Mild Conductive Hearing Loss Research Articles

A Prospective Comparative Study of Impedance Audiometry Findings Preoperatively and Postoperatively in Cases of Conventional Adenoidectomy versus Microdebrider Assisted Adenoidectomy.

The aim of the study was to evaluate and compare the efficacy of Endoscopic Adenoidectomy with Microdebrider over Conventional technique by Curettage using Impedance Audiometry findings. In this prospective, randomised, comparative study patients were divided into two groups to undergo one of the above adenoidectomy surgeries. Patients with symptoms of Adenoid hypertrophy after failed maximal medical therapy (12 weeks) were selected after due consideration of the inclusion and exclusion criteria. Baseline Impedance Audiometric assessment was done one week prior to surgery which was compared to Impedance Audiometric values 12 weeks post operatively in each group. This study enrolled 50 patients with adenoid hypertrophy, 25 patients of group A underwent Conventional adenoidectomy and the other 25 patients of group B underwent Endoscopic Adenoidectomy with Microdebrider. Significant difference in type of tympanogram before and after adenoidectomy was found in both the groups (p = 0.0008 in group A & p < 0.0001 in group B). In Group A Percentage of abnormal tympanograms becoming normal (Type A), 12 weeks after adenoidectomy was 80%. In Group B Percentage of abnormal tympanograms becoming normal (Type A), 12 weeks after adenoidectomy was 88%. A statistically significant improvement (p < 0.0001 in both the groups) in the percentage of ears with absent stapedial reflex was observed in both groups postoperatively, with no difference between the two groups suggestive of improvement in eustachian tube function. Association of Preoperatively & Postoperatively Eustachian tube function in each group undergoing adenoidectomy was statistically significant (p < 0.0001). Both forms of adenoidectomy are effective in managing adenoid hypertrophy with tubal dysfunction causing mild conductive hearing loss and prone for OME. However, the audiological and endoscopic evaluation seems to favor Endoscopic Adenoidectomy with microdebrider over conventional adenoidectomy, and it should be therefore considered in the therapeutic management of young patients with adenoidal disease.

Endoscopic Tympanoplasty in Chronic Otitis Media with Inactive Mucosal Disease

&amp;lt;i&amp;gt;Background:&amp;lt;/i&amp;gt; Chronic otitis media (COM) is a condition usually seen in patients attending the ENT department. Chronic inactive mucosal disease (CIMD) is characterized by tympanic membrane (TM) perforation with hearing loss. Endoscopic tympanoplasty (ET) is a surgical method to repair TM perforation with minimal invasion. &amp;lt;i&amp;gt;Objective:&amp;lt;/i&amp;gt; The present analysis was done to find out the outcome of ET surgeries in CIMD. &amp;lt;i&amp;gt;Methods:&amp;lt;/i&amp;gt; Retrospective data analysis was done in 30 patients underwent ET with endoscopic under-lay technique at Al-Ameen medical college, Vijapur, India. &amp;lt;i&amp;gt;Results:&amp;lt;/i&amp;gt; Average age of patients was 34.17±9.52 years. Majority (40%) patients were from 18-30 years of age group. There were 12 (40%) males and 18 (60%) females. Right-side and left-side CIMD was equally distributed in 30 patients. Sixteen (53.3%) and 14 (46.7%) patients were having right and left TM perforation, respectively. TM perforation size was small, medium and large in 43.3%, 30% and 26.7% of patients, respectively. Twenty-eight (93.3%) patients had temporalis fascia and 2 (6.7%) patients had tragal cartilage as graft material. Two (6.7%) patients had graft rejection without improvement in hearing. No patient had complication or any miscellaneous issues. Eighteen (60.0%), 11 (36.7%) and 1 (3.3%) pre-operative patient with pure-tone average (PTA) had mild, moderate, and severe conductive hearing loss (CHL), respectively. All patients with PTA were improved after surgery. &amp;lt;i&amp;gt;Conclusion: &amp;lt;/i&amp;gt;ET is an effective, minimally invasive, and less painful surgical technique for repair of central TM perforations in CIMD.

The presence of a submucous cleft palate in patients with isolated cleft lip and middle ear dysfunction

PurposeRecent studies have suggested that children with an isolated cleft lip (CL) are more likely to develop middle ear disease and eustachian tube dysfunction (ETD) compared to the general population. This may be related to abnormal palatal musculature or an undiagnosed submucosal cleft palate (SMCP). We aim to determine the prevalence of SMCP in patients with CL who exhibit ETD. Materials and methodsA retrospective chart review was performed for children with an isolated CL requiring tympanostomy tubes over a 20-year period at an academic tertiary care medical center. Demographic, clinical, and surgical data were collected. ResultsThree hundred twelve patients had an isolated CL, and 29 (9.3 %) children required tympanostomy tubes. Of those, nine (31 %) were found to have a SMCP (7 males, 6 Caucasian). The average age at CL repair was 3.94 ± 1.03 months, and the average age at tympanostomy tube placement was 13.68 ± 13.8 months. All nine patients had chronic otitis media, with four having mild conductive hearing loss and three having moderate conductive hearing loss. The SMCP was diagnosed at the time of CL diagnosis (4), after CL diagnosis with the diagnosis of chronic otitis media/ETD (2) and after a diagnosis of chronic otitis media/ETD. ConclusionMiddle ear disease or eustachian tube dysfunction in a patient with an isolated cleft lip should raise suspicion for an accompanying undiagnosed SMCP.

Assessment of Hearing in Patients with Head Injury: A Prospective Study.

Hearing impairment is a well-known outcome of head trauma. The most prevalent site of injury is the peripheral structures. Hearing loss dissipates in most cases but can continue in some cases and may improve in some. To evaluate the incidence of hearing loss and ascertain its type and degree in patients with head injury. To estimate the progression or regression of hearing loss in head injury patients during follow-up. 60 patients with head injuries with any ear symptoms were included in the study. The severity of head injury is graded according to the Glasgow Coma Scale (GCS). Patients were subjected to High Resolution Computed Tomogram (HRCT) temporal bone, and Pure Tone Audiometry (PTA) was performed within 24h of presenting. PTA repeated after 3months. The degree of hearing loss and its progression or regression were assessed. Of the 60 patients, 56 (93.3%) had hearing loss on PTA. 50 Cases (83.3%) showed conductive hearing loss (CHL). 6 (10%) had mixed hearing loss (MHL). 4 cases with MHL had a transverse temporal bone fracture on radiological evaluation. 41 (68.3%) had mild CHL, 4 (6.7%) had moderate MHL, and 2 (3.3%) had moderately severe MHL. PTA values reduced significantly from 1st to 2nd visit in both ears. In our study, there was significant improvement in hearing during follow-up, after 3months of head injury indicating improvement in hearing. The improvement in hearing was noticed in all cases except for one case with transverse temporal bone fracture and moderately severe hearing loss. Routine otological examination should be considered in all patients with head injuries. Meticulous and timely management of these cases can significantly reduce morbidity in the patient.

Audiologic Profile of Chronic Otitis Media with Effusion in Children

Background: Otitis media with effusion (OME), the most common ear disease in pediatrics, can lead to hearing loss (HL) and might have a significant impact on a child’s auditory and speech development. Objectives: This study was conducted to indicate the audiologic profile of children with chronic OME who were scheduled for tympanostomy tube placement. Methods: Otoscopy, pure-tone audiometry, and tympanometry assessments were carried out in 663 children (420 males and 243 females) who had a chronic OME diagnosis and were scheduled for ear surgery. They were selected consecutively at Imam Khomeini Hospital, Ahvaz, Iran. The paired sample t-test was conducted to compare mean hearing thresholds before and after ear surgery. Results: The most frequent age groups affected by OME were 12 - 36 months (33.48%) and 36-72 months (31.67%). The majority of children (60.03%) showed retracted tympanic membrane (TM), and the most common color of the TM was yellowish-brown, observed in 74.20% of cases. Before surgery, the majority of patients demonstrated mild conductive hearing loss (61.08%) and a Type B tympanogram (73.75%). The myringotomy site of 61.53% of children was anterior-inferior. Four hundred-eight children indicated serous secretion. The mean pure-tone average before surgery was significantly reduced after surgery (45.23 ± 23.25 vs. 27.83 ± 15.86 dB HL, P = 0.001). This improvement was about 18 and 17 dB in the right and left ears 2 months after surgery, respectively. The postoperative findings also indicated that in 487 children (73.45%), hearing thresholds returned to normal limits. Conclusions: It is essential to address chronic OME promptly to prevent potential long-term impacts on a child’s hearing, speech, and language. Treatment options, such as watchful waiting or surgical intervention, depending on the severity and duration of the condition, are effective procedures in this group of patients.

Development of a smartphone-based Turkish digits in noise test

BackgroundPure-tone audiometry is the traditional gold standard for assessment and screening of hearing impairment, but it requires the use of calibrated devices and soundproof booth. Mobile apps can offer a good alternative to traditional methods in limited circumstances and in some emergency situations, especially when traditional methods are not available. The aim of the study was to develop an easily accessible mobile-based Turkish Digit in Noise Test screening test for the assessment of hearing.MethodsThe digits were read by a male speaker whose native language is Turkish. A mobile application was developed in accordance with the Android operating system. Twenty-five individuals with normal hearing, 25 individuals with bilateral mild sensorineural hearing loss, 25 with bilateral mild mixed hearing loss, and 25 with bilateral mild conductive hearing loss total of 100 participated in the study. All participants were between the ages of 18–60. The Turkish Digit in Noise Test mobile application was applied to the participants and the test scores were compared among the types of hearing loss.ResultsThe Turkish Digit in Noise Test scores of participants with bilateral mild sensorineural hearing loss (19.4 ± 5.39) and mixed hearing loss (22.96 ± 4.52) were lower than those of participants with normal hearing (39.68 ± 6.82) (p < .01). In addition, the results of participants with bilateral mild sensorineural hearing loss (19.4 ± 5.39) and mixed hearing loss (22.96 ± 4.52) were lower than those of participants with conductive hearing loss (36.88 ± 6.31) (p < .01).ConclusionAn easy and accessible Turkish Digit in Noise Test mobile application has been developed using which one can assess his/her hearing.

Audiological Profile in Allergic Rhinitis, a Hospital Based Study.

A type-I hypersensitivity reaction of the nasal mucosa, allergic rhinitis (AR) is distinguished by nasal obstruction, watery rhinorrhea, sneezing, and throat, mouth, and nose irritation. It is assumed that allergies can affect the inner, middle, or outer ear. Many writers have studied the relationship between allergic rhinitis and otitis media. Most of them concur that bacterial infection and Eustachian tube obstruction are significant risk factors for the development of otitis media with effusion in addition to allergies. One hundred study participants had a full clinical evaluation that included an ENT history and examination. In the ENT OPD, the audiological examination was conducted using Pure Tone Audiometry (PTA) and Impedance Audiometry (IA). At frequencies of 250 and 8000 Hz, respectively, the bone and air conduction thresholds were studied. The commercially available "AT235 INTERACOUSTICS" tympanometer was used for the tympanometry procedure. With pressure variations between + 200 and - 300daPa, tympanometry was carried out employing a 226 Hz probe tone. Mean age of study population was 52.16 and 24% each in age group 51 to 60 and 61 to 70 years respectively. 73 (73%) were male and 27 (27%) were female. 46% of allergic rhinitis study population was found to have normal hearing and 43% had mild conductive hearing loss. Most common type of impedance curve was A type (47%). Patients having acute phase of allergy with symptoms less than 3 months had more ear block and secretory otitis media. Patients with duration more than 3 months had resolved secretory otitis media hence the hearing was normal in 33 cases and 11 had mild conductive hearing loss. This study was concluded that there is correlation between the severity of the hearing loss and duration of allergic rhinitis.

Incidence and risk factors of hearing loss in patients with Turner Syndrome.

Hearing loss (HL) is one of the main medical complications for Turner Syndrome (TS) patients, with an earlier presentation and higher incidence than normal women. However, the etiology of HL in TS is unclear. The aim of this study was to investigate the hearing status of TS patients in China and the influencing factors, so as to provide a theoretical basis for early intervention treatment for TS patients with HL. In total 46 female patients aged 14-32 diagnosed with TS received tympanic membrane and audiological examinations, including pure tone audiometry and tympanometry. In addition, the effects of karyotype, sex hormone levels, thyroid function, insulin, blood lipids, bone mineral density, age and other factors on hearing levels were analyzed, and the possible risk factors associated with HL in TS patients were explored. In 9 patients (19.6%) had HL, including 1 (2.2%) with mild conductive hearing loss, 5 (10.9%) with mild sensorineural hearing loss, 3 (6.5%) with moderate sensorineural hearing loss. TS is often associated with age-related mid-frequency and high-frequency HL, and the incidence of HL increases with age. Compared with other karyotypes, patients with 45, X haplotype have an increased risk of mid-frequency HL. Therefore, karyotype may be a predictor of hearing problems in TS.

Bilateral Superior Semi-Circular Canal Dehiscence Presenting as Conductive Hearing Loss with Vestibular Symptoms: A Client Centre Case Report

Background: Superior semicircular canal dehiscence (SSCD) is a rare bone defect in the petrous part of the temporal bone. In this syndrome, a third window is created between the middle cranial fossa and the bony labyrinth of the inner ear which can lead to stimulation of the vestibular system by sound. Patients usually have symptoms such as vertigo, imbalance, autophony, pulsatile tinnitus, and aural fullness. The clinical symptoms of this disease vary from person to person. The Case: This study reports a case of a rare bilateral SSCD in a 39-year-old woman with imbalance and autophony problems. The audiological findings showed a bilateral mild conductive hearing loss at low frequencies with symptoms of vertigo and torsional nystagmus. The SSCD was diagnosed by computed tomography. Then, the patient underwent bone repair surgery. Auditory and balance tests were performed again after the surgery to evaluate the extent of recovery. Conclusion: The SSCD can be diagnosed by using the mentioned test battery. By choosing the appropriate treatment methods and following up of the outcomes, most of the problems of patients with SSCD can be solved. Keywords: Superior semicircular canal dehiscence; bilateral; conductive hearing loss

Analysis of audiological features in infants with unilateral hearing loss

Objective:To investigate the audiological characteristics and possible causes of unilateral hearing loss in infants and young children. Methods:105 infants from Beijing Maternal and Child Health Care Institution who failed the newborn hearing screening and were referred to the Children's Hearing Diagnosis Center of PLA General Hospital for hearing diagnosis. They were diagnosed with unilateral hearing loss and underwent clinical data collection. A full set of audiological examinations included ABR, 40 Hz auditory event related potential, ASSR, DPOAE, tympanometry. Results:①In initial diagnosis, 45 cases（42.86%） had mild hearing loss, 19 cases（18.10%） had moderate hearing loss, 14 cases（13.33%） had severe hearing loss, and 27 cases（25.71%） had severe hearing loss; Among them, 65 cases（61.90%） were conductive hearing loss or mixed hearing loss, and 40 cases（38.10%） were sensorineural hearing loss. ②83 of 105 cases had follow-up visits: 24 cases were normal, 15 cases with mild hearing loss, 4 cases with moderate hearing loss, 12 cases with severe hearing loss, and 26 cases with extremely severe hearing loss, 2 cases of hearing loss in both ears. ③From the initial diagnosis to the follow-up diagnosis, the change of mild hearing loss was the largest, followed by moderate hearing loss, severe and extremely severe hearing loss basically did not change; the number of mild and severe conductive hearing loss which recovered to normal hearing was most, the number of sensorineural hearing loss changed little. Conclusion:The infants who failed the newborn hearing screening and were diagnosed with unilateral hearing loss were mainly mild to moderate conductive hearing loss and severe to extremely severe sensorineural hearing loss. The hearing of children with hearing loss gradually improved, and severe and extremely severe sensorineural hearing loss remained unchanged.

Management of a facial nerve schwannoma with fractionated stereotactic radiotherapy: a case report

Abstract Introduction: Neuroma of the facial nerve (NFN) is an extremely rare benign tumour that can involve any segment of the facial nerve. It is revealed by facial weakness with or without hearing loss and has commonly been managed by microsurgery. Our purpose is to systematically review the literature about the role of fractionated stereotactic radiotherapy (FSRT) on the treatment of NFN. Clinical case: We report the case of a 70-year-old-woman who presented progressively worsening facial paralysis associated with mild conductive hearing loss and dizziness. The multimodal magnetic resonance imaging (MRI) was very suggestive of an intrapetrous neuroma, centred on the tract of the VII nerve and the left geniculate ganglion. She was treated by FSRT at the dose of 18 Gy in three fractions on the isodose line 80 %. After 18-month follow-up, she reported a facial weakness improvement. The MRI revealed a stable disease. Conclusion: The clinical presentation of the schwannoma of the facial nerve depends essentially on its location. It is therefore very variable, ranging from an isolated mild hearing loss to a vestibular syndrome with facial paralysis. Through this observation with literature review, we reported a long-term tumour control with improvement of pre-treatment symptomatology with FSRT.

Cross-Sectional Study of Hearing Status in Primary Students in Mainstream and Special Schools

Background. The only way to prevent the negative outcomes of hearing loss in children (speech, mental, learning, socialization disorders) is early diagnosis of the pathology and rehabilitation onset. It can be provided by hearing screening programs for children of different ages, including school-age children. Hearing screening is not performed among school-age children in Russian Federation. Objective. The aim is to study the prevalence and structure of hearing disorders in students in mainstream and special (for children with visual impairments) schools to determine the strategy for implementing hearing screening of school-age children in Russian Federation. Methods. The study included children of two groups who had not previously been diagnosed with hearing disorders: group 1 — students of 1–4 grades of mainstream school, group 2 — students of 1–4 grades of special school (children with visual impairments) (St. Petersburg). The screening stage included otoscopy, tympanometry, otoacoustic emissions, pure tone audiometry. Children with any problems later underwent a complex hearing examination at Center of Pediatric Audiology (St Petersburg) to confirm the presence of hearing disorder and for disease differential diagnosis. The major indicator in this study is the percent (%) of children with confirmed hearing disorder in each group. The additional indicator is the proportion of various pathological conditions in hearing disorders’ structure (persistent disorders and hearing loss degree included). Study methods: otoscopy, tympanometry, pure tone audiometry, speech audiometry, otoacoustic emissions and auditory brainstem responses. Results. We have revealed abnormalities in 23% of 183 children from mainstream school. Hearing disorders were confirmed in 19.7% of children. Most children were diagnosed with temporary mild and moderate conductive hearing loss, whereas 3.9% were diagnosed with permanent (sensorineural) hearing loss. The total percent of children with confirmed hearing disorder was not significantly different in 148 children from special school. Therefore, they have 2.5 times more cases of permanent hearing loss and children with more severe hearing disorder. Conclusion. The obtained data confirm the hearing screening relevance in school-age children. Further studies are required to develop hearing screening protocol for school-age children considering the features of audiologic service and educational system in Russian Federation.

PLASMA CELL GRANULOMA OF MASTOID: A RARE CASE REPORT

Plasma cell granuloma is a rare benign lesion which is found most frequently in the lungs, and rarely in the head and neck.[1] In this study, we present 22year old male with right sided otalgia, tinnitus, hearing loss and swelling over right postauricular region. On otoscopy, tympanic membrane was intact and dull and pure tone audiometry showed right mild conductive hearing loss. HRCT mastoid and MRI brain suggested CSOM with cholesteatoma. Intact canal wall mastoidectomy with debulking of tumour was done. HPE reported plasma cell granuloma (inammatory pseudotumour) which was conrmed by Immunohistochemistry. Post operative period was uneventful. This case report is being highlighted for its rarity and unusual presentation.

Assessment Of Hearing Threshold Among Post Repaired Cleft Palate Patients In Korle-Bu Teaching Hospital, Ghana

Objective: The aim of the study was to assess the hearing threshold in patients with repaired cleft palate and to determine the degree of hearing loss in various types of cleft palate.Methods: This was a cross-sectional study which was conducted on 97 consenting patients with clinical diagnosis of repaired cleft palate at the Plastic and Reconstructive surgery unit, Korle Bu Teaching Hospital. The hearing loss threshold levels in the rightand left cleft palates were then compared using Chisquare test of independence.Results: A total of 97 participants who had cleft palate were seen that is 194 ears were examined. Most of patients had cleft of secondary palate (n=65, 67.0%), only one participant had cleft of primary palate only (1.0%) and the rest had cleft of both primary andsecondary palate (n=31, 32.0%). The age range of patients in this study was between the ages of 6 years to 12 years with a mean (±SD) age of 7.43 (3.85) and the male to female ratio was 1:1. Out of the total ear examined, 76 were mild conductive hearing loss and 95 ears had abnormal tympanogram. The overall prevalence rate for the abnormal tympanograms (B, C1, C2) in both ears is 49%. Therewas no statistically significant association between the level of hearing loss and the type of cleft palate for the left ear and the right ear respectively as well as the association between the type of tympanogram and the type of cleft palate for the left ear and the right ear respectively (p&gt;0.05).Conclusion: Prevalence rate of hearing loss among post repaired cleft palate subjects is 33%. This hearing loss is usually mild conductive hearing loss only. Mild conductive hearing loss and abnormal tympanogram was common between the ages of 6-8yearsirrespective of the type of cleft palate.

The Effect of Hearing Aids on Sound Localization in Mild Unilateral Conductive Hearing Loss.

Binaural hearing is of utmost importance for communicating in noisy surroundings and localizing the direction of sound. Unilateral hearing loss (UHL) affects the quality of life in both childhood and adulthood, speech development, and academic achievements. Sound amplification using air-conducting hearing aids (HAs) is a common option for hearing rehabilitation of UHL. The processing time of digital HAs can significantly delay the acoustic stimulation in 3 to 10 milliseconds, which is far longer than the maximal natural interaural time difference (ITD) of 750 microseconds. This can further impair spatial localization in these patients. We sought to assess whether HA effects on ITD and interaural level difference (ILD) impair localization among subjects with unilateral conductive hearing loss (UCHL). "Normal"-hearing participants underwent localization testing in different free field settings. Ten volunteers with "normal"-hearing thresholds participated. Repeated assessments were compared between "normal" (binaural) hearing, UCHL induced by insertion of an inactivated HA to the ear canal (conductive HL), and amplification with a HA. In UCHL mode, with HA switched-off, localization was significantly impaired compared to "normal" hearing (NH; η2 = 0.151). Localization error was more pronounced when sound was presented from the front and from the side of the occluded ear. When switched-on, amplification with HAs significantly improved localization for all participants compared to UCHL. Better localization with HAs was seen in high frequencies compared to low frequencies (η2 = 0.08, 0.03). Even with HAs, localization did not reach that of NH (η2 = 0.034). Mild UCHL caused localization to deteriorate. HAs significantly improved sound localization, albeit the delay caused by the device processing time. Most of the improvements were seen in high-frequency sounds, representing a beneficial effect of amplification on ILD. Our results have potential clinical value in situations of mild CHL, for instance, otitis media with effusion.

Hearing impairment in patients with oral submucous fibrosis

Abstract Introduction: Oral submucous fibrosis (OSMF) is a premalignant condition of the oral cavity. The pathological changes in OSMF often affect mucosa, submucosa, and underlying muscles in the oral cavity and pharynx. The pathological changes of the tubal and para-tubal muscles can affect the function of the Eustachian tube. The Eustachian tube dysfunction in OSMF often may result in hearing impairment. Aim: This study aims to evaluate the effect of OSMF on Eustachian tube function resulting in hearing impairment. Materials and Methods: This prospective study was carried out at a tertiary care teaching hospital of Eastern India from June 2019 to July 2021. There were 68 patients with OSMF enrolled in this study by simple random sampling. In this study, 68 patients (136 ears) suffering from OSMF with hearing impairment or fullness/blockage feeling in the ear who participated in this study. The clinical profile of these patients was worked out by taking a detailed history and clinical examination. All the patients underwent audiological evaluation with pure-tone audiometry and tympanometry. Results and Discussion: Out of 68 patients, 42 (61.76%) were male and 26 (38.23%) were female with a male-to-female ratio of 1.61:1. The age ranges of the patients who participated in this study were between 18 years and 65 years. Pure-tone audiometry showed normal hearing in 86 (63.24%) ears, mild conductive hearing loss in 31 (22.79%) ears, moderate conductive hearing loss in 14 (10.29%) ears, and sensorineural hearing loss in 5 (3.68%) ears. Conclusion: The Eustachian tube may be blocked by the effect of the OSMF and result in hearing loss. Hence, while treating OSMF, hearing impairment in OSMF has to be kept in mind.

Hearing Loss, Congenital HIV, and Medulloblastoma: A Case Report

Hearing Loss, Congenital HIV, and Medulloblastoma: A Case Report

Hemangioma of the External Auditory Canal and Temporal Bone: A Case Report and Comprehensive Literature Review.

Although hemangiomas are common in the head and neck area, they are uncommon in the temporal bone. External auditory canal (EAC) hemangiomas are a relatively uncommon otologic condition. In the English literature, only 29 cases of temporal bone hemangioma have been reported. We also present the case of a 32-year-old male patient who presented with an 8-month history of decreased hearing, tinnitus, and aural fullness on the right side. Otoscopic examination of the right ear revealed a smooth, oval, well-circumscribed, reddish, pulsatile, nontender mass, which was about 1 cm in diameter and occupied two-thirds of the EAC. It was soft in consistency, compressible, and appeared to be arising from the right posterior-superior portion of the bony canal wall; the tympanic membrane seemed to be uninvolved. The patient had mild conductive hearing loss of the right ear with an average air-bone gap of 20 dB; the left side was normal. High-resolution contrast-enhanced computed tomographic scanning of the temporal bone showed well-defined, rounded, homogenously enhancing lesions at the posterior-superior aspect of right EAC measuring 0.7 × 0.8 cm. Angiography was performed and there was evidence of vascular blush in the region of the right EAC. Three blood vessels were identified and embolized. The mass was completely removed by the endaural approach, and a retroauricular skin graft to restore cutaneous integrity was not required. Histopathology indicated a capillary hemangioma without cytological atypia or mitotic activity. There was no recurrence 1 year after the surgery.

Phonological Process in Arabic-Speaking Children with Down Syndrome: A Psycholinguistic Investigation

No prevalence statistics for articulation and phonological problems in Arabic children with Down syndrome (DS) have been published. The goal of this study was to see how common consonant production errors and phonological processes are in Emirati Arabic-speaking children with DS, and how they relate to their intellectual level and hearing status. Thirty Emirati children with DS, aged 9–12 years, and a control group of the same age, participated. An informal linguistic assessment was used to diagnose all the participants. All the participants were found to have phonological and articulation problems. On total words in mistake and typical segmental errors, there were significant disparities between the normal hearing group and the mild conductive hearing loss group. On the total number of wrong words and normal and atypical segmental errors, there were similar significant disparities between mild and severe intellectual impairments. Furthermore, as the age of the participants increased, the percentage of errors reduced.

Profile of paediatric tuberculosis mastoiditis -a case series

Tuberculosis (TB) otitis media is an uncommon site of extrapulmonary TB and can primarily present as a complicated TB mastoiditis (TBM). This complication is rare in children, even in TB endemic areas but necessitates early identification as delays can lead to severe morbidities. We describe the clinical characteristics as a case series to raise awareness of the condition, and highlight fundamentals related to diagnosis and management.A retrospective chart review of clinical and radiological information of five children with TBM seen at the Red Cross War Memorial Children's Hospital in Cape Town, South Africa, over the last 5 years. Variables collected included symptomatology, duration of disease, investigations and management.All were under 5 years of age and presented with typical features of acute bacterial mastoiditis. Mean duration of symptoms was 12 days (range 3-30 days). Two children had known TB contacts. Two children had pulmonary involvement, one with miliary TB. CT of the temporal bone demonstrated extensive bony destruction of the petromastoid and demineralised ossicles in all cases. Three children had intracranial extension. Four children demonstrated hearing loss between 30 dB and 83 dB. Necrotising granulomatous inflammation was present in the mastoid specimens in all cases. Confirmatory diagnosis was made via GeneXpert polymerase chain reaction (PCR) (2), Ziehl-Nielson (ZN) stain (1) or a positive TB culture (2). Postoperatively, one patient had normal hearing, two patients had mild conductive hearing loss (CHL), one had mild-moderate CHL and one had profound hearing loss.Delays in identification and management result in marked bony destruction and hearing loss. Radiological and surgical findings typical of TBM, therefore, require tissue sampling from the ear for urgent microscopic, PCR and histologic testing, allowing the avoidance of a mastoidectom. In a TB endemic setting, children with typical findings and necrotising granulomatous inflammation on histology should be considered for prompt commencement of anti-TB therapy while awaiting a definitive diagnosis.