 114 degrees

Arteriovenous malformation of the external ear: a clinical assessment with a scoping review of the literature.

PubMed

Kim, Shin Hye; Han, Seung Hoon; Song, Yoonjae; Park, Chang Sik; Song, Jae-Jin

Auricular Arteriovenous Malformation of the external ear is a rarely encountered disease; in particular, arteriovenous malformation arising from the auricle, with spontaneous bleeding, has seldom been reported. In the current study, we report an unusual case of late-onset auricular arteriovenous malformation originating from the posterior auricular artery that was confirmed by computed tomographic angiography. The case was successfully managed by pre-surgical intravascular embolization followed by total lesion excision. Prompted by this case, we also present a scoping review of the literature. A case of a 60 year-old man with right auricular arteriovenous malformation treated in our tertiary care center, and 52 patients with auricular arteriovenous malformation described in 10 case reports and a retrospective review are presented. Auricular arteriovenous malformation can manifest as swelling of the ear, pulsatile tinnitus, pain, and/or bleeding. On physical examination, a pulsatile swelling and/or a tender mass is evident. When arteriovenous malformation is suspected, the lesions should be visualized using imaging modalities that optimally detect vascular lesions, and managed via embolization, mass excision, or auricular resection. Effectiveness of the various diagnostic methods used and the treatment outcomes were analyzed. Various imaging modalities including Doppler sonography, computed tomographic angiography, magnetic resonance angiography, and/or transfemoral cerebral angiography were used to diagnose 38 cases reported in the literature. In another 15 cases, no imaging was performed; treatment was determined solely by physical examination and auscultation. Of the total of 53 cases, 12 were not treated (their symptoms were merely observed) whereas 20 underwent therapeutic embolization. In total, 32 patients, including 1 patient who was not treated and 10 with persistent or aggravated arteriovenous malformation after previous embolization, underwent mass excision or auricular resection depending on the extent of the lesion. No major postoperative complication was recorded. The postoperative follow-up duration varied from 1 month to 19 years, and only one case of unresectable, residual cervicofacial arteriovenous malformation was recorded. Auricular arteriovenous malformation is a rarely encountered disease, but should be suspected if a patient presents with a swollen ear and pulsatile tinnitus. Appropriate imaging is essential for diagnosis and evaluation of the extent of disease. As embolization affords only relatively poor control, total surgical removal of the vascular mass is recommended. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Internal versus external features in triggering the brain waveforms for conjunction and feature faces in recognition.

PubMed

Nie, Aiqing; Jiang, Jingguo; Fu, Qiao

2014-08-20

Previous research has found that conjunction faces (whose internal features, e.g. eyes, nose, and mouth, and external features, e.g. hairstyle and ears, are from separate studied faces) and feature faces (partial features of these are studied) can produce higher false alarms than both old and new faces (i.e. those that are exactly the same as the studied faces and those that have not been previously presented) in recognition. The event-related potentials (ERPs) that relate to conjunction and feature faces at recognition, however, have not been described as yet; in addition, the contributions of different facial features toward ERPs have not been differentiated. To address these issues, the present study compared the ERPs elicited by old faces, conjunction faces (the internal and the external features were from two studied faces), old internal feature faces (whose internal features were studied), and old external feature faces (whose external features were studied) with those of new faces separately. The results showed that old faces not only elicited an early familiarity-related FN400, but a more anterior distributed late old/new effect that reflected recollection. Conjunction faces evoked similar late brain waveforms as old internal feature faces, but not to old external feature faces. These results suggest that, at recognition, old faces hold higher familiarity than compound faces in the profiles of ERPs and internal facial features are more crucial than external ones in triggering the brain waveforms that are characterized as reflecting the result of familiarity.

A case of direct intracranial extension of tuberculous otitis media.

PubMed

Kim, Dong-Kee; Park, Shi-Nae; Park, Kyung-Ho; Yeo, Sang Won

2014-02-01

We describe a very rare case of tuberculous otitis media (TOM) with direct intracranial extension. The patient was a 55-year-old man who presented to our ENT clinic for evaluation of severe headaches and right-sided otorrhea. A biopsy of granulation tissue obtained from the right external auditory canal demonstrated chronic inflammation that was suggestive of mycobacterial infection. Magnetic resonance imaging of the brain indicated intracranial extension of TOM through a destroyed tegmen mastoideum. After 2 months of antituberculous medication, the headaches and otorrhea were controlled, and the swelling in the external ear canal subsided greatly. Rarely does TOM spread intracranially. In most such cases, intracranial extension of tuberculosis occurs as the result of hematogenous or lymphogenous spread. In rare cases, direct spread through destroyed bone can occur, as it did in our patient.

The battle against noise in industry

NASA Astrophysics Data System (ADS)

Iudin, E. Ia.

The physiological effects of noise in manufacturing plants and other industrial facilities are discussed, and several common noise abatement methods are described. Consideration is given to the acoustic properties of three types of noise which are present in industrial plants: aerohydrodynamic noise; mechanical noise; and electromagnetic noise. Among the specific noise abatement techniques discussed are: sound isolation by means of noise-absorbant screens; insulation or noise-emitting media; and acoustic interference. The use of earplugs and external ear protectors for protection of individual workers in noisy work environments is also considered.

Otorhinolaryngologic disorders and diving accidents: an analysis of 306 divers.

PubMed

Klingmann, Christoph; Praetorius, Mark; Baumann, Ingo; Plinkert, Peter K

2007-10-01

Diving is a very popular leisure activity with an increasing number of participants. As more than 80% of the diving related problems involve the head and neck region, every otorhinolaryngologist should be familiar with diving medical standards. We here present an analysis of more than 300 patients we have treated in the past four years. Between January 2002 and October 2005, 306 patients presented in our department with otorhinological disorders after diving, or after diving accidents. We collected the following data: name, sex, age, date of treatment, date of accident, diagnosis, special aspects of the diagnosis, number of dives, diving certification, whether and which surgery had been performed, history of acute diving accidents or follow up treatment, assessment of fitness to dive and special remarks. The study setting was a retrospective cohort study. The distribution of the disorders was as follows: 24 divers (8%) with external ear disorders, 140 divers (46%) with middle ear disorders, 56 divers (18%) with inner ear disorders, 53 divers (17%) with disorders of the nose and sinuses, 24 divers (8%) with decompression illness (DCI) and 9 divers (3%) who complained of various symptoms. Only 18% of the divers presented with acute disorders. The most common disorder (24%) was Eustachian tube dysfunction. Female divers were significantly more often affected. Chronic sinusitis was found to be associated with a significantly higher number of performed dives. Conservative treatment failed in 30% of the patients but sinus surgery relieved symptoms in all patients of this group. The middle ear is the main problem area for divers. Middle ear ventilation problems due to Eustachian tube dysfunction can be treated conservatively with excellent results whereas pathology of the tympanic membrane and ossicular chain often require surgery. More than four out of five patients visited our department to re-establish their fitness to dive. Although the treatment of acute diving-related disorders is an important field for the treatment of divers, the main need of divers seems to be assessment and recovery of their fitness to dive.

The Pitfalls and Important Distances in Temporal Bone HRCT of the Subjects with High Jugular Bulbs - Preliminary Report.

PubMed

Inal, Mikail; Muluk, Nuray B; Dağ, Ersel; Arıkan, Osman K; Kara, Simay A

2015-01-01

High jugular bulb (HJB) may be detected unilaterally or bilaterally in temporal bone high resolution computerized tomography (HRCT). In this retrospective study, we investigated the pitfalls and important surgical distances in patients with unilateral and bilateral HJB via temporal bone HRCT. In this preliminary report, the study group consisted of 20 adult patients (12 male, 8 female), or 40 ears, all of which underwent temporal bone HRCT. We divided them into groups that consisted of bilateral HJB (14 ears), unilateral HJB (13 ears), and control (No HJB, 13 ears). The anotomical relationships of the sigmoid sinus, jugular bulb, and carotid artery with several landmarks in the temporal bone were studied via temporal bone axial and coronal HRCT. The shortest distances between certain points were measured. These measurements were analyzed in respect to pneumatization. Dehiscence on the jugular bulb (JB) and internal carotid artery (ICA) and the dominance of JB were also evaluated for all of the groups. In the axial sections of the temporal bone HRCTs, the sigmois sinus (SS)-external auditory canal (EAC) distance of the bilateral HJB group (14.00±1.17 mm) was significantly lower than that of the control group (16.46±2.14 mm). The JB-posteromedial points of the umbo on the ear drum (ED) distance of the bilateral HJB (6.28±1.72 mm) and the unilateral HJB groups (7.23±2.00 mm) were significantly lower than that of the control group (11.15±2.30 mm). In the coronal sections of the temporal bone HRCT, the JB-F distance of the bilateral HJB group (5.42±2.10 mm) was significantly lower than that of the control group (8.30±2.28 mm). As the mastoid pneumatisation and mastoid volume increased, the percentage of ICA-dehiscence and the percentage of JB-dehiscence increased. In subjects with well-pneumatised mastoids, the doctors should be aware of the increased risk of ICA-dehiscence and JB-dehiscence. These measurements should be done in greater series to yield more thorough knowledge.

A general review of the otolaryngologic manifestations of Down Syndrome.

PubMed

Chin, Christopher J; Khami, Maria M; Husein, Murad

2014-06-01

Down Syndrome (DS) is the most common chromosome abnormality in liveborn children. Otolaryngologists frequently encounter these patients in their practice; in one survey, 50% of DS patients had been seen by Otolaryngology at least once. As such, it is essential that the practicing Otolaryngologist is aware of the otologic, rhinologic, and laryngologic manifestations of this complex disease and comfortable in the management and treatment of these unique patients. Our goal was to provide this information in a concise and definitive document. A comprehensive literature review using PubMed was completed. The terms "Otolaryngology", "Head and neck", "Ear, nose, throat", "Down Syndrome", and "Trisomy 21" were searched in various combinations. Applicable articles that discussed the Otolaryngologic manifestations of Down Syndrome were included. In total, fifty articles were included for review. The Down Syndrome child tends to have smaller external ear canals, have higher rates of chronic ear disease, and may present with conductive, sensorineural, or mixed hearing loss. As such, DS patients should receive behaviouralaudiological testing every 6 monthsand annually after the age of three in addition to closer follow-up by an Otolaryngologist if tympanic membranes cannot be visualized or if the external auditory canals are significantly stenosed. Management should involve close follow-up and a low threshold for PE tube placement to reduce the risks for speech and language delay. Chronic rhinitis in the Down Syndrome patient is common. Retrognathia, hypotonia, and macroglossia can all cause obstructive sleep apnea (OSA) in this population and therefore each DS patient should get an overnight polysomnograph. Subglottic stenosis, vocal cord paralysis and laryngomalacia are not infrequently seen in the Down Syndrome patient. To reduce acquired subglottic stenosis, endotracheal tubes that are at least two sizes smaller than what is appropriate for the patient's age should be used. Down Syndrome is common and there are many Otolaryngologic manifestations. We recommend that this patient population visit an Otolaryngologist on a regular basis and that the practicing Otolaryngologist is comfortable with the management and treatment of the unique challenges faced with these children. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Transcanal microscope-assisted endoscopic myringoplasty in children.

PubMed

Migirov, Lela; Wolf, Michael

2015-04-01

Myringoplasty can be technically difficult in the pediatric patients due to the narrowness of the external auditory canal and the generally small size of the ear. Moreover, temporalis fascia grafts and myringoplasties for anterior perforations are more likely to fail in children. Surgical management of anterior perforations requires total exposure of the anterior angle however a microscope may fail to provide a view of the anterior edge in most of perforations. Recently, different endoscopes are used in the performance of ear surgery in general and myringoplasty in particular. Current study aimed to investigate the outcome of transcanal microscope-assisted endoscopic myringoplasty in homogenous group of children. The medical records of 22 children were retrospectively reviewed for age, perforation size and location, surgical and audiological findings, and outcome. All myringoplasties were performed by first author with a chondro-perichondrial graft that has been harvested from the tragus and placed medial to the tympanic membrane remnants, utilizing the underlay technique and 14-mm length, 3-mm diameter, 0° and 30° endoscopes. A microscope was occasionally used for removal of the sclerotic plaques and releasing adhesions surrounding the ossicles when bimanual manipulations were needed. Surgical success was defined as a tympanic membrane with no perforation, retraction, or graft lateralization for at least 18 months following surgery. Thirteen large-, 8 medium- and 1 small-sized perforations (defined as 75, 50 or 25%, respectively, of the tympanic membrane area), of which 14 were anterior, 2 central and 6 posterior marginal, were repaired. The edges of the defect could not be visualized under a microscope due to bone overhanging or a curved or narrow EAC in 8 anterior perforations. Intact tympanic membranes and dry ears were achieved in all operated children. The audiometric air conduction level (average of 0.5-3 kHz) for the entire cohort ranged between 10-51.3 dB (mean 32.8) preoperatively and between 5-35 dB (mean 18.2) postoperatively. The transcanal microscope-assisted endoscopic myringoplasty had a 100% rate of surgical success in children. This technique can be especially appropriate for patients with narrow external canals, anterior defects and bone overhang making the perforation margins barely visible under a microscope.

Malignant otitis externa in a healthy non-diabetic patient.

PubMed

Liu, Xiao-Long; Peng, Hong; Mo, Ting-Ting; Liang, Yong

2016-08-01

A healthy 60-year-old male was initially treated for external otitis, and subsequently received multiple surgeries including abscess drainage, temporal bone debridement, canaloplasty of the external auditory meatus, and fistula excision and was treated with numerous antibiotics at another hospital over a 1-year period. He was seen at our hospital on February 14, 2014 with a complaint of a non-healing wound behind the left ear and drainage of purulent fluid. He had no history of diabetes mellitus or compromised immune function. Computed tomography (CT) and magnetic resonance imaging (MRI) studies at our hospital showed osteomyelitis involving the left temporal, occipital, and sphenoid bones, the mandible, and an epidural abscess. Routine blood testing and tests of immune function were normal, and no evidence of other infectious processes was found. He was diagnosed with malignant otitis externa (MOE). Bone debridement and incision and drainage of the epidural abscess were performed, and vancomycin was administered because culture results revealed Corynebacterium jeikeium, Corynebacterium xerosis, and Enterococcus faecalis. MOE should be considered in healthy patients with external otitis who fail initial treatment.

Intratympanic hemorrhage and concussion in a football offensive lineman.

PubMed

Waninger, Kevin N; Gloyeske, Brian M; Hauth, John M; Vanic, Keith A; Yen, David M

2014-03-01

A 26-year-old arena football lineman participating in a "bull in the ring" blocking and tackling drill was blindsided by an opposing teammate. He sustained a direct helmet-to-helmet blow to the right temporal area. This case describes a unique mechanism of ear barotrauma (intratympanic hemorrhage) and concussion caused by helmet-to-helmet contact in American football. Initial sideline evaluation revealed mild headache, confusion, dizziness, photophobia, and tinnitus, all consistent with a concussion diagnosis. Physical examination revealed a large postauricular contusion over the right mastoid process and diffuse right intratympanic hemorrhage on examination. No hemotympanum or effusion of the middle ear was noted. Abnormalities were seen on vestibular testing and visual accommodation and convergence testing. Computed tomography and magnetic resonance imaging were performed with attention to the temporal bones and were normal. Neuropsychological testing was abnormal compared to baseline. Audiology testing was within normal limits. Diagnosis was intratympanic hemorrhage secondary to barotrauma caused by helmet-to-helmet contact, with mastoid contusion and season-ending concussion. The tympanic membrane (TM) is a highly vascular membrane that is very sensitive to variations of atmospheric pressure. Overpressure can enter the external auditory canal, stretching and displacing the TM medially and causing injury to the tympanic membrane secondary to barotrauma. This concussed football player was never able to return to play due to his postconcussive symptoms. He had no residual hearing or ear problems. Copyright © 2014 Elsevier Inc. All rights reserved.

Anatomic measurements of the posterior tympanum related to the round window vibroplasty in congenital aural atresia and stenosis patients.

PubMed

Chen, Keguang; Yin, Dongming; Lyu, Huiying; Yang, Lin; Zhang, Tianyu; Dai, Peidong

2016-01-01

With the aggravation of the external auditory canal malformation, the size of extra-niche fossa became smaller, providing concrete data and valuable information for the better design, selecting and safer implantation of the transducer in the area of round window niche. Three-dimensional measurements and assessments before surgery might be helpful for a safer surgical approach and implantation of a vibrant soundbridge. The aim of this study was to investigate whether differences exist in the morphology of the posterior tympanum related to the round window vibroplasty among congenital aural atresia (CAA), congenital aural stenosis (CAS), and a normal control group, and to analyze its effect on the round window implantation of vibrant soundbridge. CT images of 10 normal subjects (20 ears), 27 CAS patients (30 ears), and 25 CAA patients (30 ears) were analyzed. The depth and the size of outside fossa of round window niche related to the round window vibroplasty (extra-niche fossa)and the distances between the center of round window niche and extra-niche fossa were calculated based on three-dimensional reconstruction using mimics software. Finally, the data were analyzed statistically. The size of extra-niche fossa in the atresia group was smaller than in the stenosis group (p < 0.05); furthermore, the size of extra-niche fossa in the stenosis group was smaller than that of the control group (p < 0.05). There was no statistically significant difference of the depth of extra-niche fossa among different groups.

Evaluation of the chemical model of vestibular lesions induced by arsanilate in rats

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vignaux, G.; Univ Caen, Caen, F-14000; Chabbert, C.

Several animal models of vestibular deficits that mimic the human pathology phenotype have previously been developed to correlate the degree of vestibular injury to cognate vestibular deficits in a time-dependent manner. Sodium arsanilate is one of the most commonly used substances for chemical vestibular lesioning, but it is not well described in the literature. In the present study, we used histological and functional approaches to conduct a detailed exploration of the model of vestibular lesions induced by transtympanic injection of sodium arsanilate in rats. The arsanilate-induced damage was restricted to the vestibular sensory organs without affecting the external ear, themore » oropharynx, or Scarpa's ganglion. This finding strongly supports the absence of diffusion of arsanilate into the external ear or Eustachian tubes, or through the eighth cranial nerve sheath leading to the brainstem. One of the striking observations of the present study is the complete restructuring of the sensory epithelia into a non sensory epithelial monolayer observed at 3 months after arsanilate application. This atrophy resembles the monolayer epithelia observed postmortem in the vestibular epithelia of patients with a history of lesioned vestibular deficits such as labyrinthectomy, antibiotic treatment, vestibular neuritis, or Ménière's disease. In cases of Ménière's disease, aminoglycosides, and platinum-based chemotherapy, vestibular hair cells are destroyed, regardless of the physiopathological process, as reproduced with the arsanilate model of vestibular lesion. These observations, together with those presented in this study of arsanilate vestibular toxicity, suggest that this atrophy process relies on a common mechanism of degeneration of the sensory epithelia.« less

Comparison of radio frequency energy absorption in ear and eye region of children and adults at 900, 1800 and 2450 MHz.

PubMed

Keshvari, J; Lang, S

2005-09-21

The increasing use of mobile communication devices, especially mobile phones by children, has triggered discussions on whether there is a larger radio frequency (RF) energy absorption in the heads of children compared to that of adults. The objective of this study was to clarify possible differences in RF energy absorption in the head region of children and adults using computational techniques. Using the finite-difference time-domain (FDTD) computational method, a set of specific absorption rate (SAR) calculations were performed for anatomically correct adult and child head models. A half-wave dipole was used as an exposure source at 900, 1800 and 2450 MHz frequencies. The ear and eye regions were studied representing realistic exposure scenarios to current and upcoming mobile wireless communication devices. The differences in absorption were compared with the maximum energy absorption of the head model. Four magnetic resonance imaging (MRI) based head models, one female, one adult, two child head models, aged 3 and 7 years, were used. The head models greatly differ from each other in terms of size, external shape and the internal anatomy. The same tissue dielectric parameters were applied for all models. The analyses suggest that the SAR difference between adults and children is more likely caused by the general differences in the head anatomy and geometry of the individuals rather than age. It seems that the external shape of the head and the distribution of different tissues within the head play a significant role in the RF energy absorption.

Treatment and Prognosis of Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear: A Multi-Institutional Retrospective Review of 87 Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ogawa, Kazuhiko; Nakamura, Katsumasa; Hatano, Kazuo

Purpose: To examine the relative roles of surgery, radiotherapy, and chemotherapy in the management of patients with squamous cell carcinomas of the external auditory canal and middle ear. Methods and Materials: The records of 87 patients with histologically confirmed squamous cell carcinoma who were treated between 1984 and 2005 were reviewed. Fifty-three patients (61%) were treated with surgery and radiotherapy (S + RT group) and the remaining 34 patients with radiotherapy alone (RT group). Chemotherapy was administered in 34 patients (39%). Results: The 5-year actuarial overall and disease-free survival (DFS) rates for all patients were 55% and 54%, respectively. Onmore » univariate analysis, T stage (Stell's classification), treatment modality, and Karnofsky performance status had significant impact on DFS. On multivariate analysis, T stage and treatment modality were significant prognostic factors. Chemotherapy did not influence DFS. The 5-year DFS rate in T1, T2, and T3 patients was 83%, 45%, and 0 in the RT group (p < 0.0001) and 75%, 75%, and 46% in the S + RT group (p = 0.13), respectively. The 5-year DFS rate in patients with negative surgical margins, those with positive margins, and those with macroscopic residual disease was 83%, 55%, and 38%, respectively (p = 0.007). Conclusions: Radical radiotherapy is the treatment of choice for early-stage (T1) diseases, whereas surgery (negative surgical margins if possible) with radiotherapy is recommended as the standard care for advanced (T2-3) disease. Further clarification on the role of chemotherapy is necessary.« less

Up-regulation of peroxidase proliferator-activated receptor gamma in cholesteatoma.

PubMed

Hwang, Soon Jae; Kang, Hee Joon; Song, Jae-Jun; Kang, Jae Seong; Woo, Jeong Soo; Chae, Sung Won; Lee, Heung-Man

2006-01-01

To evaluate the localization and expression of peroxidase proliferator-activated receptor (PPAR)gamma in cholesteatoma epithelium. Experimental study. Reverse-transcription polymerase chain reaction was performed on cholesteatoma tissues from 10 adult patients undergoing tympanomastoid surgery for middle ear cholesteatoma and on 10 samples of normal external auditory canal skin tissue. The expression levels of PPARgamma to glyceraldehyde-3-phosphate dehydrogenase transcripts were semiquantified by densitometry. We also characterized the cellular localization of the PPARgamma protein immunohistochemically. Ki-67 was also localized to compare the proliferative activity of cells in cholesteatoma epithelium and in normal external auditory canal skin. PPARgamma mRNA and protein were detected in normal external auditory canal skin and in cholesteatoma epithelium. The expression level of PPARgamma mRNA in cholesteatoma was significantly increased compared with that in normal external auditory canal skin. PPARgamma protein was expressed in cells mainly in the granular and prickle cell layers. However, the intensity of its expression was generally decreased in the parabasal layer of the cholesteatoma epithelium. Ki-67 was expressed in the nuclei of cells in the basal and parabasal layers, and a greater number of cells were Ki-67 immunopositive in cholesteatoma epithelium. PPARgamma is up-regulated in the cholesteatoma epithelium compared with normal external auditory canal skin. These results suggest that PPARgamma may play an important role in the pathogenesis of cholesteatoma.

The Muslim Headscarf and Face Perception: “They All Look the Same, Don't They?”

PubMed Central

Toseeb, Umar; Bryant, Eleanor J.; Keeble, David R. T.

2014-01-01

The headscarf conceals hair and other external features of a head (such as the ears). It therefore may have implications for the way in which such faces are perceived. Images of faces with hair (H) or alternatively, covered by a headscarf (HS) were used in three experiments. In Experiment 1 participants saw both H and HS faces in a yes/no recognition task in which the external features either remained the same between learning and test (Same) or switched (Switch). Performance was similar for H and HS faces in both the Same and Switch condition, but in the Switch condition it dropped substantially compared to the Same condition. This implies that the mere presence of the headscarf does not reduce performance, rather, the change between the type of external feature (hair or headscarf) causes the drop in performance. In Experiment 2, which used eye-tracking methodology, it was found that almost all fixations were to internal regions, and that there was no difference in the proportion of fixations to external features between the Same and Switch conditions, implying that the headscarf influenced processing by virtue of extrafoveal viewing. In Experiment 3, similarity ratings of the internal features of pairs of HS faces were higher than pairs of H faces, confirming that the internal and external features of a face are perceived as a whole rather than as separate components. PMID:24520313

Initiating and developing clinical services, training and research in a low resource setting: the Malawi ENT experience.

PubMed

Mulwafu, Wakisa; Nyirenda, Thomas Elliot; Fagan, Johannes J; Bem, Chris; Mlumbe, Kumvana; Chitule, Jean

2014-07-01

Sub-Saharan Africa countries like Malawi have a paucity of ear, nose and throat (ENT) data, services and training opportunities. To reflect on new Malawian ENT experience and to propose guidelines to poorly resourced countries. Analysis of data predating and following establishment of ENT services in Malawi. In 2008 the first and only Malawian ENT specialist established ENT services with external funding. Fifteen clinical officers have been trained and a nurse placed at each outreach hospital. In 2012, 15,284 consultations were recorded: 543 (3.6%) from outreach clinics. Forty-nine percent needed medical treatment, while 45% needed medical advice. Surgery was performed on 2.7% of patients; 21% for foreign bodies in the nose and throat and 18% for foreign bodies and biopsies of ears. To establish accessible and sustainable specialist ENT services in a poor country requires building on an established local health delivery system, careful planning and investment in personnel, infrastructure, training and data collection. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Are Coronae Restricted to Venus?: Corona-Like Tectonovolcanic Structures on Earth

NASA Astrophysics Data System (ADS)

Lopez, Ivan; Marquez, Alvaro; Oyarzun, Roberto

1997-04-01

Coronae may not be tectonovolcanic features ‘unique to Venus’ because both the processes that lead to corona formation, and their final tectonovolcanic output (formation of domes, plateaus, extensional rings, etc.), are also found on Earth. Large-scale corona formation processes on Earth may be restricted (because of plate motion) but not absent. The same applies to resurfacing processes. We here suggest that at least, the early stages of corona formation can be recognized in intraplate tectonic settings on Earth. The African plate displays many Cenozoic examples of plume-related domal uplifts and volcanism (e.g., Hoggar, Tibesti, Darfur, Ethiopia). Furthermore, the east African rift system (EARS) around lake Victoria displays many striking features that resemble those of the Venus coronae associated with extensional belts. Among these are the following: (1) an overall elliptical shape; (2) the existence of a mantle plume (Kenya plume) centered beneath lake Victoria; (3) a central plateau (east African plateau); (4) an external extensional belt (the EARS east and west branches); (5) doming processes (Kenya dome); and last but not least (6) volcanism.

A new species of small-eared shrew (Mammalia, Eulipotyphla, Cryptotis) from the Lacandona rain forest, Mexico

USGS Publications Warehouse

Guevara, Lázaro; Sánchez-Cordero, Víctor; León-Paniagua, Livia; Woodman, Neal

2014-01-01

The diversity and distribution of mammals in the American tropics remain incompletely known. We describe a new species of small-eared shrew (Soricidae, Cryptotis) from the Lacandona rain forest, Chiapas, southern Mexico. The new species is distinguished from other species of Cryptotis on the basis of a unique combination of pelage coloration, size, dental, cranial, postcranial, and external characters, and genetic distances. It appears most closely related to species in the Cryptotis nigrescens species group, which occurs from southern Mexico to montane regions of Colombia. This discovery is particularly remarkable because the new species is from a low-elevation habitat (approximately 90 m), whereas most shrews in the region are restricted to higher elevations, typically > 1,000 m. The only known locality for the new shrew is in one of the last areas in southern Mexico where relatively undisturbed tropical vegetation is still found. The type locality is protected by the Mexican government as part of the Yaxchilán Archaeological Site on the border between Mexico and Guatemala.

The preauricular sinus: a review of its clinical presentation, treatment, and associations.

PubMed

Scheinfeld, Noah S; Silverberg, Nanette B; Weinberg, Jeffrey M; Nozad, Valerie

2004-01-01

Preauricular sinuses (ear pits) are common congenital abnormalities. Usually asymptomatic, they manifest as small dells adjacent to the external ear near the anterior margin of the ascending limb of the helix, most frequently on the right side. Preauricular sinuses can be either inherited or sporadic. When inherited, they show an incomplete autosomal dominant pattern with reduced penetrance and variable expression. They may be bilateral, increasing the likelihood of being inherited, in 25-50% of cases. Preauricular sinuses are features of other conditions or syndromes in 3-10% of cases, primarily in association with deafness and branchio-oto-renal (BOR) syndrome. When other congenital anomalies coexist with these sinuses, auditory testing and renal ultrasound should be considered. Sinuses may become infected, most commonly with gram-positive bacteria, in which case their exudates should be cultured and appropriate antibiotics administered. Recurrent infection is a clear indication for complete excision and provides the only definitive cure. Recurrence rates after surgery range from 9% to 42%. Meticulous excision by an experienced head and neck surgeon minimizes the risk of recurrence.

A neuronal network model with simplified tonotopicity for tinnitus generation and its relief by sound therapy.

PubMed

Nagashino, Hirofumi; Kinouchi, Yohsuke; Danesh, Ali A; Pandya, Abhijit S

2013-01-01

Tinnitus is the perception of sound in the ears or in the head where no external source is present. Sound therapy is one of the most effective techniques for tinnitus treatment that have been proposed. In order to investigate mechanisms of tinnitus generation and the clinical effects of sound therapy, we have proposed conceptual and computational models with plasticity using a neural oscillator or a neuronal network model. In the present paper, we propose a neuronal network model with simplified tonotopicity of the auditory system as more detailed structure. In this model an integrate-and-fire neuron model is employed and homeostatic plasticity is incorporated. The computer simulation results show that the present model can show the generation of oscillation and its cessation by external input. It suggests that the present framework is promising as a modeling for the tinnitus generation and the effects of sound therapy.

Effects of a sensory branch to the posterior external ear canal: coughing, pain, Ramsay Hunt's syndrome and Hitselberger's sign.

PubMed

Mulazimoglu, S; Flury, R; Kapila, S; Linder, T

2017-04-01

A distinct nerve innervating the external auditory canal can often be identified in close relation to the facial nerve when gradually thinning the posterior canal wall. This nerve has been attributed to coughing during cerumen removal, neuralgic pain, Hitselberger's sign and vesicular eruptions described in Ramsay Hunt's syndrome. This study aimed to demonstrate the origin and clinical impact of this nerve. In patients with intractable otalgia or severe coughing whilst inserting a hearing aid, who responded temporarily to local anaesthesia, the symptoms could be resolved by sectioning a sensory branch to the posterior canal. In a temporal bone specimen, it was revealed that this nerve is predominantly a continuation of Arnold's nerve, also receiving fibres from the glossopharyngeal nerve and facial nerve. Histologically, the communicating branch from the facial nerve was confirmed. Surgeons should be aware of the posterior auricular sensory branch and its clinical implications.

Effectiveness of Ear Splint Therapy for Ear Deformities

PubMed Central

2017-01-01

Objective To present our experience with ear splint therapy for babies with ear deformities, and thereby demonstrate that this therapy is an effective and safe intervention without significant complications. Methods This was a retrospective study of 54 babies (35 boys and 19 girls; 80 ears; age ≤3 months) with ear deformities who had received ear splint therapy at the Center for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University Hospital between December 2014 and February 2016. Before the initiation of ear splint therapy, ear deformities were classified with reference to the standard terminology. We compared the severity of ear deformity before and after ear splint therapy by using the physician's ratings. We also compared the physician's ratings and the caregiver's ratings on completion of ear splint therapy. Results Among these 54 babies, 41 children (58 ears, 72.5%) completed the ear splint therapy. The mean age at initiation of therapy was 52.91±18.26 days and the treatment duration was 44.27±32.06 days. Satyr ear, forward-facing ear lobe, Darwinian notch, overfolded ear, and cupped ear were the five most common ear deformities. At the completion of therapy, the final physician's ratings of ear deformities were significantly improved compared to the initial ratings (8.28±1.44 vs. 2.51±0.92; p<0.001). There was no significant difference between the physician's ratings and the caregiver's ratings at the completion of ear splint therapy (8.28±1.44 vs. 8.0±1.61; p=0.297). Conclusion We demonstrated that ear splint therapy significantly improved ear deformities in babies, as measured by quantitative rating scales. Ear splint therapy is an effective and safe intervention for babies with ear deformities. PMID:28289646

[Analyses of the factors relevant to revision tympanomastoid surgery].

PubMed

Li, Li; Fan, Zhaomin; Han, Yuechen; Xu, Lei; Chen, Dong; Wang, Haibo

2016-05-01

To analyze factors relevant to revisional tympanomastoid surgery for chronic otitis media(COM). The clinical data of 159 patients (159 ears), who exhibited either wet ear or relapsed after the initial operation, and were subjected to revisional tympanomastoid surgery, were retrospectively analyzed in this study. Of those 159 consecutive patients, 85 were males and 74 were females, aged 11-64 years, with a median age of 36 years old. The situations in terms of intra-operative findings, surgical procedures, change dressing post-operation, dry ear time, and the improvement of aural ability during the second operation, were recorded and analyzed. The second surgery found that, of those 159 patients underwent the re-operation, 67 presented with cholesteatoma and 92 had no cholesteatoma. In addition, the inadequate skeletonization and insufficient opening for mastoid cavity accounted for 70.4% (112/159) of all previous operations, the external auditory canal stenosis for 98.7% (157/159), the high facial ridge leading to insufficient drainage for 61.0% (97/159), the lesion in tympanic ostium of Eustachian tube for 34.6% (55/159), the insufficient drainage due to inappropriate post-operating dressing for 5.0% (8/159), the postauricular incision for 30.8% (49/159), and the endaural incision for 69.2% (110/159). As for the re-operation of the canal wall down mastoidectomy, tympanoplasty plus plastic repairing of cavity of concha were performed in 94 cases, the modified Bondy plus plastic repairing of cavity of concha in four cases, the radical mastoidectomy plus plastic repairing of cavity of concha in 59 cases, and the simple cleaning for mastoid cavity in two cases. Since one to two weeks after the revisional operations, the post-operating dressing was performed with aid of microscopy once a week on average. The average dry ear time ranged from 2 to 6 weeks (median=3 weeks). During a period of 6-93 months for the follow-up, all patients presented with dry ears. The epithelialization of the operating cavity was well and the tympanic membranes were integrity. Neither granulation tissue nor cholesteatoma was found to reoccur. Both pure tone hearing thresholds and air-bone gap decreased in 87 cases after the revisional operation, with statistically significant different in comparison to those two parameters before the operation (P<0.05). The primary causes responsible for the wet ear or reoccurrent cholesteatoma after tympanomastoid surgery may be related to the improper operation procedures and selection of incision, the non-standard operation, inexhaustive removal of pathological tissues, as well as the irregular postoperation change dressing, and other factors.

Assessment of the Antimicrobial Activity of Algae Extracts on Bacteria Responsible of External Otitis

PubMed Central

Pane, Gianluca; Cacciola, Gabriele; Giacco, Elisabetta; Mariottini, Gian Luigi; Coppo, Erika

2015-01-01

External otitis is a diffuse inflammation around the external auditory canal and auricle, which is often occurred by microbial infection. This disease is generally treated using antibiotics, but the frequent occurrence of antibiotic resistance requires the development of new antibiotic agents. In this context, unexplored bioactive natural candidates could be a chance for the production of targeted drugs provided with antimicrobial activity. In this paper, microbial pathogens were isolated from patients with external otitis using ear swabs for over one year, and the antimicrobial activity of the two methanol extracts from selected marine (Dunaliella salina) and freshwater (Pseudokirchneriella subcapitata) microalgae was tested on the isolated pathogens. Totally, 114 bacterial and 11 fungal strains were isolated, of which Staphylococcus spp. (28.8%) and Pseudomonas aeruginosa (P. aeruginosa) (24.8%) were the major pathogens. Only three Staphylococcus aureus (S. aureus) strains and 11 coagulase-negative Staphylococci showed resistance to methicillin. The two algal extracts showed interesting antimicrobial properties, which mostly inhibited the growth of isolated S. aureus, P. aeruginosa, Escherichia coli, and Klebsiella spp. with MICs range of 1.4 × 109 to 2.2 × 1010 cells/mL. These results suggest that the two algae have potential as resources for the development of antimicrobial agents. PMID:26492256

Evaluation of the Interplate and Intraplate Deformations of the African Continent Using cGNSS Data

NASA Astrophysics Data System (ADS)

Apolinário, J. P.; Fernandes, R. M. S.; Bos, M. S.; Meghraoui, M.; Miranda, J. M. A.

2014-12-01

Two main plates, Nubia and Somalia, plus some few more tectonic blocks in the East African Rift System (EARS) delimit the African continent. The major part of the external plate boundaries of Africa is well defined by oceanic ridge systems with the exception of the Nubia-Eurasia complex convergence-collision tectonic zone. In addition, the number and distribution of the tectonic blocks along the EARS region is a major scientific issue that has not been completely answered so far. Nevertheless, the increased number of cGNSS (continuous Global Navigation Satellite Systems) stations in Africa with sufficient long data span is helping to better understand and constrain the complex sub-plate distribution in the EARS as well as in the other plate boundaries of Africa. This work is the geodetic contribution for the IGCP-Project 601 - "Seismotectonics and Seismic Hazards in Africa". It presents the current tectonic relative motions of the African continent based on the analysis of the estimated velocity field derived from the existing network of cGNSS stations in Africa and bordering plate tectonics. For the majority of the plate pairs, we present the most recent estimation of their relative velocity using a dedicated processing. The velocity solutions are computed using HECTOR, a software that takes into account the existing temporal correlations between the daily solutions of the stations. It allows to properly estimate the velocity uncertainties and to detect any artifacts in the time-series. For some of the plate pairs, we compare our solutions of the angular velocities with other geodetic and geophysical models. In addition, we also study the sensitivity of the derived angular velocity to changes in the data (longer data-span for some stations) for tectonic units with few stations, and in particular for the Victoria and Rovuma blocks of the EARS. Finally, we compute estimates of velocity fields for several sub-regions correlated with the seismotectonic provinces and discuss the level of interplate and intraplate deformations in Africa.

Classification of Newborn Ear Malformations and their Treatment with the EarWell Infant Ear Correction System.

PubMed

Daniali, Lily N; Rezzadeh, Kameron; Shell, Cheryl; Trovato, Matthew; Ha, Richard; Byrd, H Steve

2017-03-01

A single practice's treatment protocol and outcomes following molding therapy on newborn ear deformations and malformations with the EarWell Infant Ear Correction System were reviewed. A classification system for grading the severity of constricted ear malformations was created on the basis of anatomical findings. A retrospective chart/photograph review of a consecutive series of infants treated with the EarWell System from 2011 to 2014 was undertaken. The infants were placed in either deformation or malformation groups. Three classes of malformation were identified. Data regarding treatment induction, duration of treatment, and quality of outcome were collected for all study patients. One hundred seventy-five infant ear malformations and 303 infant ear deformities were treated with the EarWell System. The average age at initiation of treatment was 12 days; the mean duration of treatment was 37 days. An average of six office visits was required. Treated malformations included constricted ears [172 ears (98 percent)] and cryptotia [three ears (2 percent)]. Cup ear (34 ears) was considered a constricted malformation, in contrast to the prominent ear deformity. Constricted ears were assigned to one of three classes, with each subsequent class indicating increasing severity: class I, 77 ears (45 percent); class II, 81 ears (47 percent); and class III, 14 ears (8 percent). Molding therapy with the EarWell System reduced the severity by an average of 1.2 points (p < 0.01). Complications included minor superficial excoriations and abrasions. The EarWell System was shown to be effective in eliminating or reducing the need for surgery in all but the most severe malformations. Therapeutic, IV.

[Recent advances in research on Malassezia microbiota in humans].

PubMed

Sugita, Takashi; Zhang, Enshi; Tanaka, Takafumi; Nishikawa, Akemi; Tajima, Mami; Tsuboi, Ryoji

2013-01-01

Malassezia species of lipophilic yeasts account for most fungal microbiota. Although they colonize healthy skin, they are also associated with several skin diseases, including pityriasis versicolor, seborrheic dermatitis, Malassezia folliculitis, and atopic dermatitis. To date, 14 members of the Malassezia genus have been identified. Of these, both M. globosa and M. restricta predominate, regardless of skin-disease type. Comprehensive analysis of fungal microbiota in the skin of patients with atopic dermatitis using an rRNA clone library method revealed that fungal microbiota cluster according to disease severity. The external ear canal and sole of the foot are colonized by specific Malassezia microbiota.

3D finite element model of the chinchilla ear for characterizing middle ear functions

PubMed Central

Wang, Xuelin; Gan, Rong Z.

2016-01-01

Chinchilla is a commonly used animal model for research of sound transmission through the ear. Experimental measurements of the middle ear transfer function in chinchillas have shown that the middle ear cavity greatly affects the tympanic membrane (TM) and stapes footplate (FP) displacements. However, there is no finite element (FE) model of the chinchilla ear available in the literature to characterize the middle ear functions with the anatomical features of the chinchilla ear. This paper reports a recently completed 3D FE model of the chinchilla ear based on X-ray micro-computed tomography images of a chinchilla bulla. The model consisted of the ear canal, TM, middle ear ossicles and suspensory ligaments, and the middle ear cavity. Two boundary conditions of the middle ear cavity wall were simulated in the model as the rigid structure and the partially flexible surface, and the acoustic-mechanical coupled analysis was conducted with these two conditions to characterize the middle ear function. The model results were compared with experimental measurements reported in the literature including the TM and FP displacements and the middle ear input admittance in chinchilla ear. An application of this model was presented to identify the acoustic role of the middle ear septa - a unique feature of chinchilla middle ear cavity. This study provides the first 3D FE model of the chinchilla ear for characterizing the middle ear functions through the acoustic-mechanical coupled FE analysis. PMID:26785845

Ear molding in newborn infants with auricular deformities.

PubMed

Byrd, H Steve; Langevin, Claude-Jean; Ghidoni, Lorraine A

2010-10-01

A review of a single physician's experience in managing over 831 infant ear deformities (488 patients) is presented. The authors' methods of molding have advanced from the use of various tapes, glues, and stents, to a comprehensive yet simple system that shapes the antihelix, the triangular fossa, the helical rim, and the overly prominent conchal-mastoid angle (EarWell Infant Ear Correction System). The types of deformities managed, and their relative occurrence, are as follows: (1) prominent/cup ear, 373 ears (45 percent); (2) lidding/lop ear, 224 ears (27 percent); (3) mixed ear deformities, 83 ears (10 percent) (all had associated conchal crus); (4) Stahl's ear, 66 ears (8 percent); (5) helical rim abnormalities, 58 ears (7 percent); (6) conchal crus, 25 ears (3 percent); and (7) cryptotia, two ears (0.2 percent). Bilateral deformities were present in 340 patients (70 percent), with unilateral deformities in 148 patients (30 percent). Fifty-eight infant ears (34 patients) were treated using the final version of the EarWell Infant Ear Correction System with a success rate exceeding 90 percent (good to excellent results). The system was found to be most successful when begun in the first week of the infant's life. When molding was initiated after 3 weeks from birth, only approximately half of the infants had a good response. Congenital ear deformities are common and only approximately 30 percent self-correct. These deformities can be corrected by initiating appropriate molding in the first week of life. Neonatal molding reduces the need for surgical correction with results that often exceed what can be achieved with the surgical alternative.

Effect of target-masker similarity on across-ear interference in a dichotic cocktail-party listening task.

PubMed

Brungart, Douglas S; Simpson, Brian D

2007-09-01

Similarity between the target and masking voices is known to have a strong influence on performance in monaural and binaural selective attention tasks, but little is known about the role it might play in dichotic listening tasks with a target signal and one masking voice in the one ear and a second independent masking voice in the opposite ear. This experiment examined performance in a dichotic listening task with a target talker in one ear and same-talker, same-sex, or different-sex maskers in both the target and the unattended ears. The results indicate that listeners were most susceptible to across-ear interference with a different-sex within-ear masker and least susceptible with a same-talker within-ear masker, suggesting that the amount of across-ear interference cannot be predicted from the difficulty of selectively attending to the within-ear masking voice. The results also show that the amount of across-ear interference consistently increases when the across-ear masking voice is more similar to the target speech than the within-ear masking voice is, but that no corresponding decline in across-ear interference occurs when the across-ear voice is less similar to the target than the within-ear voice. These results are consistent with an "integrated strategy" model of speech perception where the listener chooses a segregation strategy based on the characteristics of the masker present in the target ear and the amount of across-ear interference is determined by the extent to which this strategy can also effectively be used to suppress the masker in the unattended ear.

Inner ear damage following electric current and lightning injury: a literature review.

PubMed

Modayil, P C; Lloyd, G W; Mallik, A; Bowdler, D A

2014-05-01

Audiovestibular sequelae of electrical injury, due to lightning or electric current, are probably much more common than indicated in literature. The aim of the study was to review the impact of electrical injury on the cochleovestibular system. Studies were identified through Medline, Embase, CINAHL and eMedicine databases. Medical Subject Headings used were 'electrical injury', 'lightning', 'deafness' and 'vertigo'. All prospective and retrospective studies, case series and case reports of patients with cochlear or vestibular damage due to lightning or electrical current injury were included. Studies limited to external and middle ear injuries were excluded. Thirty-five articles met the inclusion criteria. Fifteen reported audiovestibular damage following electric current injury (domestic or industrial); a further 15 reported lightning injuries and five concerned pathophysiology and management. There were no histological studies of electrical current injury to the human audiovestibular system. The commonest acoustic insult after lightning injury is conductive hearing loss secondary to tympanic membrane rupture and the most frequent vestibular symptom is transient vertigo. Electrical current injuries predominantly cause pure sensorineural hearing loss and may significantly increase a patient's lifetime risk of vertigo. Theories for cochleovestibular damage in electrical injury include disruption of inner ear anatomy, electrical conductance, hypoxia, vascular effects and stress response hypothesis. The pathophysiology of cochleovestibular damage following electrical injury is unresolved. The mechanism of injury following lightning strike is likely to be quite different from that following domestic or industrial electrical injury. The formulation of an audiovestibular management protocol for patients who have suffered electrical injuries and systematic reporting of all such events is recommended.

Otologic manifestations of Fanconi anemia and other inherited bone marrow failure syndromes.

PubMed

Kalejaiye, Adedoyin; Giri, Neelam; Brewer, Carmen C; Zalewski, Christopher K; King, Kelly A; Adams, Charleen D; Rosenberg, Philip S; Kim, H Jeffrey; Alter, Blanche P

2016-12-01

The inherited bone marrow failure syndromes (IBMFSs) are diverse disorders with syndrome-specific features; their otologic and audiologic manifestations have not been well described. Our objective was to characterize these in patients with Fanconi anemia (FA), dyskeratosis congenita (DC), Diamond-Blackfan anemia (DBA), and Shwachman-Diamond syndrome (SDS), and to determine the association between physical findings and hearing loss. Patients with an IBMFS underwent comprehensive clinical and laboratory evaluations and testing for syndrome-specific gene mutations. Hearing loss was measured by pure tone audiometry and otologic abnormalities by otomicroscopy. Patients included 33 with FA, 37 with DC, 32 with DBA, and nine with SDS. Hearing loss was most frequent in patients with FA (45%) and DBA (14%). The most common type of hearing loss in FA was conductive (65%). Absent or hypoplastic radius, noted in 21% of the patients with FA, was associated with hearing loss in all cases. Otomicroscopy was abnormal in 66% of patients with FA. Characteristic ear abnormalities included small tympanic membrane (66%), malformed malleus (57%), aberrant tympanic bony island (48%), narrow external auditory canal (EAC) (32%), and abnormal course of chorda tympani (34%). Ear malformations were almost always associated with hearing loss. Hearing loss was rare in patients with DC and SDS. FA is the major IBMFS with associated hearing loss, which is most commonly conductive. Radial hypoplasia or aplasia and characteristic congenital ear malformations are associated with hearing loss in patients with FA. Recognition of these syndrome-specific abnormalities should lead to earlier management of hearing loss. © 2016 Wiley Periodicals, Inc.

Cochlear Implant Electrode Effect on Sound Energy Transfer within the Cochlea during Acoustic Stimulation

PubMed Central

Greene, Nathaniel T.; Mattingly, Jameson K.; Jenkins, Herman A.; Tollin, Daniel J.; Easter, James R.; Cass, Stephen P.

2015-01-01

Hypothesis Cochlear implants (CI) designed for hearing preservation will not alter mechanical properties of the middle and inner ear as measured by intracochlear pressure (PIC) and stapes velocity (Vstap). Background CIs designed to provide combined electrical and acoustic stimulation (EAS) are now available. To maintain functional acoustic hearing, it is important to know if a CI electrode can alter middle or inner ear mechanics, as any alteration could contribute to elevated low-frequency thresholds in EAS patients. Methods Seven human cadaveric temporal bones were prepared, and pure-tone stimuli from 120Hz–10kHz were presented at a range of intensities up to 110 dB SPL. PIC in the scala vestibuli (PSV) and tympani (PST) were measured with fiber-optic pressure sensors concurrently with VStap using laser Doppler vibrometry. Five CI electrodes from two different manufacturers, with varying dimensions were inserted via a round window approach at six different depths (16–25 mm). Results The responses of PIC and VStap to acoustic stimulation were assessed as a function of stimulus frequency, normalized to SPL in the external auditory canal (EAC), in baseline and electrode inserted conditions. Responses measured with electrodes inserted were generally within ~5 dB of baseline, indicating little effect of cochlear implant electrode insertion on PIC and VStap. Overall, mean differences across conditions were small for all responses, and no substantial differences were consistently visible across electrode types. Conclusions Results suggest that the influence of a CI electrode on middle and inner ear mechanics is minimal, despite variation in electrode lengths and configurations. PMID:26333018

Distribution of elastic fibers in the head and neck: a histological study using late-stage human fetuses.

PubMed

Kinoshita, Hideaki; Umezawa, Takashi; Omine, Yuya; Kasahara, Masaaki; Rodríguez-Vázquez, José Francisco; Murakami, Gen; Abe, Shinichi

2013-03-01

There is little or no information about the distribution of elastic fibers in the human fetal head. We examined this issue in 15 late-stage fetuses (crown-rump length, 220-320 mm) using aldehyde-fuchsin and elastica-Masson staining, and we used the arterial wall elastic laminae and external ear cartilages as positive staining controls. The posterior pharyngeal wall, as well as the ligaments connecting the laryngeal cartilages, contained abundant elastic fibers. In contrast with the sphenomandibular ligament and the temporomandibular joint disk, in which elastic fibers were partly present, the discomalleolar ligament and the fascial structures around the pterygoid muscles did not have any elastic fibers. In addition, the posterior marginal fascia of the prestyloid space did contain such fibers. Notably, in the middle ear, elastic fibers accumulated along the tendons of the tensor tympani and stapedius muscles and in the joint capsules of the ear ossicle articulations. Elastic fibers were not seen in any other muscle tendons or vertebral facet capsules in the head and neck. Despite being composed of smooth muscle, the orbitalis muscle did not contain any elastic fibers. The elastic fibers in the sphenomandibular ligament seemed to correspond to an intermediate step of development between Meckel's cartilage and the final ligament. Overall, there seemed to be a mini-version of elastic fiber distribution compared to that in adults and a different specific developmental pattern of connective tissues. The latter morphology might be a result of an adaptation to hypoxic conditions during development.

Distribution of elastic fibers in the head and neck: a histological study using late-stage human fetuses

PubMed Central

Kinoshita, Hideaki; Umezawa, Takashi; Omine, Yuya; Kasahara, Masaaki; Rodríguez-Vázquez, José Francisco; Murakami, Gen

2013-01-01

There is little or no information about the distribution of elastic fibers in the human fetal head. We examined this issue in 15 late-stage fetuses (crown-rump length, 220-320 mm) using aldehyde-fuchsin and elastica-Masson staining, and we used the arterial wall elastic laminae and external ear cartilages as positive staining controls. The posterior pharyngeal wall, as well as the ligaments connecting the laryngeal cartilages, contained abundant elastic fibers. In contrast with the sphenomandibular ligament and the temporomandibular joint disk, in which elastic fibers were partly present, the discomalleolar ligament and the fascial structures around the pterygoid muscles did not have any elastic fibers. In addition, the posterior marginal fascia of the prestyloid space did contain such fibers. Notably, in the middle ear, elastic fibers accumulated along the tendons of the tensor tympani and stapedius muscles and in the joint capsules of the ear ossicle articulations. Elastic fibers were not seen in any other muscle tendons or vertebral facet capsules in the head and neck. Despite being composed of smooth muscle, the orbitalis muscle did not contain any elastic fibers. The elastic fibers in the sphenomandibular ligament seemed to correspond to an intermediate step of development between Meckel's cartilage and the final ligament. Overall, there seemed to be a mini-version of elastic fiber distribution compared to that in adults and a different specific developmental pattern of connective tissues. The latter morphology might be a result of an adaptation to hypoxic conditions during development. PMID:23560235

Otitis

MedlinePlus

Ear infection; Infection - ear ... of the ear. The condition can be: Acute ear infection. Starts suddenly and lasts for a short period of time. It is often painful. Chronic ear infection. Occurs when the ear infection does not go ...

Audiological characteristics of infants with abnormal transient evoked otoacoustic emission and normal auditory brainstem response.

PubMed

Huang, Lihui; Han, Demin; Guo, Ying; Liu, Sha; Cui, Xiaoyan; Mo, Lingyan; Qi, Beier; Cai, Zhenghua; Liu, Hui; En, Hui; Guo, Liansheng

2008-10-01

Audiological characteristics were investigated in 81 ears of 53 infants with abnormal transient evoked otoacoustic emission (TEOAE) and normal auditory brainstem response (ABR). The relationship between ABR and other hearing testing methods, including 40Hz auditory event-related potential (40Hz-AERP), auditory steady state response (ASSR), distortion product otoacoustic emission (DPOAE), tympanometry, and acoustic reflex, was analyzed. Of the 81 ears, 18 ears (22.2%) were normal, while 63 ears (77.8%) were abnormal according to the tests. Testing of the 40 Hz AERP (36 ears) and ASSR (45 ears) revealed that 14 ears (38.9%) and 27 ears (60.0%) were abnormal, respectively. Testing of DPOAE in 68 ears revealed that 50 ears (73.5%) were abnormal. Testing of tympanometry in 50 ears and acoustic reflex in 47 ears revealed that 9 ears (18%) and 27 ears (57.4%) were abnormal, respectively. The present data suggests that the hearing of infants cannot be sufficiently evaluated with ABR only and that it must be evaluated with integrative audiological testing methods.

Middle ear impedance measurements in large vestibular aqueduct syndrome.

PubMed

Bilgen, Cem; Kirkim, Günay; Kirazli, Tayfun

2009-06-01

To assess the effect of inner ear pressure on middle ear impedance in patients with large vestibular aqueduct syndrome (LVAS). Data from admittance tympanometry and multifrequency tympanometry on 8 LVAS patients and control subjects were studied. Static acoustic compliance (SAC) values for the ears with stable sensorineural hearing loss (SNHL) were within the limits of the mean values of control groups except for two ears. The resonance frequency (RF) values of the ears with stable SNHL were lower than the mean values of control groups except for three ears. SAC values for the two ears with fluctuating SNHL were lower and the RF values were higher than the mean values of control groups. Decreased SAC values and increased RF values found in the ears with fluctuating SNHL might be an indirect indicator of increased inner ear pressure, while low RF values in the ears with stable SNHL might reflect the decreased inner ear impedance.

Nonsurgical correction of congenital ear abnormalities in the newborn: Case series.

PubMed

Smith, Wg; Toye, Jw; Reid, A; Smith, Rw

2005-07-01

To determine whether a simple, nonsurgical treatment for congenital ear abnormalities (lop-ear, Stahl's ear, protruding ear, cryptotia) improved the appearance of ear abnormalities in newborns at six weeks of age. This is a descriptive case series. All newborns with identified abnormalities were referred by their family physician to one paediatrician (WGS) in a small level 2 perinatal centre. The ears were waxed and taped in a standard manner within 10 days of birth. Pictures were taken before taping and at the end of taping (one month). All patients and pictures were assessed by one plastic surgeon (JWT) at six weeks of age and scored using a standard scoring system. A telephone survey of the nontreatment group was conducted. The total number of ears assessed was 90. Of this total, 69 ears were taped and fully evaluated in the study (77%). The refusal rate was 23%. In the treatment group, 59% had lop-ear, 19% had Stahl's ear, 17% had protruding ear and 3% had cryptotia. Overall correction (excellent/improved) for the treatment group was 90% (100% for lop-ear, 100% for Stahl's ear, 67% for protruding ear and 0% for cryptotia). In the nontreatment (refusal) group, 67% of the ears failed to correct spontaneously. No complications were recognized by the authors or parents by six weeks. The percentage of newborns in one year in the perinatal centre with recognized ear abnormalities was 6% (90 of 1600). A simple, nonsurgical treatment in a Caucasian population appeared to be very effective in correcting congenital ear abnormalities with no complications and high patient/parent satisfaction.

Sonographic Measurement of Fetal Ear Length in Turkish Women with a Normal Pregnancy

PubMed Central

Özdemir, Mucize Eriç; Uzun, Işıl; Karahasanoğlu, Ayşe; Aygün, Mehmet; Akın, Hale; Yazıcıoğlu, Fehmi

2014-01-01

Background: Abnormal fetal ear length is a feature of chromosomal disorders. Fetal ear length measurement is a simple measurement that can be obtained during ultrasonographic examinations. Aims: To develop a nomogram for fetal ear length measurements in our population and investigate the correlation between fetal ear length, gestational age, and other standard fetal biometric measurements. Study Design: Cohort study. Methods: Ear lengths of the fetuses were measured in normal singleton pregnancies. The relationship between gestational age and fetal ear length in millimetres was analysed by simple linear regression. In addition, the correlation of fetal ear length measurements with biparietal diameter, head circumference, abdominal circumference, and femur length were evaluated.Ear length measurements were obtained from fetuses in 389 normal singleton pregnancies ranging between 16 and 28 weeks of gestation. Results: A nomogram was developed by linear regression analysis of the parameters ear length and gestational age. Fetal ear length (mm) = y = (1.348 X gestational age)−12.265), where gestational ages is in weeks. A high correlation was found between fetal ear length and gestational age, and a significant correlation was also found between fetal ear length and the biparietal diameter (r=0.962; p<0.001). Similar correlations were found between fetal ear length and head circumference, and fetal ear length and femur length. Conclusion: The results of this study provide a nomogram for fetal ear length. The study also demonstrates the relationship between ear length and other biometric measurements. PMID:25667783

[Manifestation of first branchial anomaly:56 cases reportrhinitis].

PubMed

Zhang, B; Chen, L S; Huang, S L; Liang, L; Wu, P N; Zhang, S Y; L, Z M; Liang, L

2016-09-05

Objective: To sum up and conclude manifestation of congenital first branchial anomaly(CFBCA). Method: The clinical data of 56 patients from 2005 to 2015 in our hospital were retrospective reviewed. Result: Manifestation:mass without pain(26.8%),repeated sore and discharge(71.4%),otological symptom(external auditory discharge､hearing loss,28.6%).Eleven cases bacterial sample showed positive result,and most of them show pseudomonas aeruginosa and staphylococcus aureus.Auricular endoscopy typically performed stricture of external auditory canal,cholesteatoma samples accumulated in ear canal,fistula at the conjunction of the bone and cartilage and tympanic membranous attachment.Typical performance of CT(MRI)was that there were cystic,lobulated or tubular abnormal shadow related with ear canal in Pochet's triangle area whose cyst wall or pipe wall could been enhanced in enhanced CT(MRI) scans,and part of that could be connected with skin.The statistical difference between type Oslen and Work and clinical characteristics( P <0.01),and the relationship between type Oslen and Work( P <0.01).Most of Work Ⅰ were cyst type,and these two type often had no infected symptom.Most of them were young patients.Most of Work Ⅱ were sinus and fistula type ,and these two type often had infected symptom.Most of them were teenagers.Part of patients of type Work Ⅱ showed tympanic membranous attachment. Conclusion: CFBCA was rare,and it is more common in young patients and often in left part.It always performed as mass without pain､repeated sore and discharge､external auditory discharge.Most of Work Ⅰ were cyst type,and these two type often had no infected symptom and most of them were young patients .Most of Work Ⅱ were sinus and fistula type,and these two type often had infected symptom and most of them were teenagers.Auricular endoscopy,CT,MRI could help make diagnose.Doctors clinical need to differentiate it with related diseases according to different manifestations. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

The effects of V2 antagonist (OPC-31260) on endolymphatic hydrops.

PubMed

Takeda, Taizo; Sawada, Shoichi; Takeda, Setsuko; Kitano, Hiroya; Suzuki, Mikio; Kakigi, Akinobu; Takeuchi, Shunji

2003-08-01

In the present study, two experiments were performed to investigate the influence of OPC-31260 on experimentally induced endolymphatic hydrops in guinea pigs and the regulation of aquaporin-2 (AQP2) mRNA expression in the rat inner ear. In morphological studies, the increases in the ratios of the length of Reissner's membrane (IR-L) and the cross-sectional area of the scala media (IR-S) were quantitatively assessed among normal guinea pigs (normal ears) and three groups with hydropic ears: hydropic ears with no infusion (non-infusion hydropic ears), hydropic ears with an infusion of physiological saline into the scala tympani (saline-infused hydropic ears) and hydropic ears with infusion of 0.3% OPC-31260 into the scala tympani (OPC-infused hydropic ears). IR-Ls in the experimental groups were markedly larger than in the normal ear group, but there was no significant difference among the groups of non-infusion hydropic ears, saline-infused hydropic ears and OPC-infused hydropic ears. The IR-Ss of non-infusion hydropic ears and saline-infused hydropic ears (48.8-49.3%) were statistically different from that of normal ears (6.5%) (Dunnet multiple comparison test, P<0.01). However, IR-S of the OPC-infused hydropic ears (-14.8%) was significantly smaller than those of non-infusion hydropic ears and saline-infused hydropic ears (one-way ANOVA, P<0.01). In the quantitative polymerase chain reaction study, a comparison of the ratio of AQP2 and beta-actin mRNA (MAQP2/Mbeta-actin) was made between water-injected and OPC-31260-injected rats. An intravenous injection of OPC-31260 resulted in a significant decrease in MAQP2/Mbeta-actin both in the cochlea and in the endolymphatic sac (t-test, P<0.001). These results indicate that water homeostasis in the inner ear is regulated via the vasopressin-AQP2 system, and that the vasopressin type-2 antagonist OPC-31260 is a promising drug in the treatment of Meniere's disease.

Clearance by the mucociliary system in 'simple chronic otitis media'.

PubMed

Hadas, E; Sadé, J

1979-08-01

This is a study of the rate of middle ear clearance in chronic otitis media and atelectatic ears. The clearance rate was measured with the aid of non-soluble saccharin, introduced into the middle ear through an existing perforation in 'chronic ears', or through a ventilating tube in atelectatic ears. Cholesteatomatous ears were excluded. Altogether 122 ears were examined and about two-thirds of the subjects felt the sweet taste in their mouths thereafter. The average time it took for the saccharin to be transported from the middle ear to the taste buds was 33' 22" minutes in non-infected (i.e. dry) chronic ears (38 patients or 66 per cent). Wet or infected ears with chronic otitis media (30 patients, or 58 per cent) showed a slower transport rate, averaging 54' 22" minutes--the difference was significant at the 0.01 level. 8 (63 per cent) of the atelectatic ears transported the saccharin at an average rate of 50' 25". This study demonstrated that most ears with 'simple' chronic otitis media and atelectatic ears have a patent eustachian tube and that their mucociliary system can transport foreign particles through it. When the ear is infected, transport tends to be slowed down.

Implant retained auricular prosthesis with a modified hader bar: a case report.

PubMed

Lovely, M; Dathan, Pradeep C; Gopal, Dinesh; George, Biji Thomas; Chandrasekharan Nair, K

2014-06-01

Auricular prostheses for defects of external ear are retained either by mechanical means or implants. All implant retained prostheses are retained by various means such as bar and clip, magnetic attachments or a combination of bar, clip and magnets. The commonest problem encountered with the bar and clip system is loosening of the clip after 3-4 months. When magnets are used as retaining component they tend to corrode over a period of time. So various alternative retention methods which possess good retentive qualities, ease of reparability and patient friendly were tried. In the present case a newly modified Hader bar design which can act as an additional retentive feature apart from the clip is employed to increase retention. The major advantages in the modified Hader bar system were that only two implants were employed, the additional loops in the Hader bar prevented micro movements and the retentive acrylic locks were easy to repair if broken. The modified Hader bar has anti-rotational slots which prevents the sliding or rotation of the prosthesis which gave new confidence to the patient who was otherwise worried of inadvertent displacement of the ear prosthesis while playing.

The Effect of Contralateral Acoustic Stimulation on Spontaneous Otoacoustic Emissions

PubMed Central

Dhar, Sumitrajit

2009-01-01

Evoked otoacoustic emissions are often used to study the medial olivocochlear (MOC) efferents in humans. There has been concern that the emission-evoking stimulus may itself elicit efferent activity and alter the evoked otoacoustic emission. Spontaneous otoacoustic emissions (SOAEs) are hence advantageous as no external stimulation is necessary to record the response in the test ear. Contralateral acoustic stimulation (CAS) has been shown to suppress SOAE level and elevate SOAE frequency, but the time course of these effects is largely unknown. By utilizing the Choi–Williams distribution, here we report a gradual adaptation during the presence of CAS and an overshoot following CAS offset in both SOAE magnitude and frequency from six normal-hearing female human subjects. Furthermore, we have quantified the time constants of both magnitude and frequency shifts at the onset, presence, and offset of four levels of CAS. Most studies using contralateral elicitors do not stringently control the middle-ear muscle (MEM) reflex, leaving the results difficult to interpret. In addition to clinically available measures of the MEM reflex, we have incorporated a sensitive laboratory technique to monitor the MEM reflex in our subjects, allowing us to interpret the results with greater confidence. PMID:19798532

Cervical spinal tuberculosis with tuberculous otitis media masquerading as otitis externa malignans in an elderly diabetic patient: case report.

PubMed

Aderibigbe, A; Ologe, F E

2004-05-01

Extrapulmonary manifestation of tuberculosis (Tb), a medieval disease, occurs in every part of the body with varying degree of frequency but commonly in the pleural and lymph nodes. When it occurs in bones thoracolumbar vertebrae is the usual site of involvement. Other bones are less involved hence seldomly reported. This is true for other organs and parts of the body including larynx, pharynx nose and the middle ear. More importantly, isolated extrapulmonary tuberculosis without pulmonary involvement is uncommon. The case of a 65 year old Nigerian trader who presented with headache, chronic ear ache with otorrhoea, persistent neck pain and found to be diabetic on further evaluation is presented. She was hitherto managed as a case of otitis external malignans without any improvement but rather her clinical condition worsened with evidence of cervical vertebra destruction and multiple cranial nerve palsies without pulmonary tuberculosis. Prompt and effective response to anti tuberculosis drugs informed the diagnosis of tuberculosis of the cervical vertebra and tuberculous otitis media with multiple cranial nerve palsies. This case underscores the value of high index of suspicion, thorough and complete clinical evaluation in any patient with chronic symptoms and signs unresponsive to conventional treatment.

Factors affecting the prevalence of mange-mite infestations in stray dogs of Yucatán, Mexico.

PubMed

Rodriguez-Vivas, R I; Ortega-Pacheco, A; Rosado-Aguilar, J A; Bolio, G M E

2003-07-10

The aim of the present study was to determine the factors affecting the prevalence of mange-mite infestations in stray dogs of Yucatán, Mexico. The study was carried out in 200 stray dogs of Mérida capital city of Yucatán, Mexico. Four samples (head, thoracic-abdominal area, extremities and ear) were taken from each animal by skin scraping and examined microscopically in 10% KOH solution to detect the presence of mites. Mites were also collected from the external ear canal of dogs using cotton-tipped swabs. The prevalence of different mite species was calculated. A primary screening was performed using 2xK contingency tables of exposure variables. All variables with P< or =0.20 were analyzed by a logistic-binomial regression. The overall prevalence was 34%. Demodex canis (23.0%) was the most frequent mite, followed by Sarcoptes scabei var. canis (7.0%) and Otodectes cynotis (3.5%). The following factors were found: body condition (bad, OR: 5.35, CI 95%: 1.66-17.3; regular, OR: 3.72, CI 95%: 1.39-9.99) and the presence of macroscopic lesions of dermatosis (OR: 42.80, CI 95%: 13.65-134.24).

Genetic evidence for conserved non-coding element function across species–the ears have it

PubMed Central

Turner, Eric E.; Cox, Timothy C.

2014-01-01

Comparison of genomic sequences from diverse vertebrate species has revealed numerous highly conserved regions that do not appear to encode proteins or functional RNAs. Often these “conserved non-coding elements,” or CNEs, can direct gene expression to specific tissues in transgenic models, demonstrating they have regulatory function. CNEs are frequently found near “developmental” genes, particularly transcription factors, implying that these elements have essential regulatory roles in development. However, actual examples demonstrating CNE regulatory functions across species have been few, and recent loss-of-function studies of several CNEs in mice have shown relatively minor effects. In this Perspectives article, we discuss new findings in “fancy” rats and Highland cattle demonstrating that function of a CNE near the Hmx1 gene is crucial for normal external ear development and when disrupted can mimic loss-of function Hmx1 coding mutations in mice and humans. These findings provide important support for conserved developmental roles of CNEs in divergent species, and reinforce the concept that CNEs should be examined systematically in the ongoing search for genetic causes of human developmental disorders in the era of genome-scale sequencing. PMID:24478720

Could the Use of Acoustic Reflexes Prior to Administering Distortion Product Otoacoustic Emissions (DPOAEs) Affect the Results of DPOAEs?

PubMed

Garrette, Rachel; Jones, Alisha L; Wilson, Martha W

2018-05-15

The purpose of this study is to investigate whether acoustic reflex threshold testing before administration of distortion product otoacoustic emissions can affect the results of the distortion product otoacoustic emissions testing using an automated protocol. Fifteen young adults with normal hearing ranging in age from 19 to 25 years participated in the study. All participants had clear external ear canals and normal Jerger Type A tympanograms and had passed a hearing screening. Testing was performed using the Interacoustics Titan acoustic reflex threshold and distortion product otoacoustic emissions protocol. Participants underwent baseline distortion product otoacoustic emissions. A paired-samples t test was conducted for both the right and left ears to assess within-group differences between baseline distortion product otoacoustic emissions and repeated distortion product otoacoustic emissions measures. No significant differences were found in distortion product otoacoustic emission measures following administration of acoustic reflexes. The use of a protocol when using an automated system that includes both acoustic reflexes and distortion product otoacoustic emissions is important. Overall, presentation of acoustic reflexes prior to measuring distortion product otoacoustic emission did not affect distortion product otoacoustic emission results; therefore, test sequence can be modified as needed.

Why Internally Coupled Ears (ICE) Work Well

NASA Astrophysics Data System (ADS)

van Hemmen, J. Leo

2014-03-01

Many vertebrates, such as frogs and lizards, have an air-filled cavity between left and right eardrum, i.e., internally coupled ears (ICE). Depending on source direction, internal time (iTD) and level (iLD) difference as experienced by the animal's auditory system may greatly exceed [C. Vossen et al., JASA 128 (2010) 909-918] the external, or interaural, time and level difference (ITD and ILD). Sensory processing only encodes iTD and iLD. We present an extension of ICE theory so as to elucidate the underlying physics. First, the membrane properties of the eardrum explain why for low frequencies iTD dominates whereas iLD does so for higher frequencies. Second, the plateau of iTD = γ ITD for constant 1 < γ < 5 and variable input frequency <ν∘ follows; e.g., for the Tockay gecko ν∘ ~ 1 . 5 kHz. Third, we use a sectorial instead of circular membrane to quantify the effect of the extracolumella embedded in the tympanum and connecting with the cochlea. The main parameters can be adjusted so that the model is species independent. Work done in collaboration with A.P. Vedurmudi and J. Goulet; partially supported by BCCN-Munich.

Anomalies of the middle and inner ear.

PubMed

Rodriguez, Kimsey; Shah, Rahul K; Kenna, Margaret

2007-02-01

The development of the middle and inner ear highlights the intricacy of embryology. As early as 3 weeks after fertilization, the inner ear begins taking form. This process, along with development of the middle ear, continues throughout gestation. At birth, the middle ear, inner ear, and associated structures are almost adult size. An understanding of the embryologic development of the ear serves as a foundation for evaluating and managing congenital malformations of these structures. The focus of this article is the normal, abnormal, and arrested development of the middle and inner ear, with a clinical emphasis on malformed middle and inner ear structures and a discussion of associated syndromes.

History of Resuscitation :4. Development of Resuscitation in the Mid-18 Century-4 : External Stimulation to the Body.

PubMed

Asai, Takashi

2017-05-01

From the mid-18th century, several different stimulations were used to attempt to resuscitate apparently dead people. These include sound, smell, and light stimulation to the ear, nose and eyes, rubbing the body surface and spirit given to the oral cavity. The most notable stimulation was use of electricity, which was initiated by better understanding of its power by Benjamin Franklin and Luigi A. Galvani. Charles Kite developed the first electrical machine to stimulate the heart, and by 1800, it was found that the most effective site for applying electricity was over the heart.

Oscillatory flow in the cochlea visualized by a magnetic resonance imaging technique.

PubMed

Denk, W; Keolian, R M; Ogawa, S; Jelinski, L W

1993-02-15

We report a magnetic resonance imaging technique that directly measures motion of cochlear fluids. It uses oscillating magnetic field gradients phase-locked to an external stimulus to selectively visualize and quantify oscillatory fluid motion. It is not invasive, and it does not require optical line-of-sight access to the inner ear. It permits the detection of displacements far smaller than the spatial resolution. The method is demonstrated on a phantom and on living rats. It is projected to have applications for auditory research, for the visualization of vocal tract dynamics during speech and singing, and for determination of the spatial distribution of mechanical relaxations in materials.

Association Between Hearing Loss And Cauliflower Ear in Wrestlers, a Case Control Study Employing Hearing Tests.

PubMed

Noormohammadpour, Pardis; Rostami, Mohsen; Nourian, Ruhollah; Mansournia, Mohammad Ali; Sarough Farahani, Saeed; Farahbakhsh, Farzin; Kordi, Ramin

2015-06-01

According to anecdotal findings, some wrestling coaches and wrestlers believe that cauliflower ear might lead to hearing loss. Our preliminary study showed that the prevalence of hearing loss reported by the wrestlers with cauliflower ear is significantly higher than this rate among wrestlers without cauliflower ear. To the best of our knowledge, no other study has confirmed this finding employing hearing tests. To evaluate and to compare the prevalence of hearing loss among wrestlers with and without cauliflower ears employing hearing tests. The subjects were randomly selected form 14 wrestling clubs in Tehran. Subjects were 201 wrestlers with cauliflower ears (100 wrestlers with one cauliflower ear and 101 wrestlers with two cauliflower ears) and 139 wrestlers without cauliflower ears. All the participants in this study were interviewed to collect information on demographic factors and medical history of risk factors and diseases related to hearing loss. The subjects in both groups underwent otoscopic and audiologic examinations. Audiometric examination results at the frequency range of 0.5 - 8 KHz showed that the prevalence of hearing loss among cauliflower ears was higher than this rate among non-cauliflower ears. Also, the percentage of positive history of ear infections among cauliflower ears (8.4%) was about two times more than this finding among non-cauliflower ears (4.9%). This difference tended to be significant (OR: 1.86, P = 0.06, 95% CI: 0.98 - 3.53). To the best of our knowledge, this is the first study showing that the prevalence of hearing loss among cauliflower ears is higher than this rate among non-cauliflower ears confirmed by audiological tests. This emphasizes that, more preventive measures such as mandatory ear gear for wrestlers are required.

Association Between Hearing Loss And Cauliflower Ear in Wrestlers, a Case Control Study Employing Hearing Tests

PubMed Central

Noormohammadpour, Pardis; Rostami, Mohsen; Nourian, Ruhollah; Mansournia, Mohammad Ali; Sarough Farahani, Saeed; Farahbakhsh, Farzin; Kordi, Ramin

2015-01-01

Background: According to anecdotal findings, some wrestling coaches and wrestlers believe that cauliflower ear might lead to hearing loss. Our preliminary study showed that the prevalence of hearing loss reported by the wrestlers with cauliflower ear is significantly higher than this rate among wrestlers without cauliflower ear. To the best of our knowledge, no other study has confirmed this finding employing hearing tests. Objectives: To evaluate and to compare the prevalence of hearing loss among wrestlers with and without cauliflower ears employing hearing tests. Patients and Methods: The subjects were randomly selected form 14 wrestling clubs in Tehran. Subjects were 201 wrestlers with cauliflower ears (100 wrestlers with one cauliflower ear and 101 wrestlers with two cauliflower ears) and 139 wrestlers without cauliflower ears. All the participants in this study were interviewed to collect information on demographic factors and medical history of risk factors and diseases related to hearing loss. The subjects in both groups underwent otoscopic and audiologic examinations. Results: Audiometric examination results at the frequency range of 0.5 - 8 KHz showed that the prevalence of hearing loss among cauliflower ears was higher than this rate among non-cauliflower ears. Also, the percentage of positive history of ear infections among cauliflower ears (8.4%) was about two times more than this finding among non-cauliflower ears (4.9%). This difference tended to be significant (OR: 1.86, P = 0.06, 95% CI: 0.98 - 3.53). Conclusions: To the best of our knowledge, this is the first study showing that the prevalence of hearing loss among cauliflower ears is higher than this rate among non-cauliflower ears confirmed by audiological tests. This emphasizes that, more preventive measures such as mandatory ear gear for wrestlers are required. PMID:26448842

Enzymatic recontouring of auricular cartilage in a rabbit model.

PubMed

Massengill, Phillip L; Goco, Paulino E; Norlund, L Layne; Muir-Padilla, Jeanne

2005-01-01

To evaluate the effectiveness of contouring auricular cartilage in a rabbit model using biologically active enzymes injected subcutaneously. The first phase determined the most effective volume and concentration required to affect the cartilage. To accomplish this task, we used ex vivo rabbit ears from a slaughterhouse. In the second phase, we injected 1 mL of hyaluronidase (150 U per milliliter of isotonic sodium chloride solution [saline]), elastase (1 mg per milliliter of saline), or saline into the ears of live rabbits. The study took place at the Madigan Army Medical Center (Tacoma, Wash), and included 10 animals. In each rabbit, we injected the test compound in one ear and saline in the other ear (control). We injected hyaluronidase in 5 ears and elastase in 5 ears. After injection, the ears were contoured and splinted for 4 weeks. In the third phase, we changed the injection pathway in 5 animals. At 4 weeks, 4 (80%) of the 5 ears injected with hyaluronidase showed full response and 1 (20%) had a partial response. Of the 5 ears injected with elastase, 4 (80%) showed a full response while 1 (20%) demonstrated a partial response. There was a response in all 10 of the ears injected with a test compound. Of the 10 control ears, 3 (30%) showed a partial response. At 6 weeks, approximately 6 (30%) of the ears had maintained contour demonstrating a full response. The difference between the test ears and the control ears was statistically significant (P = .006). Compared with the control ears, the results were statistically significant for elastase (P = .004) and hyaluronidase (P = .02). Overall, both agents demonstrated a subjective and objective response compared with control ears. This study demonstrates that bioactive enzymes and splinting can be effective in correcting ear deformities in a rabbit model.

Swimmer's Ear (For Parents)

MedlinePlus

... scratching the ear canal, vigorous ear cleaning with cotton swabs, or putting foreign objects like bobby pins ... Also, never put objects into kids' ears, including cotton-tipped swabs. How Is Swimmer's Ear Treated? Treatment ...

Numerical analysis of ossicular chain lesion of human ear

NASA Astrophysics Data System (ADS)

Liu, Yingxi; Li, Sheng; Sun, Xiuzhen

2009-04-01

Lesion of ossicular chain is a common ear disease impairing the sense of hearing. A comprehensive numerical model of human ear can provide better understanding of sound transmission. In this study, we propose a three-dimensional finite element model of human ear that incorporates the canal, tympanic membrane, ossicular bones, middle ear suspensory ligaments/muscles, middle ear cavity and inner ear fluid. Numerical analysis is conducted and employed to predict the effects of middle ear cavity, malleus handle defect, hypoplasia of the long process of incus, and stapedial crus defect on sound transmission. The present finite element model is shown to be reasonable in predicting the ossicular mechanics of human ear.

Evidence for a Right-Ear Advantage in Newborn Hearing Screening Results.

PubMed

Ari-Even Roth, Daphne; Hildesheimer, Minka; Roziner, Ilan; Henkin, Yael

2016-12-06

The aim of the present study was to investigate the effect of ear asymmetry, order of testing, and gender on transient-evoked otoacoustic emission (TEOAE) pass rates and response levels in newborn hearing screening. The screening results of 879 newborns, of whom 387 (study group) passed screening successfully in only one ear in the first TEOAE screening, but passed screening successfully in both ears thereafter, and 492 (control group) who passed screening successfully in both ears in the first TEOAE, were retrospectively examined for pass rates and TEOAE characteristics. Results indicated a right-ear advantage, as manifested by significantly higher pass rates in the right ear (61% and 39% for right and left ears, respectively) in the study group, and in 1.75 dB greater TEOAE response amplitudes in the control group. The right-ear advantage was enhanced when the first tested ear was the right ear (76%). When the left ear was tested first, pass rates were comparable in both ears. The right-ear advantage in pass rates was similar in females versus males, but manifested in 1.5 dB higher response amplitudes in females compared with males, regardless of the tested ear and order of testing in both study and control groups. The study provides further evidence for the functional lateralization of the auditory system at the cochlear level already apparent soon after birth in both males and females. While order of testing plays a significant role in the asymmetry in pass rates, the innate right-ear advantage seems to be a more dominant contributor. © The Author(s) 2016.

Anthropometric growth study of the ear in a Chinese population.

PubMed

Zhao, Shichun; Li, Dianguo; Liu, Zhenzhong; Wang, Yibiao; Liu, Lei; Jiang, Duyin; Pan, Bo

2018-04-01

A large number of anthropometric studies of the auricle have been reported in different nations, but little data were available in the Chinese population. The aim of this study was to analyze growth changes in the ear by measuring the width and length of ears in a Chinese population. A total of 480 participants were enrolled and classified into 1-, 3-, 5-, 7-, 9-, 12-, 14-, and 18-year groups (half were boys and half were girls in each group). Ear length, ear width, body weight, and body length were measured and recorded; ear index was calculated according to ear length and ear width. The growth of auricle and differences between genders were analyzed. Growth of ear in relation to body height and weight and the degree of emphasis on the length and width of the auricle were also analyzed. Ear length and width increased with age. Ear length achieved its mature size in both 14-year-old males and females. Ear width reached its mature size in males at 7 years and in females at 5 years. Different trends of ear index were shown between males and females. People in this population paid more attention to the length than the width of the auricle. The data indicated that ear development followed increase in age. There were gender and ethnic difference in the development of ear. These results may have potential implications for the diagnosis of congenital malformations, syndromes, and planning of ear reconstruction surgery. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Evidence for a Right-Ear Advantage in Newborn Hearing Screening Results

PubMed Central

Hildesheimer, Minka; Roziner, Ilan; Henkin, Yael

2016-01-01

The aim of the present study was to investigate the effect of ear asymmetry, order of testing, and gender on transient-evoked otoacoustic emission (TEOAE) pass rates and response levels in newborn hearing screening. The screening results of 879 newborns, of whom 387 (study group) passed screening successfully in only one ear in the first TEOAE screening, but passed screening successfully in both ears thereafter, and 492 (control group) who passed screening successfully in both ears in the first TEOAE, were retrospectively examined for pass rates and TEOAE characteristics. Results indicated a right-ear advantage, as manifested by significantly higher pass rates in the right ear (61% and 39% for right and left ears, respectively) in the study group, and in 1.75 dB greater TEOAE response amplitudes in the control group. The right-ear advantage was enhanced when the first tested ear was the right ear (76%). When the left ear was tested first, pass rates were comparable in both ears. The right-ear advantage in pass rates was similar in females versus males, but manifested in 1.5 dB higher response amplitudes in females compared with males, regardless of the tested ear and order of testing in both study and control groups. The study provides further evidence for the functional lateralization of the auditory system at the cochlear level already apparent soon after birth in both males and females. While order of testing plays a significant role in the asymmetry in pass rates, the innate right-ear advantage seems to be a more dominant contributor. PMID:27927982

Microbiomes of the normal middle ear and ears with chronic otitis media.

PubMed

Minami, Shujiro B; Mutai, Hideki; Suzuki, Tomoko; Horii, Arata; Oishi, Naoki; Wasano, Koichiro; Katsura, Motoyasu; Tanaka, Fujinobu; Takiguchi, Tetsuya; Fujii, Masato; Kaga, Kimitaka

2017-10-01

The aim of this study was to profile and compare the middle ear microbiomes of human subjects with and without chronic otitis media. Prospective multicenter cohort study. All consecutive patients undergoing tympanoplasty surgery for chronic otitis media or ear surgery for conditions other than otitis media were recruited. Sterile swab samples were collected from the middle ear mucosa during surgery. The variable region 4 of the 16S rRNA gene in each sample were amplified using region-specific primers adapted for the Illumina MiSeq sequencer (Illumina, CA, USA)). The sequences were subjected to local blast and classified using Metagenome@KIN (World Fusion, Tokyo, Japan). In total, 155 participants were recruited from seven medical centers. Of these, 88 and 67 had chronic otitis media and normal middle ears, respectively. The most abundant bacterial phyla on the mucosal surfaces of the normal middle ears were Proteobacteria, followed by Actinobacteria, Firmicutes, and Bacteroidetes. The children and adults with normal middle ears differed significantly in terms of middle ear microbiomes. Subjects with chronic otitis media without active inflammation (dry ear) had similar middle ear microbiomes as the normal middle ears group. Subjects with chronic otitis media with active inflammation (wet ear) had a lower prevalence of Proteobacteria and a higher prevalence of Firmicutes than the normal middle ears. The human middle ear is inhabited by more diverse microbial communities than was previously thought. Alteration of the middle ear microbiome may contribute to the pathogenesis of chronic otitis media with active inflammation. 2b. Laryngoscope, 127:E371-E377, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Knowledge, Attitude and Practice of Ear Care in Coastal Karnataka.

PubMed

Dosemane, Deviprasad; Ganapathi, Keerthan; Kanthila, Jayashree

2015-12-01

Ear as an organ is necessary for the perception of sound and body balance. Ear infection, diabetes mellitus, hypertension and excessive use of mobile phone for listening to music at high volume all can reduce hearing. No earlier study was available in the costal Karnataka population, regarding the practice of ear care. The study objective was to ascertain the level of knowledge of the community regarding ear care, to find out whether some of the common conditions affecting hearing are known and to find out the common practices involved in maintaining ear hygiene. This cross-sectional study was conducted on 500 subjects in two tertiary care hospitals by convenient sampling, using self-administered questionnaire. Knowledge, Attitude and Practice across the age groups, religion & education background were studied. Across different education groups, 66.7%-90% did not know that 'cold' can cause ear infection and 46.7%-75.0% did not know that diabetes and hypertension can reduce hearing. When there is ear pain or discharge, people put ear drops available at home in 48.3%-75.0% across 3 age groups; 58.5%-61.5% across 3 religions and 44.8%-67.9% across 5 education groups. No statistically significant difference was found in the practice of pouring oil into ears across religions. A total of 58.6%-100% daily clean inside the ear and 70-100% use cotton buds. General perception of the people is that ear is necessary only for hearing. Majority did not know that nasal infection can affect the ear and that DM and hypertension can cause hearing loss. When there is ear pain and discharge, most of the adults put drops that are available at home. Pouring oil into the ears and cleaning inside the ear canals is routinely practiced in costal Karnataka.

Theory of forward and reverse middle-ear transmission applied to otoacoustic emissions in infant and adult ears

PubMed Central

Keefe, Douglas H.; Abdala, Carolina

2008-01-01

The purpose of this study is to understand why otoacoustic emission (OAE) levels are higher in normal-hearing human infants relative to adults. In a previous study, distortion product (DP) OAE input/output (I/O) functions were shown to differ at f2=6 kHz in adults compared to infants through 6 months of age. These DPOAE I/O functions were used to noninvasively assess immaturities in forward/reverse transmission through the ear canal and middle ear [Abdala, C., and Keefe, D. H., (2006). J. Acoust Soc. Am. 120, 3832–3842]. In the present study, ear-canal reflectance and DPOAEs measured in the same ears were analyzed using a scattering-matrix model of forward and reverse transmission in the ear canal, middle ear, and cochlea. Reflectance measurements were sensitive to frequency-dependent effects of ear-canal and middle-ear transmission that differed across OAE type and subject age. Results indicated that DPOAE levels were larger in infants mainly because the reverse middle-ear transmittance level varied with ear-canal area, which differed by more than a factor of 7 between term infants and adults. The forward middle-ear transmittance level was −16 dB less in infants, so that the conductive efficiency was poorer in infants than adults. PMID:17348521

Ear asymmetries in middle-ear, cochlear, and brainstem responses in human infants

PubMed Central

Keefe, Douglas H.; Gorga, Michael P.; Jesteadt, Walt; Smith, Lynette M.

2008-01-01

In 2004, Sininger and Cone-Wesson examined asymmetries in the signal-to-noise ratio (SNR) of otoacoustic emissions (OAE) in infants, reporting that distortion-product (DP)OAE SNR was larger in the left ear, whereas transient-evoked (TE)OAE SNR was larger in the right. They proposed that cochlear and brainstem asymmetries facilitate development of brain-hemispheric specialization for sound processing. Similarly, in 2006 Sininger and Cone-Wesson described ear asymmetries mainly favoring the right ear in infant auditory brainstem responses (ABRs). The present study analyzed 2640 infant responses to further explore these effects. Ear differences in OAE SNR, signal, and noise were evaluated separately and across frequencies (1.5, 2, 3, and 4 kHz), and ABR asymmetries were compared with cochlear asymmetries. Analyses of ear-canal reflectance and admittance showed that asymmetries in middle-ear functioning did not explain cochlear and brainstem asymmetries. Current results are consistent with earlier studies showing right-ear dominance for TEOAE and ABR. Noise levels were higher in the right ear for OAEs and ABRs, causing ear asymmetries in SNR to differ from those in signal level. No left-ear dominance for DPOAE signal was observed. These results do not support a theory that ear asymmetries in cochlear processing mimic hemispheric brain specialization for auditory processing. PMID:18345839

Taking Care of Your Ears

MedlinePlus

... Audiologist Perforated Eardrum What's Hearing Loss? Can Loud Music Hurt My Ears? What Is an Ear Infection? Swimmer's Ear Your Ears What's Earwax? View more About Us Contact Us Partners Editorial Policy Permissions Guidelines Privacy Policy & Terms of Use Notice ...

Prevalence, prenatal diagnosis and clinical features of oculo-auriculo-vertebral spectrum: a registry-based study in Europe

PubMed Central

Barisic, Ingeborg; Odak, Ljubica; Loane, Maria; Garne, Ester; Wellesley, Diana; Calzolari, Elisa; Dolk, Helen; Addor, Marie-Claude; Arriola, Larraitz; Bergman, Jorieke; Bianca, Sebastiano; Doray, Berenice; Khoshnood, Babak; Klungsoyr, Kari; McDonnell, Bob; Pierini, Anna; Rankin, Judith; Rissmann, Anke; Rounding, Catherine; Queisser-Luft, Annette; Scarano, Gioacchino; Tucker, David

2014-01-01

Oculo-auriculo-vertebral spectrum is a complex developmental disorder characterised mainly by anomalies of the ear, hemifacial microsomia, epibulbar dermoids and vertebral anomalies. The aetiology is largely unknown, and the epidemiological data are limited and inconsistent. We present the largest population-based epidemiological study to date, using data provided by the large network of congenital anomalies registries in Europe. The study population included infants diagnosed with oculo-auriculo-vertebral spectrum during the 1990–2009 period from 34 registries active in 16 European countries. Of the 355 infants diagnosed with oculo-auriculo-vertebral spectrum, there were 95.8% (340/355) live born, 0.8% (3/355) fetal deaths, 3.4% (12/355) terminations of pregnancy for fetal anomaly and 1.5% (5/340) neonatal deaths. In 18.9%, there was prenatal detection of anomaly/anomalies associated with oculo-auriculo-vertebral spectrum, 69.7% were diagnosed at birth, 3.9% in the first week of life and 6.1% within 1 year of life. Microtia (88.8%), hemifacial microsomia (49.0%) and ear tags (44.4%) were the most frequent anomalies, followed by atresia/stenosis of external auditory canal (25.1%), diverse vertebral (24.3%) and eye (24.3%) anomalies. There was a high rate (69.5%) of associated anomalies of other organs/systems. The most common were congenital heart defects present in 27.8% of patients. The prevalence of oculo-auriculo-vertebral spectrum, defined as microtia/ear anomalies and at least one major characteristic anomaly, was 3.8 per 100 000 births. Twinning, assisted reproductive techniques and maternal pre-pregnancy diabetes were confirmed as risk factors. The high rate of different associated anomalies points to the need of performing an early ultrasound screening in all infants born with this disorder. PMID:24398798

Protection Against Hearing Loss in General Aviation Operations, Phase II

NASA Technical Reports Server (NTRS)

Parker, J. F., Jr.

1972-01-01

An inflight evaluation of four aural protectors is presented. The hearing protection devices studied were ear muffs, plastic ear plugs, rubber ear plugs, and wax ear plugs. It is concluded that ear plugs are satisfactory for providing adequate sound attenuation in general aviation aircraft. However, two problems were found in the use of ear plugs; comfort and interference with cabin communications.

Estimation of outer-middle ear transmission using DPOAEs and fractional-order modeling of human middle ear

NASA Astrophysics Data System (ADS)

Naghibolhosseini, Maryam

Our ability to hear depends primarily on sound waves traveling through the outer and middle ear toward the inner ear. Hence, the characteristics of the outer and middle ear affect sound transmission to/from the inner ear. The role of the middle and outer ear in sound transmission is particularly important for otoacoustic emissions (OAEs), which are sound signals generated in a healthy cochlea, and recorded by a sensitive microphone placed in the ear canal. OAEs are used to evaluate the health and function of the cochlea; however, they are also affected by outer and middle ear characteristics. To better assess cochlear health using OAEs, it is critical to quantify the impact of the outer and middle ear on sound transmission. The reported research introduces a noninvasive approach to estimate outer-middle ear transmission using distortion product otoacoustic emissions (DPOAEs). In addition, the role of the outer and middle ear on sound transmission was investigated by developing a physical/mathematical model, which employed fractional-order lumped elements to include the viscoelastic characteristics of biological tissues. Impedance estimations from wideband refectance measurements were used for parameter fitting of the model. The model was validated comparing its estimates of the outer-middle ear sound transmission with those given by DPOAEs. The outer-middle ear transmission by the model was defined as the sum of forward and reverse outer-middle ear transmissions. To estimate the reverse transmission by the model, the probe-microphone impedance was calculated through estimating the Thevenin-equivalent circuit of the probe-microphone. The Thevenin-equivalent circuit was calculated using measurements in a number of test cavities. Such modeling enhances our understanding of the roles of different parts of the outer and middle ear and how they work together to determine their function. In addition, the model would be potentially helpful in diagnosing pathologies of cochlear or middle ear origin.

Teasing in younger and older children with microtia before and after ear reconstruction.

PubMed

Johns, Alexis L; Lewin, Sheryl L; Im, Daniel D

2017-06-01

This study prospectively measured teasing and emotional adjustment before and after ear reconstruction in younger and older children with microtia. Participants with isolated microtia (n = 28) were divided into two groups by age at surgery, with a younger group aged 3-5 years (n = 13) with a mean age of 4.0 (0.71) years at the time of surgery and an older group aged 6-10 years old (n = 15) with a mean age of 7.87 (1.30) years. Children and their parents were interviewed preoperatively and a year after surgery about teasing and emotions about their ear(s). Teasing began between the ages of 2.4-4.8 years. A third of the younger group and all of the older group reported preoperative teasing. Before surgery, the older group reported higher rates of negative emotions about their ear(s) and teasing was correlated for all ages with feeling sad, worried, and mad about their ear(s). After surgery, teasing and negative emotions significantly decreased with increased happiness about their ear(s). Postoperative teasing was correlated with trying to hide their ear(s). There were significant interactions from before to after surgery based on surgery age for frequency of teasing, sadness, and feeling mad, with the older group showing relatively greater change postoperatively. Teasing and negative emotions about their ear(s) decreased for all ages after surgery, with a potential protective factor seen in younger surgery age.

Impact of socio-economic status on ear health and behaviour in children: A cross-sectional study in the capital of India.

PubMed

Gupta, Divya; Gulati, Achal; Gupta, Umang

2015-11-01

Socio-economic differences in the society have been a major cause for the discrepancy in disease and behavioural patterns in society. With 360 million people (32 million children) in the world suffering from disabling hearing losses, it is imperative to gain an insight into the impact of differences in socio-economic strata on children's ear health issues, their knowledge of ear ailments and attitude towards ear health so as to suggest policies addressing ear health issues. The study was carried out in two different school types namely government schools and private schools which represent wide difference in the socio-economic status of the students studying there. A questionnaire was administered to students aged 10 to 13 years to assess the current ear care practices, knowledge regarding ear ailments, attitude towards hearing and their adaptability to reform. The children belonging to higher socio-economic status were found to have lesser incidence of ear diseases and ear abuse, more referrals for ear ailments, lesser indulgence in risky ear health behaviours, better knowledge pool, positive attitude towards ear health and hearing and were more adaptable to change for better hearing. Structures of social disparity are essential determinants of ear health acting both independently and through their influence on behavioural determinants of health. Increasing awareness of ear health issues at the school level itself should be one of the goals of health care providers. Copyright © 2015. Published by Elsevier Ireland Ltd.

Middle Ear Infections (For Parents)

MedlinePlus

... Staying Safe Videos for Educators Search English Español Middle Ear Infections KidsHealth / For Parents / Middle Ear Infections What's ... en español Infecciones del oído medio What Are Middle Ear Infections? Ear infections happen when viruses or bacteria ...

[Transitory evoked otoacoustic emissions and distortion product emissions in disorders of middle ear ventilation].

PubMed

Schmuziger, N; Hauser, R; Probst, R

1996-06-01

Both the amplitude and power spectra of otoacoustic emissions are affected by the transfer properties of the middle ear. This prospective study examined the influence of eustachian tube dysfunction on transiently evoked otoacoustic emissions (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs). In all, 18 ears were studied that exhibited negative middle ear pressures with or without middle ear fluid. Measurements were performed at the time of diagnosis during the recovery stage, and after the middle ear became normally ventilated. Findings showed that TEOAE and DPOAE levels increased while airbone gaps were reduced by an average of 8 dB after negative middle ear pressures returned from -400 daPa to a normal state. There was a tendency for negative middle ear pressure to affect DPOAEs more in the 1-kHz region than in higher frequencies. By contrast, TEOAEs and airbone gaps were more uniformly affected across the entire frequency range. These results for ears with eustachian tube dysfunction were somewhat different from those results of studies obtained in healthy ears tested during experimental changes in middle ear pressure.

Missing links in some curious auditory phenomena: a tale from the middle ear.

PubMed

Carpenter, Michelle S; Cacace, Anthony T; Mahoney, Marty J

2012-02-01

Broadband middle ear power reflectance (BMEPR) is an emerging noninvasive electroacoustic measure that evaluates transmission/reflection properties of the middle ear in high resolution. It is applicable over the entire age continuum and is rapid to perform. However, it remains to be determined if BMEPR is just an incremental step in the evolution of middle ear assessment or a major advance in the way middle ear function can be evaluated. To evaluate effects of age, gender, ear, and frequency on BMEPR measurements in adults without a history of middle ear disease and to assess whether these factors require consideration in test development; to review how these data may influence active physiologic process within the inner ear; to consider how they reconcile with previously published results; and to suggest applications for future research. Prospective, cross-sectional, multivariate analysis to evaluate the effects of age, gender, ear, and frequency on BMEPR in humans without a history of middle ear disease and no air-bone gaps exceeding 10 dB for any frequency. Fifty-six adults in two age groups (Group 1: 18-25 yr, n = 28; Group 2: ≥50 and <66 yr, n = 28). Each age group was stratified by ear and gender in a balanced design. Pure tone air conduction and bone-conduction audiometry was conducted in a commercial sound booth, using a clinical audiometer with standard earphones enclosed in supra-aural ear cushions, and a standard bone-conduction oscillator and headband to evaluate for air-bone gaps. Broadband middle ear power reflectance was measured using a calibrated, commercially available computer-controlled system that incorporated a high quality probe assembly to transduce stimuli and record acoustic responses from the ear canal. Data were analyzed with a four-way (2 × 2 × 2 × 16) repeated measures analysis-of-variance (ANOVA) to evaluate the effects of age group (young vs. old), gender (male vs. female), ear (left vs. right), and frequency (258 to 5040 Hz) on BMEPR. The ANOVA revealed a significant main effect of frequency. There were also gender × ear, gender × frequency, and age × gender × ear interactions. The three-way, age × gender × ear interaction captured the essence of results and revealed lowest power reflectance values in younger females and for right ears. This trend partially reversed in the older age group where higher power reflectance values were observed only in right ears of older females. The significant effects of age, gender, ear, and frequency on BMEPR parallel ear- and gender-related differences in hearing sensitivity, ear, and gender differences in the prevalence of spontaneous otoacoustic emissions (OAEs), gender differences in the magnitude of transient evoked OAEs, and ear differences in transient evoked contralateral OAE suppression effects reported in the literature. While original discussions of these aforementioned effects focused primarily on endocochlear and olivocochlear mechanisms, the BMEPR measurements reported herein suggest that middle ear transmission characteristics may also play a role. American Academy of Audiology.

Ear discharge

MedlinePlus

... swabs or other small objects into the ear Middle ear infection Other causes of ear discharge include: Eczema ... tube surgery - what to ask your doctor Images Ear anatomy Eardrum repair - series References Bauer CA, Jenkins HA. Otologic symptoms and syndromes. In: Flint PW, Haughey BH, Lund V, et ...

Genetic Architecture of Ear Fasciation in Maize (Zea mays) under QTL Scrutiny

PubMed Central

Mendes-Moreira, Pedro; Alves, Mara L.; Satovic, Zlatko; dos Santos, João Pacheco; Santos, João Nina; Souza, João Cândido; Pêgo, Silas E.; Hallauer, Arnel R.; Vaz Patto, Maria Carlota

2015-01-01

Maize ear fasciation Knowledge of the genes affecting maize ear inflorescence may lead to better grain yield modeling. Maize ear fasciation, defined as abnormal flattened ears with high kernel row number, is a quantitative trait widely present in Portuguese maize landraces. Material and Methods Using a segregating population derived from an ear fasciation contrasting cross (consisting of 149 F2:3 families) we established a two location field trial using a complete randomized block design. Correlations and heritabilities for several ear fasciation-related traits and yield were determined. Quantitative Trait Loci (QTL) involved in the inheritance of those traits were identified and candidate genes for these QTL proposed. Results and Discussion Ear fasciation broad-sense heritability was 0.73. Highly significant correlations were found between ear fasciation and some ear and cob diameters and row number traits. For the 23 yield and ear fasciation-related traits, 65 QTL were identified, out of which 11 were detected in both environments, while for the three principal components, five to six QTL were detected per environment. Detected QTL were distributed across 17 genomic regions and explained individually, 8.7% to 22.4% of the individual traits or principal components phenotypic variance. Several candidate genes for these QTL regions were proposed, such as bearded-ear1, branched silkless1, compact plant1, ramosa2, ramosa3, tasselseed4 and terminal ear1. However, many QTL mapped to regions without known candidate genes, indicating potential chromosomal regions not yet targeted for maize ear traits selection. Conclusions Portuguese maize germplasm represents a valuable source of genes or allelic variants for yield improvement and elucidation of the genetic basis of ear fasciation traits. Future studies should focus on fine mapping of the identified genomic regions with the aim of map-based cloning. PMID:25923975

Ear canal dynamic motion as a source of power for in-ear devices

NASA Astrophysics Data System (ADS)

Delnavaz, Aidin; Voix, Jérémie

2013-02-01

Ear canal deformation caused by temporomandibular joint (jaw joint) activity, also known as "ear canal dynamic motion," is introduced in this paper as a candidate source of power to possibly recharge hearing aid batteries. The geometrical deformation of the ear canal is quantified in 3D by laser scanning of different custom ear moulds. An experimental setup is proposed to measure the amount of power potentially available from this source. The results show that 9 mW of power is available from a 15 mm3 dynamic change in the ear canal volume. Finally, the dynamic motion and power capability of the ear canal are investigated in a group of 12 subjects.

Inner Ear Drug Delivery for Auditory Applications

PubMed Central

Swan, Erin E. Leary; Mescher, Mark J.; Sewell, William F.; Tao, Sarah L.; Borenstein, Jeffrey T.

2008-01-01

Many inner ear disorders cannot be adequately treated by systemic drug delivery. A blood-cochlear barrier exists, similar physiologically to the blood-brain barrier, which limits the concentration and size of molecules able to leave the circulation and gain access to the cells of the inner ear. However, research in novel therapeutics and delivery systems has led to significant progress in the development of local methods of drug delivery to the inner ear. Intratympanic approaches, which deliver therapeutics to the middle ear, rely on permeation through tissue for access to the structures of the inner ear, whereas intracochlear methods are able to directly insert drugs into the inner ear. Innovative drug delivery systems to treat various inner ear ailments such as ototoxicity, sudden sensorineural hearing loss, autoimmune inner ear disease, and for preserving neurons and regenerating sensory cells are being explored. PMID:18848590

Transmission matrix analysis of the chinchilla middle ear

PubMed Central

Songer, Jocelyn E.; Rosowski, John J.

2008-01-01

Despite the common use of the chinchilla as an animal model in auditory research, a complete characterization of the chinchilla middle ear using transmission matrix analysis has not been performed. In this paper we describe measurements of middle-ear input admittance and stapes velocity in ears with the middle-ear cavity opened under three conditions: intact tympano-ossicular system and cochlea, after the cochlea has been drained, and after the stapes has been fixed. These measurements, made with stimulus frequencies of 100–8000 Hz, are used to define the transmission matrix parameters of the middle ear and to calculate the cochlear input impedance as well as the middle-ear output impedance. This transmission characterization of the chinchilla middle ear will be useful for modeling auditory sensitivity in the normal and pathological chinchilla ear. PMID:17672642

Ear wax

MedlinePlus

See your provider if your ears are blocked with wax and you are unable to remove the wax. Also call if you have an ear wax blockage and you develop new symptoms, such as: Drainage from the ear Ear pain Fever Hearing loss that continues after you clean the wax

A new method for correcting type I and type II constricted (cup and lop) ears.

PubMed

Xiaogeng, Hu; Hongxing, Zhuang; Qinghua, Yang; Haiyue, Jiang; Yanyong, Zhao

2006-01-01

Tanzer suggested the term "constricted ear," denoting a spectrum of deformities limited to the superior third of the ear. Tanzer classified the constricted ear into three types. Type I ears have involvement of the helix, which usually is flattened. Type II ears show involvement of both the helix and the scapha. With type III ears, the auricle is rolled into a nearly tubular form that some authors regard as a form of microtia. The authors' new method for correcting the constricted ear varies in accordance with the diverse degree of deformity. The new method was used to correct constricted ears through a one-stage operation in eight type I cases. For the remaining six type 2 cases, the methods were combined with composite grafting. Most of the patients were satisfied with the final results. Therefore, the authors conclude that their approach is suitable for the treatment of type I and type II constricted ears.

Handheld tympanometer measurements in conscious dogs for the evaluation of the middle ear and auditory tube.

PubMed

Strain, George M; Fernandes, Asia J

2015-06-01

Otitis externa is frequently accompanied by otitis media, yet it can be difficult to evaluate the tympanum, middle ear and auditory tube without the use of advanced radiographic imaging. The objective was to develop techniques for tympanometry testing in conscious dogs and to present normative data for clinical use of this equipment to enable assessment of the tympanum, middle ear and auditory tube. Sixteen hounds (14 female) from a school teaching colony. Dogs were gently restrained in a standing position. After cleaning of the ear canal, a tympanometer probe tip extension was placed in the vertical canal and automated testing performed using a handheld device. Both ears were tested in all dogs. Acceptable recordings were obtained from both ears of 13 dogs, from one ear in each of two dogs and from neither ear of one dog, resulting in data from 28 of 32 (88%) ears. Otoscopic examination confirmed the absence of inflammation or any other obvious explanation for the noncompliant dogs. No significant differences were seen between ears for any measure. Normative data are reported for peak compliance, peak compliance pressure, gradient and ear canal volume. Tympanograms can be recorded in conscious dogs to assist in the evaluation of the middle ear structures. © 2015 ESVD and ACVD.

Deriving the real-ear SPL of audiometric data using the "coupler to dial difference" and the "real ear to coupler difference".

PubMed

Munro, K J; Davis, J

2003-04-01

The purpose of the study was to compare the measured real-ear sound pressure level (SPL) of audiometer output with the derived real-ear SPL obtained by adding the coupler to dial difference (CDD) and real-ear to coupler difference (RECD) to the audiometer dial reading. The real-ear SPL and RECD were measured in one ear of 16 normally hearing subjects using a probe-tube microphone. The CDD transform and the RECD transfer function were measured in an HA1 and an HA2 2-cc coupler using an EAR-LINK foam ear-tip or a customized earmold. The RECD transfer function was measured using the EARTone ER 3A and the Audioscan RE770 insert earphone. The procedures were very reliable with mean differences on retest of less than 1 dB. The mean difference between the measured and derived real-ear SPL was generally less than 1 dB and rarely exceeded 3 dB in any subject. The CDD measured for an individual audiometer and the RECD measured for an individual ear can be used to derive a valid estimate of real-ear SPL when it has not been possible to measure this directly.

Chinchilla middle-ear admittance and sound power: High-frequency estimates and effects of inner-ear modifications

PubMed Central

Ravicz, Michael E.; Rosowski, John J.

2012-01-01

The middle-ear input admittance relates sound power into the middle ear (ME) and sound pressure at the tympanic membrane (TM). ME input admittance was measured in the chinchilla ear canal as part of a larger study of sound power transmission through the ME into the inner ear. The middle ear was open, and the inner ear was intact or modified with small sensors inserted into the vestibule near the cochlear base. A simple model of the chinchilla ear canal, based on ear canal sound pressure measurements at two points along the canal and an assumption of plane-wave propagation, enables reliable estimates of YTM, the ME input admittance at the TM, from the admittance measured relatively far from the TM. YTM appears valid at frequencies as high as 17 kHz, a much higher frequency than previously reported. The real part of YTM decreases with frequency above 2 kHz. Effects of the inner-ear sensors (necessary for inner ear power computation) were small and generally limited to frequencies below 3 kHz. Computed power reflectance was ∼0.1 below 3.5 kHz, lower than with an intact ME below 2.5 kHz, and nearly 1 above 16 kHz. PMID:23039439

Expression of macrophage migration inhibitory factor and CD74 in the inner ear and middle ear in lipopolysaccharide-induced otitis media.

PubMed

Ishihara, Hisashi; Kariya, Shin; Okano, Mitsuhiro; Zhao, Pengfei; Maeda, Yukihide; Nishizaki, Kazunori

2016-10-01

Significant expression of macrophage migration inhibitory factor and its receptor (CD74) was observed in both the middle ear and inner ear in experimental otitis media in mice. Modulation of macrophage migration inhibitory factor and its signaling pathway might be useful in the management of inner ear inflammation due to otitis media. Inner ear dysfunction secondary to otitis media has been reported. However, the specific mechanisms involved are not clearly understood. The aim of this study is to investigate the expression of macrophage migration inhibitory factor and CD74 in the middle ear and inner ear in lipopolysaccharide-induced otitis media. BALB/c mice received a transtympanic injection of either lipopolysaccharide or phosphate-buffered saline (PBS). The mice were sacrificed 24 h after injection, and temporal bones were processed for polymerase chain reaction (PCR) analysis, histologic examination, and immunohistochemistry. PCR examination revealed that the lipopolysaccharide-injected mice showed a significant up-regulation of macrophage migration inhibitory factor in both the middle ear and inner ear as compared with the PBS-injected control mice. The immunohistochemical study showed positive reactions for macrophage migration inhibitory factor and CD74 in infiltrating inflammatory cells, middle ear mucosa, and inner ear in the lipopolysaccharide-injected mice.

Thyroid Hormone Receptors Control Developmental Maturation of the Middle Ear and the Size of the Ossicular Bones

PubMed Central

Cordas, Emily A.; Ng, Lily; Hernandez, Arturo; Kaneshige, Masahiro; Cheng, Sheue-Yann

2012-01-01

Thyroid hormone is critical for auditory development and has well-known actions in the inner ear. However, less is known of thyroid hormone functions in the middle ear, which contains the ossicles (malleus, incus, stapes) that relay mechanical sound vibrations from the outer ear to the inner ear. During the later stages of middle ear development, prior to the onset of hearing, middle ear cavitation occurs, involving clearance of mesenchyme from the middle ear cavity while the immature cartilaginous ossicles attain appropriate size and ossify. Using in situ hybridization, we detected expression of Thra and Thrb genes encoding thyroid hormone receptors α1 and β (TRα1 and TRβ, respectively) in the immature ossicles, surrounding mesenchyme and tympanic membrane in the mouse. Thra+/PV mice that express a dominant-negative TRα1 protein exhibited deafness with elevated auditory thresholds and a range of middle ear abnormalities including chronic persistence of mesenchyme in the middle ear into adulthood, markedly enlarged ossicles, and delayed ossification of the ossicles. Congenitally hypothyroid Tshr−/− mice and TR-deficient Thra1−/−;Thrb−/− mice displayed similar abnormalities. These findings demonstrate that middle ear maturation is TR dependent and suggest that the middle ear is a sensitive target for thyroid hormone in development. PMID:22253431

Comparison of packing material in an animal model of middle ear trauma.

PubMed

Perez, Enrique; Hachem, Ralph Abi; Carlton, Daniel; Bueno, Isabel; Vernon, Stephen; Van De Water, Thomas R; Angeli, Simon I

2016-01-01

To compare the performance of absorbable gelatin sponge (AGS) with polyurethane foam (PUF) as middle ear packing material after mucosal trauma. Using a randomized, controlled and blinded study design fifteen guinea pigs underwent middle ear surgery with mucosal trauma performed on both ears. One ear was packed with either PUF or AGS while the contralateral ear remained untreated and used as non-packed paired controls. Auditory brainstem response (ABR) thresholds were measured pre-operatively and repeated at 1, 2, and 6weeks postoperatively. Histological analysis of middle ear mucosa was done in each group to evaluate the inflammatory reaction and wound healing. Another eighteen animals underwent middle ear wounding and packing in one ear while the contralateral ear was left undisturbed as control. Twelve guinea pigs were euthanized at 2weeks postoperatively, and six were euthanized at 3days post-operatively. Mucosal samples were collected for analysis of TGF-β1 levels by enzyme-linked immunosorbent assay. ABR recordings demonstrate that threshold level changes from baseline were minor in PUF packed and control ears. Threshold levels were higher in the AGS packed ears compared with both control and PUF packed ears for low frequency stimuli. Histological analysis showed persistence of packing material at 6weeks postoperatively, inflammation, granulation tissue formation, foreign body reaction and neo-osteogenesis in both AGS and PUF groups. TGF-β1 protein levels did not differ between groups. PUF and AGS packing cause inflammation and neo-osteogenesis in the middle ear following wounding of the mucosa and packing. Copyright © 2016 Elsevier Inc. All rights reserved.

A simplified method for correcting Tanzer's group II constricted ears: Construction of the superior crus as a strut with cartilage expansion grafting.

PubMed

Kim, Young Soo; Chung, Seum

2016-04-01

A constricted ear, also known as a cup ear or lop ear, is a deformity characterized by curling of the upper portion of the ear, including the helix, scapha, and antihelix. In Tanzer's classification, group II constricted ears have deformities involving the helix and the scapha. Although partial or total absence of the superior crus of the antihelix has been noted in group II constricted ears, most plastic surgeons have corrected group II constricted ears using the expansion technique and skin flaps, without formation of the superior crus. However, the expansion technique does not always yield satisfactory results in group II constricted ears. Between May 2011 and April 2014, the authors operated on 21 patients with group II constricted ears using the technique described in this study. The follow-up period ranged from 2 months to 2 years. In our procedure for correcting group II constricted ears, we focused on restoring the superior crus of the antihelix. As a strong superior crus acts as a strut in the upper third of the ear, it supports the helical rim and creates the scapha. Eventually, the newly formed superior crus enables the helical rim to expand in the upper third of the constricted ear. In this article, we present our method of correcting group II constricted ears, in which the superior crus is constructed as a strut and cartilage expansion grafts are used. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Barotrauma vis-a-vis the "chronic otitis media syndrome": two conditions with middle ear gas deficiency Is secretory otitis media a contraindication to air travel?

PubMed

Sadé, Jacob; Ar, Amos; Fuchs, Camil

2003-03-01

We compared 17 patients (29 ears) with barotrauma with 171 patients suffering from "chronic ears" (secretory otitis media, atelectasis, or previously operated cholesteatoma). The patients with "chronic ears" were followed up prospectively, and none were found to suffer from barotrauma after flying on a commercial airplane. The mastoid pneumatization (seen on lateral mastoid radiographs) was significantly larger in ears with barotrauma, averaging 16.85 cm2, versus 12.9 cm2 in normal controls, whereas in "chronic ears" it was only 3.6 cm2. During flight on a commercial airplane, the middle ear has to equalize about 20% of its gas volume with the ambient pressure. This equalization must happen within 15 to 20 minutes of ascent and descent in order to avoid barotrauma. This 20% is a fivefold greater task for ears with a large mastoid pneumatization than for ears with an undeveloped pneumatization; "chronic ears" usually have an undeveloped mastoid pneumatization. The smaller the middle ear (mastoid) volume, the smaller the volume of gas needed to pass through the eustachian tube in order to equalize pressure changes during flying. This factor may explain why "chronic ears" rarely suffer from barotrauma. It also implies that eustachian tubes of secretory otitis, atelectatic, and cholesteatomatous ears have little problem in equalizing large pressure differences (over 2,000 mm H2O) within 15 to 20 minutes of landing, in contrast to what has been traditionally believed. Individuals with "chronic ears" can be advised that they can fly safely.

Ear Pieces

ERIC Educational Resources Information Center

DiJulio, Betsy

2011-01-01

In this article, the author describes an art project wherein students make fanciful connections between art and medicine. This project challenges students to interpret "ear idioms" (e.g. "blow it out your ear," "in one ear and out the other") by relying almost entirely on realistic ear drawings, the placement of them, marks, and values. In that…

[Constricted ear therapy with free auricular composite grafts].

PubMed

Liu, Tun; Zhang, Lian-sheng; Zhuang, Hong-xing; Zhang, Ke-yuan

2004-03-01

A simple and effective therapy for single side constricted ear. Transplanting normal side free composite auricular grafts to constricted ear (15 patients and 15 sides), then lengthening the helix, exposing the scapha, correcting deformity. The 15 patients composite grafts all survived. The helix has been lengthened, the scapha exposed, the normal ear reduced, the constricted ear augmented and two sides ear have become symmetry. This method is simple and results are satisfied.

Semiautomated Middle Ear Volume Measurement as a Predictor of Postsurgical Outcomes for Congenital Aural Atresia.

PubMed

Kabadi, S J; Ruhl, D S; Mukherjee, S; Kesser, B W

2018-02-01

Middle ear space is one of the most important components of the Jahrsdoerfer grading system (J-score), which is used to determine surgical candidacy for congenital aural atresia. The purpose of this study was to introduce a semiautomated method for measuring middle ear volume and determine whether middle ear volume, either alone or in combination with the J-score, can be used to predict early postoperative audiometric outcomes. A retrospective analysis was conducted of 18 patients who underwent an operation for unilateral congenital aural atresia at our institution. Using the Livewire Segmentation tool in the Carestream Vue PACS, we segmented middle ear volumes using a semiautomated method for all atretic and contralateral normal ears on preoperative high-resolution CT imaging. Postsurgical audiometric outcome data were then analyzed in the context of these middle ear volumes. Atretic middle ear volumes were significantly smaller than those in contralateral normal ears ( P < .001). Patients with atretic middle ear volumes of >305 mm 3 had significantly better postoperative pure tone average and speech reception thresholds than those with atretic ears below this threshold volume ( P = .01 and P = .006, respectively). Atretic middle ear volume incorporated into the J-score offered the best association with normal postoperative hearing (speech reception threshold ≤ 30 dB; OR = 37.8, P = .01). Middle ear volume, calculated in a semiautomated fashion, is predictive of postsurgical audiometric outcomes, both independently and in combination with the conventional J-score. © 2018 by American Journal of Neuroradiology.

Development of a morphing technique for predicting the position and size of an artificial ear in hemifacial microsomia patients.

PubMed

Coward, Trevor J; Richards, Robin; Scott, Brendan J J

2014-01-01

People with hemifacial microsomia may be missing an ear on the affected side of the face. The principal aim of the study was to develop a morphing technique and to determine whether it could be used to appropriately position an artificial ear, as well as to give an indication of prosthesis size in comparison with the natural ear. Comparisons also were made between the artificial ears being worn by the patients with their natural ears. Data from stereophotogrammetry images of the faces of 10 people were converted into stereolithographic format. Anthropometric points on the face and ear of the unaffected side were plotted. By a process of scaling, the distance between facial landmarks on the unaffected side was estimated for the affected side so as to identify where the morphed ear would be positioned once generated. Generally, the morphed ears appeared to be in acceptable positions. There was a statistically significant difference between the position of the morphed and natural ears (P = .011), as well as the artificial and natural ears (P = .001), but this was unlikely to have any clinical implications. There were no significant differences among the sizes of the natural, morphed, and artificial ears (P = .072). Morphing appears to offer a more precise way of planning the positioning and construction of an artificial ear on patients with hemifacial microsomia than traditional methods. Differences in facial shape on either side of the face may impact on the process. This requires further study.

The prominent antihelix and helix--the myth of the 'overcorrected' ear in otoplasty.

PubMed

Shokrollahi, Kayvan; Manning, Steven; Sadri, Amir; Molajo, Adeyinka; Lineaweaver, William

2015-06-01

Classic teaching of ear anatomy in the context of otoplasty states that if the antihelical fold is more prominent than the helical fold after surgery then the ear is "overcorrected." We set out to explore the role of the antihelix in normal ear anatomy, its relevance to aesthetic perceptions of the ear, and a snapshot of its incidence in nonoperated ears. To readily identify junior staff in our department, their color photographs, names, and contact details are posted on every ward. Using digital methods, we cropped the left ear out of the source images, making them unidentifiable. Clinical and nonclinical staff in our unit were asked to choose their favorite and their least favorite ears based on their aesthetic appeal. Responses were tabulated and the 2 most popular ears were compared. The preferred ear did not conform to the traditional dogma because it had a prominent antihelix and was statistically significant when compared to other choices. We also noted that a prominent antihelix is common among the general population and among colleagues within the department, and hence "normal." Also interesting was that the helix of the ear chosen as the most aesthetic was also the ear where the helix was almost touching the side of the head. We found that when judging the aesthetic nature of the "virgin" ear, antihelical fold prominence did not appear to be a negative attribute. Indeed, we noted that a prominent antihelix was a common attribute, and we conclude that this was a normal variant without undue negative aesthetic stigma. A surgically corrected ear should not necessarily be regarded as a poor outcome simply on the basis of antihelical prominence. Furthermore, we postulate that patients who have a prominent antihelix might be part of a spectrum of individuals who might have had the subtype of prominent ears featuring a deep conchal bowl. Finally, although not tested directly, it appears that we do not have an idea of our own ear shape, as none of the participants was able to recognize their own ear from the photographs.

Duplication of the External Auditory Canal: Two Cases and a Review of the Literature

PubMed Central

Goudakos, John K.; Blioskas, Sarantis; Psillas, George; Vital, Victor; Markou, Konstantinos

2012-01-01

The objective of the present paper is to describe the clinical presentation, diagnostic process, surgical treatment, and outcome of 2 patients with first branchial cleft anomaly. The first case was an 8-year-old girl presented with an elastic lesion located in the left infra-auricular area, in close relation with the lobule, duplicating the external auditory canal. The magnetic resonance imaging revealed a lesion, appearing as a rather well-circumscribed mass within the left parotid gland and duplicating the ear canal. A superficial parotidectomy was subsequently performed, with total excision of the cyst. The second patient was a 15-year-old girl presented with a congenital fistula of the right lateral neck. At superficial parotidectomy, a total excision of the fistula was performed. During the operation the tract was recorded to lay between the branches of the facial nerve, extending with a blind ending canal parallel to the external acoustic meatus. Conclusively, first branchial cleft anomalies are rare malformations with cervical, parotid, or auricular clinical manifestations. Diagnosis of first branchial cleft lesions is achieved mainly through careful physical examination. Complete surgical excision with wide exposure of the lesion is essential in order to achieve permanent cure and avoid recurrence. PMID:23213587

Spatial Hearing with Incongruent Visual or Auditory Room Cues

PubMed Central

Gil-Carvajal, Juan C.; Cubick, Jens; Santurette, Sébastien; Dau, Torsten

2016-01-01

In day-to-day life, humans usually perceive the location of sound sources as outside their heads. This externalized auditory spatial perception can be reproduced through headphones by recreating the sound pressure generated by the source at the listener’s eardrums. This requires the acoustical features of the recording environment and listener’s anatomy to be recorded at the listener’s ear canals. Although the resulting auditory images can be indistinguishable from real-world sources, their externalization may be less robust when the playback and recording environments differ. Here we tested whether a mismatch between playback and recording room reduces perceived distance, azimuthal direction, and compactness of the auditory image, and whether this is mostly due to incongruent auditory cues or to expectations generated from the visual impression of the room. Perceived distance ratings decreased significantly when collected in a more reverberant environment than the recording room, whereas azimuthal direction and compactness remained room independent. Moreover, modifying visual room-related cues had no effect on these three attributes, while incongruent auditory room-related cues between the recording and playback room did affect distance perception. Consequently, the external perception of virtual sounds depends on the degree of congruency between the acoustical features of the environment and the stimuli. PMID:27853290

The Contribution of Head Movement to the Externalization and Internalization of Sounds

PubMed Central

Brimijoin, W. Owen; Boyd, Alan W.; Akeroyd, Michael A.

2013-01-01

Background When stimuli are presented over headphones, they are typically perceived as internalized; i.e., they appear to emanate from inside the head. Sounds presented in the free-field tend to be externalized, i.e., perceived to be emanating from a source in the world. This phenomenon is frequently attributed to reverberation and to the spectral characteristics of the sounds: those sounds whose spectrum and reverberation matches that of free-field signals arriving at the ear canal tend to be more frequently externalized. Another factor, however, is that the virtual location of signals presented over headphones moves in perfect concert with any movements of the head, whereas the location of free-field signals moves in opposition to head movements. The effects of head movement have not been systematically disentangled from reverberation and/or spectral cues, so we measured the degree to which movements contribute to externalization. Methodology/Principal Findings We performed two experiments: 1) Using motion tracking and free-field loudspeaker presentation, we presented signals that moved in their spatial location to match listeners’ head movements. 2) Using motion tracking and binaural room impulse responses, we presented filtered signals over headphones that appeared to remain static relative to the world. The results from experiment 1 showed that free-field signals from the front that move with the head are less likely to be externalized (23%) than those that remain fixed (63%). Experiment 2 showed that virtual signals whose position was fixed relative to the world are more likely to be externalized (65%) than those fixed relative to the head (20%), regardless of the fidelity of the individual impulse responses. Conclusions/Significance Head movements play a significant role in the externalization of sound sources. These findings imply tight integration between binaural cues and self motion cues and underscore the importance of self motion for spatial auditory perception. PMID:24312677

Clinical investigation and mechanism of air-bone gaps in large vestibular aqueduct syndrome.

PubMed

Merchant, Saumil N; Nakajima, Hideko H; Halpin, Christopher; Nadol, Joseph B; Lee, Daniel J; Innis, William P; Curtin, Hugh; Rosowski, John J

2007-07-01

Patients with large vestibular aqueduct syndrome (LVAS) often demonstrate an air-bone gap at the low frequencies on audiometric testing. The mechanism causing such a gap has not been well elucidated. We investigated middle ear sound transmission in patients with LVAS, and present a hypothesis to explain the air-bone gap. Observations were made on 8 ears from 5 individuals with LVAS. The diagnosis of LVAS was made by computed tomography in all cases. Investigations included standard audiometry and measurements of umbo velocity by laser Doppler vibrometry (LDV) in all cases, as well as tympanometry, acoustic reflex testing, vestibular evoked myogenic potential (VEMP) testing, distortion product otoacoustic emission (DPOAE) testing, and middle ear exploration in some ears. One ear with LVAS had anacusis. The other 7 ears demonstrated air-bone gaps at the low frequencies, with mean gaps of 51 dB at 250 Hz, 31 dB at 500 Hz, and 12 dB at 1,000 Hz. In these 7 ears with air-bone gaps, LDV showed the umbo velocity to be normal or high normal in all 7; tympanometry was normal in all 6 ears tested; acoustic reflexes were present in 3 of the 4 ears tested; VEMP responses were present in all 3 ears tested; DPOAEs were present in 1 of the 2 ears tested, and exploratory tympanotomy in 1 case showed a normal middle ear. The above data suggest that an air-bone gap in LVAS is not due to disease in the middle ear. The data are consistent with the hypothesis that a large vestibular aqueduct introduces a third mobile window into the inner ear, which can produce an air-bone gap by 1) shunting air-conducted sound away from the cochlea, thus elevating air conduction thresholds, and 2) increasing the difference in impedance between the scala vestibuli side and the scala tympani side of the cochlear partition during bone conduction testing, thus improving thresholds for bone-conducted sound. We conclude that LVAS can present with an air-bone gap that can mimic middle ear disease. Diagnostic testing using acoustic reflexes, VEMPs, DPOAEs, and LDV can help to identify a non-middle ear source for such a gap, thereby avoiding negative middle ear exploration. A large vestibular aqueduct may act as a third mobile window in the inner ear, resulting in an air-bone gap at low frequencies.

[Comparative evaluation of mastoidoplasty results in application of various plastic materials].

PubMed

Zaporoshchenko, A Iu; Kravchenko, S V

2015-01-01

The results of surgical treatment of 62 patients, suffering chronic purulent middle otitis, were analyzed. The structure of mastoid processus and attic constitutes a base for choice of middle ear surgical sanation. Sanation operation with preservation or reconstruction of external acoustical meatus posterior wall was finished with combined mastoidoplasty using autobone, spongioid bone bioimplant Tutoplast or bioceramic material "Sintekost". Achievement of a steady sanating effect have promoted in late postoperative period a trustworthy lowering of the perception threshold of the bone--conducted sounds as on vocal, and also on high frequencies, while of the air--conducted sounds--on vocal frequencies. This permits in perspective to perform a hearing--improving operations with good functional result.

[Electromyographic differential diagnosis in cases of abducens nerve paresis with nuclear or distal neurogenic sive myogenic origine (author's transl)].

PubMed

Heuser, M

1979-09-01

Abducens nerve paresis may be of nuclear, of peripheral distal neurogenic origine, or is simulated by a myogenic weakness of abduction. Polygraphic emg analysis of the oculoauricularphenomenon (oap) permits a differentiation. In the emg, the oap proved to be a physiologic and constant automatic and always bilateral interaction between the hemolateral abducens nerve and both Nn. faciales with corresponding and obligatory coinnervation of the Mm. retroauricularis of the external ear. In case of medullary, nuclear or internuclear lesions, the oap is disturbed, instable, diminished or abolished, whereas in distal neurogenic or myogenic paresis, even in complete paralysis the oap is bilaterally well preserved.

Genetic Architecture of Ear Fasciation in Maize (Zea mays) under QTL Scrutiny.

PubMed

Mendes-Moreira, Pedro; Alves, Mara L; Satovic, Zlatko; Dos Santos, João Pacheco; Santos, João Nina; Souza, João Cândido; Pêgo, Silas E; Hallauer, Arnel R; Vaz Patto, Maria Carlota

2015-01-01

Knowledge of the genes affecting maize ear inflorescence may lead to better grain yield modeling. Maize ear fasciation, defined as abnormal flattened ears with high kernel row number, is a quantitative trait widely present in Portuguese maize landraces. Using a segregating population derived from an ear fasciation contrasting cross (consisting of 149 F2:3 families) we established a two location field trial using a complete randomized block design. Correlations and heritabilities for several ear fasciation-related traits and yield were determined. Quantitative Trait Loci (QTL) involved in the inheritance of those traits were identified and candidate genes for these QTL proposed. Ear fasciation broad-sense heritability was 0.73. Highly significant correlations were found between ear fasciation and some ear and cob diameters and row number traits. For the 23 yield and ear fasciation-related traits, 65 QTL were identified, out of which 11 were detected in both environments, while for the three principal components, five to six QTL were detected per environment. Detected QTL were distributed across 17 genomic regions and explained individually, 8.7% to 22.4% of the individual traits or principal components phenotypic variance. Several candidate genes for these QTL regions were proposed, such as bearded-ear1, branched silkless1, compact plant1, ramosa2, ramosa3, tasselseed4 and terminal ear1. However, many QTL mapped to regions without known candidate genes, indicating potential chromosomal regions not yet targeted for maize ear traits selection. Portuguese maize germplasm represents a valuable source of genes or allelic variants for yield improvement and elucidation of the genetic basis of ear fasciation traits. Future studies should focus on fine mapping of the identified genomic regions with the aim of map-based cloning.

Biomechanical Modeling and Measurement of Blast Injury and Hearing Protection Mechanisms

DTIC Science & Technology

2015-10-01

12 software into Workbench V. 15 in CFX/ANSYS; 2) building the geometry of the ear model with ossicular chain and cochlear load in CFX; 3...the ear canal to middle ear. The model consists of the ear canal, TM, middle ear ossicles and suspensory ligaments, middle ear cavity, and cochlear ...the TM, ossicles, and ligaments/muscle tendons with the cochlear load applied on the stapes footplate. 17 Fig. 21. Time-history plots of

Ear-EEG detects ictal and interictal abnormalities in focal and generalized epilepsy - A comparison with scalp EEG monitoring.

PubMed

Zibrandtsen, I C; Kidmose, P; Christensen, C B; Kjaer, T W

2017-12-01

Ear-EEG is recording of electroencephalography from a small device in the ear. This is the first study to compare ictal and interictal abnormalities recorded with ear-EEG and simultaneous scalp-EEG in an epilepsy monitoring unit. We recorded and compared simultaneous ear-EEG and scalp-EEG from 15 patients with suspected temporal lobe epilepsy. EEGs were compared visually by independent neurophysiologists. Correlation and time-frequency analysis was used to quantify the similarity between ear and scalp electrodes. Spike-averages were used to assess similarity of interictal spikes. There were no differences in sensitivity or specificity for seizure detection. Mean correlation coefficient between ear-EEG and nearest scalp electrode was above 0.6 with a statistically significant decreasing trend with increasing distance away from the ear. Ictal morphology and frequency dynamics can be observed from visual inspection and time-frequency analysis. Spike averages derived from ear-EEG electrodes yield a recognizable spike appearance. Our results suggest that ear-EEG can reliably detect electroencephalographic patterns associated with focal temporal lobe seizures. Interictal spike morphology from sufficiently large temporal spike sources can be sampled using ear-EEG. Ear-EEG is likely to become an important tool in clinical epilepsy monitoring and diagnosis. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Could ionizing radiation forestall cauliflower ear?

PubMed

Hwang, K; Kim, C W; Lee, S I; Park, I S; Kim, W C; Loh, J J

2001-02-01

Repeated trauma to the ear very often results in "cauliflower ear." Many methods have been suggested to prevent an injured ear from demonstrating a cauliflowerlike deformity. The principles of treatment are evacuation of the hematoma, control of the reaccumulation of fluid, and maintenance of the cartilage contour. The authors studied the effect of ionizing radiation on deformed rabbit ears induced by repeated trauma. Twenty ears (10 rabbits) were used in the experiment. The animals were divided into four groups (control, preradiation, low dose, and high dose). Hematoma was produced by pounding the lateral side of the auricle 10 times with a 50-g weight at a height of 15 cm. The thickness of the injured and uninjured sites was measured, and histological analysis was performed for each group. The thickness of the ears of the irradiated groups was significantly less than the control group. The authors think that radiation treatment of repeatedly injured ears could prevent ear deformity, and could possibly be an adjunctive form of management of cauliflower ear in addition to hematoma evacuation and compression therapy.

Ear Disorders

MedlinePlus

... most common illness in infants and young children. Tinnitus, a roaring in your ears, can be the ... problems in your inner ear; its symptoms include tinnitus and dizziness. Ear barotrauma is an injury to ...

Ear Scaffold Reconstruction Using Ultrasonic Aspirator for Cauliflower Ear.

PubMed

Hao, Scarlett; Angster, Kristen; Hubbard, Fleesie; Greywoode, Jewel; Vakharia, Kalpesh T

2018-04-01

Untreated auricular hematomas from ear trauma can result in an ear deformation known as cauliflower ear, secondary to fibrosis and new cartilage overgrowth. Cauliflower ear reconstruction has traditionally utilized tools such as a drill or a scalpel in order to improve auricular cosmesis. We present a case report utilizing an ultrasonic aspirator to recontour the fibrosed cartilage of a cauliflower ear. The ultrasonic aspirator has advantages over traditional tools in its ability to provide finely controlled bone removal without damage to surrounding soft tissue. The patient in this case report underwent multistage reconstruction using the ultrasonic aspirator with excellent cosmetic result and patient satisfaction.

Two flaps and Z-plasty technique for correction of longitudinal ear lobe cleft.

PubMed

Lee, Paik-Kwon; Ju, Hong-Sil; Rhie, Jong-Won; Ahn, Sang-Tae

2005-06-01

Various surgical techniques have been reported for the correction of congenital ear lobe deformities. Our method, the two-flaps-and-Z-plasty technique, for correcting the longitudinal ear lobe cleft is presented. This technique is simple and easy to perform. It enables us to keep the bulkiness of the ear lobe with minimal tissue sacrifice, and to make a shorter operation scar. The small Z-plasty at the free ear lobe margin avoids notching deformity and makes the shape of the ear lobe smoother. The result is satisfactory in terms of matching the contralateral normal ear lobe in shape and symmetry.

Ear pain and its treatment in hypobaric chamber training in the Japan Air Self-Defense Force.

PubMed

Ohrui, Nobuhiro; Takeuchi, Akihiko; Tong, Andrew; Iwata, Masashi

2008-06-01

We have documented that ear pain is the most prevalent physiologic incident during hypobaric chamber training in the Japan Air Self-Defense Force. Ear pain may increase also in flight in the future because it is closely related to allergic rhinitis. Therefore, it is very important to know the characteristic of ear pain and the efficacy of its treatment. The incidence of ear pain was calculated in each training profile from 1990 to 1998. Type III chamber flight records were further analyzed for the characteristics of ear pain: relationship with a trainee occupational category, time of occurrence of ear pain, and efficacy of treatment. Of 17,935 exposures, 740 trainees (4.1%) had ear pain. Of 7,047 trainees, 429 (6.1%) complained of ear pain especially in Type III, totaling 625 times. Fighter pilots and cargo pilots complained of ear pain one twelfth and one third the number of times, respectively, compared with passengers. Of the 625 episodes, 616 (98.6%) occurred during descent. Three kinds of treatment were administered until the pain was relieved in the following order: Valsalva maneuver, Politzer bag, and decompression. The efficacy rates were 35.8, 92.3, and 83.9%, respectively. Only 5 trainees (0.07%) could not complete training due to ear pain despite treatment. The combination treatment of Valsalva maneuver, Politzer bag, and decompression is very effective for relieving ear pain encountered during hypobaric chamber training. A health specialist needs to understand ear pain and its treatment in hypobaric environment such as aircraft.

Inner ear anomalies and conductive hearing loss in children with Apert syndrome: an overlooked otologic aspect.

PubMed

Zhou, Guangwei; Schwartz, Lynn Thomas; Gopen, Quinton

2009-02-01

To identify the occurrence of inner ear structural anomalies and conductive hearing loss (CHL) in children with Apert syndrome. Retrospective review. Pediatric tertiary referral center. Twenty pediatric patients with Apert syndrome were found; all patients (38/40 ears) had inner ear anomalies. Computerized tomography of the head/temporal bone, pure-tone (including air and bone conduction) audiometry, and tympanometry. Imaging demonstrating inner ear anomalies, including malformations of the cochlea, dilated vestibule, and/or semicircular canal; audiologic findings of air-bone gap(s). Hearing loss was found in 90% of the patients with Apert syndrome, and 80% of them had CHL. Air-bone gaps were found at all frequencies, with larger gaps at low frequencies. Fifty percent (20/40) of the ears had better than 0 dB hearing level bone conduction thresholds at 250 and/or 500 Hz. Normal middle ear pressure and mobility were found in all ears with intact eardrum. Inner ear anomalies were found in all patients, and 90% of them had bilateral involvement. Most frequently observed inner ear anomalies were dilated vestibule, malformed lateral semicircular canal, and cochlear dysplasia. Children with Apert syndrome may present with significant CHL that cannot be explained by minor middle ear pathologies alone. This conductive loss may be, at least partially, attributed to the inner ear anomalies; however, these structural anomalies are usually not recognized in these patients. Failure to close air-bone gap after surgical intervention may raise the suspicion of inner ear anomalies, and computed tomographic scan of the temporal bone can provide definitive proof.

Effect of Probe Tube Insertion Depth on Spectral Measures of Speech

PubMed Central

Caldwell, Marc; Souza, Pamela E.; Tremblay, Kelly L.

2006-01-01

This study investigated how depth variations in the tip of the probe tube affected spectral measures of speech recorded in the external ear canal. Consonant-vowel nonsense syllables were recorded with a probe tube microphone system in 10 adult participants with normal middle ear function. Recordings were made with the probe tube tip placed 1 mm, 5 mm, and 10 mm beyond the medial tip of a custom earmold. The effect of probe depth was evaluated on spectral levels (one-third octave and one-twelfth octave band). Extending the probe tube 10 mm past the medial tip of the earmold gave the most accurate results, with relatively lower sound levels for either the 1-mm or 5-mm insertion depth. In general, the effect of insertion depth was minimal at frequencies below 3 to 4 kHz, although this varied with the specific phoneme and the width of the analysis bands. The authors found no significant difference between 1- and 5-mm insertion depths, suggesting that as long as the tip of the probe tube is sufficiently close to the tympanic membrane to capture the highest frequency of interest, it makes little difference if it is less than 5 mm beyond the earmold tip. PMID:16959735

Presentation of Preauricular Sinus and Preauricular Sinus Abscess in Southwest Nigeria

PubMed Central

Adegbiji, W. A.; Alabi, B. S.; Olajuyin, O. A.; Nwawolo, C. C.

2013-01-01

BACKGROUND AND AIM: Preauricular sinus abscess is a common congenital external ear disease. This abscess is usually misdiagnosed because it is commonly overlooked during physical examination. In Nigeria, the prevalence was 9.3% in Ilorin, north central Nigeria This study is to determine the distribution and clinical presentation of the preauricular sinus abscess in Ekiti, south west Nigeria. MATERIALS AND METHODS: This is a prospective hospital based study of all patients with diagnosis of preauricular sinus abscess seen in our clinic carried out between April 2008 to March 2010. Detailed clinical history, administered interviewer’s assisted questionnaires full examination and. Data obtained were collated and analysed. RESULTS: Preauricular sinus were noticed in 184 (4.4%) out of 4170 patients seen during the study period. Preauricular sinus abscess were noticed in 21 (11.4%) of the preauricular sinuses especially in children. Unilateral preauricular sinus abscess accounted for 90.5%. Common presenting complaints were preauricular swelling (81.0%), 90.5% with recurrent earaches, 76.2% with ear discharges. All patients had antibiotic / analgesic while 17 out of 21 (81.0%) had surgical excisions. CONCLUSION: Preauricular sinus abscess were noticed among 11.4% of the preauricular sinuses especially in children, unilateral preauricular sinus abscess accounted for 90.5%. Common complaints were otorrhoea, earaches, and swelling and they were mostly managed surgically. PMID:24711764

[New record of a bat species from China, Megaderma spasma (Linnaeus, 1758)].

PubMed

Zhang, Li-Biao; Gong, Yan-Yan; Zhu, Guang-Jian; Hong, Ti-Yu; Zhao, Xu-Dong; Mao, Xiu-Guang

2010-06-01

One male bat was collected in a cave in Cuibi Hill (N: 21 degree 53', E: 101 degree 18', H: 683 m a.s.l.), Menglun Town, Mengla County, Yunnan Province, on November 26, 2006. This bat is of medium body size, with 60.7 mm forearm and 21.4 g body mass. Its ears are large ovals and joined medially to the forehead at about 15% of the height of inner margin. The tragus of each ear is slender and distinctly bifid. The noseleaf is simple, and the posterior noseleaf is oval with obtuse tip and convex sides, a significant longitudinal ridge laying middle, which connects to intermediate noseleaf at the base. Intermediate noseleaf presents triangle with a W-shaped tip. Frontal noseleaf is horseshoe shape and attached directly to the muzzle. The tail is absent, and the second finger of each wing has only one phalanx. There are no upper incisors, Pm3 and Pm3. The upper canine has an anterior and a large posterior basal cusps. This bat is identified as lesser false vampire, Megaderma spasma, which is a new record of China. Its external and craniodental measurements were presented and compared with those of M. lyra. The specimen is preserved in Guangdong Entomological Institute.

Leishmania (Viannia) braziliensis infection in two Colombian dogs: a note on infectivity for sand flies and response to treatment.

PubMed

Travi, Bruno L; Tabares, Carlos Javier; Cadena, Horacio

2006-10-01

Although canine cutaneous leishmaniasis has been reported in several foci of South America, no published information from Colombia is available. We report on two cases found in the Pacific coast region of this country, which presented as a single scrotal ulcer in one dog, and two ulcers on the external surface of the ear in a second dog. Parasites were isolated by culture in Senekjie's culture medium and identified using monoclonal antibodies. The capacity of these dogs to transmit the parasites to sand fly vectors (Lutzomyia trapidoi, Lutzomyia gomezi, Lutzomyia longipalpis, Lutzomyia youngi) was tested by allowing the flies to feed on the lesion borders. Both isolates were identified as Leishmania (Viannia) braziliensis. No infections were detected upon dissection of engorged flies. A single peri-and sub-lesional injection of 1-2 ml of pentavalent antimony in the dog with ear lesions resulted in clinical cure 6 weeks post-treatment. These observations suggest that although dogs are susceptible to L. braziliensis, their reservoir competence could be low. However, if further studies indicate that canines are capable reservoir hosts of L. Viannia spp., the local treatment of lesions could become a feasible approach to diminish the risk of human infection in the peridomestic setting, without sacrificing infected dogs.

A multidisciplinary approach to paediatric hearing loss: programme at the centre for hearing intervention and language development, National University Hospital, Singapore.

PubMed

Lim, Lynne H Y

2008-12-01

The objective is to describe the multidisciplinary management programme at the National University Hospital (NUH) in Singapore for children with hearing impairment (HI). Over 99.95% of babies born at NUH have hearing tested with both otoacoustic emission and automated auditory brainstem response tests by 6 weeks of age. The referral rate to Otolaryngology is 0.5%. Acquired causes of congenital HI are decreasing. Thirty percent of patients at NUH with idiopathic congenital sensorineural HI have DFNB1/ GJB6 Connexin 26 HI. CT scan or MRI imaging has a higher diagnostic yield when there is unilateral, fluctuating or non-Connexin 26 related HI. Routine electrocardiogram and Opthalmology evaluations will exclude associations of fatal cardiac rhythm anomaly and retinopathy. Other investigations are directed by history and clinical examination. There is now a very wide range of increasingly sophisticated medication, neuro-otologic external, middle and inner ear surgery, hearing aids, middle ear implants and cochlear implants available to improve hearing. A multidisciplinary team from neonatology, paediatrics, otolaryngology, audiology, auditory verbal and speech therapy, ophthalmology, radiology, and psychology working closely with the child, family and schools is needed to develop a cost-effective and comprehensive management programme for paediatric HI.

Longitudinal endolymph movements and endocochlear potential changes induced by stimulation at infrasonic frequencies.

PubMed

Salt, A N; DeMott, J E

1999-08-01

The inner ear is continually exposed to pressure fluctuations in the infrasonic frequency range (< 20 Hz) from external and internal body sources. The cochlea is generally regarded to be insensitive to such stimulation. The effects of stimulation at infrasonic frequencies (0.1 to 10 Hz) on endocochlear potential (EP) and endolymph movements in the guinea pig cochlea were studied. Stimuli were applied directly to the perilymph of scala tympani or scala vestibuli of the cochlea via a fluid-filled pipette. Stimuli, especially those near 1 Hz, elicited large EP changes which under some conditions exceeded 20 mV in amplitude and were equivalent to a cochlear microphonic (CM) response. Accompanying the electrical responses was a cyclical, longitudinal displacement of the endolymph. The amplitude and phase of the CM varied according to which perilymphatic scala the stimuli were applied to and whether a perforation was made in the opposing perilymphatic scala. Spontaneously occurring middle ear muscle contractions were also found to induce EP deflections and longitudinal endolymph movements comparable to those generated by perilymphatic injections. These findings suggest that cochlear fluid movements induced by pressure fluctuations at infrasonic frequencies could play a role in fluid homeostasis in the normal state and in fluid disturbances in pathological states.

Field experiments using SPEAR: a speech control system for UGVs

NASA Astrophysics Data System (ADS)

Chhatpar, Siddharth R.; Blanco, Chris; Czerniak, Jeffrey; Hoffman, Orin; Juneja, Amit; Pruthi, Tarun; Liu, Dongqing; Karlsen, Robert; Brown, Jonathan

2009-05-01

This paper reports on a Field Experiment carried out by the Human Research and Engineering Directorate at Ft. Benning to evaluate the efficacy of using speech to control an Unmanned Ground Vehicle (UGV) concurrently with a handcontroller. The SPEAR system, developed by Think-A-Move, provides speech-control of UGVs. The system picks up user-speech in the ear canal with an in-ear microphone. This property allows it to work efficiently in high-noise environments, where traditional speech systems, employing external microphones, fail. It has been integrated with an iRobot PackBot 510 with EOD kit. The integrated system allows the hand-controller to be supplemented with speech for concurrent control. At Ft. Benning, the integrated system was tested by soldiers from the Officer Candidate School. The Experiment had dual focus: 1) Quantitative measurement of the time taken to complete each station and the cognitive load on users; 2) Qualitative evaluation of ease-of-use and ergonomics through soldier-feedback. Also of significant benefit to Think-A-Move was soldier-feedback on the speech-command vocabulary employed: What spoken commands are intuitive, and how the commands should be executed, e.g., limited-motion vs. unlimited-motion commands. Overall results from the Experiment are reported in the paper.

Treatment of otitis media by transtympanic delivery of antibiotics

PubMed Central

Yang, Rong; Sabharwal, Vishakha; Okonkwo, Obiajulu S.; Shlykova, Nadya; Tong, Rong; Lin, Lily Yun; Wang, Weiping; Guo, Shutao; Rosowski, John J.; Pelton, Stephen I.; Kohane, Daniel S.

2017-01-01

Otitis media is the most common reason U.S. children receive antibiotics. The requisite 7- to 10-day course of oral antibiotics can be challenging to deliver in children, entails potential systemic toxicity, and encourages selection of antimicrobial-resistant bacteria. We developed a drug delivery system that, when applied once to the tympanic membrane through the external auditory canal, delivers an entire course of antimicrobial therapy to the middle ear. A penta-block copolymer poloxamer 407–polybutylphosphoester (P407-PBP) was designed to flow easily during application and then to form a mechanically strong hydrogel on the tympanic membrane. U.S. Food and Drug Administration–approved chemical permeation enhancers within the hydrogel assisted flux of the antibiotic ciprofloxacin across the membrane. This drug delivery system completely eradicated otitis media from nontypable Haemophilus influenzae (NTHi) in 10 of 10 chinchillas, whereas only 62.5% of animals receiving 1% ciprofloxacin alone had cleared the infection by day 7. The hydrogel system was biocompatible in the ear, and ciprofloxacin was undetectable systemically (in blood), confirming local drug delivery and activity. This fast-gelling hydrogel could improve compliance, minimize side effects, and prevent systemic distribution of antibiotics in one of the most common pediatric illnesses, possibly minimizing the development of antibiotic resistance. PMID:27629487

Pilot study to establish a nasal tip prediction method from unknown human skeletal remains for facial reconstruction and skull photo superimposition as applied to a Japanese male populations.

PubMed

Utsuno, Hajime; Kageyama, Toru; Uchida, Keiichi; Kibayashi, Kazuhiko; Sakurada, Koichi; Uemura, Koichi

2016-02-01

Skull-photo superimposition is a technique used to identify the relationship between the skull and a photograph of a target person: and facial reconstruction reproduces antemortem facial features from an unknown human skull, or identifies the facial features of unknown human skeletal remains. These techniques are based on soft tissue thickness and the relationships between soft tissue and the skull, i.e., the position of the ear and external acoustic meatus, pupil and orbit, nose and nasal aperture, and lips and teeth. However, the ear and nose region are relatively difficult to identify because of their structure, as the soft tissues of these regions are lined with cartilage. We attempted to establish a more accurate method to determine the position of the nasal tip from the skull. We measured the height of the maxilla and mid-lower facial region in 55 Japanese men and generated a regression equation from the collected data. We obtained a result that was 2.0±0.99mm (mean±SD) distant from the true nasal tip, when applied to a validation set consisting of another 12 Japanese men. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Behavior of poly(glycerol sebacate) plugs in chronic tympanic membrane perforations.

PubMed

Sundback, C A; McFadden, J; Hart, A; Kulig, K M; Wieland, A M; Pereira, M J N; Pomerantseva, I; Hartnick, C J; Masiakos, P T

2012-10-01

The tympanic membrane (TM), separating the external and middle ear, consists of fibrous connective tissue sandwiched between epithelial layers. To treat chronic ear infections, tympanostomy drainage tubes are placed in surgically created holes in TMs which can become chronic perforations upon extrusion. Perforations are repaired using a variety of techniques, but are limited by morbidity, unsatisfactory closure rates, or minimal regeneration of the connective tissue. A more effective, minimally-invasive therapy is necessary to enhance the perforation closure rate. Current research utilizing decellularized or alignate materials moderately enhance closure but the native TM architecture is not restored. Poly(glycerol sebacate) (PGS) is a biocompatible elastomer which supports cell migration and enzymatically degrades in contact with vascularized tissue. PGS spool-shaped plugs were manufactured using a novel process. Using minimally invasive procedures, these elastomeric plugs were inserted into chronic chinchilla TM perforations. As previously reported, effective perforation closure occurred as both flange surfaces were covered by confluent cell layers; >90% of perforations were closed at 6-week postimplantation. This unique in vivo environment has little vascularized tissue. Consequently, PGS degradation was minimal over 16-week implantation, hindering regeneration of the TM fibrous connective tissue. PGS degradation must be enhanced to promote complete TM regeneration. Copyright © 2012 Wiley Periodicals, Inc.

Electrical Stimulation of the Ear, Head, Cranial Nerve, or Cortex for the Treatment of Tinnitus: A Scoping Review

PubMed Central

Adjamian, Peyman

2016-01-01

Tinnitus is defined as the perception of sound in the absence of an external source. It is often associated with hearing loss and is thought to result from abnormal neural activity at some point or points in the auditory pathway, which is incorrectly interpreted by the brain as an actual sound. Neurostimulation therapies therefore, which interfere on some level with that abnormal activity, are a logical approach to treatment. For tinnitus, where the pathological neuronal activity might be associated with auditory and other areas of the brain, interventions using electromagnetic, electrical, or acoustic stimuli separately, or paired electrical and acoustic stimuli, have been proposed as treatments. Neurostimulation therapies should modulate neural activity to deliver a permanent reduction in tinnitus percept by driving the neuroplastic changes necessary to interrupt abnormal levels of oscillatory cortical activity and restore typical levels of activity. This change in activity should alter or interrupt the tinnitus percept (reduction or extinction) making it less bothersome. Here we review developments in therapies involving electrical stimulation of the ear, head, cranial nerve, or cortex in the treatment of tinnitus which demonstrably, or are hypothesised to, interrupt pathological neuronal activity in the cortex associated with tinnitus. PMID:27403346

A morphometric study of the human ear.

PubMed

Alexander, K Skaria; Stott, David J; Sivakumar, Branavan; Kang, Norbert

2011-01-01

We examined variations in the shape of the human ear according to age, sex and ethnic group with particular attention to ear prominence. 420 volunteers were recruited. Measurements included; head height and length, ear height and axis, antihelix taken off angle, earlobe length and width, ear width at the helical root and tragus. Prominence was measured at the helical root and tragus (conchomastoid angle, conchal bowl depth and helical-mastoid distance). Good symmetry was shown for all measurements. Ethnically Indian volunteers had the largest ears (both length and width), followed by Caucasians, and Afro-Caribbeans. This trend was significant in males (p<0.001), but not significant in females (p=0.087). Ears increased in size throughout life. Subjectively, only 2% of volunteers felt their ears were prominent compared to 10% in the opinion of the principal investigator. No objective measurements were identified that accurately predicted subjective perceptions of prominence. We found consistent trends in ear morphology depending on ethnic group, age and sex. Our study was unable to define an objective method for assessing ear prominence. Decisions about what constitutes a prominent ear should be left to personal and aesthetic choice. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Scanning Thin-Sheet Laser Imaging Microscopy Elucidates Details on Mouse Ear Development

PubMed Central

Kopecky, Benjamin; Johnson, Shane; Schmitz, Heather; Santi, Peter; Fritzsch, Bernd

2016-01-01

Background The mammalian inner ear is transformed from a flat placode into a three-dimensional (3D) structure with six sensory epithelia that allow for the perception of sound and both linear and angular acceleration. While hearing and balance problems are typically considered to be adult onset diseases, they may arise as a developmental perturbation to the developing ear. Future prevention of hearing or balance loss requires an understanding of how closely genetic mutations in model organisms reflect the human case, necessitating an objective multidimensional comparison of mouse ears with human ears that have comparable mutations in the same gene. Results Here, we present improved 3D analyses of normal murine ears during embryonic development using optical sections obtained through Thin-Sheet Laser Imaging Microscopy. We chronicle the transformation of an undifferentiated otic vesicle between mouse embryonic day 11.5 to a fully differentiated inner ear at postnatal day 15. Conclusions Our analysis of ear development provides new insights into ear development, enables unique perspectives into the complex development of the ear, and allows for the first full quantification of volumetric and linear aspects of ear growth. Our data provide the framework for future analysis of mutant phenotypes that are currently under-appreciated using only two dimensional renderings. PMID:22271591

Scanning thin-sheet laser imaging microscopy elucidates details on mouse ear development.

PubMed

Kopecky, Benjamin; Johnson, Shane; Schmitz, Heather; Santi, Peter; Fritzsch, Bernd

2012-03-01

The mammalian inner ear is transformed from a flat placode into a three-dimensional (3D) structure with six sensory epithelia that allow for the perception of sound and both linear and angular acceleration. While hearing and balance problems are typically considered to be adult onset diseases, they may arise as a developmental perturbation to the developing ear. Future prevention of hearing or balance loss requires an understanding of how closely genetic mutations in model organisms reflect the human case, necessitating an objective multidimensional comparison of mouse ears with human ears that have comparable mutations in the same gene. Here, we present improved 3D analyses of normal murine ears during embryonic development using optical sections obtained through Thin-Sheet Laser Imaging Microscopy. We chronicle the transformation of an undifferentiated otic vesicle between mouse embryonic day 11.5 to a fully differentiated inner ear at postnatal day 15. Our analysis of ear development provides new insights into ear development, enables unique perspectives into the complex development of the ear, and allows for the first full quantification of volumetric and linear aspects of ear growth. Our data provide the framework for future analysis of mutant phenotypes that are currently under-appreciated using only two dimensional renderings. Copyright © 2012 Wiley Periodicals, Inc.

Ear Infection (Middle Ear)

MedlinePlus

... secretions from the middle ear Swelling, inflammation and mucus in the eustachian tubes from an upper respiratory ... your baby for at least six months. Breast milk contains antibodies that may offer protection from ear ...

49 CFR Appendix C to Part 227 - Audiometric Baseline Revision

Code of Federal Regulations, 2011 CFR

2011-10-01

... FRA STS. The two ears are examined separately and independently for improvement and for worsening. If one ear meets the criteria for revision of baseline, then the baseline is revised for that ear only. Therefore, if the two ears show different hearing trends, the baseline for the left ear may be from one test...

49 CFR Appendix C to Part 227 - Audiometric Baseline Revision

Code of Federal Regulations, 2012 CFR

2012-10-01

... FRA STS. The two ears are examined separately and independently for improvement and for worsening. If one ear meets the criteria for revision of baseline, then the baseline is revised for that ear only. Therefore, if the two ears show different hearing trends, the baseline for the left ear may be from one test...

Ear Injuries (For Parents)

MedlinePlus

... Inserting something into the ear. Things like a cotton swab, fingernail, or pencil can scratch the ear ... Never stick anything in their ears — not even cotton swabs or their fingers. Regular bathing should be ...

Expansion method in secondary total ear reconstruction for undesirable reconstructed ear.

PubMed

Liu, Tun; Hu, Jintian; Zhou, Xu; Zhang, Qingguo

2014-09-01

Ear reconstruction by autologous costal cartilage grafting is the most widely applied technique with fewer complications. However, undesirable ear reconstruction brings more problems to plastic surgeons. Some authors resort to free flap or osseointegration technique with prosthetic ear. In this article, we introduce a secondary total ear reconstruction with expanded skin flap method. From July 2010 to April 2012, 7 cases of undesirable ear reconstruction were repaired by tissue expansion method. Procedures including removal of previous cartilage framework, soft tissue expander insertion, and second stage of cartilage framework insertion were performed to each case regarding their local conditions. The follow-up time ranged from 6 months to 2.5 years. All of the cases recovered well with good 3-dimensional forms, symmetrical auriculocephalic angle, and stable fixation. All these evidence showed that this novel expansion method is safe, stable, and less traumatic for secondary total ear reconstruction. With sufficient expanded skin flap and refabricated cartilage framework, lifelike appearance of reconstructed ear could be acquired without causing additional injury.

Cortical Auditory Evoked Potentials to Evaluate Cochlear Implant Candidacy in an Ear With Long-standing Hearing Loss: A Case Report.

PubMed

Patel, Tirth R; Shahin, Antoine J; Bhat, Jyoti; Welling, D Bradley; Moberly, Aaron C

2016-10-01

We describe a novel use of cortical auditory evoked potentials in the preoperative workup to determine ear candidacy for cochlear implantation. A 71-year-old male was evaluated who had a long-deafened right ear, had never worn a hearing aid in that ear, and relied heavily on use of a left-sided hearing aid. Electroencephalographic testing was performed using free field auditory stimulation of each ear independently with pure tones at 1000 and 2000 Hz at approximately 10 dB above pure-tone thresholds for each frequency and for each ear. Mature cortical potentials were identified through auditory stimulation of the long-deafened ear. The patient underwent successful implantation of that ear. He experienced progressively improving aided pure-tone thresholds and binaural speech recognition benefit (AzBio score of 74%). Findings suggest that use of cortical auditory evoked potentials may serve a preoperative role in ear selection prior to cochlear implantation. © The Author(s) 2016.

[Adaptability of sweet corn ears to a frozen process].

PubMed

Ramírez Matheus, Alejandra O; Martínez, Norelkys Maribel; de Bertorelli, Ligia O; De Venanzi, Frank

2004-12-01

The effects of frozen condition on the quality of three sweet corn ears (2038, 2010, 2004) and the pattern (Bonanza), were evaluated. Biometrics characteristics like ear size, ear diameter, row and kernel deep were measured as well as chemical and physical measurement in fresh and frozen states. The corn ears were frozen at -95 degrees C by 7 minutes. The yield and stability of the frozen ears were evaluated at 45 and 90 days of frozen storage (-18 degrees C). The average commercial yield as frozen corn ear for all the hybrids was 54.2%. The industry has a similar value range of 48% to 54%. The ear size average was 21.57 cm, row number was 15, ear diameter 45.54 mm and the kernel corn deep was 8.57 mm. All these measurements were found not different from commercial values found for the industry. All corn samples evaluated showed good stability despites the frozen processing and storage. Hybrid 2038 ranked higher in quality.

Can you hear me now? Understanding vertebrate middle ear development

PubMed Central

Chapman, Susan Caroline

2010-01-01

The middle ear is a composite organ formed from all three germ layers and the neural crest. It provides the link between the outside world and the inner ear, where sound is transduced and routed to the brain for processing. Extensive classical and modern studies have described the complex morphology and origin of the middle ear. Non-mammalian vertebrates have a single ossicle, the columella. Mammals have three functionally equivalent ossicles, designated the malleus, incus and stapes. In this review, I focus on the role of genes known to function in the middle ear. Genetic studies are beginning to unravel the induction and patterning of the multiple middle ear elements including the tympanum, skeletal elements, the air-filled cavity, and the insertion point into the inner ear oval window. Future studies that elucidate the integrated spatio-temporal signaling mechanisms required to pattern the middle ear organ system are needed. The longer-term translational benefits of understanding normal and abnormal ear development will have a direct impact on human health outcomes. PMID:21196256

Identifying position, visibility, dimensions, and angulation of the ear.

PubMed

Mohamed, Kasim; Christian, Jayanth; Jeyapalan, Karthigeyan; Natarajan, Shanmuganathan; Banu, Fathima; Veeravalli, Padmanabhan T

2014-01-01

We selected 254 subjects between the ages of 18 and 30 yr to assess the ear position, angulations of the ear in relation to the nose, visibility from the frontal view, and dimensions of the ear by using various anthropometric points of the face. Subjects were divided into four groups based on facial form. A reference plane indicator, facial topographical measurements, metal ruler, and digital photography were used. While considering the position of the ear, in all facial forms except square tapering, the most samples showed a tendency for the subaurale being in line with subnasale. Regression analysis showed a tendency to gnathion distance is the most dependent variable with length of the ear kept as a constant predictor, while both interalar distance and exocanthion to endocanthion distance correlate highly significantly to the width of the ear. In all subjects, the visibility of the ear when viewed from the front was an average of 1.5 mm. Regardless of facial form, ear angulation was generally less than nose angulation.

Test-Retest Reliability and Minimal Detectable Change of Randomized Dichotic Digits in Learning-Disabled Children: Implications for Dichotic Listening Training.

PubMed

Mahdavi, Mohammad Ebrahim; Pourbakht, Akram; Parand, Akram; Jalaie, Shohreh

2018-03-01

Evaluation of dichotic listening to digits is a common part of many studies for diagnosis and managing auditory processing disorders in children. Previous researchers have verified test-retest relative reliability of dichotic digits results in normal children and adults. However, detecting intervention-related changes in the ear scores after dichotic listening training requires information regarding trial-to-trial typical variation of individual ear scores that is estimated using indices of absolute reliability. Previous studies have not addressed absolute reliability of dichotic listening results. To compare the results of the Persian randomized dichotic digits test (PRDDT) and its relative and absolute indices of reliability between typical achieving (TA) and learning-disabled (LD) children. A repeated measures observational study. Fifteen LD children were recruited from a previously performed study with age range of 7-12 yr. The control group consisted of 15 TA schoolchildren with age range of 8-11 yr. The Persian randomized dichotic digits test was administered on the children under free recall condition in two test sessions 7-12 days apart. We compared the average of the ear scores and ear advantage between TA and LD children. Relative indices of reliability included Pearson's correlation and intraclass correlation (ICC 2,1 ) coefficients and absolute reliability was evaluated by calculation of standard error of measurement (SEM) and minimal detectable change (MDC) using the raw ear scores. The Pearson correlation coefficient indicated that in both groups of children the ear scores of test and retest sessions were strongly and positively (greater than +0.8) correlated. The ear scores showed excellent ICC coefficient of consistency (0.78-0.82) and fair to excellent ICC coefficient of absolute agreement (0.62-0.74) in TA children and excellent ICC coefficients of consistency and absolute agreement in LD children (0.76-0.87). SEM and SEM% of the ear scores in TA children were 1.46 and 1.44% for the right ear and 4.68 and 5.47% for the left ear. SEM and SEM% of the ear scores in LD children were 4.55 and 5.88% for the right ear to 7.56 and 12.81% for the left ear. MDC and MDC% of the ear scores in TA children varied from 4.03 and 3.99% for the right ear to 12.93 and 15.13% for the left ear. MDC and MDC% of the ear scores in LD children varied from 12.57 and 16.25% for the right ear to 20.89 and 35.39% for the left ear. The LD children indicated test-retest relative reliability as high as TA children in the ear scores measured by PRDDT. However, within-subject variations of the ear scores calculated by indices of absolute reliability were considerably higher in LD children versus TA children. The results of the current study could have implications for detecting real training-related changes in the ear scores. American Academy of Audiology

Preserved Acoustic Hearing in Cochlear Implantation Improves Speech Perception

PubMed Central

Sheffield, Sterling W.; Jahn, Kelly; Gifford, René H.

2015-01-01

Background With improved surgical techniques and electrode design, an increasing number of cochlear implant (CI) recipients have preserved acoustic hearing in the implanted ear, thereby resulting in bilateral acoustic hearing. There are currently no guidelines, however, for clinicians with respect to audio-metric criteria and the recommendation of amplification in the implanted ear. The acoustic bandwidth necessary to obtain speech perception benefit from acoustic hearing in the implanted ear is unknown. Additionally, it is important to determine if, and in which listening environments, acoustic hearing in both ears provides more benefit than hearing in just one ear, even with limited residual hearing. Purpose The purposes of this study were to (1) determine whether acoustic hearing in an ear with a CI provides as much speech perception benefit as an equivalent bandwidth of acoustic hearing in the non-implanted ear, and (2) determine whether acoustic hearing in both ears provides more benefit than hearing in just one ear. Research Design A repeated-measures, within-participant design was used to compare performance across listening conditions. Study Sample Seven adults with CIs and bilateral residual acoustic hearing (hearing preservation) were recruited for the study. Data Collection and Analysis Consonant-nucleus-consonant word recognition was tested in four conditions: CI alone, CI + acoustic hearing in the nonimplanted ear, CI + acoustic hearing in the implanted ear, and CI + bilateral acoustic hearing. A series of low-pass filters were used to examine the effects of acoustic bandwidth through an insert earphone with amplification. Benefit was defined as the difference among conditions. The benefit of bilateral acoustic hearing was tested in both diffuse and single-source background noise. Results were analyzed using repeated-measures analysis of variance. Results Similar benefit was obtained for equivalent acoustic frequency bandwidth in either ear. Acoustic hearing in the nonimplanted ear provided more benefit than the implanted ear only in the wideband condition, most likely because of better audiometric thresholds (>500 Hz) in the nonimplanted ear. Bilateral acoustic hearing provided more benefit than unilateral hearing in either ear alone, but only in diffuse background noise. Conclusions Results support use of amplification in the implanted ear if residual hearing is present. The benefit of bilateral acoustic hearing (hearing preservation) should not be tested in quiet or with spatially coincident speech and noise, but rather in spatially separated speech and noise (e.g., diffuse background noise). PMID:25690775

Swimmer's Ear

MedlinePlus

... Eardrum Taking Care of Your Ears Can Loud Music Hurt My Ears? Your Ears What's Earwax? How Do Pain Relievers Work? View more About Us Contact Us Partners Editorial Policy Permissions Guidelines Privacy Policy & Terms of Use Notice ...

Laser-assisted tympanostomy (LAT) in adult individuals

NASA Astrophysics Data System (ADS)

Prokopakis, E. P.; Lachanas, V. A.; Helidonis, Emmanuel S.; Velegrakis, G.

2004-06-01

Objectives: To assess outcome, in adult individuals undergone Laser Assisted Tympanostomy (LAT) without ventilation tube placement. Method: LAT was performed on a total of 95 ears (72 individuals). Indications included serous otitis media with effusion (44 ears/31 patients), eustachian tube dysfunction (32 ears/24 patients), acute otitis media (13 ears/11 patients), and endoscopic visualization of the middle ear (6 ears/6 patients). Results: Middle ear disease was resolved after the closure of tympanostomy in 48% of patients with serous otitis media with effusion. In 78% of patients with Eustachian tube dysfunction symptoms were diminished. All patients with acute otitis media had a satisfactory outcome. LAT was found quite effective in patients undergoing middle ear endoscopy. Conclusion: LAT without ventilation tubes provides a safe alternative surgical option in adult patients in certain cases. The selection criteria for this procedure are addressed in detail.

Structures that Contribute to Middle-Ear Admittance in Chinchilla

PubMed Central

Rosowski, John J.; Ravicz, Michael E.; Songer, Jocelyn E.

2009-01-01

We describe measurements of middle-ear input admittance in chinchillas (Chinchilla lanigera) before and after various manipulations that define the contributions of different middle-ear components to function. The chinchilla’s middle-ear air spaces have a large effect on the low-frequency compliance of the middle ear, and removing the influences of these spaces reveals a highly admittant tympanic membrane and ossicular chain. Measurements of the admittance of the air spaces reveal that the high-degree of segmentation of these spaces has only a small effect on the admittance. Draining the cochlea further increases the middle-ear admittance at low frequencies and removes a low-frequency (less than 300 Hz) level dependence in the admittance. Spontaneous or sound-driven contractions of the middle-ear muscles in deeply anesthetized animals were associated with significant changes in middle-ear admittance. PMID:16944166

Structural Diversity in the Inner Ear of Teleost Fishes: Implications for Connections to the Mauthner Cell

NASA Technical Reports Server (NTRS)

Popper, Arthur N.; Edds-Walton, Peggy L.

1995-01-01

A body of literature suggests that the Mauthner cell startle response can be elicited by stimulation of the ear. While we know that there are projections to the M-cell from the ear, the specific endorgan(s) of the ear projecting to the M-cell are not known. Moreover, there are many reasons to question whether there is one pattern of inner ear to M-cell connection or whether the endorgan(s) projection to the M-cell varies in species that have different hearing capabilities of hearing structures. In this paper, we briefly review the structure of fish ears, with an emphasis on structural regionalization within the ear. We also review the central projections of the ear, along with a discussion of the limited data on projections to the M-cell.

Does ear endoscopy provide advantages in the outpatient management of open mastoidectomy cavities?

PubMed

Freire, Gustavo Subtil Magalhães; Sampaio, Andre Luiz Lopes; Lopes, Rafaela Aquino Fernandes; Nakanishi, Márcio; de Oliveira, Carlos Augusto Costa Pires

2018-01-01

To evaluate the use of ear endoscopy in the postoperative management of open mastoidectomy cavities, and to test whether ear endoscopy improves inspection and cleaning compared with ear microscopy. Prospective study. Thirty-two ears were divided into two groups: group 1, examination and cleaning of mastoid cavities under endoscopic visualization after microscopic standard ear cleaning; group 2, examination and cleaning of mastoid cavities under microscopic visualization after endoscope-assisted ear cleaning. We assessed the ability of each method to provide exposure and facilitate cleaning, comparing the benefits of microscopy and endoscopy when used sequentially and vice-versa. Endoscopy provided additional benefits for exposure in 61.1% of cases and cleaning in 66.7%. Microscopy provided no additional benefits in terms of exposure in any case, and provided added benefit for cleaning in only 21.4% of cases. For outpatient postoperative care of open mastoidectomy cavities, ear endoscopy provides greater benefit over ear microscopy than vice-versa. In over half of all cases, endoscopy was able to expose areas not visualized under the microscope. Furthermore, in two-thirds of cases, endoscopy enabled removal of material that could not be cleared under microscopy. Ear endoscopy was superior to microscopy in terms of enabling exposure and cleaning of hard-to-reach sites, due to its wider field of vision. Ear endoscopy is a feasible technique for the postoperative management of open mastoidectomy cavities. Ear endoscopy provided superior advantages in terms of exposure and aural cleaning compared with microscopy.

Clinical Investigation and Mechanism of Air-Bone Gaps in LargeVestibular Aqueduct Syndrome

PubMed Central

Merchant, Saumil N.; Nakajima, Hideko H.; Halpin, Christopher; Nadol, Joseph B.; Lee, Daniel J.; Innis, William P.; Curtin, Hugh; Rosowski, John J.

2008-01-01

Objectives Patients with large vestibular aqueduct syndrome (LVAS) often demonstrate an air-bone gap at the low frequencies on audiometric testing. The mechanism causing such a gap has not been well elucidated. We investigated middle ear sound transmission in patients with LVAS, and present a hypothesis to explain the air-bone gap. Methods Observations were made on 8 ears from 5 individuals with LVAS. The diagnosis of LVAS was made by computed tomography in all cases. Investigations included standard audiometry and measurements of umbo velocity by laser Doppler vibrometry (LDV) in all cases, as well as tympanometry, acoustic reflex testing, vestibular evoked myogenic potential (VEMP) testing, distortion product otoacoustic emission (DPOAE) testing, and middle ear exploration in some ears. Results One ear with LVAS had anacusis. The other 7 ears demonstrated air-bone gaps at the low frequencies, with mean gaps of 51 dB at 250 Hz, 31 dB at 500 Hz, and 12 dB at 1,000 Hz. In these 7 ears with air-bone gaps, LDV showed the umbo velocity to be normal or high normal in all 7; tympanometry was normal in all 6 ears tested; acoustic reflexes were present in 3 of the 4 ears tested; VEMP responses were present in all 3 ears tested; DPOAEs were present in 1 of the 2 ears tested, and exploratory tympanotomy in 1 case showed a normal middle ear. The above data suggest that an air-bone gap in LVAS is not due to disease in the middle ear. The data are consistent with the hypothesis that a large vestibular aqueduct introduces a third mobile window into the inner ear, which can produce an air-bone gap by 1) shunting air-conducted sound away from the cochlea, thus elevating air conduction thresholds, and 2) increasing the difference in impedance between the scala vestibuli side and the scala tympani side of the cochlear partition during bone conduction testing, thus improving thresholds for bone-conducted sound. Conclusions We conclude that LVAS can present with an air-bone gap that can mimic middle ear disease. Diagnostic testing using acoustic reflexes, VEMPs, DPOAEs, and LDV can help to identify a non–middle ear source for such a gap, thereby avoiding negative middle ear exploration. A large vestibular aqueduct may act as a third mobile window in the inner ear, resulting in an air-bone gap at low frequencies. PMID:17727085

Listening to Nature's orchestra with peculiar ears

NASA Astrophysics Data System (ADS)

Yager, David D.

2003-04-01

Insects use hearing for the crucial tasks of communicating with conspecifics and avoiding predators. Although all are based on the same acoustic principles, the diversity of insect ears is staggering and instructive. For instance, a South African grasshopper demonstrates that hearing conspecific calls is possible over distances 1 km with ears that do not have tympana. Actually, these creatures have six pairs of ears that play different roles in behavior. In numerical contrast, praying mantises have just a single ear in the ventral midline. The ear is very effective at detecting ultrasonic bat cries. However, the bioacoustics of sound transduction by two tympana facing each other in a deep, narrow slit is a puzzle. Tachinid flies demonstrate that directional hearing at 5 kHz is possible with a pair of ears fused together to give a total size of 1 mm. The ears are under the fly's chin. Hawk moths have their ears built into their mouthparts and the tympanum is more like a hollow ball than the usual membrane. As an apt last example, cicada ears are actually part of the orchestra: their tympana function both in sound reception and sound production.

Incorporating anthropometry into design of ear-related products.

PubMed

Liu, Bor-Shong

2008-01-01

To achieve mass customization and collaborative product design, human factors and ergonomics should play a key development role. The purpose of this study was to provide product designers with the anthropometic dimensions of outer ears for different demographic data, including gender and age. The second purpose was to compare the dimensions of various ear-related products (i.e., earphone, bluetooth earphone and ear-cup earphone) with the anthropometic database and recommend appropriate solutions for design. Two hundred subjects aged 20-59 was selected for this study and divided into four age stratifications. Further, three different dimensions of the outer ear (i.e., the earhole length, the ear connection length and the length of the pinna) were measured by superimposed grid photographic technique. The analysis of variance (ANOVA) was used to investigate the effects of gender, and age on ear dimensions. The results showed that all ear dimensions had significant gender effects. A comparison between the anthropometric dimensions and those of current products revealed that most current ear-related products need to be redesigned using anthropometric data. The shapes of earhole and pinna are not circular. Consequently, ear products need to be elongated so that users may feel more comfortably and not have the product slip off easily.

Structure and function of the mammalian middle ear. I: Large middle ears in small desert mammals.

PubMed

Mason, Matthew J

2016-02-01

Many species of small desert mammals are known to have expanded auditory bullae. The ears of gerbils and heteromyids have been well described, but much less is known about the middle ear anatomy of other desert mammals. In this study, the middle ears of three gerbils (Meriones, Desmodillus and Gerbillurus), two jerboas (Jaculus) and two sengis (elephant-shrews: Macroscelides and Elephantulus) were examined and compared, using micro-computed tomography and light microscopy. Middle ear cavity expansion has occurred in members of all three groups, apparently in association with an essentially 'freely mobile' ossicular morphology and the development of bony tubes for the middle ear arteries. Cavity expansion can occur in different ways, resulting in different subcavity patterns even between different species of gerbils. Having enlarged middle ear cavities aids low-frequency audition, and several adaptive advantages of low-frequency hearing to small desert mammals have been proposed. However, while Macroscelides was found here to have middle ear cavities so large that together they exceed brain volume, the bullae of Elephantulus are considerably smaller. Why middle ear cavities are enlarged in some desert species but not others remains unclear, but it may relate to microhabitat. © 2015 Anatomical Society.

Ear Aesthetics: Investigation by the Use of an Online Viral Survey.

PubMed

Steele, Jessica; Farmer, Eleanor; O'Hara, Justine; Bulstrode, Neil

2017-03-01

The ear is a key facial feature and yet few studies have previously assessed ear aesthetics. This study aimed to assess the anatomical components of the ear that have the greatest impact on the perception of ear aesthetics. Three photographs of a male adult ear (close-up, lateral, posterior) were digitally manipulated such that in each, 1 anatomical element of the ear was either enlarged or reduced. A complete set of 16 photographs including a repeat of the original ear as a control were randomized and entered into an online survey that required respondents to rate the attractiveness of each ear on a scale of 1 (least attractive) to 10 (most attractive). The survey was disseminated using email and social media. A total of 248 responses were received, 155 women and 92 men. Respondents were grouped by demographics of age and occupation. Reducing (R) or enlarging (E) the helix (R, P = 0.0256; E, P = 0.003), concha (R, P = 0.0002; E, P = <0.0001) and lobule (R, P = 0.0006; E, P < 0.0001) had a significant effect on ratings of attractiveness. Altering the tragus had no significant effect (R, P = 0.448; E, P = 0.201). In lateral view, raising the height of the ear had a significant effect (P = <0.0001) but not in lowering the height (P = 0.3038). Increasing and decreasing the projection of the ears both had a significant effect (P < 0.0001). The results of this study have provided useful evidence regarding the anatomical components of the ear that have the greatest effect on ear aesthetics. Furthermore, this study has proven the usefulness of conducting research using viral online surveys.

Evaluation of plasma fibrinogen concentration as a diagnostic indicator of inflammation in red-eared sliders (Trachemys scripta elegans).

PubMed

Moore, A Russell; Allender, Matthew C; Mitchell, Mark A; MacNeill, Amy L

2015-01-15

To critically evaluate plasma fibrinogen concentration as a diagnostic indicator of inflammation in red-eared sliders (Trachemys scripta elegans). Prospective induced-disease model and prospective cross-sectional study. Plasma samples from 12 purpose-bred red-eared sliders and 153 farm-raised red-eared sliders. A modification of the Jacobsson method was developed to measure fibrinogen concentration in platelet-poor plasma from red-eared sliders. Purpose-bred turtles had been inoculated with a ranavirus (n = 4) or sterile PBS solution (8) as part of another study. Farm-raised red-eared sliders were categorized as healthy (n = 138) or overtly ill (15) on the basis of physical examination findings at the time of blood sample collection. Samples from 124 of the 138 healthy red-eared sliders were used to establish a fibrinogen concentration reference interval as measured by the modified Jacobsson method. Fibrinogen concentrations in ranavirus-infected and physically ill turtles were compared with those of healthy turtles to determine whether fibrinogen concentration would be a useful diagnostic indicator of inflammation in red-eared sliders. The modified Jacobsson method was reliably used to measure fibrinogen concentration. The fibrinogen concentration reference interval from healthy reproductively active female red-eared sliders was right skewed. Fibrinogen concentration did not differ significantly between healthy red-eared sliders and ranavirus-infected or overtly ill red-eared sliders. A reference interval for red-eared slider plasma fibrinogen concentration was established and partitioned by sex to account for considerable right skewing observed for females. Fibrinogen concentration was not a useful indicator of inflammation in red-eared sliders with ranavirus infection or other overt illnesses.

Measurement of body temperature in adult patients: comparative study of accuracy, reliability and validity of different devices.

PubMed

Rubia-Rubia, J; Arias, A; Sierra, A; Aguirre-Jaime, A

2011-07-01

We compared a range of alternative devices with core body temperature measured at the pulmonary artery to identify the most valid and reliable instrument for measuring temperature in routine conditions in health services. 201 patients from the intensive care unit of the Candelaria University Hospital, Canary Islands, admitted to hospital between April 2006 and July 2007. All patients (or their families) gave informed consent. Readings from gallium-in-glass, reactive strip and digital in axilla, infra-red ear and frontal thermometers were compared with the pulmonary artery core temperature simultaneously. External factors suspected of having an influence on the differences were explored. The cut-off point readings for each thermometer were fixed for the maximum negative predictive value in comparison with the core temperature. The validity, reliability, accuracy, external influence, the waste they generated, ease of use, speed, durability, security, comfort and cost of each thermometer was evaluated. An ad hoc overall valuation score was obtained from these parameters for each instrument. For an error of ± 0.2°C and concordance with respect to fever, the gallium-in-glass thermometer gave the best results. The largest area under the receiver operating characteristic (ROC) curve is obtained by the digital axillar thermometer with probe (0.988 ± 0.007). The minimum difference between readings was given by the infrared ear thermometer, in comparison with the core temperature (-0.1 ± 0.3°C). Age, weight, level of conscience, male sex, environmental temperature and vaso-constrictor medication increases the difference in the readings and fever treatment reduces it, although this is not the same for all thermometers. The compact digital axillar thermometer and the digital thermometer with probe obtained the highest overall valuation score. If we only evaluate the aspects of validity, reliability, accuracy and external influence, the best thermometer would be the gallium-in-glass after 12 min. The gallium-in-glass thermometer is less accurate after only 5 min in comparison with the reading taken after being placed for 12 min. If we add the evaluation of waste production, ease-of-use, speed, durability, security, patient comfort and costs, the thermometers that obtain the highest score are the compact digital and digital with probe in right axilla. Copyright © 2010 Elsevier Ltd. All rights reserved.

Ear Deformations Give Bats a Physical Mechanism for Fast Adaptation of Ultrasonic Beam Patterns

NASA Astrophysics Data System (ADS)

Gao, Li; Balakrishnan, Sreenath; He, Weikai; Yan, Zhen; Müller, Rolf

2011-11-01

A large number of mammals, including humans, have intricate outer ear shapes that diffract incoming sound in a direction- and frequency-specific manner. Through this physical process, the outer ear shapes encode sound-source information into the sensory signals from each ear. Our results show that horseshoe bats could dynamically control these diffraction processes through fast nonrigid ear deformations. The bats’ ear shapes can alter between extreme configurations in about 100 ms and thereby change their acoustic properties in ways that would suit different acoustic sensing tasks.

Long-Term Asymmetric Hearing Affects Cochlear Implantation Outcomes Differently in Adults with Pre- and Postlingual Hearing Loss

PubMed Central

Boisvert, Isabelle; McMahon, Catherine M.; Dowell, Richard C.; Lyxell, Björn

2015-01-01

In many countries, a single cochlear implant is offered as a treatment for a bilateral hearing loss. In cases where there is asymmetry in the amount of sound deprivation between the ears, there is a dilemma in choosing which ear should be implanted. In many clinics, the choice of ear has been guided by an assumption that the reorganisation of the auditory pathways caused by longer duration of deafness in one ear is associated with poorer implantation outcomes for that ear. This assumption, however, is mainly derived from studies of early childhood deafness. This study compared outcomes following implantation of the better or poorer ear in cases of long-term hearing asymmetries. Audiological records of 146 adults with bilateral hearing loss using a single hearing aid were reviewed. The unaided ear had 15 to 72 years of unaided severe to profound hearing loss before unilateral cochlear implantation. 98 received the implant in their long-term sound-deprived ear. A multiple regression analysis was conducted to assess the relative contribution of potential predictors to speech recognition performance after implantation. Duration of bilateral significant hearing loss and the presence of a prelingual hearing loss explained the majority of variance in speech recognition performance following cochlear implantation. For participants with postlingual hearing loss, similar outcomes were obtained by implanting either ear. With prelingual hearing loss, poorer outcomes were obtained when implanting the long-term sound-deprived ear, but the duration of the sound deprivation in the implanted ear did not reliably predict outcomes. Contrary to an apparent clinical consensus, duration of sound deprivation in one ear has limited value in predicting speech recognition outcomes of cochlear implantation in that ear. Outcomes of cochlear implantation are more closely related to the period of time for which the brain is deprived of auditory stimulation from both ears. PMID:26043227

Middle Ear Infection (Chronic Otitis Media) and Hearing Loss

MedlinePlus

... You Middle Ear Infection (Chronic Otitis Media) and Hearing Loss Middle Ear Infection (Chronic Otitis Media) and ... loss. How does otitis media affect a child’s hearing? All children with middle ear infection or fluid ...

Testing a Method for Quantifying the Output of Implantable Middle Ear Hearing Devices

PubMed Central

Rosowski, J.J.; Chien, W.; Ravicz, M.E.; Merchant, S.N.

2008-01-01

This report describes tests of a standard practice for quantifying the performance of implantable middle ear hearing devices (also known as implantable hearing aids). The standard and these tests were initiated by the Food and Drug Administration of the United States Government. The tests involved measurements on two hearing devices, one commercially available and the other home built, that were implanted into ears removed from human cadavers. The tests were conducted to investigate the utility of the practice and its outcome measures: the equivalent ear canal sound pressure transfer function that relates electrically driven middle ear velocities to the equivalent sound pressure needed to produce those velocities, and the maximum effective ear canal sound pressure. The practice calls for measurements in cadaveric ears in order to account for the varied anatomy and function of different human middle ears. PMID:17406105

Different clinical presentation and management of temporal bone fibrous dysplasia in children.

PubMed

Mierzwiński, Józef; Kosowska, Justyna; Tyra, Justyna; Haber, Karolina; Drela, Maria; Paczkowski, Dariusz; Burduk, Paweł

2018-01-15

Fibrous dysplasia is a slowly progressive benign fibro-osseous disorder that involves one or multiple bones with a unilateral distribution in most cases. It is a lesion of unknown etiology, uncertain pathogenesis, and diverse histopathology. Temporal bone involvement is the least frequently reported type, especially in children. We reviewed available articles regarding fibrous dysplasia with temporal bone involvement in children and added four patients aged 7 to 17 years who were diagnosed and treated in our institution from 2006 to 2017. The patients' clinical picture comprised head deformity, external canal stenosis, headache, progressive conductive and/or sensorineural hearing loss, tinnitus, and sudden deafness. Two patients had experienced severe episodic vertigo with nausea and vomiting. Two were referred to us with external canal obstruction and secondary cholesteatoma formation with broad middle ear destruction. One was diagnosed with acute mastoiditis and intracranial complications. Optimal management of fibrous dysplasia is unclear and can be challenging, especially in children. In our two patients with disease expansion and involvement of important structures, surgical treatment was abandoned and a "wait-and-scan" policy was applied. The other two were qualified for surgical treatment. One patient underwent two surgeries: modified lateral petrosectomy (canal left open) with pathological tissue removal, cavity obliteration, and subsequent tympanoplasty. Another patient with extensive destruction of the left temporal bone underwent canal wall down mastoidectomy with perisinus abscess drainage and revision 12 months later. Tympanoplasty was unsatisfactory in both patients because of slow progression of the middle ear pathology. None of our patients underwent pharmacological treatment. In younger patients, observation and a "wait-and-scan" protocol is relevant until significant function, or cosmetic deficits are obvious. Surgery is not preferred and should be delayed until puberty because fibrous dysplasia has a tendency to stabilize after adolescence. In patients with severe symptoms medical treatment can be implemented, but safety of this treatment in children remain controversial.

Diversity of acoustic tracheal system and its role for directional hearing in crickets

PubMed Central

2013-01-01

Background Sound localization in small insects can be a challenging task due to physical constraints in deriving sufficiently large interaural intensity differences (IIDs) between both ears. In crickets, sound source localization is achieved by a complex type of pressure difference receiver consisting of four potential sound inputs. Sound acts on the external side of two tympana but additionally reaches the internal tympanal surface via two external sound entrances. Conduction of internal sound is realized by the anatomical arrangement of connecting trachea. A key structure is a trachea coupling both ears which is characterized by an enlarged part in its midline (i.e., the acoustic vesicle) accompanied with a thin membrane (septum). This facilitates directional sensitivity despite an unfavorable relationship between wavelength of sound and body size. Here we studied the morphological differences of the acoustic tracheal system in 40 cricket species (Gryllidae, Mogoplistidae) and species of outgroup taxa (Gryllotalpidae, Rhaphidophoridae, Gryllacrididae) of the suborder Ensifera comprising hearing and non hearing species. Results We found a surprisingly high variation of acoustic tracheal systems and almost all investigated species using intraspecific acoustic communication were characterized by an acoustic vesicle associated with a medial septum. The relative size of the acoustic vesicle - a structure most crucial for deriving high IIDs - implies an important role for sound localization. Most remarkable in this respect was the size difference of the acoustic vesicle between species; those with a more unfavorable ratio of body size to sound wavelength tend to exhibit a larger acoustic vesicle. On the other hand, secondary loss of acoustic signaling was nearly exclusively associated with the absence of both acoustic vesicle and septum. Conclusion The high diversity of acoustic tracheal morphology observed between species might reflect different steps in the evolution of the pressure difference receiver; with a precursor structure already present in ancestral non-hearing species. In addition, morphological transitions of the acoustic vesicle suggest a possible adaptive role for the generation of binaural directional cues. PMID:24131512

Benefits to Speech Perception in Noise From the Binaural Integration of Electric and Acoustic Signals in Simulated Unilateral Deafness

PubMed Central

Ma, Ning; Morris, Saffron; Kitterick, Pádraig Thomas

2016-01-01

Objectives: This study used vocoder simulations with normal-hearing (NH) listeners to (1) measure their ability to integrate speech information from an NH ear and a simulated cochlear implant (CI), and (2) investigate whether binaural integration is disrupted by a mismatch in the delivery of spectral information between the ears arising from a misalignment in the mapping of frequency to place. Design: Eight NH volunteers participated in the study and listened to sentences embedded in background noise via headphones. Stimuli presented to the left ear were unprocessed. Stimuli presented to the right ear (referred to as the CI-simulation ear) were processed using an eight-channel noise vocoder with one of the three processing strategies. An Ideal strategy simulated a frequency-to-place map across all channels that matched the delivery of spectral information between the ears. A Realistic strategy created a misalignment in the mapping of frequency to place in the CI-simulation ear where the size of the mismatch between the ears varied across channels. Finally, a Shifted strategy imposed a similar degree of misalignment in all channels, resulting in consistent mismatch between the ears across frequency. The ability to report key words in sentences was assessed under monaural and binaural listening conditions and at signal to noise ratios (SNRs) established by estimating speech-reception thresholds in each ear alone. The SNRs ensured that the monaural performance of the left ear never exceeded that of the CI-simulation ear. The advantages of binaural integration were calculated by comparing binaural performance with monaural performance using the CI-simulation ear alone. Thus, these advantages reflected the additional use of the experimentally constrained left ear and were not attributable to better-ear listening. Results: Binaural performance was as accurate as, or more accurate than, monaural performance with the CI-simulation ear alone. When both ears supported a similar level of monaural performance (50%), binaural integration advantages were found regardless of whether a mismatch was simulated or not. When the CI-simulation ear supported a superior level of monaural performance (71%), evidence of binaural integration was absent when a mismatch was simulated using both the Realistic and the Ideal processing strategies. This absence of integration could not be accounted for by ceiling effects or by changes in SNR. Conclusions: If generalizable to unilaterally deaf CI users, the results of the current simulation study would suggest that benefits to speech perception in noise can be obtained by integrating information from an implanted ear and an NH ear. A mismatch in the delivery of spectral information between the ears due to a misalignment in the mapping of frequency to place may disrupt binaural integration in situations where both ears cannot support a similar level of monaural speech understanding. Previous studies that have measured the speech perception of unilaterally deaf individuals after CI but with nonindividualized frequency-to-electrode allocations may therefore have underestimated the potential benefits of providing binaural hearing. However, it remains unclear whether the size and nature of the potential incremental benefits from individualized allocations are sufficient to justify the time and resources required to derive them based on cochlear imaging or pitch-matching tasks. PMID:27116049

Benefits to Speech Perception in Noise From the Binaural Integration of Electric and Acoustic Signals in Simulated Unilateral Deafness.

PubMed

Ma, Ning; Morris, Saffron; Kitterick, Pádraig Thomas

2016-01-01

This study used vocoder simulations with normal-hearing (NH) listeners to (1) measure their ability to integrate speech information from an NH ear and a simulated cochlear implant (CI), and (2) investigate whether binaural integration is disrupted by a mismatch in the delivery of spectral information between the ears arising from a misalignment in the mapping of frequency to place. Eight NH volunteers participated in the study and listened to sentences embedded in background noise via headphones. Stimuli presented to the left ear were unprocessed. Stimuli presented to the right ear (referred to as the CI-simulation ear) were processed using an eight-channel noise vocoder with one of the three processing strategies. An Ideal strategy simulated a frequency-to-place map across all channels that matched the delivery of spectral information between the ears. A Realistic strategy created a misalignment in the mapping of frequency to place in the CI-simulation ear where the size of the mismatch between the ears varied across channels. Finally, a Shifted strategy imposed a similar degree of misalignment in all channels, resulting in consistent mismatch between the ears across frequency. The ability to report key words in sentences was assessed under monaural and binaural listening conditions and at signal to noise ratios (SNRs) established by estimating speech-reception thresholds in each ear alone. The SNRs ensured that the monaural performance of the left ear never exceeded that of the CI-simulation ear. The advantages of binaural integration were calculated by comparing binaural performance with monaural performance using the CI-simulation ear alone. Thus, these advantages reflected the additional use of the experimentally constrained left ear and were not attributable to better-ear listening. Binaural performance was as accurate as, or more accurate than, monaural performance with the CI-simulation ear alone. When both ears supported a similar level of monaural performance (50%), binaural integration advantages were found regardless of whether a mismatch was simulated or not. When the CI-simulation ear supported a superior level of monaural performance (71%), evidence of binaural integration was absent when a mismatch was simulated using both the Realistic and the Ideal processing strategies. This absence of integration could not be accounted for by ceiling effects or by changes in SNR. If generalizable to unilaterally deaf CI users, the results of the current simulation study would suggest that benefits to speech perception in noise can be obtained by integrating information from an implanted ear and an NH ear. A mismatch in the delivery of spectral information between the ears due to a misalignment in the mapping of frequency to place may disrupt binaural integration in situations where both ears cannot support a similar level of monaural speech understanding. Previous studies that have measured the speech perception of unilaterally deaf individuals after CI but with nonindividualized frequency-to-electrode allocations may therefore have underestimated the potential benefits of providing binaural hearing. However, it remains unclear whether the size and nature of the potential incremental benefits from individualized allocations are sufficient to justify the time and resources required to derive them based on cochlear imaging or pitch-matching tasks.

Cauliflower Ear and Skin Infections among Wrestlers in Tehran.

PubMed

Kordi, Ramin; Mansournia, Mohammad Ali; Nourian, Roh Allah; Wallace, W Angus

2007-01-01

The purpose of the study was to describe the magnitude of the selected sports medicine problems (i.e. cauliflower ear and skin infections) among wrestlers in Tehran. A number of 411 wrestlers were randomly selected from wrestling clubs in Tehran employing cluster sample setting method. The participants were interviewed using a specially designed and validated questionnaire. Nearly half of the participants (44%) had "cauliflower ears". Only 23% of these participants had received any kind of treatment for their acute ear haematomas that are known to result in "cauliflower ears". The prevalence of reported hearing loss among participants with cauliflower ears (11.5%, 95%CI: 6.9 to 16.2) was significantly more than this prevalence among those participants without cauliflower ears (1.8%, 95%CI: 0.1 to 3.5) (p < 0.05). More than half of the participants (52%) had skin infection diagnosed by a physician during the previous year. This study has identified evidence of an increase in hearing loss as a possible side effect of either cauliflower ear or ear injury in wrestling in Iran. There has been an outbreak of ringworm and there is a significant potential for an outbreak of impetigo among wrestlers in Tehran. Key pointsSkin infections are prevalent among wrestlers in Tehran.Commonly wrestlers in Tehran continue to carry out wrestling training while affected by skin infections.Cauliflower ear "is common among wrestlers in Tehran.More research is needed to investigate hearing loss as a possible side effect of either cauliflower ear or ear injury in wrestling in Iran.

Active transcutaneous bone conduction implant: audiological results in paediatric patients with bilateral microtia associated with external auditory canal atresia.

PubMed

Bravo-Torres, Sofía; Der-Mussa, Carolina; Fuentes-López, Eduardo

2018-01-01

To describe, in terms of functional gain and word recognition, the audiological results of patients under 18 years of age implanted with the active bone conduction implant, Bonebridge™. Retrospective case studies conducted by reviewing the medical records of patients receiving implants between 2014 and 2016 in the public health sector in Chile. All patients implanted with the Bonebridge were included (N = 15). Individuals who had bilateral conductive hearing loss, secondary to external ear malformations, were considered as candidates. The average hearing threshold one month after switch on was 25.2 dB (95%CI 23.5-26.9). Hearing thresholds between 0.5 and 4 kHz were better when compared with bone conduction hearing aids. Best performance was observed at 4 kHz, where improvements to hearing were observed throughout the adaptation process. There was evidence of a significant increase in the recognition of monosyllables. The Bonebridge implant showed improvements to hearing thresholds and word recognition in paediatric patients with congenital conductive hearing loss.

Middle ear osteoma causing progressive facial nerve weakness: a case report.

PubMed

Curtis, Kate; Bance, Manohar; Carter, Michael; Hong, Paul

2014-09-18

Facial nerve weakness is most commonly due to Bell's palsy or cerebrovascular accidents. Rarely, middle ear tumor presents with facial nerve dysfunction. We report a very unusual case of middle ear osteoma in a 49-year-old Caucasian woman causing progressive facial nerve deficit. A subtle middle ear lesion was observed on otoscopy and computed tomographic images demonstrated an osseous middle ear tumor. Complete surgical excision resulted in the partial recovery of facial nerve function. Facial nerve dysfunction is rarely caused by middle ear tumors. The weakness is typically due to a compressive effect on the middle ear portion of the facial nerve. Early recognition is crucial since removal of these lesions may lead to the recuperation of facial nerve function.

Ear Problems

MedlinePlus

... may have OTITIS MEDIA, an infection of the middle ear. Self CareSee your doctor. Many ear infections will ... half-alcohol, half-white vinegar solution in the ear before and after swimming or ... JOINT (TMJ) SYNDROME, a disorder that affects the jaw joint, may ...

Inner Ear Barotrauma After Underwater Pool Competency Training Without the Use of Compressed Air Case and Review.

PubMed

McIntire, Sean; Boujie, Lee

2016-01-01

Inner ear barotrauma can occur when the gas-filled chambers of the ear have difficulty equalizing pressure with the outside environment after changes in ambient pressure. This can transpire even with small pressure changes. Hypobaric or hyperbaric environments can place significant stress on the structures of the middle and inner ear. If methods to equalize pressure between the middle ear and other connected gas-filled spaces (i.e., Valsalva maneuver) are unsuccessful, middle ear overpressurization can occur. This force can be transmitted to the fluid-filled inner ear, making it susceptible to injury. Damage specifically to the structures of the vestibulocochlear system can lead to symptoms of vertigo, hearing loss, and tinnitus. This article discusses the case of a 23-year-old male Marine who presented with symptoms of nausea and gait instability after performing underwater pool competency exercises to a maximum depth of 13 feet, without breathing compressed air. Diagnosis and management of inner ear barotrauma are reviewed, as is differentiation from inner ear decompression sickness. 2016.

On Applicability of Tunable Filter Bank Based Feature for Ear Biometrics: A Study from Constrained to Unconstrained.

PubMed

Chowdhury, Debbrota Paul; Bakshi, Sambit; Guo, Guodong; Sa, Pankaj Kumar

2017-11-27

In this paper, an overall framework has been presented for person verification using ear biometric which uses tunable filter bank as local feature extractor. The tunable filter bank, based on a half-band polynomial of 14th order, extracts distinct features from ear images maintaining its frequency selectivity property. To advocate the applicability of tunable filter bank on ear biometrics, recognition test has been performed on available constrained databases like AMI, WPUT, IITD and unconstrained database like UERC. Experiments have been conducted applying tunable filter based feature extractor on subparts of the ear. Empirical experiments have been conducted with four and six subdivisions of the ear image. Analyzing the experimental results, it has been found that tunable filter moderately succeeds to distinguish ear features at par with the state-of-the-art features used for ear recognition. Accuracies of 70.58%, 67.01%, 81.98%, and 57.75% have been achieved on AMI, WPUT, IITD, and UERC databases through considering Canberra Distance as underlying measure of separation. The performances indicate that tunable filter is a candidate for recognizing human from ear images.

Is Attention Shared Between the Ears?1

PubMed Central

Shiffrin, Richard M.; Pisoni, David B.; Castaneda-Mendez, Kicab

2012-01-01

This study tests the locus of attention during selective listening for speech-like stimuli. Can processing be differentially allocated to the two ears? Two conditions were used. The simultaneous condition involved one of four randomly chosen stop-consonants being presented to one of the ears chosen at random. The sequential condition involved two intervals; in the first S listened to the right ear; in the second S listened to the left ear. One of the four consonants was presented to an attended ear during one of these intervals. Experiment I used no distracting stimuli. Experiment II utilized a distracting consonant not confusable with any of the four target consonants. This distractor was always presented to any ear not containing a target. In both experiments, simultaneous and sequential performance were essentially identical, despite the need for attention sharing between the two ears during the simultaneous condition. We conclude that selective attention does not occur during perceptual processing of speech sounds presented to the two ears. We suggest that attentive effects arise in short-term memory following processing. PMID:23226838

Major evolutionary transitions and innovations: the tympanic middle ear

PubMed Central

2017-01-01

One of the most amazing transitions and innovations during the evolution of mammals was the formation of a novel jaw joint and the incorporation of the original jaw joint into the middle ear to create the unique mammalian three bone/ossicle ear. In this review, we look at the key steps that led to this change and other unusual features of the middle ear and how developmental biology has been providing an understanding of the mechanisms involved. This starts with an overview of the tympanic (air-filled) middle ear, and how the ear drum (tympanic membrane) and the cavity itself form during development in amniotes. This is followed by an investigation of how the ear is connected to the pharynx and the relationship of the ear to the bony bulla in which it sits. Finally, the novel mammalian jaw joint and versatile dentary bone will be discussed with respect to evolution of the mammalian middle ear. This article is part of the themed issue ‘Evo-devo in the genomics era, and the origins of morphological diversity’. PMID:27994124

Practical otic anatomy and physiology of the dog and cat.

PubMed

Njaa, Bradley L; Cole, Lynette K; Tabacca, Natalie

2012-11-01

Knowledge of the normal structure and function of the canine and feline ear is critical to be able to diagnose abnormalities that either involve the ear or originate within one or more of the ear compartments. In addition, a veterinarian must be aware of various structures within or associated with the ear so that they are not damaged or destroyed while treating an animal with otic disease. This article provides a brief discussion of the various anatomic features of the ear and normal physiology of portions of the ear. Copyright © 2012 Elsevier Inc. All rights reserved.

Management of auricular hematoma and the cauliflower ear.

PubMed

Greywoode, Jewel D; Pribitkin, Edmund A; Krein, Howard

2010-12-01

Acute auricular hematoma is common after blunt trauma to the side of the head. A network of vessels provides a rich blood supply to the ear, and the ear cartilage receives its nutrients from the overlying perichondrium. Prompt management of hematoma includes drainage and prevention of reaccumulation. If left untreated, an auricular hematoma can result in complications such as perichondritis, infection, and necrosis. Cauliflower ear may result from long-standing loss of blood supply to the ear cartilage and formation of neocartilage from disrupted perichondrium. Management of cauliflower ear involves excision of deformed cartilage and reshaping of the auricle. © Thieme Medical Publishers.

Contralateral ear occlusion for improving the reliability of otoacoustic emission screening tests.

PubMed

Papsin, Emily; Harrison, Adrienne L; Carraro, Mattia; Harrison, Robert V

2014-01-01

Newborn hearing screening is an established healthcare standard in many countries and testing is feasible using otoacoustic emission (OAE) recording. It is well documented that OAEs can be suppressed by acoustic stimulation of the ear contralateral to the test ear. In clinical otoacoustic emission testing carried out in a sound attenuating booth, ambient noise levels are low such that the efferent system is not activated. However in newborn hearing screening, OAEs are often recorded in hospital or clinic environments, where ambient noise levels can be 60-70 dB SPL. Thus, results in the test ear can be influenced by ambient noise stimulating the opposite ear. Surprisingly, in hearing screening protocols there are no recommendations for avoiding contralateral suppression, that is, protecting the opposite ear from noise by blocking the ear canal. In the present study we have compared transient evoked and distortion product OAEs measured with and without contralateral ear plugging, in environmental settings with ambient noise levels <25 dB SPL, 45 dB SPL, and 55 dB SPL. We found out that without contralateral ear occlusion, ambient noise levels above 55 dB SPL can significantly attenuate OAE signals. We strongly suggest contralateral ear occlusion in OAE based hearing screening in noisy environments.

Effects of Varieties, Producing Areas, Ears, and Ear Positions of Single Maize Kernels on Near-Infrared Spectra for Identification and Traceability.

PubMed

An, Dong; Cui, Yongjin; Liu, Xu; Jia, Shiqiang; Zheng, Shuyun; Che, Xiaoping; Liu, Zhe; Zhang, Xiaodong; Zhu, Dehai; Li, Shaoming

2016-01-01

The effects of varieties, producing areas, ears, and ear positions of maize on near-infrared (NIR) spectra were investigated to determine the factors causing the differences in NIR fingerprints of maize varieties. A total of 130 inbred lines were grown in two regions in China, and 12,350 kernel samples were analyzed through NIR spectroscopy. Spectral differences among varieties, producing areas, ears, and ear positions were determined and compared on the basis of pretreated spectra. The bands at 1300-1470, 1768-1949, 2010-2064, and 2235-2311 nm were mainly affected by the producing area. Band selection and principal component analysis were applied to improve the influence of variety on NIR spectra by processing the pretreated spectra. The degrees of the influence of varieties, producing areas, ears, and ear positions were calculated, and the percentages of the influence of varieties, producing areas, ears, and ear positions were 45.40%, 42.66%, 8.22%, and 3.72%, respectively. Therefore, genetic differences among maize inbred lines are the main factors accounted for NIR spectral differences. Producing area is a secondary factor. These results could provide a reference for researchers who authenticate varieties, perform geographical origin traceabilities, and conduct maize seed breeding.

A short-wave infrared otoscope for middle ear disease diagnostics (Conference Presentation)

NASA Astrophysics Data System (ADS)

Carr, Jessica A.; Valdez, Tulio; Bruns, Oliver; Bawendi, Moungi

2016-02-01

Otitis media, a range of inflammatory conditions of the middle ear, is the second most common illness diagnosed in children. However, the diagnosis can be challenging, particularly in pediatric patients. Otitis media is commonly over-diagnosed and over-treated and has been identified as one of the primary factors in increased antibiotic resistance. We describe the development of a short-wave infrared (SWIR) otoscope for objective middle ear effusion diagnosis. The SWIR otoscope can unambiguously detect the presence of middle ear fluid based on its strong light absorption in the SWIR. This absorption causes a stark, visual contrast between the presence and absence of fluid behind the tympanic membrane. Additionally, when there is no middle ear fluid, the deeper tissue penetration of SWIR light allows the SWIR otoscope to better visualize middle ear anatomy through the tympanic membrane than is possible with visible light. We demonstrate that in healthy, adult human ears, SWIR otoscopy can image a range of middle ear anatomy, including landmarks of the entire ossicular chain, the promontory, the round window niche, and the chorda tympani. We suggest that SWIR otoscopy can provide valuable diagnostic information complementary to that provided by visible pneumotoscopy in the diagnosis of middle ear effusions, otitis media, and other maladies of the middle ear.

Fly-ear inspired acoustic sensors for gunshot localization

NASA Astrophysics Data System (ADS)

Liu, Haijun; Currano, Luke; Gee, Danny; Yang, Benjamin; Yu, Miao

2009-05-01

The supersensitive ears of the parasitoid fly Ormia ochracea have inspired researchers to develop bio-inspired directional microphone for sound localization. Although the fly ear is optimized for localizing the narrow-band calling song of crickets at 5 kHz, experiments and simulation have shown that it can amplify directional cues for a wide frequency range. In this article, a theoretical investigation is presented to study the use of fly-ear inspired directional microphones for gunshot localization. Using an equivalent 2-DOF model of the fly ear, the time responses of the fly ear structure to a typical shock wave are obtained and the associated time delay is estimated by using cross-correlation. Both near-field and far-field scenarios are considered. The simulation shows that the fly ear can greatly amplify the time delay by ~20 times, which indicates that with an interaural distance of only 1.2 mm the fly ear is able to generate a time delay comparable to that obtained by a conventional microphone pair with a separation as large as 24 mm. Since the parameters of the fly ear structure can also be tuned for muzzle blast and other impulse stimulus, fly-ear inspired acoustic sensors offers great potential for developing portable gunshot localization systems.

Desmoplastic small round cell tumor of the middle ear: A case report.

PubMed

Xu, Jing; Yao, Mengwei; Yang, Xinxin; Liu, Tao; Wang, Shaohua; Ma, Dengdian; Li, Xiaoyu

2018-04-01

Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive and malignant tumor. This report describes a case involving DSRCT of the middle ear which no case has been reported in the literature till date. A 59-year-old Chinese man with a 40-year history of repeated suppuration of his right ear and 1-year history of drooping of the angle of mouth. The CT of the middle ear and brain scan and enhanced MRI showed space occupying lesion in the right middle ear. Desmoplastic small round cell tumor of the middle ear. After relevant examinations, radical mastoidectomy and subtotal temporal bone resection were performed on the right ear under general anesthesia. The patient underwent postoperative adjuvant chemoradiation therapy. The patient was counterchecked regularly,there was norecurrence of DSRCT of the middle ear. Four years after surgery, the CT and MRI of the middle ear mastoid showed right middle ear soft tissue shadow,but postoperative pathological results showed proliferative fibrous and vascular tissues with chronic inflammatory cell infiltration and necrosis. DSRCT is a relatively aggressive, malignant mesenchymal tumor, with a very poor prognosis.The diagnosis of DSRCT relies on immunohistological data. Early diagnosis, radical surgery, chemotherapy, and radiotherapy are considered a reasonable way to prolong survival.

A Longitudinal Study in Children With Sequential Bilateral Cochlear Implants: Time Course for the Second Implanted Ear and Bilateral Performance.

PubMed

Reeder, Ruth M; Firszt, Jill B; Cadieux, Jamie H; Strube, Michael J

2017-01-01

Whether, and if so when, a second-ear cochlear implant should be provided to older, unilaterally implanted children is an ongoing clinical question. This study evaluated rate of speech recognition progress for the second implanted ear and with bilateral cochlear implants in older sequentially implanted children and evaluated localization abilities. A prospective longitudinal study included 24 bilaterally implanted children (mean ear surgeries at 5.11 and 14.25 years). Test intervals were every 3-6 months through 24 months postbilateral. Test conditions were each ear and bilaterally for speech recognition and localization. Overall, the rate of progress for the second implanted ear was gradual. Improvements in quiet continued through the second year of bilateral use. Improvements in noise were more modest and leveled off during the second year. On all measures, results from the second ear were poorer than the first. Bilateral scores were better than either ear alone for all measures except sentences in quiet and localization. Older sequentially implanted children with several years between surgeries may obtain speech understanding in the second implanted ear; however, performance may be limited and rate of progress gradual. Continued contralateral ear hearing aid use and reduced time between surgeries may enhance outcomes.

Ear wax

PubMed Central

2008-01-01

Introduction Ear wax only becomes a problem if it causes a hearing impairment or other ear-related symptoms. Ear wax is more likely to accumulate and cause a hearing impairment when normal extrusion is prevented — for example, by the use of hearing aids, or by the use of cotton buds to clean the ears. Ear wax can visually obscure the ear drum, and may need to be removed for diagnostic purposes. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of methods to remove ear wax? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2007 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found nine systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: ear syringing; manual removal (other than ear syringing); and wax softeners (alone or prior to syringing). PMID:19450340

Effect of cochlear implantation on middle ear function: A three-month prospective study.

PubMed

Wasson, Joseph D; Campbell, Luke; Chambers, Scott; Hampson, Amy; Briggs, Robert J S; O'Leary, Stephen J

2018-05-01

To determine if cochlear implantation has a delayed effect on the middle ear conductive hearing mechanism by measuring laser Doppler vibrometry (LDV) of the tympanic membrane (TM) in both implanted and contralateral control ears preoperatively and 3 months postoperatively, and then comparing the relative change in LDV outcome measures between implanted and control ears. Prospective cohort study. Eleven preoperative adult unilateral cochlear implant recipients in previously unoperated ears with normal anatomy and aerated temporal bones were included in this study. The magnitude and phase angle of umbo velocity transfer function in response to air- conduction (AC) stimulus, and the magnitude of umbo velocity in response to bone- conduction (BC) stimulus were measured in the implant ear and the contralateral control ear preoperatively and 3 months postoperatively and compared. No significant changes in the magnitude or phase angle of TM velocity in response to either AC or BC stimulus were observed in the implanted ear relative to the contralateral control ear 3 months following cochlear implantation. From the results of LDV measurements, it can be said that cochlear implantation has no significant delayed effect on the middle ear conductive mechanism. 4. Laryngoscope, 128:1207-1212, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Better late than never: effective air-borne hearing of toads delayed by late maturation of the tympanic middle ear structures.

PubMed

Womack, Molly C; Christensen-Dalsgaard, Jakob; Hoke, Kim L

2016-10-15

Most vertebrates have evolved a tympanic middle ear that enables effective hearing of airborne sound on land. Although inner ears develop during the tadpole stages of toads, tympanic middle ear structures are not complete until months after metamorphosis, potentially limiting the sensitivity of post-metamorphic juveniles to sounds in their environment. We tested the hearing of five species of toads to determine how delayed ear development impairs airborne auditory sensitivity. We performed auditory brainstem recordings to test the hearing of the toads and used micro-computed tomography and histology to relate the development of ear structures to hearing ability. We found a large (14-27 dB) increase in hearing sensitivity from 900 to 2500 Hz over the course of ear development. Thickening of the tympanic annulus cartilage and full ossification of the middle ear bone are associated with increased hearing ability in the final stages of ear maturation. Thus, juvenile toads are at a hearing disadvantage, at least in the high-frequency range, throughout much of their development, because late-forming ear elements are critical to middle ear function at these frequencies. We discuss the potential fitness consequences of late hearing development, although research directly addressing selective pressures on hearing sensitivity across ontogeny is lacking. Given that most vertebrate sensory systems function very early in life, toad tympanic hearing may be a sensory development anomaly. © 2016. Published by The Company of Biologists Ltd.

[Efficacy of high-resolution CT in differential diagnosis of chronic suppurative otitis media and cholesteatoma otitis media by soft-tissue shadows].

PubMed

Sun, Xiao-wei; Zhang, Jian-ji; Ding, Yuan-ping; Dou, Fen-fen; Zhang, Han-bing; Gong, Ke-bo; Xu, An-ting

2011-05-01

To evalute the efficacy of high-resolution CT(HRCT) in differential diagnosis and treatment of chronic suppurative otitis media and cholesteatoma otitis media by soft-tissue shadows. HRCT scanning was performed in 120 cases, 153 ears, with chronic otitis suppurative media and cholesteatoma otitis media, of which original data were processed with multi-planar reconstruction (MPR) and maximum intensity projection (MIP), the characteristics of the soft-tissue shadows' growth, window width or window leveling and bony destruction were respectively observed, as well as compared with the surgery findings. In 120 patients (153 ears), 109 ears were diagnosed as cholesteatoma otitis media, and 44 ears were diagnosed as chronic suppurative otitis media, among which 33 ears had granulation tissue and 11 ears had secretion. One hundred and seven ears were postoperatively diagnosed as cholesteatoma otitis media, among which 25 ears had granulation tissue. Among 46 ears of chronic suppurative otitis media, 35 ears had granulation tissue, and only 11 ears had secretion. A 98.6% diagnostic accuracy can be reached with HRCT in diagnosing cholesteatoma otitis media and chronic suppurative otitis media. The Youden's index was 0.98, 0.98 and 1.00 respectively with HRCT in diagnosing cholesteatoma, granulation tissue and secretion. Combination of the three different imaging methods, axial images, coronal MPR images and MIP images, can improve the efficacy of the HRCT diagnosis and definite chronic otitis media, which can be routinely used for surgery plan.

Ear Infection in Isolated Cleft Lip: Etiological Implications.

PubMed

Ruegg, Teresa A; Cooper, Margaret E; Leslie, Elizabeth J; Ford, Matthew D; Wehby, George L; Deleyiannis, Frederic W B; Czeizel, Andrew E; Hecht, Jacqueline T; Marazita, Mary L; Weinberg, Seth M

2017-03-01

  Chronic ear infections are a common occurrence in children with orofacial clefts involving the secondary palate. Less is known about the middle ear status of individuals with isolated clefts of the lip, although several studies have reported elevated rates of ear infection in this group. The purpose of this retrospective study was to test the hypothesis that chronic ear infections occur more frequently in isolated cleft lip cases (n = 94) compared with controls (n = 183).   A questionnaire was used to obtain information on history of chronic ear infection. The association between ear infection status (present/absent) and cleft lip status (cleft lip case/control) was tested using both chi-square and logistic regression.   The reported occurrence of chronic ear infection was significantly greater in cleft lip cases (31%) compared with unaffected controls (11%). After adjusting for age and sex, having a cleft lip increased the odds of being positive for ear infection by a factor greater than 3 (odds ratio = 3.698; 95% confidence interval = 1.91 to 7.14). Within cleft lip cases, there was no difference in the occurrence of ear infection by defect laterality or by the type of clefting present in the family history. Although velopharyngeal insufficiency was present in 18.4% of our cleft lip sample, there was no statistical association between ear infection and abnormal speech patterns. These results may have potential implications both for the clinical management of isolated cleft lip cases and for understanding the etiology of orofacial clefting.

Inner ear problems of Thai priest at Priest Hospital.

PubMed

Karnchanakas, Taweporn; Tantanavat, Are; Sinsakontavat, Jamjan

2008-01-01

The inner ear problems of Thai priest at Priest Hospital had never been reported previously, so Department of Ear Nose Throat try to correlate the metebotic disorder with inner ear problems. 1) To study the fasting blood sugar (FBS), total cholesterol (T. Chol), low density lipoprotein (LDL), and triglyceride (TG), the factors expected to involve in inner ear problems of priests at Priest Hospital. 2) To compare the FBS, T. Chol, HDL, LDL, and TG of priests with inner ear problems at Priest Hospital. 3) To find the percentage of abnormal from FBS, T. Chol, LDL, and TG. The study using 83 sampling of priests with inner ear problems and 107 priests as a controlled group. The research instruments used to collect data was the questionnaire which composed of general information, physical, ear-nose-throat and neurological examination, pure tone audiometry, brainstem evoke response audiometry (BERA) and the blood tests:FBS, T. Chol, TG, and LDL. The inner ear problems were composed of: 1) Dizziness 2) Hearing Loss 3) Tinnitus Aurium. The descriptive statistics were used to analyze the data from questionnaires and utilized frequency, percentage, standard deviation (S.D.) and t-test to achieve desired results. Priest at middle age and elderly with inner ear problems had greater FBS and TG than expected values of the control group. The middle age and elderly priests who had greater FBS and TG than expected values were sick with inner ear problems that causing dizziness, hearing loss and tinnitus aurium.

Ear Infection in Isolated Cleft Lip: Etiological Implications

PubMed Central

Ruegg, Teresa A.; Cooper, Margaret E.; Leslie, Elizabeth J.; Ford, Matthew D.; Wehby, George L.; Deleyiannis, Frederic W.B.; Czeizel, Andrew E.; Hecht, Jacqueline T.; Marazita, Mary L.; Weinberg, Seth M.

2015-01-01

Background and Hypothesis Chronic ear infections are a common occurrence in children with orofacial clefts involving the secondary palate. Less is known about the middle ear status of individuals with isolated clefts of the lip, although several studies have reported elevated rates of ear infection in this group. The purpose of this retrospective study was to test the hypothesis that chronic ear infections occur more frequently in isolated cleft lip cases (n=94) compared with controls (n=183). Methods A questionnaire was used to obtain information on history of chronic ear infection. The association between ear infection status (present/absent) and cleft lip status (cleft lip case/control) was tested using both chi-square and logistic regression. Results and Conclusions The reported occurrence of chronic ear infection was significantly greater in cleft lipcases (31%) compared to unaffected controls (11%). After adjusting for age and sex, having a cleft lip increased the odds of being positive for ear infection by a factor greater than three (OR=3.698; 95%CI=1.91–7.14). Within cleft lipcases, there was no difference in the occurrence of ear infection by defect laterality or by the type of clefting present in the family history. Although velopharyngeal insufficiency was present in 18.4% of our cleft lip sample, there was no statistical association between ear infection and abnormal speech patterns. These results may have potential implications both for the clinical management of isolated cleft lip cases and for understanding the etiology of orofacial clefting. PMID:26153759

In situ tissue engineering with synthetic self-assembling peptide nanofiber scaffolds, PuraMatrix, for mucosal regeneration in the rat middle-ear

PubMed Central

Akiyama, Naotaro; Yamamoto-Fukuda, Tomomi; Takahashi, Haruo; Koji, Takehiko

2013-01-01

Middle-ear mucosa maintains middle-ear pressure. However, the majority of surgical cases exhibit inadequate middle-ear mucosal regeneration, and mucosal transplantation is necessary in such cases. The aim of the present study was to assess the feasibility of transplantation of isolated mucosal cells encapsulated within synthetic self-assembling peptide nanofiber scaffolds using PuraMatrix, which has been successfully used as scaffolding in tissue engineering, for the repair of damaged middle-ear. Middle-ear bullae with mucosa were removed from Sprague Dawley (SD) transgenic rats, transfected with enhanced green fluorescent protein (EGFP) transgene and excised into small pieces, then cultured up to the third passage. After surgical elimination of middle-ear mucosa in SD recipient rats, donor cells were encapsulated within PuraMatrix and transplanted into these immunosuppressed rats. Primary cultured cells were positive for pancytokeratin but not for vimentin, and retained the character of middle-ear epithelial cells. A high proportion of EGFP-expressing cells were found in the recipient middle-ear after transplantation with PuraMatrix, but not without PuraMatrix. These cells retained normal morphology and function, as confirmed by histological examination, immunohistochemistry, and electron microscopy, and multiplied to form new epithelial and subepithelial layers together with basement membrane. The present study demonstrated the feasibility of transplantation of cultured middle-ear mucosal epithelial cells encapsulated within PuraMatrix for regeneration of surgically eliminated mucosa of the middle-ear in SD rats. PMID:23926427

In situ tissue engineering with synthetic self-assembling peptide nanofiber scaffolds, PuraMatrix, for mucosal regeneration in the rat middle-ear.

PubMed

Akiyama, Naotaro; Yamamoto-Fukuda, Tomomi; Takahashi, Haruo; Koji, Takehiko

2013-01-01

Middle-ear mucosa maintains middle-ear pressure. However, the majority of surgical cases exhibit inadequate middle-ear mucosal regeneration, and mucosal transplantation is necessary in such cases. The aim of the present study was to assess the feasibility of transplantation of isolated mucosal cells encapsulated within synthetic self-assembling peptide nanofiber scaffolds using PuraMatrix, which has been successfully used as scaffolding in tissue engineering, for the repair of damaged middle-ear. Middle-ear bullae with mucosa were removed from Sprague Dawley (SD) transgenic rats, transfected with enhanced green fluorescent protein (EGFP) transgene and excised into small pieces, then cultured up to the third passage. After surgical elimination of middle-ear mucosa in SD recipient rats, donor cells were encapsulated within PuraMatrix and transplanted into these immunosuppressed rats. Primary cultured cells were positive for pancytokeratin but not for vimentin, and retained the character of middle-ear epithelial cells. A high proportion of EGFP-expressing cells were found in the recipient middle-ear after transplantation with PuraMatrix, but not without PuraMatrix. These cells retained normal morphology and function, as confirmed by histological examination, immunohistochemistry, and electron microscopy, and multiplied to form new epithelial and subepithelial layers together with basement membrane. The present study demonstrated the feasibility of transplantation of cultured middle-ear mucosal epithelial cells encapsulated within PuraMatrix for regeneration of surgically eliminated mucosa of the middle-ear in SD rats.

Inner ear anatomy in Waardenburg syndrome: radiological assessment and comparison with normative data.

PubMed

Kontorinis, Georgios; Goetz, Friedrich; Lanfermann, Heinrich; Luytenski, Stefan; Giesemann, Anja M

2014-08-01

As patients with Waardenburg syndrome (WS) represent potential candidates for cochlear implantation, their inner ear anatomy is of high significance. There is an ongoing debate whether WS is related to any inner ear dysplasias. Our objective was to evaluate radiologically the inner ear anatomy in patients with WS and identify any temporal bone malformations. A retrospective case review was carried out in a tertiary, referral center. The high resolution computed tomography (HRCT) scans of the temporal bone from 20 patients (40 ears) with WS who were managed for deafness in a tertiary referral center from 1995 to 2012 were retrospectively examined. Measurements of 15 different inner ear dimensions, involving the cochlea, the vestibule, the semicircular canals and the internal auditory meatus, as well as measurements of the vestibular aqueduct, were performed independently by two neuroradiologists. Finally, we compared the results from the WS group with a control group consisting of 50 normal hearing subjects (100 ears) and with previously reported normative values. Inner ear malformations were not found in any of the patients with WS. All measured inner ear dimensions were within the normative values compiled by our study group as well as by others. Inner ear malformations are not characteristic for all types of WS; however, certain rare subtypes might be related to inner ear deformities. Normative cochleovestibular dimensions that can help in assessing the temporal bone anatomy are provided. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Identifying Otosclerosis with Aural Acoustical Tests of Absorbance, Group Delay, Acoustic Reflex Threshold, and Otoacoustic Emissions.

PubMed

Keefe, Douglas H; Archer, Kelly L; Schmid, Kendra K; Fitzpatrick, Denis F; Feeney, M Patrick; Hunter, Lisa L

2017-10-01

Otosclerosis is a progressive middle-ear disease that affects conductive transmission through the middle ear. Ear-canal acoustic tests may be useful in the diagnosis of conductive disorders. This study addressed the degree to which results from a battery of ear-canal tests, which include wideband reflectance, acoustic stapedius muscle reflex threshold (ASRT), and transient evoked otoacoustic emissions (TEOAEs), were effective in quantifying a risk of otosclerosis and in evaluating middle-ear function in ears after surgical intervention for otosclerosis. To evaluate the ability of the test battery to classify ears as normal or otosclerotic, measure the accuracy of reflectance in classifying ears as normal or otosclerotic, and evaluate the similarity of responses in normal ears compared with ears after surgical intervention for otosclerosis. A quasi-experimental cross-sectional study incorporating case control was used. Three groups were studied: one diagnosed with otosclerosis before corrective surgery, a group that received corrective surgery for otosclerosis, and a control group. The test groups included 23 ears (13 right and 10 left) with normal hearing from 16 participants (4 male and 12 female), 12 ears (7 right and 5 left) diagnosed with otosclerosis from 9 participants (3 male and 6 female), and 13 ears (4 right and 9 left) after surgical intervention from 10 participants (2 male and 8 female). Participants received audiometric evaluations and clinical immittance testing. Experimental tests performed included ASRT tests with wideband reference signal (0.25-8 kHz), reflectance tests (0.25-8 kHz), which were parameterized by absorbance and group delay at ambient pressure and at swept tympanometric pressures, and TEOAE tests using chirp stimuli (1-8 kHz). ASRTs were measured in ipsilateral and contralateral conditions using tonal and broadband noise activators. Experimental ASRT tests were based on the difference in wideband-absorbed sound power before and after presenting the activator. Diagnostic accuracy to classify ears as otosclerotic or normal was quantified by the area under the receiver operating characteristic curve (AUC) for univariate and multivariate reflectance tests. The multivariate predictor used a small number of input reflectance variables, each having a large AUC, in a principal components analysis to create independent variables and followed by a logistic regression procedure to classify the test ears. Relative to the results in normal ears, diagnosed otosclerosis ears more frequently showed absent TEOAEs and ASRTs, reduced ambient absorbance at 4 kHz, and a different pattern of tympanometric absorbance and group delay (absorbance increased at 2.8 kHz at the positive-pressure tail and decreased at 0.7-1 kHz at the peak pressure, whereas group delay decreased at positive and negative-pressure tails from 0.35-0.7 kHz, and at 2.8-4 kHz at positive-pressure tail). Using a multivariate predictor with three reflectance variables, tympanometric reflectance (AUC = 0.95) was more accurate than ambient reflectance (AUC = 0.88) in classifying ears as normal or otosclerotic. Reflectance provides a middle-ear test that is sensitive to classifying ears as otosclerotic or normal, which may be useful in clinical applications. American Academy of Audiology

Ear Tubes

MedlinePlus

... of the ear drum or eustachian tube, Down Syndrome, cleft palate, and barotrauma (injury to the middle ear caused by a reduction of air pressure, ... specialist) may be warranted if you or your child has experienced repeated ... fluid in the middle ear, barotrauma, or have an anatomic abnormality that ...

Use of infrared emission detection thermometer in Chinese neonates.

PubMed

Ng, D K; Liu, Y S; Ho, J C

1999-07-01

To evaluate the reproducibility of Thermoscan, an infrared emission detection ear thermometer, and to establish the normal reference range of ear temperature in Chinese neonates. Neonates were recruited from the inpatients population with exclusion of those suffering from infections. Forty-nine neonates were recruited with 1,115 temperature taking sessions. Mean left ear temperature was 36.64 degrees C +/- 0.35 degree C. Mean right ear temperature was 36.64 degrees C +/- 0.37 degree C. Clinical repeatability for left and right ear was 0.17 degree C and 0.17 degree C, respectively. Thermoscan produced reproducible results in Chinese neonates. The normal range of ear temperature for Chinese neonates is 35 degrees C to 37 degrees C. Ear temperature > 37.8 degrees C should be regarded as fever.

Audiometric Predictions Using SFOAE and Middle-Ear Measurements

PubMed Central

Ellison, John C.; Keefe, Douglas H.

2006-01-01

Objective The goals of the study are to determine how well stimulus-frequency otoacoustic emissions (SFOAEs) identify hearing loss, classify hearing loss as mild or moderate-severe, and correlate with pure-tone thresholds in a population of adults with normal middle-ear function. Other goals are to determine if middle-ear function as assessed by wideband acoustic transfer function (ATF) measurements in the ear canal account for the variability in normal thresholds, and if the inclusion of ATFs improves the ability of SFOAEs to identify hearing loss and predict pure-tone thresholds. Design The total suppressed SFOAE signal and its corresponding noise were recorded in 85 ears (22 normal ears and 63 ears with sensorineural hearing loss) at octave frequencies from 0.5 – 8 kHz using a nonlinear residual method. SFOAEs were recorded a second time in three impaired ears to assess repeatability. Ambient-pressure ATFs were obtained in all but one of these 85 ears, and were also obtained from an additional 31 normal-hearing subjects in whom SFOAE data were not obtained. Pure-tone air-and bone-conduction thresholds and 226-Hz tympanograms were obtained on all subjects. Normal tympanometry and the absence of air-bone gaps were used to screen subjects for normal middle-ear function. Clinical decision theory was used to assess the performance of SFOAE and ATF predictors in classifying ears as normal or impaired, and linear regression analysis was used to test the ability of SFOAE and ATF variables to predict the air-conduction audiogram. Results The ability of SFOAEs to classify ears as normal or hearing impaired was significant at all test frequencies. The ability of SFOAEs to classify impaired ears as either mild or moderate-severe was significant at test frequencies from 0.5 to 4 kHz. SFOAEs were present in cases of severe hearing loss. SFOAEs were also significantly correlated with air-conduction thresholds from 0.5 to 8 kHz. The best performance occurred using the SFOAE signal-to-noise ratio (S/N) as the predictor, and the overall best performance was at 2 kHz. The SFOAE S/N measures were repeatable to within 3.5 dB in impaired ears. The ATF measures explained up to 25% of the variance in the normal audiogram; however, ATF measures did not improve SFOAEs predictors of hearing loss except at 4 kHz. Conclusions In common with other OAE types, SFOAEs are capable of identifying the presence of hearing loss. In particular, SFOAEs performed better than distortion-product and click-evoked OAEs in predicting auditory status at 0.5 kHz; SFOAE performance was similar to that of other OAE types at higher frequencies except for a slight performance reduction at 4 kHz. Because SFOAEs were detected in ears with mild to severe cases of hearing loss they may also provide an estimate of the classification of hearing loss. Although SFOAEs were significantly correlated with hearing threshold, they do not appear to have clinical utility in predicting a specific behavioral threshold. Information on middle-ear status as assessed by ATF measures offered minimal improvement in SFOAE predictions of auditory status in a population of normal and impaired ears with normal middle-ear function. However, ATF variables did explain a significant fraction of the variability in the audiograms of normal ears, suggesting that audiometric thresholds in normal ears are partially constrained by middle-ear function as assessed by ATF tests. PMID:16230898

Biocompatibility of Liposome Nanocarriers in the Rat Inner Ear After Intratympanic Administration

NASA Astrophysics Data System (ADS)

Zou, Jing; Feng, Hao; Sood, Rohit; Kinnunen, Paavo K. J.; Pyykko, Ilmari

2017-05-01

Liposome nanocarriers (LPNs) are potentially the future of inner ear therapy due to their high drug loading capacity and efficient uptake in the inner ear after a minimally invasive intratympanic administration. However, information on the biocompatibility of LPNs in the inner ear is lacking. The aim of the present study is to document the biocompatibility of LPNs in the inner ear after intratympanic delivery. LPNs with or without gadolinium-tetra-azacyclo-dodecane-tetra-acetic acid (Gd-DOTA) were delivered to the rats through transtympanic injection. The distribution of the Gd-DOTA-containing LPNs in the middle and inner ear was tracked in vivo using MRI. The function of the middle and inner ear barriers was evaluated using gadolinium-enhanced MRI. The auditory function was measured using auditory brainstem response (ABR). The potential inflammatory response was investigated by analyzing glycosaminoglycan and hyaluronic acid secretion and CD44 and TLR2 expression in the inner ear. The potential apoptosis was analyzed using terminal transferase (TdT) to label the free 3'OH breaks in the DNA strands of apoptotic cells with TMR-dUTP (TUNEL staining). As a result, LPNs entered the inner ear efficiently after transtympanic injection. The transtympanic injection of LPNs with or without Gd-DOTA neither disrupted the function of the middle and inner ear barriers nor caused hearing impairment in rats. The critical inflammatory biological markers in the inner ear, including glycosaminoglycan and hyaluronic acid secretion and CD44 and TLR2 expression, were not influenced by the administration of LPNs. There was no significant cell death associated with the administration of LPNs. The transtympanic injection of LPNs is safe for the inner ear, and LPNs may be applied as a drug delivery matrix in the clinical therapy of sensorineural hearing loss.

Modulation by glycyrrhetinic acid derivatives of TPA-induced mouse ear oedema.

PubMed Central

Inoue, H.; Mori, T.; Shibata, S.; Koshihara, Y.

1989-01-01

1. The anti-inflammatory effects of glycyrrhetinic acid and its derivatives on TPA (12-O-tetradecanoylphorbol-13-acetate)-induced mouse ear oedema were studied. The mechanisms of TPA-induced ear oedema were first investigated with respect to the chemical mediators. 2. The formation of ear oedema reached a maximum 5 h after TPA application (2 micrograms per ear) and the prostaglandin E2 (PGE2) production of mouse ear increased with the oedema formation. 3. TPA-induced ear oedema was prevented by actinomycin D and cycloheximide (0.1 mg per ear, respectively) when applied during 60 min after TPA treatment. 4. Of glycyrrhetinic acid derivatives examined, dihemiphthalate derivatives (IIe, IIe', IIIa, IIIa', IVa, IVa') most strongly inhibited ear oedema on both topical (ID50, 1.6 mg per ear for IIe, 2.0 mg per ear for IIIa and 1.6 mg per ear for IVa) and oral (ID50, 88 mg kg-1 for IIe', 130 mg kg-1 for IIIa' and 92 mg kg-1 for IVa') administration. 5. Glycyrrhetinic acid (Ia) and its derivatives applied 30 min before TPA treatment were much more effective in inhibiting oedema than when applied 30 min after TPA. A dihemiphthalate of triterpenoid compound IVa completely inhibited oedema, even when applied 3 h before TPA treatment. 6. Glycyrrhetinic acid (Ia) and deoxoglycyrrhetol (IIa), the parent compounds, produced little inhibition by oral administration at less than 200 mg kg-1. 7. These results suggest that the dihemiphthalate derivatives of triterpenes derived from glycyrrhetinic acid by chemical modification are useful for the treatment of skin inflammation by both topical and oral application. PMID:2924072

Customized acoustic transform functions and their accuracy at predicting real-ear hearing aid performance.

PubMed

Munro, K J; Hatton, N

2000-02-01

The purpose of the study was to evaluate the validity of predicting the real-ear aided response by adding customized acoustic transform functions to the performance of a hearing aid in a 2-cc coupler. The real-ear hearing aid response, the real-ear-to-coupler difference (RECD/HA2), and field to behind-the-ear microphone transfer functions were measured in both ears of 24 normally hearing subjects using probe-tube microphone equipment. The RECD/HA2 transform function was obtained using both insert earphones and with the hearing aid/ pressure comparison method. An RECD/HA2 transfer function was also obtained with a customized earmold, ER-3A foam tip, and an oto-admittance tip. Validity estimates were calculated as the difference between the derived and measured real-ear response. The derived response was generally within 5 dB of the measured real-ear response when it incorporated an RECD/HA2 transform function obtained with a customized earmold for the specific ear in question. Discrepancies increased when the RECD/HA2 transfer function was obtained from the same subject but the opposite ear. There were significant differences between the RECD/HA2 transform function obtained with customized and temporary earmolds. As a result, the derived response incorporating these transforms differed significantly from the measured real-ear response obtained with the customized earmold. The insert earphone and the hearing aid RECD/HA2 transfer function were equally valid. The derived response may be used as a substitute for in situ hearing aid response procedures when it incorporates acoustic transform functions obtained with a customized earmold from the specific ear in question.

Altered Expression of Middle and Inner Ear Cytokines in Mouse Otitis Media

PubMed Central

MacArthur, Carol J.; Pillers, De-Ann M.; Pang, Jiaqing; Kempton, J. Beth; Trune, Dennis R.

2010-01-01

Objectives/Hypothesis The inner ear is at risk for sensorineural hearing loss in both acute and chronic otitis media (OM), but the underlying mechanisms underlying sensorineural hearing loss are unknown. Previous gene expression array studies showed cytokine genes might be upregulated in the cochleas of mice with acute and chronic otitis media. This implies that the inner ear could manifest a direct inflammatory response to OM that may cause sensorineural damage. Therefore, to better understand inner ear cytokine gene expression during OM, quantitative RT-PCR and immunohistochemistry were performed on mouse models to evaluate middle and inner ear inflammatory and remodeling cytokines. Study Design Basic science experiment. Methods An acute OM model was created in Balb/c mice by a transtympanic injection of S. pneumoniae in one ear; the other ear used as a control. C3H/HeJ mice were screened for unilateral chronic OM with the non-infected ear serving as control. Results Both acute and chronic OM caused both the middle ear and inner tissues in these two mouse models to over express numerous cytokine genes related to tissue remodeling (TNFα, FGF, BMP) and angiogenesis (VEGF), as well as inflammatory cell proliferation (IL-1α,β, IL-2, IL-6). Immunohistochemistry confirmed that both the middle ear and inner ear tissues expressed these cytokines. Conclusion Cochlear tissues are capable of expressing cytokine mRNA that contributes to the inflammation and remodeling that occur in association with middle ear disease. This provides a potential molecular basis for the transient and permanent sensorineural hearing loss often reported with acute and chronic OM. Level of Evidence N/A PMID:21271590

Vestibular sensory functional status of cochlear implanted ears versus non-implanted ears in bilateral profound deaf adults.

PubMed

Cozma, Romică Sebastian; Dima-Cozma, Lucia Corina; Rădulescu, Luminiţa Mihaela; Hera, Maria Cristina; Mârţu, Cristian; Olariu, Raluca; Cobzeanu, Bogdan Mihail; Bitere, Oana Roxana; Cobzeanu, Mihail Dan

2018-01-01

Patients with hearing loss who underwent cochlear implantation can present symptomatic or asymptomatic vestibular damages earlier or later after the surgery. The vestibular permanent lesions could be acute, produced by surgical trauma or could be progressive due to local morphological changes made by the presence of the portelectrode in the inner ear (fibrosis related, ossification, basilar membrane distortion, endolymphatic hydrops). Besides histopathological findings in inner ear of cochlear implanted patients, the vestibular permanent damages could be found by assessment of clinical vestibular status. This study reports the sensorial vestibular functional findings for adults in cochlear implanted ears related to the electrode insertion type (cochleostomy or round window approach) and comparing to non-implanted deaf ears. A total of 20 adult patients with 32 cochlear implanted ears (12 patients with binaural cochlear implant and eight with monoaural) were selected for postoperatory vestibular examination by cervical and ocular vestibular myogenic potentials and vestibular caloric tests. The same tests were made for a control group of 22 non-implanted deaf ears. Functional testing results were reported related to the electrode insertion approach. For the cochleostomy group, we found different deficits: in 40% for saccular function, 44% for utricular function, and 12% horizontal canal dysfunction. In round window group, the deficit was present in 14.29% for saccular function, 28.57% for utricular function, and 28.58% for horizontal canal. In 46.88% of implanted ears, the vestibular function was completely preserved on all tested sensors. In conclusion, the vestibular functional status after inner ear surgery presents sensorial damages in 53.12% ears compare with the vestibular dysfunction existing in 50% of deaf non-operated ears. Round window insertion allows for better conservation of the vestibular function.

Micro CT visualization of silver nanoparticles in the middle and inner ear of rat and transportation pathway after transtympanic injection.

PubMed

Zou, Jing; Hannula, Markus; Misra, Superb; Feng, Hao; Labrador, Roberto Hanoi; Aula, Antti S; Hyttinen, Jari; Pyykkö, Ilmari

2015-01-27

Silver nanoparticles (Ag NPs) displayed strong activities in anti-bacterial, anti-viral, and anti-fungal studies and were reportedly efficient in treating otitis media. Information on distribution of AgNPs in different compartments of the ear is lacking. To detect distribution of Ag NPs in the middle and inner ear and transportation pathways after transtympanic injection. Contrast effect of Ag NPs in the micro CT imaging was assessed in a phantom. AgNPs at various concentrations (1.85 mM, 37.1 mM, and 370.7 mM) were administered to rat middle ear using transtympanic injection and cadaver heads were imaged using micro CT at several time points. The lowest concentration of Ag NPs that could be visualized using micro CT was 37.1 mM. No difference was observed between the solvents, deionized H2O and saline. Ag NPs at 37.1 mM were visible in the middle ear on 7 d post-administration. Ag NPs at 370.7 mM generated signals in the middle ear, ossicular chain, round window membrane, oval window, scala tympani, and Eustachian tube for both 4 h and 24 h time points. A gradient distribution of Ag NPs from the middle ear to the inner ear was detected. The pathways for Ag NPs to be transported from the middle ear into the inner ear are round and oval windows. This study provided the imaging evidence that Ag NPs are able to access the inner ear in a dose-dependent manner after intratympanic administration, which is relevant to design the delivery concentration in the future clinic application in order to avoid adverse inner ear effect.

Auditory Evoked Potential Mismatch Negativity in Normal-Hearing Adults

PubMed Central

Schwade, Laura Flach; Didoné, Dayane Domeneghini; Sleifer, Pricila

2017-01-01

Introduction  Mismatch Negativity (MMN) corresponds to a response of the central auditory nervous system. Objective  The objective of this study is to analyze MMN latencies and amplitudes in normal-hearing adults and compare the results between ears, gender and hand dominance. Methods  This is a cross-sectional study. Forty subjects participated, 20 women and 20 men, aged 18 to 29 years and having normal auditory thresholds. A frequency of 1000Hz (standard stimuli) and 2000Hz (deviant stimuli) was used to evoked the MMN. Results  Mean latencies in the right ear were 169.4ms and 175.3ms in the left ear, with mean amplitudes of 4.6µV in the right ear and 4.2µV in the left ear. There was no statistically significant difference between ears. The comparison of latencies between genders showed a statistically significant difference for the right ear, being higher in the men than in women. There was no significant statistical difference between ears for both right-handed and left-handed group. However, the results indicated that the latency of the right ear was significantly higher for the left handers than the right handers. We also found a significant result for the latency of the left ear, which was higher for the right handers. Conclusion  It was possible to obtain references of values for the MMN. There are no differences in the MMN latencies and amplitudes between the ears. Regarding gender, the male group presented higher latencies in relation to the female group in the right ear. Some results indicate that there is a significant statistical difference of the MMN between right- and left-handed individuals. PMID:28680490

[Effect of rehabilitation for prelingual deaf children who use cochlear implants in conjunction with hearing aids in the opposite ears].

PubMed

Tian, Yanjing; Zhou, Huifang; Zhang, Jing; Yang, Dong; Xu, Yi; Guo, Yuxi

2012-10-01

To compare the effect of rehabilitation of prelingual deaf children who used a cochlear implant (CI) in one ear and a hearing aids in the opposite ear while the hearing level of the opposite ears are different. Hearing ability, language ability and learning ability was included in the content. The aim of this research is to investigate better style of rehabilitation, and to offer the best help to the prelingual deaf children. Accord ing to the hearing level of the ear opposite to the one wearing a cochlear implant and whether the opposite ear wear a hearing aid or not, 30 prelingual deaf children were divided into three groups, including cochlear implant with opposite severe hearing loss and hearing aid ear (CI+SHA), cochlear implant with opposite profound hearing loss and hearing aid ear (CI+PHA), cochlear implant only (CI). The effect of rehabilitation was assessed in six different times (3,6,9,12,15 and 18 months after the cochlear implants and hearing aids began to work). The longer time the rehabilitation spends, the better the hearing ability,language ability and the learning ability were. The hearing ability of CI+SHA was better than those of CI+PHA (P<0.05) and CI (P<0.05). The language ability and learning ability of CI-SHA was nearly equal to those of the other two groups. The prelingual deaf children should take much more time on rehabilitation. The effect of rehabilitation for prelingual deaf children who used cochlear implant in one ear and hearing aid in the other depend on the residual hearing level of the other ear. If a prelingual deaf children still has any residual hearing level in the ear opposite to the cochlear implant ear, it is better for him/her to wear a hearing aid in the ear.

21 CFR 874.4420 - Ear, nose, and throat manual surgical instrument.

Code of Federal Regulations, 2010 CFR

2010-04-01

... device includes the esophageal dilator; tracheal bistour (a long, narrow surgical knife); tracheal dilator; tracheal hook; laryngeal injection set; laryngeal knife; laryngeal saw; laryngeal trocar...; wire ear loop; microrule; mirror; mobilizer; ear, nose, and throat punch; ear, nose and throat knife...

[Evaluation of otoacoustic emissions in relation to brainstem evoked auditory potentials in children].

PubMed

Rado-Triveño, Julia; Alen-Ayca, Jaime

2016-01-01

To determine the validity of the use of acoustic otoacoustic emissions in comparison with the evoked potentials Auditory brainstem examination (PEATC), a study was carried out with 96 children between 0 and 4 years of age that went to Instituto Nacional de Rehabilitación in Lima, Peru. The results show a cut-off point corresponding to 1 in (+): 17.67 in right ear and 16.72 in left ear, and LR (-): 0.25 in ear right and 0.24 in left ear; ROC curve with area under the right ear curve of 0.830 (p<0.001) was obtained and in left ear of 0.829 (p<0.001). According to the results of LR (+) the sensitivity is 76% in the right ear and 65% In the left ear that coincides with the conformation of the ROC curve. In conclusion, acoustic emissions would not represent an alternative sufficiently discriminatory alternative as a screening test in this population.

Modeling Analysis of Biomechanical Changes of Middle Ear and Cochlea in Otitis Media

NASA Astrophysics Data System (ADS)

Gan, Rong Z.; Zhang, Xiangming; Guan, Xiying

2011-11-01

A comprehensive finite element (FE) model of the human ear including the ear canal, middle ear, and spiral cochlea was developed using histological sections of human temporal bone. The cochlea was modeled with three chambers separated by the basilar membrane and Reissner's membrane and filled with perilymphatic fluid. The viscoelastic material behavior was applied to middle ear soft tissues based on dynamic measurements of tissues in our lab. The model was validated using the experimental data obtained in human temporal bones and then used to simulate various stages of otitis media (OM) including the changes of morphology, mechanical properties, pressure, and fluid level in the middle ear. Function alterations of the middle ear and cochlea in OM were derived from the model and compared with the measurements from temporal bones. This study indicates that OM can be simulated in the FE model to predict the hearing loss induced by biomechanical changes of the middle ear and cochlea.

The molecular basis of neurosensory cell formation in ear development: a blueprint for hair cell and sensory neuron regeneration?

PubMed Central

Fritzsch, Bernd; Beisel, Kirk W.; Hansen, Laura

2014-01-01

Summary The inner ear of mammals uses neurosensory cells derived from the embryonic ear for mechanoelectric transduction of vestibular and auditory stimuli (the hair cells) and conducts this information to the brain via sensory neurons. As with most other neurons of mammals, lost hair cells and sensory neurons are not spontaneously replaced and result instead in age-dependent progressive hearing loss. We review the molecular basis of neurosensory development in the mouse ear to provide a blueprint for possible enhancement of therapeutically useful transformation of stem cells into lost neurosensory cells. We identify several readily available adult sources of stem cells that express, like the ectoderm-derived ear, genes known to be essential for ear development. Use of these stem cells combined with molecular insights into neurosensory cell specification and proliferation regulation of the ear, might allow for neurosensory regeneration of mammalian ears in the near future. PMID:17120192

Musical ear syndrome in adult cochlear implant patients.

PubMed

Low, W-K; Tham, C A; D'Souza, V-D; Teng, S-W

2013-09-01

Except for a single case report, musical ear syndrome in cochlear implantees has not been studied. We aimed to study the prevalence and nature of musical ear syndrome among adult cochlear implant patients, as well as the effect on their emotional well-being. STUDY DESIGN, PATIENTS AND INTERVENTION: A cross-sectional survey of patients aged 18 years and above who had received cochlear implants for profound hearing loss between 1997 and 2010. Of the 82 patients studied, 18 (22 per cent) were found to have experienced musical ear syndrome. Seven and 11 patients had musical ear syndrome prior to and after cochlear implantation, respectively. The character of musical ear syndrome symptoms was described as instrumental music (n = 2), singing (6) or both (10). Fourteen patients reported an adverse emotional effect, with three expressing ‘intolerance’. In this study, 22 per cent of cochlear implantees experienced musical ear syndrome. These symptoms affected patients’ emotional state, but most coped well. Musical ear syndrome can occur prior to and after cochlear implantation.

Correction of Lying Ears by Augmentation of the Conchoscaphal Angle.

PubMed

Kim, Sung-Eun; Yeo, Chi-Ho; Kim, Taegon; Kim, Yong-Ha; Lee, Jun Ho; Chung, Kyu-Jin

2017-01-01

Lying ears are defined as ears that protrude less from the head, and in frontal view, are characterized by lateral positioning of antihelical contour relative to the helical rim. These aesthetically displeasing ears require correction in accord with the goals of otoplasty stated by McDowell. The authors present a case of lying ears treated by correcting the conchomastoid angle using Z-plasty, resection of posterior auricular muscle, and correction of the conchoscaphal angle by releasing cartilage using 2 full-thickness incisions and grafting of a conchal cartilage spacer. By combining these techniques, the authors efficiently corrected lying ears and produced aesthetically pleasing results.

Anatomy, Physiology and Function of the Auditory System

NASA Astrophysics Data System (ADS)

Kollmeier, Birger

The human ear consists of the outer ear (pinna or concha, outer ear canal, tympanic membrane), the middle ear (middle ear cavity with the three ossicles malleus, incus and stapes) and the inner ear (cochlea which is connected to the three semicircular canals by the vestibule, which provides the sense of balance). The cochlea is connected to the brain stem via the eighth brain nerve, i.e. the vestibular cochlear nerve or nervus statoacusticus. Subsequently, the acoustical information is processed by the brain at various levels of the auditory system. An overview about the anatomy of the auditory system is provided by Figure 1.

Distortion product otoacoustic emissions upon ear canal pressurization.

PubMed

Zebian, Makram; Schirkonyer, Volker; Hensel, Johannes; Vollbort, Sven; Fedtke, Thomas; Janssen, Thomas

2013-04-01

The purpose of this study was to quantify the change in distortion product otoacoustic emission (DPOAE) level upon ear canal pressurization. DPOAEs were measured on 12 normal-hearing human subjects for ear canal static pressures between -200 and +200 daPa in (50 ± 5) daPa steps. A clear dependence of DPOAE levels on the pressure was observed, with levels being highest at the maximum compliance of the middle ear, and decreasing on average by 2.3 dB per 50 daPa for lower and higher pressures. Ear canal pressurization can serve as a tool for improving the detectability of DPOAEs in the case of middle-ear dysfunction.

[Magnetic resonance imaging study and cochlear implantation in post-meningitic deaf patients].

PubMed

Liu, Xiuli; Yao, Yiwen; He, Guili; Zhai, Lijie

2004-07-01

To investigate the clinical application of magnetic resonance imaging (MRI) in post-meningitic patients and its impact on surgical decision. The pre-operative MRI data and auditory brainstem response (ABR) examination of five post-meningitic patients were studied. They were implanted with cochleas. The interval between the onset of bacterial meningitis and the hearing loss was (15.8 +/- 15.0)d and it was longer in children than adults. Five ears showed membranous cochlear labyrinth abnormality; 3 ears had vestibule vestibule abnormality; 8 ears demonstrated semicircular canal abnormality on MRI examinations in totally 10 ears. The mean hearing threshold of 10 ears was (102.0 +/- 7.1)dB HL,that of the operated ears was (98.0 +/- 5.7)dB HL and that of the un-operated ears was (106.0 +/- 6.5)dB HL. It was (15.8 +/- 15.0)d from the bacterial meningitis onset to hearing loss. The interval is longer in children than adults. There were 3 ears that electrodes could not be inserted completely. The bacterial meningitis may cause the abnormalities of inner ears and the MRI before surgery is essential for the pre-operative planning of cochlear implant.

Gustatory otalgia and wet ear syndrome: a possible cross-innervation after ear surgery.

PubMed

Saito, H

1999-04-01

The chorda tympani and Arnold's nerves have close approximation to each other and their cross-innervation is possible after ear surgery. A retrospective study was performed with a temporal bone pathology case and two clinical cases as representatives of such a possibility. Patients had severe otalgia and wet ear during gustatory stimulation. A temporal bone pathology case was studied under a light microscope. Earache and/or wet ear were provoked during gustatory stimulation. Wet ear was tested with iodine-starch reaction after the subject tasted lemon juice. The temporal bone specimen has clusters of regenerated fibers in the tympanic cavity in the area of the chorda tympani and Arnold's nerves, suggesting a possibility of mixing. There are regenerated fibers in the iter chordae anterius, showing successful bridging of the chorda tympani nerves across a long gap. Detachment of the skin over the operated mastoid bowl obscured signs in one clinical case. Another clinical case of gustatory wet ear showed objective evidence of cross-innervation with iodine-starch reaction. The detachment procedure and iodine-starch reaction were the proofs that the signs were related to regenerated fibers. This is the first report of gustatory otalgia and wet ear after ear surgery.

Stem Cell Therapy for the Inner Ear

PubMed Central

Okano, Takayuki

2012-01-01

In vertebrates, perception of sound, motion, and balance is mediated through mechanosensory hair cells located within the inner ear. In mammals, hair cells are only generated during a short period of embryonic development. As a result, loss of hair cells as a consequence of injury, disease, or genetic mutation, leads to permanent sensory deficits. At present, cochlear implantation is the only option for profound hearing loss. However, outcomes are still variable and even the best implant cannot provide the acuity of a biological ear. The recent emergence of stem cell technology has the potential to open new approaches for hair cell regeneration. The goal of this review is to summarize the current state of inner ear stem cell research from a viewpoint of its clinical application for inner ear disorders to illustrate how complementary studies have the potential to promote and refine stem cell therapies for inner ear diseases. The review initially discusses our current understanding of the genetic pathways that regulate hair cell formation from inner ear progenitors during normal development. Subsequent sections discuss the possible use of endogenous inner ear stem cells to induce repair as well as the initial studies aimed at transplanting stem cells into the ear. PMID:22514095

Selective forces on origin, adaptation and reduction of tympanal ears in insects.

PubMed

Strauß, Johannes; Stumpner, Andreas

2015-01-01

Insect ears evolved many times independently. As a consequence, a striking diversity exists in the location, construction and behavioural implementation of ears. In this review, we first summarise what is known about the evolutionary origin of ears and the presumed precursor organs in the various insect groups. Thereafter, we focus on selective forces for making and keeping an ear: we discuss detecting and localising predators and conspecifics, including establishing new "private" channels for intraspecific communication. More advanced aspects involve judging the distance of conspecifics, or assessing individual quality from songs which makes auditory processing a means for exerting sexual selection on mating partners. We try to identify negative selective forces, mainly in the context of energy expenditure for developing and keeping an ear, but also in conjunction with acoustic communication, which incorporates risks like eavesdropping by predators and parasitoids. We then discuss balancing pressures, which might oppose optimising an ear for a specific task (when it serves different functions, for example). Subsequently, we describe various scenarios that might have led to a reduction or complete loss of ears in evolution. Finally, we describe cases of sex differences in ears and potential reasons for their appearance.

Munchausen by proxy syndrome mimicking systemic autoinflammatory disease: case report and review of the literature.

PubMed

Wittkowski, Helmut; Hinze, Claas; Häfner-Harms, Sigrid; Oji, Vinzenz; Masjosthusmann, Katja; Monninger, Martina; Grenzebach, Ulrike; Foell, Dirk

2017-04-05

Systemic autoinflammatory diseases (SAIDs) represent a growing number of monogenic, polygenic or multifactorial disorders that are often difficult to diagnose. Here we report a patient who was initially erroneously diagnosed and treated for SAID. Symptoms consisted of recurrent fever, erythematous and/or blistering skin lesions, angioedema, susceptibility to bleeding, external ear infections and reversible anisocoria in the absence of laboratory evidence of systemic inflammation. After two and a half years of extensive diagnostic work-up and multiple empirical therapies, a final diagnosis of Munchausen by proxy syndrome (MBPS) was established. The diagnosis of SAID needs to be carefully reassessed if measurable systemic inflammation is missing, and MBPS should be included in the differential diagnosis.

The Envoy® Totally Implantable Hearing System, St. Croix Medical

PubMed Central

Kroll, Kai; Grant, Iain L.; Javel, Eric

2002-01-01

The Totally Implantable Envoy® System is currently undergoing clinical trials in both the United States and Europe. The fully implantable hearing device is intended for use in patients with sensorineural hearing loss. The device employs piezoelectric transducers to sense ossicle motion and drive the stapes. Programmable signal processing parameters include amplification, compression, and variable frequency response. The fully implantable attribute allows users to take advantage of normal external ear resonances and head-related transfer functions, while avoiding undesirable earmold effects. The high sensitivity, low power consumption, and high fidelity attributes of piezoelectric transducers minimize acoustic feedback and maximize battery life (Gyo, 1996; Yanagihara, (1987) and 2001). The surgical procedure to install the device has been accurately defined and implantation is reversible. PMID:25425915

Infective Dermatitis in an Adult Patient With HTLV-1

PubMed Central

Riveros, Rosalba; Medina, Raquel; Morel, Maida

2015-01-01

Abstract: Infective dermatitis is a chronic exudative eczematous eruption presenting in human T-lymphotropic virus type 1 (HTLV-1)–infected people. It presents with relapsing erythematous, scaly, and crusted lesions affecting simultaneously the scalp, external ear, retroauricular area, eyelid, paranasal skin, neck axilla, and groin. Superimposed Staphylococcus and Streptococcus infection are common. It mainly affects children and exceptionally adults, and there are only a few published cases. The authors present the first reported case in Paraguay of an adult patient who had symptoms of human T-lymphotropic virus type 1–associated progressive tropical spastic paraparesis, and 6 years after the onset of the neurological symptoms, the patient developed infective dermatitis lesions on the skin, with frequent exacerbations since then. PMID:26588341

21 CFR 870.2710 - Ear oximeter.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ear oximeter. 870.2710 Section 870.2710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Monitoring Devices § 870.2710 Ear oximeter. (a) Identification. An ear...

Can Loud Music Hurt My Ears?

MedlinePlus

... Videos for Educators Search English Español Can Loud Music Hurt My Ears? KidsHealth / For Kids / Can Loud Music Hurt My Ears? Print en español La música ... up? Oh! You want to know if loud music can hurt your ears . Are you asking because ...

21 CFR 870.2710 - Ear oximeter.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear oximeter. 870.2710 Section 870.2710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Monitoring Devices § 870.2710 Ear oximeter. (a) Identification. An ear...