DOCSLIB.ORG

A Giant Cholesteatoma of the Mastoid Extending Into the Foramen

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
A Giant Cholesteatoma of the Mastoid Extending Into the Foramen Neurology International 2018; volume 10:7625 A giant cholesteatoma of the mastoid extending into Introduction Correspondence: Yuekang Zhang, Department of Neurosurgery, Post Graduate Training the foramen magnum: Cholesteatomas are benign, slowly pro- Centre, West China Hospital, Sichuan gressive lesions that are usually found in the University; 37 Guo Xue Xiang Road, A case report and review 1-5 temporal bone. They are epidermoid Chengdu, Sichuan 610041, P.R. China. of literature cysts of embryologic origin that result in Tel.: +86.18980601975 - Fax: +86.02885422490. progressive desquamation and trapping of E-mail: [email protected] Seidu A. Richard,1-3 Li Qiang,1 squamous epithelium behind an intact tym- panic membrane.6 They can be congenital Key words: Cholesteatoma, Case report, Zhi Gang Lan,1 Yuekang Zhang,1 or acquired.1,4,5 They can be classified into Dizziness, Epidermoid Cyst, Hearing loss, Chao You1 supralabyrinthine, infralabyrinthine, mas- Tinnitus. 1Department of Neurosurgery, West sive labyrinthine, infralabyrinthine-apical, Contributions: SAR conceived the project and and apical.1,4 They have the penchant for China Hospital, Sichuan University, designed the study; SAR, LQ and ZQL col- 2 China; Department of Immunology, the petrous apex, skull base, and internal lected patient’s data; YZ and CY provided Jiangsu University, China; 3Department auditory canal. Also, these lesions may technical assistance in the study; SAR pre- of Surgery, Volta Regional Hospital, Ho, infiltrate other vital soft tissue structures pared the illustration, analyzed data and wrote such as the sigmoid sinus, jugular vein and Ghana the paper. artery, and the cerebellopontine angle.1,4,5 Symptoms associated with cholesteatomas Conflict of interest: the authors declare no includes vertigo, tinnitus, otorrhea, and potential conflict of interest. otalgia.1,7 To the best of our understanding Abstract no data has reported cholesteatoma that Funding: none. extends from the temporal bone into the Cholesteatomas are very rare benign, Received for publication: 31 January 2018. foramen magnum. We therefore present a progressive lesions that have embryologic Accepted for publication: 4 February 2018. case of cholesteatoma extending down into only derivation and usually result in progressive the foramen magnum and review of litera- This work is licensed under a Creative exfoliation and confinement of squamous ture on the pathogenesis of cholesteatoma. Commons Attribution NonCommercial 4.0 epithelium behind an intact or preciously License (CC BY-NC 4.0). infected tympanic membrane. To the best of use our understanding no reports demonstrates ©Copyright S.A. Richard et al., 2018 the extension of cholesteatoma from the Case Report Licensee PAGEPress, Italy Neurology International 2018; 10:7625 temporal bone into the foramen magnum. We present a case of 67-year-old man doi:10.4081/ni.2018.7625 We therefore present a case of with recurrent tinnitus in the left ear and cholesteatoma extending down into the dizziness for over one-year duration. He foramen magnum. We report a case of 67- had mild unilateral hearing loss, no otor- year-old man with a giant cholesteatoma rhea, vertigo, pain, cognitive impairment, with mild obstructive hydrocephalus. Left extending into the foramen magnum with- vomiting, facial numbness, hypoesthesia, frontal white matter showed a spotty lesion out substantial destruction of the mastoid blurred vision, choking and movement dis- that is hypo-intense on T1 and Hyper- and petrous temporal bones. The patient’s orders. Past history of ear infection was intense on T2 which could be the beginning major symptoms were recurrent tinnitus in unremarkable. All other systems were unre- of mild degenerative process. There were the left ear and dizziness with unilateral markable. There was no family history of no abnormalities on the temporal bone and conductive hearing loss. A working diagno- such disease. He did not have any ear sur- for that matter the whole skull. A working sis of cholesteatomas was made combining geries prior to the presentation. On exami- diagnosis epidermoid or arachnoid cyst was the symptoms and magnetic resonance nation, there were no obvious deformities made combining the symptoms and MRI imaging findings. He was then successfullyNon-commercialaround the ears. Otoscopy revealed an intact findings (Figure 1). operated on with very minimal postopera- tympanic membrane with no visible pathol- After general anesthesia, the patient tive complications. Cholesteatomas origi- ogy in the mesotympanum. Examination of was put in the park-bench position. Routing use of inferior cranial nerves monitoring nating from the mastoid bone often linger cranial nerves was unremarkable. such as electromyographic (EMG) and with the patients for many years in a sub- Audiometry demonstrated total hearing loss auditory brainstem responses (ABRs) was clinical state and progress into a massive with reduced middle ear compliance in the left ear. All laboratory investigations as well carried out to maximize the preservation of size before causing symptoms. Patients with as other ancillary investigations (CXR, the cranial nerves. We used the suboccipital unilateral conductive hearing loss who are ECG etc) were normal. paramedian approach. A linear suboccipital otherwise asymptomatic and have a normal Pre-operative MRI done showed a paramedian incision was made and extend- tympanic membrane should be suspected lesion that is hypo-intense on T1, hyper- ed down to the occipital hairline. A high- with a progressive cholesteatoma. intense on T2 and hypointensive on FLAIR speed miller was used to perform a suboc- Cholesteatoma should be one of the work- and showed no enhancement with gadolini- cipital paramedian craniotomy. ing diagnosis when an elderly patient pres- um administration. The lesion was about Additionally, posterior rim of foramen mag- ent with unilateral conductive hearing loss 3.0×2.5×2.5 cm in diameter. The lesion dis- num and the lamina of C1 were also that is associated with tinnitus and dizzi- placed the medulla oblongata to the right removed to gain wider exposure of the ness. side and compressed the bilateral cerebel- lesion. After placing several tack-up stitches lum hemispheres. The third, fourth and to the dura, the lesion was observed lying bilateral ventricles are slightly enlarged between jugular foramen and the foramen [page 28] [Neurology International 2018; 10:7625] Case Report magnum. The lesion was about 3.0×2.5×2.5 pathogenesis which includes: i) the exis- acquired cholesteatoma still remains to be cm in diameter. The microscope was used tence of an ectopic epidermis rest, ii) in- distinctly clarified, it is believed to be mul- throughout the operation. The lesion was growth of meatal epidermis, iii) metaplasia tifactorial, as many theories have been rec- completely suctioned out without any cra- following infection/inflammation, and fas- ommended and researched on.13 It has been nial nerves dysfunction. Post-operative CT- cinatingly, iv) reflux of amniotic fluid con- demonstrated that iatrogenic or non-iatro- scan done confirmed total resection of the taining squamous epithelium in utero into genic tympanic membrane trauma such as lesions with very slight edema around the the middle ear. Nonetheless, the epithelial perforation, displacement, retraction or brain stem (Figure 2). Samples of the lesion rest theory is generally accepted.13 invagination, tympanic membrane disease, are as shown in (Figure 3). Pathology report Congenital cholesteatomas in the middle tympanic cavity mucosa disease, ear infec- confirmed cholesteatoma or epidermoid ear frequently present with cunning hearing tion, and Eustachian tube dysfunction are cyst (Figure 4). The patient had a good loss during childhood years and are usually likely to initiate acquired cholesteatoma recovery and discharge home on the seventh found incidentally behind the tympanic pathogenesis.13,15 The pathogenesis of day after operation. Hearing improved membrane during routine otoscopy.2,14 acquired aural cholesteatoma has also been markedly. A scheduled review was arranged Nevertheless, congenital cholesteatomas explained by four basic theories: i) invagi- on the third month after operation. One and may be absolutely asymptomatic, particu- nation of the tympanic membrane (retrac- half year follow-up show no recurrence of larly when their origin is from the mastoid tion pocket cholesteatoma), ii) basal cell the lesion. where the diagnosis occurs only as an inci- hyperplasia, iii) epithelial in-growth dental finding on imaging hence the diagno- through perforation (the migration theory), sis is often belated until mid to late adult- and iv) squamous metaplasia of middle ear hood because of the asymptomatic nature of epithelium.13 The most widely accepted Discussion the disease.2,14 In such cases, the most com- pathogenesis of acquired cholesteatoma is mon symptoms are dizziness, pain, or the theory that negative pressure causes a Cholesteatomas or epidermoid cysts swelling that may be localized to the tempo- deepening retraction pocket that, when originate from progressive desquamation of ral area of the head or to the neck.2,14 obstructed, desquamated keratin cannot be the epithelium.1,2,4,5,7 They are classified Even though the pathophysiology of the cleared from the recess, and cholesteatoma into congenital or acquired base on their only pathogenesis.1,4,5 In our case, it was very difficult to arrive at a definitive conclusion on whether the lesion is congenital
Load more

Recommended publications
  • BMC Ear, Nose and Throat Disorders Biomed Central
    BMC Ear, Nose and Throat Disorders BioMed Central Case report Open Access Acute unilateral hearing loss as an unusual presentation of cholesteatoma Daniel Thio*1, Shahzada K Ahmed2 and Richard C Bickerton3 Address: 1Department of Otorhinolaryngology, South Warwickshire General Hospitals NHS Trust Warwick CV34 5BW UK, 2Department of Otorhinolaryngology, South Warwickshire General Hospitals NHS Trust Warwick CV34 5BW UK and 3Department of Otorhinolaryngology, South Warwickshire General Hospitals NHS Trust Warwick CV34 5BW UK Email: Daniel Thio* - [email protected]; Shahzada K Ahmed - [email protected]; Richard C Bickerton - [email protected] * Corresponding author Published: 18 September 2005 Received: 10 July 2005 Accepted: 18 September 2005 BMC Ear, Nose and Throat Disorders 2005, 5:9 doi:10.1186/1472-6815-5-9 This article is available from: http://www.biomedcentral.com/1472-6815/5/9 © 2005 Thio et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Cholesteatomas are epithelial cysts that contain desquamated keratin. Patients commonly present with progressive hearing loss and a chronically discharging ear. We report an unusual presentation of the disease with an acute hearing loss suffered immediately after prolonged use of a pneumatic drill. Case presentation: A 41 year old man with no previous history of ear problems presented with a sudden loss of hearing in his right ear immediately following the prolonged use of a pneumatic drill on concrete.
    [Show full text]
  • Cholesteatoma Handout
    Cholesteatoma Handout A cholesteatoma is a skin growth that occurs in an abnormal location, usually in the middle ear space behind the eardrum. It often arises from repeated or chronic infection, which causes an in-growth of the skin of the eardrum. Cholesteatomas often take the form of a cyst or pouch that sheds layers of old skin that build up inside the ear. Over time, the cholesteatoma can increase in size and destroy the surrounding delicate bones of the middle ear. Hearing loss, dizziness, and facial muscle paralysis are rare but can result from continued cholesteatoma growth. What are the symptoms? Initially, the ear may drain fluid, sometimes with a foul odor. As the cholesteatoma pouch or sac enlarges, it can cause a full feeling or pressure in the ear, along with hearing loss. Dizziness, or muscle weakness on one side of the face can also occur. Is it dangerous? Ear cholesteatomas can be dangerous and should never be ignored. Bone erosion can cause the infection to spread into the surrounding areas, including the inner ear and brain. If untreated, deafness, brain abscess, meningitis, and rarely death can occur. What treatment can be provided? Initial treatment may consist of a careful cleaning of the ear, antibiotics, and ear drops. Therapy aims to stop drainage in the ear by controlling the infection. The extent or growth characteristics of a cholesteatoma must then be evaluated. Cholesteatomas usually require surgical treatment to protect the patient from serious complications. Hearing and balance tests and CT scans of the ear may be necessary. These tests are performed to determine the hearing level remaining in the ear and the extent of destruction the cholesteatoma has caused.
    [Show full text]
  • Bedside Neuro-Otological Examination and Interpretation of Commonly
    J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.2004.054478 on 24 November 2004. Downloaded from BEDSIDE NEURO-OTOLOGICAL EXAMINATION AND INTERPRETATION iv32 OF COMMONLY USED INVESTIGATIONS RDavies J Neurol Neurosurg Psychiatry 2004;75(Suppl IV):iv32–iv44. doi: 10.1136/jnnp.2004.054478 he assessment of the patient with a neuro-otological problem is not a complex task if approached in a logical manner. It is best addressed by taking a comprehensive history, by a Tphysical examination that is directed towards detecting abnormalities of eye movements and abnormalities of gait, and also towards identifying any associated otological or neurological problems. This examination needs to be mindful of the factors that can compromise the value of the signs elicited, and the range of investigative techniques available. The majority of patients that present with neuro-otological symptoms do not have a space occupying lesion and the over reliance on imaging techniques is likely to miss more common conditions, such as benign paroxysmal positional vertigo (BPPV), or the failure to compensate following an acute unilateral labyrinthine event. The role of the neuro-otologist is to identify the site of the lesion, gather information that may lead to an aetiological diagnosis, and from there, to formulate a management plan. c BACKGROUND Balance is maintained through the integration at the brainstem level of information from the vestibular end organs, and the visual and proprioceptive sensory modalities. This processing takes place in the vestibular nuclei, with modulating influences from higher centres including the cerebellum, the extrapyramidal system, the cerebral cortex, and the contiguous reticular formation (fig 1).
    [Show full text]
  • Cochlear Implants in Unilateral Hearing Loss for Tinnitus Suppression
    Central Annals of Otolaryngology and Rhinology Review Article *Corresponding author Mohamed Salah Elgandy, Department of Otolaryngology-Head and Neck Surgery, University of Cochlear Implants in Unilateral Iowa hospital and clinics, 200 Hawkins drive, Iowa, Iowa City 52242.PFP 21167, USA, Tel; +1(319)519-3862; Email; Hearing Loss for Tinnitus Submitted: 19 January 2019 Accepted: 06 February 2019 Suppression Published: 08 February 2019 ISSN: 2379-948X 1,2 2,3 Mohamed Salah Elgandy *and Richard S. Tyler Copyright 1Department of Otolaryngology-Head and Neck Surgery, Zagazig University, Egypt © 2019 Elgandy et al. 2Department of Otolaryngology-Head and Neck Surgery, University of Iowa, USA 3Department of Communication Sciences and Disorders, University of Iowa, USA OPEN ACCESS Keywords Abstract • Unilateral hearing loss Tinnitus is a pervasive symptom that can affect many people with hearing loss. • Tinnitus It is found that its incidence is increasing due to accompanying occupational and • Electrical stimulation environmental noise. Even, there is no standard treatment is present up till now, but • Cochlear implants cochlear implants (CIs) positive effects are well proven and documented. This article provides an overview of many publicly available reports about cochlear implants and tinnitus, with review of several articles demonstrating the benefit of cochlear implants for unilateral hearing loss and tinnitus. We believe that this approach will help many, and should be considered as standard practice and reimbursed. INTRODUCTION An increase in rate. Unilateral hearing loss affecting approximately18.1 million • Decrease in rate persons in the United States [1]. Patients with unilateral deafness • Periodic activity frequently also experience tinnitus, which can have a profound • Synchronous activity cross neurons has been associated with an increased incidence of depression, impact on an individual’s quality of life.
    [Show full text]
  • Chronic Suppurative Otitis Media PETER MORRIS, Menzies School of Health Research, Casuarina, Northern Territory, Australia
    Clinical Evidence Handbook A Publication of BMJ Publishing Group Chronic Suppurative Otitis Media PETER MORRIS, Menzies School of Health Research, Casuarina, Northern Territory, Australia This is one in a series of Chronic suppurative otitis media causes We do not know whether tympanoplasty chapters excerpted from recurrent or persistent discharge (otorrhea) with or without mastoidectomy improves the Clinical Evidence Handbook, published by through a perforation in the tympanic mem- symptoms compared with no surgery or the BMJ Publishing Group, brane, and can lead to thickening of the other treatments in adults or children with London, U.K. The medical middle ear mucosa and mucosal polyps. It chronic suppurative otitis media. information contained herein is the most accurate usually occurs as a complication of persistent Cholesteatoma is an abnormal accumula- available at the date of acute otitis media (AOM) with perforation tion of squamous epithelium usually found publication. More updated in childhood. in the middle ear cavity and mastoid process and comprehensive infor- Chronic suppurative otitis media is a of the temporal bone. Granulation tissue mation on this topic may • be available in future print common cause of hearing impairment, dis- and ear discharge are often associated with editions of the Clinical Evi- ability, and poor scholastic performance. secondary infection of the desquamating dence Handbook, as well Occasionally it can lead to fatal intracranial epithelium. as online at http://www. infections and acute mastoiditis, especially Cholesteatoma can be congenital (behind clinicalevidence.bmj.com (subscription required). in developing countries. an intact tympanic membrane) or acquired. In children with chronic suppurative oti- If untreated, it may progressively enlarge and A collection of Clinical tis media, topical antibiotics may improve erode the surrounding structures.
    [Show full text]
  • 32 3. UNADDRESSED HEARING PROBLEMS This Section Contains
    3. UNADDRESSED HEARING PROBLEMS This section contains: a description of the types of hearing problems that affect children; the prevalence of hearing problems; unmet needs for hearing screening, diagnosis and treatment; and evidence on the learning consequences of unaddressed hearing problems. Definitions Normal hearing was defined in 1965 by the American Academy of Ophthalmology and Otolaryngology (AAOO) as any hearing loss up to 26 dB. This level of hearing loss is the point at which an individual begins to find it difficult to understand typical speech in a quiet environment. The AAOO guidelines around normal hearing have not changed since this cutoff was established and are supported by the American Medical Association and the American Academy of Audiology. Hearing deficits are categorized and defined in various ways, and there is variation in defining levels of hearing loss across countries, states, and health care providers. There are no widely agreed upon definitions for all types and levels of hearing loss. The American Speech-Language-Hearing Association (ASHA) categorizes and defines hearing loss primarily by type, degree, and configuration.103 Type of Hearing Loss (as defined by ASHA) ● Sensorineural hearing loss (SNHL) is the most common type of permanent hearing loss and “happens when there is damage to the inner ear (cochlea) or to the nerve pathways from the inner ear to the brain.” Audible speech may be unclear or sound muffled. This type of hearing loss can usually not be corrected with medical treatment or surgery. SNHL can be caused by: ○ Drugs that are toxic to hearing ○ Hearing loss that runs in the family (genetic or hereditary) ○ Head trauma ○ Malformation of the inner ear ○ Exposure to loud noise ● Conductive hearing loss “occurs when sound is not sent easily through the outer ear canal to the eardrum and the tiny bones (ossicles) of the middle ear.” Sounds will seem softer and less easy to hear.
    [Show full text]
  • A Unilateral Cochlear Implant for Tinnitus
    REVIEW PAPER DOI: 10.5935/0946-5448.20180022 International Tinnitus Journal. 2018;22(2):128-132. A Unilateral Cochlear Implant for Tinnitus Mohamed Salah Elgandy1 Richard Tyler2,3 Camille Dunn2 Marlan Hansen2 Bruce Gantz2 Abstract In recent years a growing number of Patients with unilateral hearing loss have been undergoing cochlear implantation. We provide an overview of the efficacy of cochlear implants (CIs) to rehabilitate patients with unilateral deafness with regards to sound localization, speech recognition, and tinnitus. Although CI is not yet an FDA-approved treatment for unilateral deafness, several recent studies show improvements in speech understanding, sound localization, and tinnitus. Based on encouraging results and the unique ability to restore binaural sound processing, the benefits to many as an aid to their tinnitus, we argue that CIs should be offered as a treatment for unilateral deafness. Keywords: hearing loss, tinnitus, electrical stimulation, cochlear implants. 1Department of Otolaryngology-Head and Neck Surgery, Zagazig University, Egypt 2Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, USA 3Department of Communication Sciences and Disorders, University of Iowa, Iowa City, USA Send correspondence to: Mohamed Salah Elgandy Department of Otolaryngology-Head and Neck Surgery, Zagazig University, Egypt. E-mail: [email protected] Paper submitted to the ITJ-EM (Editorial Manager System) on August 30, 2018; and accepted on September 10, 2018. International Tinnitus Journal, Vol. 22, No 2 (2018) 128 www.tinnitusjournal.com INTRODUCTION disturbances. It is important to note that the therapy in these situations is for depression and anxiety, not tinnitus. Unilateral hearing loss implies a profound sensori- neural hearing loss in one ear and no greater than a mild As with any bothersome, common disorder that lacks hearing loss in the opposite ear.
    [Show full text]
  • Research Dissertation Title: the Pattern of Hearing Loss As Seen at the University of Benin Teaching Hospital, Benin City
    RESEARCH DISSERTATION TITLE: THE PATTERN OF HEARING LOSS AS SEEN AT THE UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN CITY. BY DR. PAUL R O C ADOBAMEN ADDRESS: ENT UNIT, DEPARTMENT OF SURGERY, UBTH, BENIN CITY. A RESEARCH DISSERTATION, SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE AWARD OF FMCORL OF THE NATIONAL POST GRADUATE MEDICAL COLLEGE OF NIGERIA. MAY 2006. 1 CANDIDATE’S DECLARATION I, Dr. Adobamen P R O C hereby declare that: “The pattern of hearing loss as seen at the University of Benin Teaching Hospital, Benin City”; - Is an original prospective work done by me as the sole author and assistance received is duly acknowledged. - This work has not been previously submitted either in part or in full to any other College for a Fellowship nor has it been submitted elsewhere for publication. SIGNATURE------------------------ DATE------------------------------- 2 CERTIFICATION This study titled: “The pattern of hearing loss as seen at the University of Benin Teaching Hospital (UBTH), Benin City” was done by Dr. Adobamen P R O C under our supervision. We also supervised the writing of this dissertation. 1. NAME: Prof. F O Ogisi. FRCS, FICS, FWACS, FMCORL, DLO. STATUS: CONSULTANT OTORHINOLARYNGOLOGIST, HEAD AND NECK SURGEON, PROFESSOR. ADDRESS: DEPARTMENT OF SURGERY, U. B. T. H., BENIN CITY, NIGERIA. SIGNATURE:------------------------------------------------------ DATE:------------------------------------------------------------ 2. NAME: PROF B C EZEANOLUE. FMCORL, FWACS, FICS STATUS: CONSULTANT OTORHINOLARYNGOLOGIST, HEAD AND NECK SURGEON, ASSOCIATE. PROFESSOR. ADDRESS: DEPARTMENT OF OTOLARYNGOLOGY, U.N.T.H., ENUGU, NIGERIA. SIGNATURE:------------------------------------------------------ DATE:------------------------------------------------------------ 3 DEDICATION This book is dedicated to the bride of Jesus Christ; for their gallant stand for the Word of God.
    [Show full text]
  • Hearing Loss and Auditory Disorders: Outside the Clinic
    Hollea Ryan, Au.D., Ph.D., CCC-A Audiology Program Director, Samford University Bethany Wenger, Au.D., CCC-A Pediatric Audiologist, Vanderbilt University Disclaimers • Hollea Ryan is employed by Samford University and receives financial compensation for her work. No conflict of interest exists for this presentation. • Bethany Wenger is employed by Vanderbilt University Medical Center and receives financial compensation for her work. She has previously worked as a consultant for a hearing protection device company and was financially compensated. No conflict of interest exists for this presentation. Hearing Loss and Auditory Disorders:Hearing Loss Outside and Auditorythe Clinic Disorders: Outside the Clinic AGENDA • Unilateral Hearing Loss • Minimal (Bilateral) Hearing Loss • Auditory Disorders • Non-clinical Settings • Noise-Induced Hearing Loss Learning Objectives At the completion of this presentation, the participant will be able to: 1) Detail current research findings regarding children with minimal hearing loss and/or noise-induced hearing loss. 2) Identify non-academic settings in which children with hearing loss struggle. 3) Summarize various treatment options for children with hearing loss that improve communication, academic performance, and/or quality of life. What the Literature is Indicating about Minimal/Unilateral Hearing Loss Hearing Care Practices Before and After UNHS (Fitzpatrick, Whittingham, & Durieux-Smith, 2013; Fitzpatrick, Durieux-Smith, & Whittingham, 2010) • Retrospectively evaluated 20 years of history related
    [Show full text]
  • Glossary the Following List of Terms May Be Useful to You As You Are Learning About Hearing Loss
    glossary The following list of terms may be useful to you as you are learning about hearing loss. For a comprehensive explanation please refer to the Choices booklet. This will give you detailed information on hearing loss, amplification and communication options. Semicircular canals Hammer Anvil 4. Then the auditory nerve takes the message to the brain. Outer ear Stirrup 1. The sound makes the eardrum vibrate Cochlea Inner ear Sound waves . The bones make the 2. The eardrum makes 3 fluid move and the hair the bones vibrate cells bend. Ear drum Middle ear Eustachian tube to the throat a Acoustic nerve / auditory nerve Atresia / aural atresia The acoustic nerve is a combination of the nerves Aural atresia involves some degree of failure of of hearing (the cochlear nerve) and balance (the development of the ear canal. It can also affect the vestibular nerve). The cochlear nerve carries ear drum (tympanic membrane), the tiny bones in the information about hearing to the brain, and the middle ear (ossicles), and the middle ear space. The vestibular nerve carries messages about balance pinna (outer ear) is often also affected, but the inner to the brain (see diagram above). ear (cochlea) is not usually affected. Aural atresia most commonly occurs in one ear only, but can also Acquired hearing loss / deafness occur in both ears. See ‘hearing loss, acquired’. Audiogram Amplification An audiogram is a chart used to show the results of Amplification is any process that makes a sound a hearing test. It shows what level of loudness a child louder. Hearing aids are an example of a device used can hear sounds of different pitches at.
    [Show full text]
  • Giant Congenital Cholesteatoma of the Temporal Bone
    Global Journal of Otolaryngology ISSN 2474-7556 Case Report Glob J Otolaryngol Volume 18 Issue 5 - January 2019 Copyright © All rights are reserved by Cristina Laza DOI: 10.19080/GJO.2019.18.555998 Giant Congenital Cholesteatoma of the Temporal Bone Cristina Laza* and Eugenia Enciu Clinical county hospital for emergencies Constanta, Romania Submission: December 15, 2018; Published: January 03, 2019 *Corresponding author: Cristina Laza, Clinical county hospital for emergencies Constanta, Romania Abstract Congenital or primitive cholesteatoma is a benign disease with slow progressive growth that destroys neighboring structures. It is a rare disease considered an epidermal cyst originating from the remnants of squamous keratinized epithelium, in several regions of the temporal bone such as in the middle ear (most frequent) as well as in the petrous apex, cerebellopontine cistern, external acoustic meatus and mastoid process. In this case report, we present a giant congenital cholesteatoma, occupying a part of the petrous part of the temporal bone, including middle ear and mastoid process discovered at a 12-years-old girl as an acute right otomastoiditis complicated with retro auricular abscess. There were no history of ear infections, trauma or previous surgeries on this area, the eardrum was intact, all the accusing starts after an infection of the naos- pharynx –typical for congenital cholesteatoma. In emergency using a retro auricular approach we drain the abscess located sub-periosteal a minutia’s excision of the cholesteatoma and a permanent follow up recurrence was discovered after 4 years at 16 years old –without signs of infectionand finally but we with remove tinnitus the andcholesteatoma vertigo and usingwe explore a radical the mastoidectomycavity and remove with the canal new wallcholesteatoma.
    [Show full text]
  • Differential Diagnosis and Treatment of Hearing Loss JON E
    Differential Diagnosis and Treatment of Hearing Loss JON E. ISAACSON, M.D., and NEIL M. VORA, M.D., Milton S. Hershey Medical Center, Hershey, Pennsylvania Hearing loss is a common problem that can occur at any age and makes verbal communication difficult. The ear is divided anatomically into three sections (external, middle, and inner), and pathology contributing to hearing loss may strike one or more sections. Hearing loss can be cat- egorized as conductive, sensorineural, or both. Leading causes of conductive hearing loss include cerumen impaction, otitis media, and otosclerosis. Leading causes of sensorineural hear- ing loss include inherited disorders, noise exposure, and presbycusis. An understanding of the indications for medical management, surgical treatment, and amplification can help the family physician provide more effective care for these patients. (Am Fam Physician 2003;68:1125-32. Copyright© 2003 American Academy of Family Physicians) ore than 28 million Amer- tive, the sound will be heard best in the icans have some degree of affected ear. If the loss is sensorineural, the hearing impairment. The sound will be heard best in the normal ear. differential diagnosis of The sound remains midline in patients with hearing loss can be sim- normal hearing. Mplified by considering the three major cate- The Rinne test compares air conduction gories of loss. Conductive hearing loss occurs with bone conduction. The tuning fork is when sound conduction is impeded through struck softly and placed on the mastoid bone the external ear, the middle ear, or both. Sen- (bone conduction). When the patient no sorineural hearing loss occurs when there is a longer can hear the sound, the tuning fork is problem within the cochlea or the neural placed adjacent to the ear canal (air conduc- pathway to the auditory cortex.
    [Show full text]