History Of Ear Problems Research Articles

Myringosclerosis in children with chronic renal failure on regular hemodialysis

Objective: To find out a possible association between children with chronic renal failure (CRF) on regular hemodialysis and myringosclerosis (MS). Materials and Methods: This study included 41 patients with CRF on regular hemodialysis 3 times weekly who were compared with 41 normal children without history of ear problems matched for age and sex serving as a control. Children were assessed by history, otoscopic examination, and laboratory assessment, at the time of ear examination. Results: The incidence of affected (MS) ears in CRF children was 9/82 (10.976%). While in healthy control was 4.878% (4/82 ears) with nonstatistically significant difference (P = 0.148). Regular hemodialysis for >3 years showed significantly more MS with no significant relation to the serum levels of calcium, phosphorus, parathyroid hormone, or other recorded laboratory findings. Conclusion: Regular hemodialysis for CRF more than 3 years is associated with significantly more MS incidence when dialysis duration exceeds 3 years with no significant relation laboratory findings.

Acute unilateral hearing loss as an unusual presentation of cholesteatoma

BackgroundCholesteatomas are epithelial cysts that contain desquamated keratin. Patients commonly present with progressive hearing loss and a chronically discharging ear. We report an unusual presentation of the disease with an acute hearing loss suffered immediately after prolonged use of a pneumatic drill.Case presentationA 41 year old man with no previous history of ear problems presented with a sudden loss of hearing in his right ear immediately following the prolonged use of a pneumatic drill on concrete.The cause was found to be a fractured long process of incus which had been eroded by the presence of an attic cholesteatoma.A tympanomastoidectomy and ossiculoplasty was performed with good result.ConclusionCholesteatomas may be asymptomatic and insidious in their onset. This case illustrates the point that an indolent disease such as this may present in unusual ways and the clinician must always have a high index of suspicion combined with thorough assessment and examination of every patient.

Long-term otological outcome of hamular fracture during palatoplasty

Objective It has been suggested that fracture of the hamulus during palatoplasty in children with cleft palate may lead to adverse otological sequelae, however, there is little evidence to support this. Study design and setting The otological records of 42 children with repaired cleft palate (excluding submucous cleft palate) aged 8 years old or older were examined. A questionnaire regarding the incidence, treatment, and outcome of middle ear problems was completed by the parents of 68 children with repaired cleft palate, aged 9 years old or older. Results There was no significant difference between children who did and did not undergo hamular fracture with regard to tympanic membrane appearance, audiometry, history of ear problems ( P = 1.000), ear infections ( P = 0.622), ventilation tube insertion ( P = 0.532), or surgery for chronic otitis media ( P = 1.000). Parents of children not undergoing hamular fracture reported a higher incidence of below normal hearing ( P = 0.023). Conclusion and significance There is no evidence that hamular fracture during palatoplasty affects long-term otological outcome in cleft palate.

Poor-quality water in swimming pools associated with a substantial risk of otitis externa due to Pseudomonas aeruginosa

There are many large and small public outdoor and indoor swimming pools in Tehran that hundreds of people use, especially on hot summer days. The bacteriological quality of the water of some of these pools was assayed over a period of about one year (2001-2002). To assess if these swimming pools were a health risk to users, eleven public swimming pools, in the east and northeast of the city, were examined, and the exposed people were monitored. Samples of swimming-pool waters were examined for colony counts, Escherichia coli and coliforms. In addition, Pseudomonas aeruginosa was isolated from nine (81.8%) of those pools. P. aeruginosa grew in seven (63.6%) of the swimming-pool water samples. In two (18.2%) other samples, in addition to P. aeruginosa, high rates of total bacterial count, total coliforms and faecal coliform counts were also found. At the same time, users of the swimming pools were asked to complete a questionnaire. Ear swabs were collected from 179 users with a history of ear problems during the previous two weeks. An adequate control group was chosen randomly from those who never used the investigated pools. P. aeruginosa was isolated from the ear swabs of 142 (79.3%) of the cases, as well as from 4% of the controls. Results were matched for age, sex, duration of time spent in the pools, place of occurrence and other useful information. Investigation of the contaminated swimming pools revealed that chlorination was often inadequate, especially when high numbers of people led to overuse of the pools. Although the results of this research showed that otitis externa was strongly associated with the swimming pools, due to P. aeruginosa, an extensive follow-up study is needed to determine the other possible health risks associated with public pools.

Middle ear disease in children with congenital velopharyngeal insufficiency.

To examine the incidence and natural history of middle ear disease in children with congenital velopharyngeal insufficiency (VPI) without cleft palate. Children with congenital VPI attending the combined cleft clinic at a tertiary cleft center. The diagnosis of congenital VPI in all cases was confirmed be the observation of hypernasality, nasal air escape, or both by a speech and language therapist and the demonstration of incompetence of the velopharyngeal sphincter by means of nasoendoscopy or videofluoroscopy. Children with overt cleft palate or postsurgical VPI were excluded. The children's medical records were reviewed, and a questionnaire regarding history of ear problems was sent to all parents. Children were divided into those with Pruzansky type I VPI (showing bifid uvula, midline diastasis of soft palate, or submucous cleft of the hard palate) and Pruzansky type II VPI (no visible stigmata). Incidence of reported ear problems, ear infections, hearing loss, and surgical intervention for middle ear disease in the whole group and in each of the subgroups. Seventy-one parents returned completed questionnaires. The overall incidence of middle ear disease was 63%, with 28% reported to have below-normal hearing. There was no significant difference between children with Pruzansky types I and II VPI with respect to incidence of otopathology or hearing loss. Irrespective of the presence of any visible palatal abnormalities, children with congenital VPI showed a substantial incidence of otopathology and should thus be closely monitored.

Developmental, behavioural and somatic factors in pervasive developmental disorders: preliminary analysis.

To ascertain the frequency of parental reporting of selected variables related to development, behaviour and physiology in subgroups diagnosed with pervasive developmental disorders (PDDs) and identify any significant intragroup differences. Retrospective cross-sectional analysis of records of patients (n = 512) held on a computerized database with a chronological age between 3 and 11 years resident in the UK/Republic of Ireland and with a formal diagnosis of autism, Asperger syndrome (AS) or autism spectrum disorder (ASD). Non-parametric analysis (P > 0.01) of the frequency of specific variables for PDD subgroups reported by parents/primary caregiver. VARIABLES INCLUDED: timing of symptom onset, presence of skills acquired prior to symptom onset, indications of regression and regression events, current language, history of viral infections, history of ear problems, achievement of continence, current skin complaints, current bowel habits and adverse events at parturition. Preliminary results showed general agreement with the principle diagnostic differences between the PDD subgroups with patients diagnosed with AS showing an increased frequency of skills acquired before symptom onset (two- to three-word phrase speech, toileting skills) and a decreased frequency of regression in acquired skills when compared with other PDD subgroups. Developmental milestones such as the achievement of bowel and bladder continence were also more frequently reported for the AS group. Infantile feeding problems defined as vomiting, reflux, colic and failure to feed were more frequently reported for the AS group as was a reported history of the bacterial skin infection impetigo. Results are discussed with reference to relationships between behavioural and somatic factors in PDD.