Unilateral Ear Research Articles

Real-ear Unaided Gain in Wrestlers with Unilateral Cauliflower Ear

Background and Aim: Real-Ear Unaided Gain(REUG) can reveal the outer-ear resonance which reflects the effects of body and ear factors. Deformity in the outer ear may change the real-ear unaided responses. Cauliflower ear is a common ear deformity in wrestlers. Therefore, the use of required hearing aid gain in people with hearing loss for people with cauliflower ears may be inaccurate and causes dissatisfaction. This study aimed to compare the REUG of normal and cauliflower ear in wrestlers to investigate the frequencies at which the gain may be inaccurate.
 Methods: Ten male wrestlers with the age ranged from 21 to 31 years participated in this study. The study had within-subject design and only one group. The REUGs was recorded for both ears (normal and cauliflower ears) and the results analyzed.
 Results: The mean of REUG values were significantly different between the deformed and normal ears. There were two distinct peaks in the REUG curve of the deformed ear, while there was a single peak in that of the normal ear.
 Conclusion: The differences in the REUG at 2–6 kHz between the deformed and normal ears should be adjusted to reach the optimal hearing level for a hearing aid user with cauliflower ear.
 Keywords: Cauliflower ear; real ear unaided gain; hearing aid verification; target gain

Effects of bilateral cochlear implants on vocal intensity control

Bilateral Cochlear Implants (BiCIs) can improve many perceptual tasks, including speech perception in noise, when compared to unilateral implantation. However, evidence suggests that BiCI users may perform worse on some vocal tasks, such as F0 production, than when using their better ear alone. This research aimed to determine if this detrimental effect on vocal control with BiCI devices extends to the control of vocal amplitude variations. Ten BiCI users were asked to produce a sustained vowel vocalization using both CIs and one CI separately. Their recordings were analyzed acoustically to determine long-term control of amplitude variations using the Variation of Peak Amplitude (vAm). The preliminary findings showed that using both CIs resulted in less control over vocal intensity for eight participants when compared to using one ear alone. The other two participants either showed no difference between the conditions or had a higher vAm with the unilateral ear than with the bilateral condition. The result suggests that BiCI use might detrimentally affect controlling long-term vocal intensity variation beyond any effects of unilateral CIs. Further investigation is needed to address how the vocal intensity control in BiCI users is affected.

Neurovascular conflict and sudden unilateral sensorineural hearing loss: coincidence or coexistence?

To study the association between neurovascular conflict (NVC) of the 8thcranial nerve (CN8) and unilateral sudden sensorineural hearing loss SSNHL (SSNHL). A systematic literature search of "MEDLINE" via "PubMed," "Embase," and "Google-Scholar" was conducted. Meta-analysis of pooled data was performed for NVC prevalence of SSNHL affected ears versus controls. The literature search identified 941 publications, of which, 9 included in qualitative synthesis (1030 ears) and 5 in quantitative synthesis (484 ears). NVC was as prevalent as 0.8-69% for affected ears and as 19-57% for controlled ears. No association between MRI protocol and NVC prevalence was proved. An odds ratio of 1.05 (95% confidence interval = 0.79-1.39) was calculated for association of NVC in unilateral SSNHL ears versus controls. The prevalence of NVC of CN8 in unilateral SSNHL affected ears is not significantly bigger than controls. Hence, NVC of CN8 is probably NOT associated with unilateral SSNHL.

Binaural Hearing Using the ADHEAR Bone Conduction System in the Monaurally Occluded Ear

Introduction: The study aimed to investigate binaural cues in the rehabilitation of unilateral occluded ears with a bone conduction hearing aid. Methods: The study sample consisted of 40 adult volunteers with normal hearing. Unilateral pseudo-conductive hearing loss was induced by inserting an earplug into the external auditory canal (EAC) and silicone material in the concha for ear impression. The adaptive speech-in-noise test (Italian Matrix test) was performed in three spatial orientations to assess binaural cues (summation, squelch, and head shadow effects). All evaluations were performed in the normal condition, after EAC occlusion, and after application of an adhesive bone conduction hearing aid. Binaural contrast differences were calculated in the three conditions. Results: In the EAC occlusion condition, there was a significant increase in the signal-to-noise ratio (SNR) in both the S₀N₀ (2.4 dB) and the S₉₀N₋₉₀ (7.7 dB) settings, and a slight albeit significant increase in the S₀N₉₀ setting (1.35 dB). After fitting the BC hearing aid, there was a reduction of −1.8 dB SNR (p < 0.001) in the S₀N₀ setting and −2 dB (p = 0.003) in the S₉₀N₋₉₀ setting. There was no improvement in the SNR (p = 0.405) in evaluation of the squelch effect (S₀N₉₀). These data were corroborated by a better binaural contrast due to a reduction in the summation effect in the monaural occlusion condition and a subsequent reduction in binaural contrast after fitting the hearing aid due to an increase in the summation effect (−2.5 dB vs. 0.3 dB; p < 0.001). Conclusions: Application of a bone conduction hearing aid in unilateral pseudo-conductive hearing loss strengthens speech recognition of noise by improving the summation effect and impeding the shadow effect of the head; however, there appears to be no improvement in speech perception in noise due to spatial release from masking.

Diagnostic and Therapeutic Challenges in a Case of Unilateral Red Ear.

Diagnostic and Therapeutic Challenges in a Case of Unilateral Red Ear.

Convolutional neural network model for evaluation of lasting behavioral changes in mouse with kanamycin-induced unilateral inner ear dysfunction

Convolutional neural network model for evaluation of lasting behavioral changes in mouse with kanamycin-induced unilateral inner ear dysfunction

Uncommon otological And Head & Neck Manifestations of Wegener's Granulomatosis: A Rare Case Report.

Wegener's granulomatosis is a necrotising vasculitis affecting both arterioles and venules. The classical triad involves acute inflammation of upper airway along with inflammation of lower respiratory tract and renal involvement,however other organ system may also be affected. Our patient presented with severe unilateral earache, ear discharge, hearing loss and ipsilateral facial nerve palsy as the manifestations of the disease, which are rarely reported in medical literature1.

Cardiovascular risk factors among patients with acute unilateral inner ear hypofunction: A case-control study.

To assess the prevalence of cardiovascular risk factors (CVRFs) and their impact on acute unilateral inner ear hypofunction (AUIEH), including acute unilateral peripheral vestibulopathy (AUPVP), sudden sensorineural hearing loss (SSNHL) and acute unilateral audiovestibular hypofunction (AUAVH). One hundred and twenty-five patients consecutively diagnosed with AUPVP, SSNHL or AUAVH and 250 sex- and age-matched controls were included. Cases presented a mean age of 58.6 ± 14.7 years and included 59 women and 66 men. The correlation between CVRFs (high blood pressure [HBP], diabetes mellitus [DM], dyslipidemia [DLP], cardiocerebrovascular disease [CCVD]) and AUIEH was assessed by multivariate conditional logistic regression analysis. A higher prevalence of CVRFs was identified in patients than in controls (30 individuals with DM, 53 with HBP, 45 with DLP and 14 with a previous history of CCVD, p < .05). A significantly elevated risk of AUIEH was found in patients with two or more CVRFs (adjusted odds ratio [OR] 5.11; 95% CI 2.23-11.70). Previous CCVD individually predicted AUIEH (OR 8.41; 95% CI 2.36-29.88). Subgroup analysis showed the same tendency for AUPVP and SSNHL. Acute unilateral inner ear hypofunction patients presented significantly more CVRFs than controls, and the presence of two or more CVRFs was associated with AUIEH. Future studies evaluating vascular risk in AUIEH may include AUPVP and SSNHL patients from the same source population to better characterize risk profiles that can indicate a vascular origin. 3b.

A Comparative Study of Tympanoplasty with or without Mastoidectomy in Tubotympanic Type of Chronic Suppurative Otitis Media

Background: One of the most frequent ear illnesses in underdeveloped countries is chronic suppurative otitis media (CSOM). In the treatment of CSOM, otolaryngologists debate whether to perform tympanoplasty with or without cortical mastoidectomy. Objective: To compare the outcome of tympanoplasty with or without cortical mastoidectomy in the treatment of tubotympanic type chronic suppurative otitis media. Methods: This comparative study was carried out in the Department of Otolaryngology - Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2017 to June 2019 over a period of 02 years. A total number of 60 patients who underwent type 1 tympanoplasty with or without cortical mastoidectomy were enrolled in this study. After enrollment the condition of the pinna, preauricular region, postauricular region and external auditory cannal were examined. On otoscopy, site and size of perforation of tympanic membrane, condition of the rest of the tympanic membrane, condition of the middle car mucosa and the ossicles were also examined. Tuning fork tests, test for facial nerve integrity and fistula test were performed. Hearing level was assessed by pure tone audiometry with masking. Enrolled patients were grouped into two groups. Patients who underwent type- 1 tympanoplasty alone kept in group A and who underwent type 1 tympanoplasty with cortical mastoidectomy kept in group B. Complete blood count, blood urea, serum creatinine, random sugar, ECG and X-ray chest P/A view were done routinely. Results: Females were 76.7% in group-A and 53.3% in group-B. All patients were of age between 16 to 60 years and most of them were in the age group of 21-30 years. Majority of the patients were from rural area and maximum patients were from middle class family. In most of the patients unilateral ear involvement was observed. Perforation site was central malleolar in maximum cases followed by anterior central and posterior central. Perforation size was ........

Outcome of Tympanoplasty with Cortical Mastoidectomy in Tubotympanic Type of CSOM

Background: Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in under developing countries. Otolaryngologists debate whether to perform tympanoplasty with or without cortical mastoidectomy when treating CSOM. Objective: To see the outcome of tympanoplasty with cortical mastoidectomy for hearing gain and grafting success. Methods: This observational study was carried out in the Department of Otolaryngology - Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2018 to June 2020. A total of 30 patients who underwent type 1 tympanoplasty with cortical mastoidectomy were enrolled in this study. Following enrollment, the condition of the pinna, preauricular region, postauricular region, and external auditory canal were examined. The location and extent of the tympanic membrane perforation, the state of the remaining tympanic membrane, the health of the middle ear mucosa, and the ossicles were all examined during the otoscopy. Tuning fork tests, tests for facial nerve integrity, and fistula tests were also carried out. The hearing level was assessed by pure-tone audiometry with masking. Results: Among 30 patients’ females were 53.3% and males were 46.7%. All of the patients ranged in age from 16 to 60, with the majority of them falling between the ages of 21 and 30. Most of the patients came from middle-class families, and the majority of patients were from rural areas. The majority of patients showed unilateral ear involvement. Most often, the central malleolar region was perforated, then the anterior central region and the posterior central region. The most frequent perforation size was medium, followed by small, large, and subtotal. The pre- treatment bone conduction threshold was 11.74± 4.42 dB, which was reduced to 10.14 ±3.70 dB after treatment (p&lt;0.05). The pre-treatment air conduction threshold was 39.78± 8.76 dB, which was reduced to 26.45 ±9.19 dB after treatment (p&lt;0.05). The pre-treatment air-bone ..

Oxytocin Disturbs Vestibular Compensation and Modifies Behavioral Strategies in a Rodent Model of Acute Vestibulopathy

Unilateral inner ear injury is followed by behavioral recovery due to central vestibular compensation. The therapeutic effect of oxytocin (OT) on vestibular compensation was investigated by behavioral testing in a rat model of unilateral vestibular neurectomy (UVN). Animals in the oxytocin group (UVN-OT) exhibited delayed vestibular compensation on the qualitative scale of vestibular deficits and aggravated static postural deficits (bearing surface) compared to animals in the NaCl group (UVN-NaCl). Surprisingly, oxytocin-treated animals adopt a different postural strategy than untreated animals. Instead of shifting their weight to the ipsilesional paws (left front and hind paws), they shift their weight to the front paws (right and left) without modification along the lateral axis. Furthermore, some locomotor strategies of the animals to compensate for the vestibular loss are also altered by oxytocin treatment. UVN-OT animals do not induce an increase in the distance traveled, their mean velocity is lower than that in the control group, and the ipsilesional body rotations do not increase from 7 to 30 days after UVN. This study reveals that oxytocin treatment hinders the restoration of some postural and locomotor deficits while improving others following vestibular lesions. The mechanisms of the action of oxytocin that support these behavioral changes remain to be elucidated.

Comparison Of Handicap Inventory Tinnitus Scores Before and After Intra Tympanic Steroid Injection In Tinnitus Patients

Introduction. Tinnitus is a symptom in the form of a conscious perception of sound that is not produced by a sound source outside the body. Patients with tinnitus often have complaints of quality of life, with some situations of extreme anxiety, depression, and life changes. The Tinnitus Handicap Inventory (THI) is a valid questionnaire to be associated with patients associated with tinnitus. The Tinnitus Research Initiative (TRI), an international academic organization founded in 2006, recommends the use of THI for the evaluation of tinnitus defects and therapeutic effects. Therefore, a THI assessment is needed at RSUP Dr. Mohammad Hoesin Palembang as a result of therapy. Methods. This research using a design that aims to determine the comparison of THI scores before and after intratympanic injection of corticosteroids in 18 samples at RSUP Dr. Mohammad Hoesin Palembang. Results. The average age of the sample was 57 (23-66) years and the number of men and women were the same, namely 9 (50%) samples. Most of the samples had problems in unilateral ears by 14 (77,8%) samples. The average THI before intratympanic steroid injection was 37 (12-72) and after injection was 20 (4-80). Wilcoxon test results showed significant changes between before and after intratympanic steroid injection. Conclusion. There was a significant improvement in THI scores after intratympanic steroid injection.

Development and validation of a clinical respiratory disease scoring system for guiding treatment decisions in veal calves using a Bayesian framework.

Active infectious bovine respiratory disease (BRD) is an infection of the airways that needs to be diagnosed correctly so that appropriate treatment can be initiated. The simplest and most practical test to detect active BRD in dairy calves raised for veal is the detection and interpretation of clinical signs by producers or technicians. However, the clinical scoring system currently available for veal calves lacks sensitivity and specificity, contributing to economic losses and high use of antimicrobials. An accurate and reliable batch-level test to detect active BRD is essential to tailor antimicrobial use and reduce economic losses in veal calves. The objective of this study was therefore to develop and validate a new veal calf respiratory clinical scoring system (VcCRS), including reliable clinical signs (cough, ear droop or head tilt) and increased rectal temperature to detect active BRD in batches of veal calves housed individually, and to describe the accuracy of the scoring system for identifying batches of veal calves to treat. During 2017 to 2018, clinical examination, thoracic ultrasonography (TUS) and a haptoglobin concentration (Hap) were prospectively performed on 800 veal calves housed individually in Québec, Canada. Deep nasopharyngeal swabs were performed on 250 veal calves. A Bayesian latent class model accounting for imperfect accuracy of TUS and Hap was used to obtain weights for the clinical signs and develop the VcCRS. The VcCRS was then validated externally in 3 separate data sets. Finally, the applicability of the VcCRS at batch level was determined. We found that calves with 2 of the following findings-cough, unilateral or bilateral ear droop or head tilt, or increased rectal temperature ≥39.7°C-were considered positive and had a 31% chance of having active BRD. Without at least 2 of these 2 findings, a calf had a 100% chance of not having active BRD. At the batch level, we found that a batch with ≥3 positive calves among 10 calves sampled 2 wk after arrival at the fattening unit had a 94% chance of having an active BRD prevalence ≥10%. A batch with <3 positive calves had a 95% chance of not having an active BRD prevalence ≥10%. In this study, we developed a simple individual and batch-level score that is reliable across examiners and performs effectively in the detection of active BRD in veal calves. The implementation of this VcCRS in the veal calf industry would promote the elaboration of a protocol tailoring antimicrobial use.

Use of 3-dimensional imaging and manufacturing for bilateral auricular prostheses: A case series of six patients with congenital auricular defects

The prosthetic reconstruction of unilateral ear deformity is a straightforward procedure which relies on copying the details, position, and symmetry of the existing contralateral ear. However, reconstructing bilaterally missing ears is challenging. The use of 3-dimensional (3D) technology in the prosthetic reconstruction of the bilaterally missing ears of 6 patients is described. The deformity site was created directly by segmenting the patient’s digital scan or indirectly via a desktop scanner. Adequate bone quantity and quality for implant retention and optimal implant locations were also identified virtually. The use of 3D technologies has made it more straightforward to accomplish ear symmetry, as well as to validate the orientation and location of the ears reliably with the minimum subjectivity. The printed ears were matched in shape, surface texture, and anatomy. The skin color was straightforward to record and store so that it could be reproduced at a future time. Overall, the digital manufacture of the ears was controlled, consistent, and reproducible.

Automatic segmentation of the core of the acoustic radiation in humans.

IntroductionAcoustic radiation is one of the most important white matter fiber bundles of the human auditory system. However, segmenting the acoustic radiation is challenging due to its small size and proximity to several larger fiber bundles. TractSeg is a method that uses a neural network to segment some of the major fiber bundles in the brain. This study aims to train TractSeg to segment the core of acoustic radiation.MethodsWe propose a methodology to automatically extract the acoustic radiation from human connectome data, which is both of high quality and high resolution. The segmentation masks generated by TractSeg of nearby fiber bundles are used to steer the generation of valid streamlines through tractography. Only streamlines connecting the Heschl's gyrus and the medial geniculate nucleus were considered. These streamlines are then used to create masks of the core of the acoustic radiation that is used to train the neural network of TractSeg. The trained network is used to automatically segment the acoustic radiation from unseen images.ResultsThe trained neural network successfully extracted anatomically plausible masks of the core of the acoustic radiation in human connectome data. We also applied the method to a dataset of 17 patients with unilateral congenital ear canal atresia and 17 age- and gender-paired controls acquired in a clinical setting. The method was able to extract 53/68 acoustic radiation in the dataset acquired with clinical settings. In 14/68 cases, the method generated fragments of the acoustic radiation and completely failed in a single case. The performance of the method on patients and controls was similar.DiscussionIn most cases, it is possible to segment the core of the acoustic radiations even in images acquired with clinical settings in a few seconds using a pre-trained neural network.

P270 Otomycosis: Main challenging microbial agent causing otitis externa in northern Iran

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PMObjectivesOtitis externa is one of the most common ear diseases, caused by bacterial and fungal agents. Accumulation of epithelial cells, cellular detritus, waxy substances, and microorganisms in the ear canal provide a proper environment for fungal growth, leading to annoying congestion. In this study, we aimed to identify the fungal causative agents and determine their susceptibility to the antifungal drugs were examined.MethodsAll patients with suspected otitis externa, referred to Amir-al Momenin Referral Centre from October 2020 to November 2021 entered to study. A total of 200 patients’ ear discharge and debris collected samples were examined by direct examination and cultured on SDA supplemented with chloramphenicol. Definitive identification of grown fungi was made by PCR-RFLP and sequencing of ribosomal DNA. In vitro susceptibility testing of the fungal isolates against eleven different antifungal agents was analyzed using the CLSI broth microdilution methods.ResultsA total of 101 (50.5%) cases were confirmed with otomycosis. Most patients were in their fifth decade of life (n = 35, 34.6%), female (n = 57, 56.4%), and had unilateral ear involvement (n = 78, 77.2%). The most common symptoms were earache (56.4%) and itching (51.4%). Most underlying predisposing factors are overaggressive using cotton swabs (65.3%) and history of topical antibiotics (48.5%). Among the 117 fungal isolates, Aspergillus section Nigri was the most common agent 58 (49.57%), followed by Aspergillus section Flavi 19 (16.23%), C. parapsilosis 14(11.96%), Aspergillus section Fumigati 12 (10.25%), C. orthopsilosis 6 (5.12%), C. albicans complex 5 (4.27%), Mucor spp. 2 (1.71%), and Syncephalastrum spp. 1 (0.85%). Mainly, all tested antifungals were active against the most isolates of Aspergillus, aside from tioconazole, nystatin, and terbinafine, which showed low in vitro effects. Also, nystatin and itraconazole showed higher GM MICs in against all Candida species isolates. Conversely, amphotericin B (GM = 0.07129) in Aspergillus and voriconazole (GM = 0.03686) in Candida showed the highest antifungal activity. Regarding ECV values represented by ECOFFs, one of each A. niger (MIC 8 μg/mL), A. flavus (MIC 2 μg/ml), and A. fumigatus (MIC 2 μg/ml) isolates were resistant to itraconazole.ConclusionIn this study, inconsistent with previous ones, fungal agents have overcome bacterial ones as the etiology of otitis externa. This result may relate to misuse or improper use of topical steroids, antibiotics, and inappropriate control of infection. In addition, our sample collection site was an ENT referral center and many patients have been admitted to this center due to treatment failure and suffered from recurrence. Aspergillus section Nigri isolation domination was seen, in agreement with other results. The MICs distribution of Aspergillus species isolates against triazole antifungals are close to ECVs defined by the CLSI and likely outrun it over time. We recommend that physicians request drug susceptibility testing before antibiotic therapy, to prevent the development of resistance.

Developmental eye motion plasticity after unilateral embryonic ear removal in Xenopus laevis

SummaryGaze stabilization relies on bilateral mirror-symmetric vestibular endorgans, central circuits, and extraocular motor effectors. Embryonic removal of one inner ear before the formation of these structures was used to evaluate the extent to which motor outputs in the presence of a singular inner ear can develop. Near-congenital one-eared tadpoles subjected to separate or combinatorial visuo-vestibular motion stimulation exhibited comparable eye movements, though smaller in gain to controls, whereas isolated visuo-motor responses were unaltered. Surprisingly, vestibulo-ocular reflexes were robust during off-direction motion toward the missing ear in most cases and often attenuated during on-direction motion. This bidirectional plasticity of signal encoding appears to occur at the expense of vestibular reflexes during motion in the normally preferential activation direction of the singular ear. Consequently, formation of central vestibulo-motor circuits in one-eared animals likely relies on multi-neuronal homeostatic strategies, including enhanced afferent fiber activity in the attempt to adjust bilateral sensorimotor transformations.

Assessment of the Vestibuloocular Reflex in Patients with Unilateral Chronic Middle Ear Disease Using the Video Head Impulse Test: A Preliminary Study

Objectives: This study aims to investigate the usefulness of the video head impulse test (vHIT) as a method for evaluating vestibular function in patients with unilateral chronic middle ear disease.Methods: Nineteen patients with various unilateral middle ear diseases including chronic otitis media (COM), COM with cholesteatoma, and adhesive otitis media successfully underwent preoperative vHIT. The gain of vestibuloocular reflex (VOR) and the presence of corrective saccades were compared between the affected ear and the healthy ear.Results: A total of eight male and 11 female patients with a mean age of 43.1 years were included in this retrospective study. Twelve ears had COM, four had COM with cholesteatoma, and three had adhesive otitis media. A positive history of vertigo or dizziness was reported in 36.8% of the cases. The VOR gain of the affected ears and the healthy ears were 0.97±0.16 vs. 1.00±0.08 in the horizontal canal, 0.91±0.11 vs. 0.87±0.11 in the anterior canal, and 0.87±0.17 vs. 0.99±0.12 in the posterior canal, respectively. Only VOR gain of the posterior canal was significantly decreased compared with healthy ears.Conclusions: The average VOR gains in the patients with chronic middle ear disease were within the pre-defined values of normality; however, when compared quantitatively, posterior canal gain of affected ears was significantly decreased compared to healthy ears. Our results can be explained by the anatomical proximity of the ampulla of the posterior canal and middle ear space.

Progression of Contralateral Hearing Loss in Patients with Unilateral Ear Involvement: A Scoping Review

Background:Progression of contralateral hearing loss following otologic and neuro-otologic surgeries is a distressing and rare complication. The aim of this study was to systematically review the suspected etiologies and audiological findings in adults who experienced contralateral hearing loss.Methods:PubMed/MEDLINE, PsycINFO, CINAHL, ISI Web of Science, Cochrane Library, EMBASE, and Scopus databases were searched for this scoping review. The current review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. No limits were placed on language or year of publication.Results:Of a total of 46 studies, 43 studies met the inclusion criteria reporting contralateral hearing loss. The included studies were classified into 3 different categories: contralateral hearing loss after skull base surgeries (n = 21), contralateral hearing loss after middle ear surgeries (n = 17), and contralateral hearing loss after traumatic lesions (n = 5). The cerebrospinal fluid leakage and drill-generated noise were reported as the most reported etiology of contralateral hearing loss following skull base and middle ear surgeries, respectively. The onset of contralateral hearing loss varied from immediately to 18 months after surgery. The severity of contralateral hearing loss varied from a slight to a profound degree of hearing loss.Conclusion:Our results highlighted that contralateral hearing loss should be considered following the skull base and middle ear surgeries. Furthermore, this rare complication should be noticed after traumatic lesions.

Pediatrics ear syringing in a tertiary health institution of a developing country: Our experience

Ear syringing is a common otologic procedure in otorhinolaryngologic practice worldwide. This study aimed at determining the prevalence, indications, contraindications, complications and sources of referral that are associated with ear syringing among children in a tertiary health institution of a developing country. This was a retrospective study of all patients that had ear syringing in the Ear, Nose and Throat department of our center over two years. Data was analyzed using SPSS version 18.0. Statistical significance was set at pvalue ≤0.05. There were 176 (59.9%) male participants with a male to female ratio of 1.5:1. The prevalence of ear syringing in children less than 18 years was 9.1%. Main indications for ear syringing were impacted earwax 173 (58.8%), impacted foreign body in the ear 62 (21.1%), fungal debris 41 (13.9%) and dried pus debris (post otitis externa) 15 (5.1%). Unilateral ear syringing 227 (77.2%) was more common than bilateral ear syringing 67 (22.8%), with the right ear syringing done in138 (46.9%). The majority 201 (68.4%) of the earsyringing was done by specialist ENT nurses and 86 (29.3%) by resident doctors. Two hundred and nineteen (74.5%) were performed in outpatient clinics while 67 (22.8%) were in the emergency ward. Relative contra-indications to ear syringing occurred in 184 (62.9%). Some of the contraindications were hard impacted earwax and acute otitis externa in 132 (44.9%) and 42 (14.3%) respectively. Complications occurred in 63 (21.4%) and these were failed procedures in 26 (8.8%), otalgia in 9 (3.1%), and irritating cough 9 (3.1%). The main sources of referral were Family physicians in 82 (27.9%) and Paediatricians in 76 (25.9%). Prevalence of pediatric ear syringing was 9.1%. Common indications are preventable diseases. The procedure appears very simple, but it is associated with some complications.