Mastoid Cells Research Articles

Comorbidity of Anemia and Otitis Media in Skeletal Remains

Within the clinical literature some researchers have identified a correlation between otitis media (OM) and anemia. OM is an inflammation or infection of the middle ear. Researchers have hypothesized that iron deficiency (anemia) reduces immune response and results in an increase in OM risk. For this study the comorbidity of OM and anemia was evaluated in the Hamann‐Todd Human Osteological Collection (n=20) and the Robert J. Terry Anatomical Skeletal Collection (n=105). The mastoid air cell system (MACS) hypopnuematization and porotic hyperostosis (PH) were used as skeletal markers of OM and anemia, respectively. A chi‐square test of independence between MACS hypopneumatization and PH was significant (p<0.013) (Table 1). These results lend some support to the limited clinical literature that reports anemia as a risk factor of OM, however, the relationship between anemia and OM is not discernable through skeletal remains. In addition, the results highlight the importance of comorbidities in skeletal analyses and anthropological researchers should aim to use a broad range of skeletal markers to answer questions about past populations.

Numerical simulation modeling of middle ear-eustachian tube ventilation based on Chinese digital visual human body

Objective: To establish a three-dimensional model of middle ear-eustachian tube based on Chinese digital visual human dataset, and the deformation and pressure changes of the middle ear-eustachian tube system after eustachian tube opening are simulated by computer numerical simulation. Methods: The first female Chinese Digital Visual Human data was adopted. The images were imported by Amira image processing software, and the images were segmented by Geomagic software to form a three-dimensional model of middle ear-eustachian tube system, including eustachian tube, tympanum, tympanic membrane, auditory ossicles, and mastoid air cells system. The 3D model was imported into Hypermesh software for meshing and analysis. The structural mechanics calculation was carried out by Abaqus, and gas flow was simulated by Xflow. The tissue deformation and middle ear pressure changes during eustachian tube opening were numerically simulated by fluid-solid coupling algorithm. Several pressure monitoring points including tympanum, mastoid, tympanic isthmus, and external auditory canal were set up in the model, and the pressure changes of each monitoring point were recorded and compared. Results: In this study, a three-dimensional model of middle ear-eustachian tube and a numerical simulation model of middle ear ventilation were established, including eustachian tube, tympanum, mastoid air cells, tympanic membrane, and auditory ossicles. The dynamic changes of the model after ventilation could be divided into five stages according to the pressure. In addition, the pressure changes of tympanum and tympanic isthmus were basically synchronous, and the pressure changes of mastoid air cells system were later than that of tympanum and tympanic isthmus, which verified the pressure buffering effect of mastoid. The extracted pressure curve of the external auditory canal was basically consistent with that of tympanometry in terms of value and trend, which verified the effectiveness of the model. Conclusions: The numerical simulation model of middle ear-eustachian tube ventilation established in this paper can simulate the tissue deformation and middle ear pressure changes after eustachian tube opening, and its accuracy and effectiveness are also verified. This not only lays a foundation for further research, but also provides a new research method for the study of middle ear ventilation.

Potential for personal identification using the volume of the mastoid air cells extracted from postmortem computed tomographic images

This study revealed the usefulness of volumetric analysis of mastoid air cells (MACs) extracted from postmortem computed tomography (PMCT) images in characterizing individuals. To characterize deceased persons, the MACs volumes of 61 Japanese PMCT images were measured after thresholding in Hounsfield units and based on the number of voxels on the right and left sides and the voxel size for each person. The volume differences between the right and left MACs and sex were examined. Although there were no obvious volume differences between males and females, the order of sizes on the two sides varied for each person. Moreover, deceased persons could be roughly classified using the total volume of MACs. Deceased persons with similar total volumes could be distinguished further by comparing the ratio of volumes in bilateral MACs. Although the identification process is dependent on samples and different sizes of bilateral MACs, our pilot study indicated that 81.9% (50/61) of deceased persons could be distinguished. In conclusion, volumetric analysis of MACs measured using PMCT imaging has the potential to identify individuals and reduce the number of candidates.

Otogenic Cerebellar Abscess with Cholesteatoma

Otogenic brain abscesses are the second-most common intracranial complication observed in patients of chronic otitis media, more frequently occurring with cholesteatoma. Due to the availability of antibiotics and advanced imaging techniques, the incidence and mortality of otogenic brain abscesses has reduced. Nevertheless, we still come across cases of otogenic brain abscess in modern times. Here, we report a case of the left ear chronic otitis media, squamosal type with intracranial complication of the left cerebellar abscess in a 14-year-old girl. Magnetic resonance imaging of the brain showed a thick-walled cystic lesion in the left cerebellar hemisphere measuring 41 mm × 28 mm × 26 mm suggestive of brain abscess. High-resolution computed tomography of the temporal bone showed soft-tissue density in the left mastoid air cells, in epitympanum, and mesotympanum encasing the left middle ear ossicular chain, suggestive of chronic otomastoiditis with possible underlying cholesteatoma. The patient underwent left retromastoid suboccipital craniotomy and excision of brain abscess followed by the left modified radical mastoidectomy 1 month later. Follow-up scan at 6 months showed no recurrence or any residual disease. Hence, timely surgical intervention for complicated chronic otitis media gives satisfactory results.

The Mechanism of Action of Nanomaterials Loaded with Clarithromycin after Sinusitis Surgery under the Guidance of Dynamic Enhanced Scanning.

This study was to explore the mechanism of action of nanomaterial-loaded clarithromycin (CLA) after sinusitis surgery. Under the guidance of dynamic enhanced scanning (DES). 120 patients with sinusitis admitted to the First Affiliated Hospital of China Medical University from July 2019 to March 2020 were selected and divided into a control group and an observation group according to the random number table method, with 60 cases in each group. Then, the CLA-containing nano-polylactic acid material was prepared, observed with the scanning electron microscope (SEM), and its drug release ability was tested. All patients underwent endoscopic sinus surgery under general anesthesia. After the surgery was completed, patients in the control group were given only CLA capsules, and patients in the observation group were given freshly prepared nanomaterial-loaded CLA, and both groups of patients were continuously observed for two weeks. After that, the patients were examined using the dynamic enhancement computed tomography (CT). The clinical efficacy, serum interleukin-4 (IL-4), interleukin-8 (IL-8), and tumor necrosis factor α (TNF-α) levels of the two groups of patients were observed. The secretions of the patients' sinuses were performed with microbial bacterial culture, and the results were observed and recorded. Results showed that the characterization and analysis of the nano drug-carrying preparation suggested that the polylactic acid nanomembrane showed linear fiber morphology, relatively dense distribution, not greatly different fiber diameter, and small porosity. Characterization under a field of view (FOV) of 500 um showed that the fiber surface was smooth and rich in content. The release of CLA showed a gradual and steady upward trend. On the 25th day, nearly 50% of the dose had been released, and it had reached more than 90% of the total release on the 55th day. According to the statistics on the clinical efficacy of patients, it was found that the number of cured and effective patients in the observation group was higher than that of the control group, while the number of ineffective cases was much lower than that of the control group. The dynamic enhanced CT examination results of the patients in the control group after treatment showed that the soft tissue mass on the posterior right side of the nasopharynx was reduced, but the pharyngeal suture still existed; while those in the observation group showed that the plain scan density was uniform, and the mastoid air cells were clear on both sides. The number of cases with Staphylococcus aureus (S. aureus), Staphylococcus saprophyticus (S. saprophyticus), and Pasteurella multocida infections in the observation group were observably lower than those of the control group (P< 0.05), and it was the same case for the levels of serum IL-4, IL-8, and TNF-α. Conclusion: after dynamic enhanced CT scanning, it can be found that the nanomaterial-loaded CLA increased the utilization rate of the drug, showing good clinical efficacy, and effectively improved the clinical symptoms of patients, achieving the therapeutic effect.

Congenital cholesteatoma: Clinical features and surgical outcomes

ObjectivesA typical presentation of congenital cholesteatoma (CC) is asymmetric conductive hearing loss (CHL). As CHL is usually associated with middle ear effusion, diagnosis of CC is frequently delayed. This study aimed to describe the clinical characteristics, treatment and outcomes of children with CC. MethodsThe medical files of children diagnosed with CC at a large tertiary pediatric medical center during 2000–2019 were reviewed. The primary outcome measures were: presenting symptoms, surgical findings, stage of disease, recurrence rate and hearing outcome. Imaging findings and the size of mastoid air cells were assessed in CT scans. ResultsThirty-nine children were diagnosed with CC. The presenting symptom was unilateral CHL in 85%, with an average speech reception threshold of 41.5 ± 13.7 dB in the affected ear. The mean time from first symptoms to diagnosis was 1.3 years. The surgical approach was exploratory tympanotomy in 25% and canal wall up mastoidectomy in 69%. Seventy percent of the children presented with Potsic stage III-IV. The mean postoperative speech reception threshold was 26.4 ± 12.2 dB (P = 0.002). Recurrence of cholesteatoma occurred in 38% of the patients, mostly in stage III-IV. Mastoid air cell size was significantly smaller on the affected than the unaffected side. ConclusionsIn children with persistent unilateral or asymmetric conductive hearing loss, CC should be suspected. Late diagnosis of CC is associated with a high recurrence rate. This highlights the need to promote awareness to the disease among primary physicians in the community health care system.

Comparative study on adhesive otitis media and pars tensa cholesteatoma in children

Objective: Recurrent otitis media and persistent otitis media with effusion in early childhood may cause an atelectatic eardrum and adhesive otitis media, which sometimes progress to pars tensa cholesteatoma. When and how children with adhesive otitis media should be operated on remain controversial. Therefore, this study aimed to analyze the clinical characteristics of children with adhesive otitis media and pars tensa cholesteatoma, and to determine the risk factors of progression to cholesteatoma.Methods: Seventeen ears of 15 children with adhesive otitis media (adhesive group) and 14 ears of 13 children with pars tensa cholesteatoma (tensa cholesteatoma group) who underwent tympanoplasty were included in this study. We analyzed the following clinical characteristics of children in both groups: medical and life history, associated diseases, sites of the adhesion, and development and aeration of mastoid air cells as shown by temporal bone computed tomography.Results: Most of the children in both groups had a history of recurrent otitis media and/or persistent otitis media with effusion. They showed a male predominance and a frequent association of allergic rhinitis. The number of ears showing undeveloped mastoid air cells in the tensa cholesteatoma group was significantly larger than that in the adhesive otitis media group (P=0.0068). A lack of aeration of the middle ear, including the eustachian tube, was more frequently found in ears with pars tensa cholesteatoma than in ears with adhesive otitis media (P=0.0012). Using multivariate logistic regression, the presence of otorrhea (odds ratio [OR], 14.847; 95% confidence interval [CI], 0.834–264.184), total adhesion (OR, 28.550; 95% CI, 0.962–847.508), and undeveloped mastoid air cells (OR, 19.357; 95% CI, 1.022–366.589) were related to pars tensa cholesteatoma.Conclusion: Children with adhesive otitis media should be carefully followed up in the outpatient setting. Ears with poor mastoid development may develop pars tensa cholesteatoma. Additionally, ears with middle ear effusion, total adhesion, and the presence of otorrhea tend to be at risk of pars tensa cholesteatoma. Tympanoplasty or tympanostomy tube insertion should be considered for children with adhesive otitis media who have these risk factors to prevent progression to pars tensa cholesteatoma.

The Role of Fusion Technique of Computed Tomography and Non-echo-planar Diffusion-weighted Imaging in the Evaluation of Surgical Cholesteatoma Localization.

Objective:In recent years, the fusion of computed tomography (CT) and non-echo-planar diffusion-weighted magnetic resonance imaging (non- EPI DWI) has been preferred in cholesteatoma localizations. This study aimed to investigate the role of CT and non-EPI DWI fusion imaging in cholesteatoma localizations.Methods:This retrospective study included 39 patients who underwent chronic otitis media operation [mean age of 35.10±15.33 years (18-67 years), 64.1% female, and 35.9% male] and had preoperative high-resolution temporal bone CT and non-EPI DWI examinations. Images were sent to the Advantage Workstation VolumeShare 7 for fusion. These selected images were fused on the workstation and were manually corrected by the radiologist. The sensitivity, specificity, positive and negative predictive values, and diagnostic accuracies of fused images of CT and non-EPI DWI were evaluated according to anatomic cholesteatoma localizations based on surgical data.Results:The sensitivity, specificity, positive and negative predictive values, and diagnostic accuracies of non-EPI DWI for detecting cholesteatomas were 97.14%, 75.00%, 97.14%, 75.00%, and 94.87%, respectively. Three true-negative, one false-positive, and one false-negative case were observed according to surgical results in detecting the presence of a cholesteatoma with non-EPI DWI. Moderate agreement was determined between the surgical and radiological results in detecting the presence of a cholesteatoma (k=0.721). Detecting the lesion of localization on the fused images compared to surgical found an almost perfect agreement in the mastoid antrum (k=0.948), strong agreement in the hypotympanum and mastoid cells (k=0.894), moderate agreement in the epitympanum (k=0.653), and weak agreement in those in the mesotympanum (k=0.540).Conclusions:The surgeons’ determinations are supported by the guidance of temporal CT and non-EPI DWI fused images. Therefore, preferring the fusion imaging technique could increase the quality of life by reducing unnecessary operations.

A Robust Machine learning based method to classify normal and abnormal CT scan images of mastoid air cells

A Robust Machine learning based method to classify normal and abnormal CT scan images of mastoid air cells

Case Report: Management of Chronic Supurative Otitis Media Cholesteatoma Type with Recurrent Brain Abscess Complication

Introduction: Chronic suppurative otitis media is broadly defined as chronic inflammation that involved mucose of middle ear and mastoid air cells. The most commonly encountered intracranial complication from chronic suppurative otitis media is meningitis followed by brain abscess. Antibiotics are quite effective in early and late cerebritis stage. Surgical intervention is essential once the abscess’s capsule is formed. Case Report: Reported a case of a 22-year-old male diagnosed with chronic suppurative otitis media auris dextra suspected cholesteatoma type with cerebral abscess complications. The managements are cerebral abscess drainage followed by canal wall down mastoidectomy. In patient, Recurrent cerebral abscess formed. Conclusion: Chronic suppurative otitis media with complications of cerebral abscess is treated with abscess drainage if the abscess size is &gt;2cm and followed by canal wall down mastoidectomy. Otogenic brain abscess due to chronic suppurative otitis media can occur repeatedly if abscess antibiotic therapy was/were inadequate&#x0D; Keywords: otogenic brain abscess, mastoidectomy, chronic suppurative otitis media, abscess drainage

Association study of the pneumatization degree of mastoid air cells and postoperative complications after microvascular decompression in hemifacial spasm.

This study aimed to analyse the association between the degree of pneumatization of mastoid air cells (MACs) and postoperative complications after microvascular decompression in hemifacial spasm. We retrospectively reviewed 308 patients with hemifacial spasm who underwent surgery at our institute between January 2017 and March 2021. The degree of pneumatization of MACs was classified into four grades (grades 1, 2, 3, and 4) according to method of Han et al. The clinical data of the four grades were analysed and statistically examined. There were no statistically significant differences between the four grades in terms of the operative time, intraoperative blood loss, and postoperative hospital stay (all, P > 0.05). The incidence of hearing loss was higher in grade 4 MACs (26.56%) than in grades 1 and 2 MACs (5.41% and 2.89%, respectively; P < 0.05). The incidence of facial paralysis was higher in grade 4 MACs (28.13%) than in grades 1 and 2 MACs (5.41% and 9.18%, respectively; P < 0.001). The incidence of intracranial infection was higher in grade 3 MACs (17.65%) than in grade 2 MACs (3.89%) (P < 0.05). All four patients with cerebrospinal fluid leakage belonged to grade 4 MACs. The incidence of cerebrospinal fluid leakage was higher in grade 4 MACs (5.13%) than in grade 2 MACs (P < 0.05). This study found that the degree of pneumatization of MACs was closely related to the postoperative complications after MVD surgeries. Well-pneumatized MACs increase the risk of cerebrospinal fluid leakage and intracranial infection. However, insufficient exposure increases the risk of facial paralysis and hearing loss. For patients with well-pneumatized MACs, sufficient surgical exposure is the top priority when locating the bone hole. For those who may have a latent MAC opening, preventive occlusion should be considered.

Otitis Media Complications: Labyrinthitis

Background: Otitis media is an inflammation of part or all of the middle ear mucosa, eustachian tube, mastoid antrum and mastoid cells. Otitis media has many complications, one of which is extra-cranial complications such as labyrinthitis. Objective: To know more about labyrithitis and how to treat patients with labyrinthitis in otitis media. Method: This article was written using various sources from scientific journals and medical e-books. Source searches are carried out on the online portal of journal publications such as pdf drive, National Centre for Biotechnology Information/NCBI. Result and Discussion: Labyrinthitis is an inflammatory condition that occurs in the membranous labyrinth of the inner ear which is usually accompanied by vertigo, nausea, vomiting, tinnitus, and hearing loss to hearing loss. Treatment of labyrinthitis caused by viral in outpatients can be done by meeting fluid needs and adequate rest. In labyrinthitis caused by bacteria, topical antibiotic drops should be prescribed. Conclusion: Labyrinthitis is an inflammatory condition that occurs in the membranous labyrinth of the inner ear. Patients with labyrinthitis are usually accompanied by vertigo, nausea, vomiting, tinnitus, and hearing loss to hearing loss. The causes themselves are very diverse, such as viruses, bacteria, autoimmune, and even syphilis.

Eustachian tube involvement in a patient with relapsing polychondritis detected by magnetic resonance imaging: A case report

BACKGROUNDRelapsing polychondritis (RP) is a rare inflammatory disease involving the systemic cartilage, such as the auricle, trachea, and bronchiole, among others. A patient with RP shows variable symptoms based on the involved cartilage.CASE SUMMARYA 72-year-old Japanese woman with a history of redness of the bilateral auricles for 3 d was referred to a clinician. The clinician prescribed antibiotics to the patient; however, the symptoms worsened; thus, she was referred to our hospital. Head and neck magnetic resonance imaging (MRI) showed edematous auricle with remarkable contrast, fluid collection in the bilateral mastoid cells, suggesting otitis media. The eustachian tube (ET) on the right side was also edematous with contrast enhancement. The patient was suspected of RP according to the diagnostic criteria. A biopsy of the auricular cartilage was performed by an otorhinolaryngologist, confirming pathological proof of RP. Treatments with steroids were immediately administered thereafter.CONCLUSIONWe highlight a rare case of RP with radiologically confirmed involvement of ET in the MRI.

The clinical characteristics and anatomical variations in patients with intractable unilateral Meniere's disease with and without migraine.

Migraine is more common in Meniere's disease patients, who have some certain anatomical variations. But there are limited studies focusing on the anatomical variations in patients with Meniere's disease and migraine. To explore the clinical and anatomical features in Meniere's disease patients with and without migraine, determining whether the coexistence of migraine can be used as a basis for clinical subtyping of Meniere's disease. Ninety-five Meniere's disease patients and ninety-five healthy subjects matched with age, sex were selected. A detailed questionnaire based on the diagnosis criteria of Meniere's disease and migraine was designed. According to the CT scan, we divided the mastoid cell system of all the subjects into two types: well-pneumatization type and poor-pneumatization type. Meanwhile, the shortest distance between the sigmoid sinus and the posterior wall of the external acoustic canal was measured. Compared with those without migraine, Meniere's disease patients with migraine had a higher female comorbidity, poorer mastoid pneumatization, shorter distance between the sigmoid sinus and posterior wall of the external acoustic canal, longer history, higher frequency of vertigo attacks and better average hearing threshold. In our study, anatomical features as well as several clinical manifestations were proved to differ significantly between Meniere's disease patients with and without migraine, indicating the coexistence of migraine may be one standard for the clinical subtyping of Meniere's disease.

The Relationship between Isolated Unilateral Concha Bullosa and Mastoid Air Cell Volumes

Introduction: The purpose of this study was to investigate the relationship between the pneumatization of mastoid air cells (MACs) and isolated unilateral concha bullosa (CB) using computed tomography (CT) scans of the paranasal sinuses (PNS). Material and Methods: A retrospective review of PNS CT scans from 53 patients was performed. Cases with nasal septum angulation >5° were excluded from the study. CT evaluations were made with a 128-slice multislice CT scanner in two projections, axial and coronal. Slice thickness was taken as 1 mm for volumetric analysis. Volume measurements were calculated using the syngo.via software program by selecting the relevant anatomical region and using step-by-step addition and expansion processes. Volumes of the MACs (right and left) and isolated unilateral CB (right and left) were obtained and compared using statistical analysis. Results: The volume of MACs and isolated unilateral CB did not change with age; however, the volumes of male participants were larger than that of women. It was observed that the pneumatization of MACs on the side with isolated unilateral CB was significantly greater than for opposing MACs. Discussion and Conclusion: In our study, it was concluded that the isolated unilateral CB caused a significant increase in the MACs volume on the same side of CB.

Status of the mastoid antrum and the eustachian tube function in cases of chronic otitis media

Introduction: Chronic otitis media (COM) is now synonymous with chronic suppurative otitis media, which is not actively used since COM is seldom associated with “the collection of pus.” Acute suppuration of the ear which transcends 6 weeks is considered to be COM which suggests an abnormality of the ear drum. With a prevalence incidence of 1%, Eustachian tube (ET) dysfunction is among the most important factors in the development of COM. Recently, mastoid air cells have been acknowledged as an essential compounding factor for the pathogenesis of middle ear disease. Since ET, mastoid air cell system, and nasopharyngeal mass like adenoids can play a pivotal role in the causation and persistence of COM, the current study will be taken to observe the status of ET, mastoid air cells system, nasopharynx in general, and adenoids in particular in patients of COM. Aim: This study aims to study the status of the mastoid antrum on surgical exploration, the status of ET, and nasopharynx for adenoids in patients of large, subtotal perforation, and posterosuperior retraction pockets (PSRPs). Study Design: This study was an observational, cross-sectional study. Study Setting: All the patients with large, subtotal perforation, and PSRPs visiting the Outpatient Department and Inpatient Department of ENT in Acharya Vinoba Bhave Rural Hospital (AVBRH) between 2022 and 2023 will be studied. Methods: All the selected patients of large, subtotal perforation, and posterosuperior retraction pocket (PSRP) in the age bracket of 15–65 years and satisfying the inclusion criteria will be considered and accrued in this study. We plan to look at a sample size of 50 patients (50 ears). Diagnostic nasal video endoscopy to get insight into ET function, size, and grade of adenoids by grading system given by Cassano et al. and pure-tone audiometry by ALPS AD2000 to know the type and amount of hearing loss will be carried out. Status of the mastoid antrum, the extent of the disease, status of ossicles, and associated abnormalities of temporal bone along with any other incidental findings will be noted intraoperatively. Expected Results: The data will be tabulated, analyzed statistically, and will be discussed in the context of existing research. Conclusion: The purpose of the present study is to help the surgeon have a better insight into the status of the mastoid antrum, ET in cases of large and subtotal perforation, and PSRP and nasopharynx in general with significance to adenoids in patients of COM in rural area.

Analysis of long-term anatomic results of radical mastoidectomy.

A long-term, retrospective, non-controlled study was performed on the drainage results of mastoidectomy (both radical and modified radical) and the relevant statistical factors that could influence the anatomic outcome were defined. The present study took into consideration the same cohort of 200 patients we have communicated with before in our previous studies concerning the long-term functional results of mastoidectomy and long-term results of ossicular replacement with biovitroceramic prosthesis. The patients were clinically followed for the same period of 8.12 years. The drainage (anatomic) results, similar to previously published functional results, were defined by analytical function of the severity and the period of evolution of disease. The main goal was to define the situations and factors (presence of complications, type of disease, type of tympanic perforation or status of ossicular chain) that influenced the drainage results that could provide us with some type of anatomical prognosis. The follow-up started at the moment of complete epithelization for each cavity as time represents the main study comparison criteria. Drainage failure was assessed by the number of otorrhea episodes. It was concluded that practically and ideally, a maximum of 84% of the mastoid and petrous cells can be cleaned out. The results of 78% drainage success are congruent to this theory. The remaining 16% of cells may contain irreversible lesions.

DYKE DAVIDOFF MASSON SYNDROME-AN UNUSUAL CAUSE OF REFRACTORY SEIZURE: A RARE CASE REPORT

BACKGROUND: Dyke-Davidoff-Masson Syndrome (DDMS) is a rare neurological condition characterized by drug-resistance seizures, hemiparesis, mental retardation, facial asymmetry, and intellectual disabilities. On brain imaging, the disease is characterized by cerebral hemi atrophy with ipsilateral calvarial thickening and hyperpneumotisation of paranasal sinuses or mastoid air cells. INTRODUCTION: we describe a rare case of Dyke Davidoff Masson syndrome with an unusual cause of refractory seizure in an adolescent. Diagnosis: DDMS was diagnosed from its manifestations, biochemistry indexes, and imaging (computed tomography angiography, magnetic resonance venography, and so on). Interventions: Several drugs are used to treat the disease, including valproate, carbamazepine, topiramate, and levetiracetam. Outcomes: Under the medicine treatment of sodium valproate, levetiracetam and carbamazepine, the patient experienced generalized tonic clonic seizure seizures approximately once or twice per month that lasted 30 to 60seconds each without any complications observed during a follow-up period of. CONCLUSIONS: It was concluded early diagnosis and pharmacotherapy are the keys to preventing intellectual decline in DDMS patients. Moreover, the combination of sodium valproate, levetiracetam and carbamazepine could signicantly reduce the frequency and duration of seizures, despite not eliminating them completely24months

Effects of Nasal and Paranasal Sinus Variations on Chronic Otitis Media Development in Pediatric Patients.

Chronic otitis media is an inflammatory disease of the middle ear. The airflow in the nasal passage affects the development of mastoid air cells through the eustachian tube.Nasal and paranasal pathologies and their anatomical variations cause chronic sinonasal inflammation and affect the middle ear mucosa. This study aims to reveal whether the nasal and paranasal sinus variations in pediatric patients are a factor in developing chronic otitis media. Eighty patients, with unilateral chronic otitis media, who were admitted to the otorhinolaryngology clinic between May 2015 and July 2019, were included in this retrospective study. The control group (Group 2) consisted of a total of 51 patients. None of the patients in Group 2 had otorrhea history and no signs of chronic otitis in their otoscopic examination, middle ear pathologies. The patient's anatomical variations of the nasal cavity and sinuses were evaluated with CT by a radiologist Results: Nasal septum deviation was found to be 53% in children with chronic otitis media. It was found 31.4% in the control group. Since the P value was found to be .04, this rate was considered as significant. Inferior concha hypertrophy was found to be 17.6% in the control group and 38.8% in the group with chronic otitis media, and this rate was considered significant since the P value was .035 Conclusion: We detected that septum deviation and inferior concha hypertrophy increased chronic otitis media formation in children. All these studies show that cases causing nasal obstruction, such as septum deviation, have a negative effect on middle ear pressure and increase the rate of ear diseases.

Characteristics of Acute Otitis Media Patients at The Citra Medan Perjuangan Clinic in 2020

Otitis media is inflammation of part or all of the middle ear mucosa, Eustachian tube, mastoid antrum, and mastoid cells. Otitis media is less common in adults than in children and is more common in men. The clinical symptoms of AOM depend on the stage of the disease and the age of the patient. The purpose of this study was to determine the characteristics of patients with acute otitis media in the field of battle image clinic in 2020 based on gender, age, and clinical symptoms. This research was conducted by collecting data from medical records at the citra medan perjuangan clinic in 2020. Then the data was processed using a computer, and the results were analyzed descriptively by univariate analysis. The number of samples that have been collected is 72 people. The highest distribution was male sex at 61.1%, age 1-5 years at 61.1%, and fever at 58.3%. Further research is needed to determine the risk factors for AOM that can be used as prevention.