Middle Ear Cavity Research Articles

IgG4-Related Disease Involving the Ear: A Case Report.

IgG4-related disease is a chronic inflammatory disease with widespread clinical presentation. It mimics various malignant, infectious, and inflammatory conditions, leading to confusion in diagnosis and management. Otological manifestations, though relatively rare, can lead to significant complications. A 45-year-old male with a recent history of ventilation tube placement in the right ear presented with a sensation of imbalance associated with profound hearing loss. He was managed in line of acute otitis media with labyrinthitis with steroids and antibiotics and removal of the ventilation tube. He returned in one week and presented with right-sided lower motor neuron-type facial paresis. Computed tomography images of the temporal bone showed a soft tissue density lesion in the right middle ear cavity extending to the mastoid antrum. He underwent a right cortical mastoidectomy with decompression of the facial nerve. Histopathology and immunohistochemistry of granulation tissues from the middle ear and the mastoid revealed evidence suggestive of probable IgG4 disease. IgG4-related disease is a relatively new entity, and its pathogenesis has not been properly understood. IgG4 subclass has been involved in this disease resulting in fibro-inflammatory conditions leading to tumor-like masses or fibrosis of the affected organs. Treatment includes glucocorticoids and immunosuppressant medications.

Spatiotemporal characteristics of eustachian tube development in C57BL/6 mice: Correlation between morphological and functional maturation.

The eustachian tube (ET), a critical conduit connecting the middle ear and nasopharynx, is essential for normal middle ear function. However, it remains one of the least understood anatomical structures due to its complexity and the challenges of in vitro manipulation. Historically, these challenges have hindered research into the morphology and function development of the ET. This study elucidates the spatiotemporal relationship of ET morpho-functional maturation in mice, identifying key periods and factors that lay the theoretical foundation for exploring the molecular mechanisms of ET-related diseases. We comprehensively characterized the ET development in C57BL/6 mice from embryonic day (E) 12.5 to postnatal day (P) 30, focusing on the development of cilia, secretory cells, surrounding glands, and macrophages. Immunostaining identified the localization and secretion patterns of the mucins Muc5b and Muc5ac within the ET. Additionally, using improved ET function assessment tools, we evaluated the developmental features of ET mucociliary clearance and ventilation functions. In C57BL/6 mice, E16.5 marks a critical period for middle ear cavity and ET formation. Muc5b plays a foundational role during early stages, while Muc5ac enhances function in later stages. During P7-11, despite morphological maturity, ET function remains underdeveloped but continues to improve with growth.

Conformal immunomodulatory hydrogels for the treatment of otitis media

Otitis media (OM), a condition stemming from the proliferation of various bacteria within the tympanic cavity (TC), is commonly addressed through the administration of ofloxacin (OFL), a fluoroquinolone antibiotic. Nevertheless, the escalating issue of antibiotic resistance and the challenge of drug leakage underscore the exploration of an alternative, more effective treatment modality in clinical practice. Here, we introduce a simple and easily implementable fluid-regulated strategy aimed at delivering immunomodulatory hydrogels into the TC, ensuring conformal contact with the irregular anatomical surfaces of the middle ear cavity to more effectively eliminate bacteria and treat OM. This innovative strategy exhibits expedited therapeutic process of antibiotic-resistant, acute and chronic OM rats, and significant reductions in the severity of tympanic membrane (TM) inflammation, residual bacteria within the TC (0.12 *105 CFU), and the thickness of TM/TC mucosa (17.63/32.43 μm), as compared to conventional OFL treatment (3.6, 0.76 *105 CFU, 48.70/151.26 μm). The broad-spectrum antibacterial and antibiofilm properties of this strategy against a spectrum of OM pathogens are demonstrated. The strategy is validated to bolster the host’s innate immune response through the stimulation of antibacterial protein synthesis, macrophage proliferation and activation, thereby accelerating bacterial eradication and inflammation resolution within the TC. This facile, cost-effective and in vivo degradable technology exhibits promising prospects for future clinical implementation.

Role of tympanocentesis in the prevention of middle ear barotrauma induced by fast buoyant ascent escape from 200 m underwater.

We aimed to study middle ear barotrauma caused by fast compression followed by buoyant ascent escape from 200 m underwater and its effect on the auditory system, and to validate the preventive effect of tympanocentesis on middle ear barotrauma. Twenty Sprague Dawley rats were divided into two groups: rats in group A underwent a simulated fast buoyant ascent escape from a depth of 200 m, while those in group B underwent tympanocentesis before the procedure described for group A. Ear endoscopy, acoustic conductance, and auditory brainstem response (ABR) tests were conducted before and after the procedure to evaluate the severity of middle ear barotrauma and auditory function in both groups. Additionally, histopathological examination of the middle ear in both groups was conducted to evaluate the severity of middle ear barotrauma by observing submucosal haemorrhage. None of the ears in either group showed any abnormalities before the experiment. In group A, middle ear barotrauma was universally observed after the simulation procedure. The tympanograms of all ears were initially type A and became type B after the procedure. Further, after the simulation, the hearing thresholds at different frequencies (4, 8, 16, 24, and 32 kHz) assessed by ABR significantly increased compared to those before the procedure. In group B, no middle ear barotrauma was observed, and the hearing threshold at each frequency did not change significantly compared with post-puncturing. After dissecting the middle ear, gross pathological observations were consistent with the above results. Microscopically, blood accumulation and submucosal haemorrhage in the middle ear cavity were observed in group A but not in group B. Fast buoyant ascent from 200 m underwater can cause middle ear barotrauma, resulting in hearing loss. Tympanic membrane puncture can effectively prevent middle ear barotrauma caused by the rapid buoyant ascent escape procedure.

Association Between Deviated Nasal Septum and Function of Eustachian Tube among Patients Attending a Tertiary Care Center

Deviated nasal septum is the most common cause of severe and chronic nose blockage. The eustachian tube (ET) is a tube that connects the middle ear cavity and the nasopharynx and provides middle ear ventilation. The relationship between DNS and ETF is controversial in medical literature. This study tried to find the association between deviated nasal septum and function of eustachian tube. This prospective study was conducted in Nepal Medical College Teaching Hospital, Otorhinolarynology Department from November 2022 to October2023 after acquiring ethical clearance from Institutional Review Committee. All the patients presenting to the outpatient clinic over the age of 19 with deviated nasal septum (DNS) were included. Statistical analysis was done using SPSS. A p value of < 0.05 was considered statistically significant. Our study had 71 males (54.6%) and 59 females (45.4%) with mean age 37.2±15.9 years. Of 130 patients, 56 (43.1%) had DNS to right side while 74 (56.9%) to left. All patients had moderate DNS. Age group, gender, and laterality of DNS of the patient did not show any significant association with ETDQ7 score, tympanograms and middle ear pressures on either side. Moderate DNS did not affect ETF in a significant way.

Assessment of Prevalence of Otitis Media with Effusion and Correlation Between Otoscopic Findings with Jerger's Diagnostic Tympanograms Among Pupils in Calabar Municipality.

OME is an accumulation of serous or mucoid fluid in the middle ear cavity with an intact tympanic membrane and without any sign of acute infection. This study aimed to determine the prevalence of otitis media with effusion among preschool and school-age children aged 1-10 years in private and public schools in Calabar municipality and the correlations between otoscopic findings and Jerger's diagnostic criteria among study participants. This school-based descriptive cross-sectional study used a multistage sampling technique to recruit participants. The Institutional Ethical Committee approved the study. Consent and assent were obtained from parents/guardians of children aged < 6 years and >7 years, respectively. A structured questionnaire was used to obtain sociodemographic characteristics, symptoms, and possible risk factors for otitis media with effusion. In addition, ear, nose, and throat (ENT) examinations and tympanometry were performed for each participant. Jerger's type B and C tympanograms were the diagnostic criteria for otitis media with effusion. The data were analyzed using IBM SPSS version 25, and the threshold for statistical significance was set at P < 0.05. The overall prevalence of OME was 13.8%, with P values ≤ 0.001, P = 0.597, and P = 0.007 for daycare (45.85%), public schools (14.7%), and females, respectively. Jerger type B tympanograms had a strong positive correlation with middle ear fluid (r = 0.777) on otoscopy, Jerger type C tympanograms with dull TM (r = 0.687), and retracted TM (r = 0.774). Otitis media with effusion was more prevalent among preschool children aged 1-2 years in public schools and among female children in Calabar municipalit. The otoscopic results of otitis media with effusion were consistent with Jerger's diagnostic criteria in our study.

The role of gastroesophageal reflux disease in the middle ear pathology formation

The extraesophageal reflux effect investigation on the middle ear structures in adults is of considerable interest. The gastroesophageal reflux disease associated otitis media formation mechanism is closely related to such concepts as nasopharyngeal reflux and laryngopharyngeal reflux. It has been established that the pathophysiological mechanism originates in the nasopharynx and further spread to the middle ear structures. The tympanic cavity mucous membrane under the gastric enzymes influence is prone to remodeling, which results in the various chronic inflammation types gradual formation. The study purpose was to analyze medical literature from 1990 to 2024, aimed at studying the middle ear cavity inflammation causes and mechanisms formed by the gastric contents influence. As materials and methods, this article uses publications in such scientific databases as PubMed, eLIBRARY, Science Direct, Research Gate. The analyzed scientific materials provide insight into the relationship between the tympanic cavity inflammation formation and extraesophageal manifestations of GERD, as well as the potential negative H. Pylori impact on the middle ear structures. Conclusions. A detailed understanding of the middle ear cavity inflammation formation by pathophysiological mechanisms of the extraesophageal reflux influence, consisted of various gastrointestinal tract components had been obtained. The potential H. Pylori role in the tympanic cavity mucous membrane alteration remains controversial. This is due to the large number of scientific publications conflicting results in this research field. Major scientific studies confirm that gastroesophageal reflux disease acts as a risk factor for the different types middle ear cavity inflammation formation

Bacterial Profile and Antibiotic Susceptibility Patterns of Chronic Otitis Media at a Tertiary Care Center in Maharashtra.

Background Chronic otitis media (COM) is a persistent inflammatory condition of the middle ear and mastoid cavity, characterized by otorrhea and a perforated tympanic membrane. The microbial agents associated with COM vary over time and by geographic location. According to the WHO classification of countries based on COM prevalence, India is classified as having the highest prevalence (>4%) due to a national average of 7.8%, with the majority of the burden affecting individuals in lower socioeconomic strata. Objectives The objective of this study is to analyze the bacterial profile and antibiotic susceptibility patterns of isolates in patients with COM and to examine the age and gender distribution of these patients. Methods A cross-sectional microbiological study was conducted in the Department of Otorhinolaryngology at Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to be University), Pune, India, from January 2023 to March 2023. The sample size was determined using WinPepi software. A total of 30 samples were collected from patients aged 5-15 years with active COM who presented to the ENT OPD. Patients who had been treated with antibiotics in the 15 days prior to the study were excluded. Results Of the 30 patients, most were in the age groups of 16-25 years (36.67%) and 26-35 years (16.67%), with only 10% in the 5-15 years age group. The age range of participants was eight to 55 years, with a mean age of 27 years. There was a gender disparity in the distribution of COM, with males representing 56.67% and females 43.33%, resulting in a male-to-female ratio of 1.3:1. The majority of patients had mucosal COM (24/30, 80%), while the remaining had squamosal COM (6/30, 20%). Pseudomonas aeruginosa was isolated in 24 samples (80%), and Staphylococcus aureus was identified in six samples (20%). Conclusion In the Indian context, where many predisposing factors for COM are prevalent, the disease remains highly common and can lead to severe complications if not treated promptly. This study analyzed ear swabs from 30 patients diagnosed with COM. The results revealed that P. aeruginosa was the most common microorganism, followed by S. aureus. The most effective antibiotics against P. aeruginosa were piperacillin-tazobactam, ceftazidime, and meropenem. For S. aureus, the most effective antibiotics included teicoplanin, vancomycin, linezolid, and cotrimoxazole.

Dexamethasone nanocrystals-embedded hydroxypropyl methylcellulose hydrogel increases cochlear delivery and attenuates hearing loss following intratympanic injection

Herein, dexamethasone (DEX) nanocrystalline suspension (NS)-embedded hydrogel (NS-G) was constructed using a hydroxypropyl methylcellulose (HPMC) polymer to enhance cochlear delivery and attenuate hearing loss following intratympanic (IT) injection. Hydrophobic steroidal nanocrystals were prepared using a bead milling technique and incorporated into a polysaccharide hydrogel. The NS-G system with HPMC (average molecular weight, 86,000 g/mol; 15 mg/mL) was characterized as follows: rod-shaped drug crystalline; particle size <300 nm; and constant complex viscosity ≤1.17 Pa·s. Pulverization of the drug particles into submicron diameters enhanced drug dissolution, while the HPMC matrix increased the residence time in the middle ear cavity, exhibiting a controlled release profile. The IT NS-G system elicited markedly enhanced and prolonged drug delivery (> 9 h) to the cochlear tissue compared with that of DEX sodium phosphate (DEX-SP), a water-soluble prodrug. In mice with kanamycin- and furosemide-induced ototoxicity, NS-G markedly enhanced hearing preservation across all frequencies (8–32 kHz), as revealed by an auditory brainstem response test, compared with both saline and DEX-SP. Moreover, treatment with NS-G showed enhanced anti-inflammatory effects, as evidenced by decreased levels of inflammation-related cytokines. Therefore, the IT administration of DEX NS-loaded HPMC hydrogels is a promising strategy for treating hearing loss.

External auditory canal atresia affecting the horizontal canal of a 2‐year‐old Labrador Retriever dog

AbstractA 2‐year‐old, female neutered, Labrador Retriever dog was presented with left otalgia. Otoscopic examination revealed a blind ending left external ear canal. Magnetic resonance imaging confirmed an abrupt narrowing of the lateral aspect of the horizontal canal, medial to which the remaining horizontal ear canal and middle ear cavities contained well‐delineated, homogenous, T2w, fluid‐attenuated inversion recovery and T1w hyperintense, non‐contrast enhancing material. A diagnosis of external auditory canal atresia was made based on the imaging findings. Considering the patient's age and absence of preceding trauma, a congenital cause was considered most likely. Surgical treatment by way of a total ear canal ablation with lateral bulla osteotomy was performed. At the re‐check appointment, the surgical site had healed well and there were no associated complications noted; a telephone call with the owner 5 months later documented no clinical concerns.

Assessing the Efficacy of Tragal Pumping in a Novel Tympanostomy Tube-Rat Model.

Tragal pumping (TP) is a practice of pushing on the tragus to raise pressure within the external auditory canal and is a commonly recommended adjunctive maneuver believed to facilitate the introduction of ototopical medications into the middle ear cavity via a tympanostomy tube. To investigate the efficacy of TP in the penetration of eardrops into the middle ear cavity via tympanostomy tube, we established the novel tympanostomy tube-rat model. We investigated the histology of the middle ear to determine the efficacy in moving fluid into the middle ear. Prospective controlled animal study. Animal laboratory in a university hospital. Ten rats were recruited, and a tympanostomy tube insertion and green dye eardrops into outer ears were performed on bilateral ears. TP was performed only on 1 ear and was not applied on the other ear in each rat. Green dye in a middle ear cavity in hematoxylin and eosin-stained temporal bone sections was evaluated by blinded experts in microscopic anatomy (staining grade) and by using Image J software (staining level). The results of these 2 methods were statistically validated. The staining grade (P < .001) and the staining level (P < .001) were significantly higher in the ears which we applied TP than in the control ears. The results of 2 methods were significantly and positively correlated (r = .898, P < .001). Our results showed that the TP accelerate the penetration of eardrops into the middle ear cavity in the tympanostomy tube-rat model.

Aneurysm of Petrous and Cavernous Parts of the Internal Carotid Artery: A Case Report.

İnternal carotid artery (ICA)aneurysmsare rare but they can cause high morbidity and mortality. Although these aneurysms are usually asymptomatic, they can reach huge sizes and compress the surrounding neurovascular structures. Patients typically present with neurologic symptoms due to cranial nerve compression. If they rupture, they can lead to massive epistaxis and autorage. In physical examination, pulsatile mass in the middle ear or nasal cavity can be seen. If there is a clinical suspicion of an ICA aneurysms, diagnostic radiological imaging should be performed before the surgical procedure or biopsy. Cerebral digital subtraction angiography (DSA) should be performed for definitive diagnosis. After diagnosis, appropriate endovascular or open intervention should be performed. In this case report, we present a 48-year-old female patient with severe epistaxis complaint due to an ICA aneurysm. This report aims to present this case and review the current literature.

Recent pathogenetic aspects of hearing loss in COVID: A literature review

The World Health Organisation predicts that by 2050, up to 10% of the world's population will need rehabilitation to address disability-related hearing loss. The purpose of this study was to identify the main mechanisms of hearing loss associated with Severe Acute Respiratory Syndrome Coronavirus 2 infection. The study included modern English-language scientific publications, mainly those with a high citation index, through the professional platforms MEDLINE/PubMed and Index Medicus. A total of 48 sources were selected. Research papers devoted to the development of conductive or sensorineural hearing loss, which occurred directly as a result of a viral disease, or is associated with the processes that accompany it (treatment, concomitant pathology, vaccination, etc.), were analysed. It was found that the development of viral-induced hearing loss in COVID has a multifactorial nature. The heterogeneity of audiological changes is primarily conditioned by direct viral damage to auditory analyser cells that express membrane receptors of the angiotensin converting enzyme of the second type. In addition, there is a reactivation of latent viral infection, extravasation of exudate into the middle ear cavity, blood clotting disorders, immune-mediated cell damage, local and generalised inflammatory reactions that affect both sound conduction and sound perception in one ear or both. Some cases of audiological disorders may also be of iatrogenic origin, since post-vaccination complications and ototoxic effects of medications used in the treatment of COVID-19 are not excluded, which should be considered by clinicians at all levels of healthcare to effectively manage a specific clinical scenario

Hampshire Sheep as a Large-Animal Model for Cochlear Implantation.

Sheep have been proposed as a large-animal model for studying cochlear implantation. However, prior sheep studies report that the facial nerve (FN) obscures the round window membrane (RWM), requiring FN sacrifice or a retrofacial opening to access the middle-ear cavity posterior to the FN for cochlear implantation. We investigated surgical access to the RWM in Hampshire sheep compared to Suffolk-Dorset sheep and the feasibility of Hampshire sheep for cochlear implantation via a facial recess approach. Sixteen temporal bones from cadaveric sheep heads (ten Hampshire and six Suffolk-Dorset) were dissected to gain surgical access to the RWM via an extended facial recess approach. RWM visibility was graded using St. Thomas' Hospital (STH) classification. Cochlear implant (CI) electrode array insertion was performed in two Hampshire specimens. Micro-CT scans were obtained for each temporal bone, with confirmation of appropriate electrode array placement and segmentation of the inner ear structures. Visibility of the RWM on average was 83% in Hampshire specimens and 59% in Suffolk-Dorset specimens (p = 0.0262). Hampshire RWM visibility was Type I (100% visibility) for three specimens and Type IIa (> 50% visibility) for seven specimens. Suffolk-Dorset RWM visibility was Type IIa for four specimens and Type IIb (< 50% visibility) for two specimens. FN appeared to course more anterolaterally in Suffolk-Dorset specimens. Micro-CT confirmed appropriate CI electrode array placement in the scala tympani without apparent basilar membrane rupture. Hampshire sheep appear to be a suitable large-animal model for CI electrode insertion via an extended facial recess approach without sacrificing the FN. In this small sample, Hampshire specimens had improved RWM visibility compared to Suffolk-Dorset. Thus, Hampshire sheep may be superior to other breeds for ease of cochlear implantation, with FN and facial recess anatomy more similar to humans.

Structure and scaling of the middle ear in domestic dog breeds.

Although domestic dogs vary considerably in both body size and skull morphology, behavioural audiograms have previously been found to be similar in breeds as distinct as a Chihuahua and a St Bernard. In this study, we created micro-CT reconstructions of the middle ears and bony labyrinths from the skulls of 17 dog breeds, including both Chihuahua and St Bernard, plus a mongrel and a wolf. From these reconstructions, we measured middle ear cavity and ossicular volumes, eardrum and stapes footplate areas and bony labyrinth volumes. All of these ear structures scaled with skull size with negative allometry and generally correlated better with condylobasal length than with maximum or interaural skull widths. Larger dogs have larger ear structures in absolute terms: the volume of the St Bernard's middle ear cavity was 14 times that of the Chihuahua. The middle and inner ears are otherwise very similar in morphology, the ossicular structure being particularly well-conserved across breeds. The expectation that larger ear structures in larger dogs would translate into hearing ranges shifted towards lower frequencies is not consistent with the existing audiogram data. Assuming that the audiograms accurately reflect the hearing of the breeds in question, oversimplifications in existing models of middle ear function or limitations imposed by other parts of the auditory system may be responsible for this paradox.

A Case of Middle Ear Adenomatous Neuroendocrine Tumors: Proposal of a Staging System

A 49-year-old man visited a local otolaryngology clinic with left hearing loss. He was diagnosed as left middle ear tumor and referred to us. The tumor was protruding from the left tympanic membrane. Computed tomography (CT) revealed thickening of the tympanic membrane, space-occupying lesions in the middle ear cavity and mastoid air cells, and no bone destruction in the left middle ear. Magnetic resonance imaging confirmed the CT findings, and the lesions were hyperintense on T1- and T2-weighted imaging. He was diagnosed as middle ear adenomatous neuroendocrine tumor (MEANT) with a pathological result. The patient underwent postauricular approach and canal wall-down mastoidectomy. The tumor occupied the mastoid air cells and extended into the middle ear mucosa. To prevent perilymphatic fistula, the tumor was excised as extensively as possible, while preserving the tumor around and adjacent to the stapes footplate. MEANT is extremely rare and long-term follow-up is necessary due to be potential for tumor regrowth or recurrence. Herein, we propose a new staging system for MEANT.

Renewed Concept of Mastoid Cavity Obliteration with the Use of Temporoparietal Fascial Flap Injected by Injectable Platelet-Rich Fibrin after Subtotal Petrosectomy for Cochlear Implant Patients.

Background: The subtotal petrosectomy procedure may be useful for cochlear implantation in selected patient groups. Although it is highly effective, complications can arise, which may have economic implications for the patient due to the high cost of the device. Therefore, several authors have attempted to identify the most effective concept for obliteration. Methods: We present a pilot descriptive study of application techniques for obliterating cavities after subtotal petrosectomy using a temporoparietal fascial flap (TPFF) modified with injectable platelet-rich fibrin (IPRF+) for three cochlear implant (CI) patients. Results: Our concept preserves important anatomical structures, such as the temporalis muscle, which covers the CI receiver-stimulator. Injection of IPRF+ also increases the available tissue volume for obliteration and enhances its anti-inflammatory and regenerative potential. Conclusions: To the best of our knowledge, the use of TPFF for filling the cavity has not been adopted for CI with SP and for blind sac closure. Our literature review and our experience with this small group of patients suggest that this procedure, when combined with IPRF+ injections, may reduce the risk of potential infection in the obliterated cavity, particularly when used with CI. This technique is applicable only in cases when the surgeons are convinced that the middle ear cavity is purged of cholesteatoma.

Clinical observation of Otitis Media Secretory during Covid-19.

This study aims to analyze the onset of otitis media secretory, the peak period of infection with the Omicron strain of SARS-CoV-2 virus, and the time of transmigration during a pandemic of the Omicron strain. Additionally, the study aims to investigate to study the presence of SARS-CoV-2 virus in the middle ear cavity of patients with otitis media secretory and the survival time through a new method for detecting SARS-CoV-2 virus antigen in middle ear effusion. Retrospective comparison of the incidence of otitis media secretory during infection with SARS-CoV-2 virus Omicron strain from December 15, 2022, to January 15, 2023, versus the noninfection period from December 15, 2021, to January 15, 2022. We used a questionnaire star application to investigate the demographic and epidemiological characteristics of the 40 patients with otitis media secretory who participated in this study were investigated. A novel coronavirus (2019-nCoV) antigen detection kit (colloidal gold method) was used to detect middle ear effusion in patients with otitis media secretory. The data were statistically analyzed using SPSS 29.0 software. The measurement data are expressed as x ± s , the count data are expressed as the number of cases (%), and the data were compared using the χ 2 test. p < 0.05 indicated a statistically significant difference. During the SARS-CoV-2 virus Omicron strain pandemic, the incidence of otitis media secretory increased by 15% compared with the noninfection period. The peak infection period for the SARS-CoV-2 virus Omicron strain was December 25, 2022, and December 15, 2022, and the peak time of conversion was 7 to 9 days after the infection. Middle ear effusion SARS-CoV-2 virus antigen testing was performed in patients with otitis media secretory after conversion; 5 patients (12%) were positive, and 35 patients (88%) were negative. The disease duration in patients with negative results was more than 3 weeks. Otitis media secretory is one of the most common ear complications after infection with the Omicron strain of SARS-CoV-2 virus, and the significantly higher incidence is associated with middle ear viral infection. Middle ear effusion SARS-CoV-2 virus antigen test detected the virus, which survived longer in the middle ear effusion than in the nasal cavity. The middle ear effusion test can detect SARS-CoV-2 virus antigen and determine whether the organism contains virus residue.

Morphological variations of auditory bullae in otomyine rodents (Rodentia: Otomyini) in southern African biomes.

Mammalian middle ear cavities differ from those of other taxa as they comprise three ossicles and in rodents, can be encapsulated by an auditory bulla. In small mammals, the middle ear cavity (bulla) was found to be enlarged in the desert-dwelling species; however, differences in bullar size could have been due to ancestry. In this study, we sampled seven species from three genera (Myotomys, Otomys, and Parotomys) of the African murid tribe Otomyini (laminated-toothed rats), and compared the bullar volumes and shapes between the otomyine species and within the species Myotomys unisulcatus. Photographs of museum skull specimens were taken from ventral and lateral views, and the volumes of the bullae were estimated digitally from the photographs. No sexual dimorphism in bullar volumes was found in any of the species. Corrected bullar volumes were significantly different between species and larger bullae were seen in individuals inhabiting regions with lower annual rainfall. Bullar shape (estimated using geometric morphometrics) was significantly different between the genera and the species. Parotomys have tympanic meatuses that face more anteriorly compared to both, Otomys and Myotomys. When comparing bullae within M. unisulcatus, those inhabiting regions with lower annual rainfall had significantly larger bullar volumes, but no significant difference was found in bullar shape between the regions. This study shows that otomyine rodents in more xeric habitats have different auditory structures to those inhabiting wetter habitats.

Kimura's Disease in Temporal Bone: A Case Report.

To publish a rare case of Kimura's Disease in Temporal Bone. A 27year-old male presenting with history of right ear pain and discharge for 2months was thoroughly evaluated by clinical evaluation, hematological, radiological and histopathological study. Clinical examination revealed a bulge in posterior-inferior quadrant right side of tympanic membrane. HRCT temporal bone revealed a heterogeneous attenuating focal lesion is noted in the region of right middle ear cavity, mastoid antrum mastoid air cells in continuation with the superior aspect of right jugular foramen with erosions and bone destructions, involving the mastoid air cells and sinus plate. Patient was managed surgically with right side canal wall down mastoidectomy and Type 1 Tympanoplasty. Histopathological examination showed focal ulcerated stratified epithelium, dilated elongated congested blood vessels and hemorrhage. Diagnosis was made as Kimura's disease.