Intracranial complications of chronic otitis media

European Annals of Otorhinolaryngology, Head and Neck Diseases, 2010

European Archives of Oto-rhino-laryngology, 2020

Purpose We aimed to demonstrate whether chronic otitis media with effusion (OME) is a sterile condition or biofilms-related disease through direct visualization of middle ear mucosa by Scanning electron microscopy (SEM) and culture of the effusion. Methods This case-control study included 60 children in two groups; the case group included 50 patients undergoing ventilation tube insertion (VTI) for Chronic OME (COME), and the control group included ten patients undergoing cochlear implantation (CI) surgery presenting normal middle ear mucosa. Biopsies from both groups' middle ear mucosa were evaluated for biofilm formation using scanning electron microscopy (SEM). Middle ear effusion (MEE) samples from COME patients were cultured on blood agar to detect and identify any bacterial growth. The adenoid size was evaluated and correlated to the biofilm formation in COME patients. Results There was a significant difference between case and control groups regarding biofilm formation (p-value < 0.001*). Biofilm was evident in 84% of the COME patients (cases group) and absent in the control group. Only 12 COME patients (24%) had positive MEE culture, however, 76.2% of patients with biofilm had a negative culture. Streptococcus pneumonia was the most common otopathogen found either alone or combined with other otopathogens. There was a significant negative correlation between adenoid size and biofilm grade among the studied patients. The visual identification of middle ear biofilms indicated their role in chronic OME. Middle ear biofilms need to be expected in children with OME, especially those who do not need adenoid surgery.

Vertigo, 2013

Lec-18 ‫د.سعد‬ 4/4/2016 CSOM is a long-standing infection of a part or whole of the middle ear cleft characterized by painless ear discharge and a permanent perforation with hearing loss. A perforation becomes permanent when its edges are covered by squamous epithelium and it does not heal spontaneously. 1. Classification based on anatomical considerations a. Tubotympanic disease =' safe' disease; perforation is central and non-marginal. b.Atticoantral disease='unsafe' disease: perforation is marginal or in attic: cholesteatoma. A. Healed otitis media: adhesive otitis media, tympanosclerosis. B. Inactive mucosal chronic otitis media: permanent perforation. C. Active mucosal chronic otitis media: chronic suppurative otitis media, aural polyp. D. Active squamous epithelial chronic otitis media: cholesteatoma with discharge. E. Inactive squamous epithelial chronic otitis media: retraction pocket.

Revista Brasileira De Enfermagem, 2019

Objective: to reflect on the everyday life in nursing work based on Michel de Certeau's theorization. Results: everyday life in nursing work is permeated by tactics of subjects who practice the place. Their movements escape standards, protocols and rules, re-signifying the cultural system defined beforehand. There is a practice proper to professionals who (re)invent the care based on their intentions and pressures. Patients/ users also move, create their own itinerary and, similarly to professionals, use strategies to achieve specific results in the therapeutic process. Conclusion: to think on the everyday life in nursing work as an object of research requires to consider the care (re) invention in every act in health care. We need to dive into the invisible dimension of the uncontrollable tactics of subjects that re-signify the social system.

Elsevier eBooks, 2020

International Journal of Otorhinolaryngology and Head and Neck Surgery, 2023

International Journal of Pediatric Otorhinolaryngology, 2011

The examinees were children from 2 to 12 years old treated at the Clinic of Otorhinolaryngology and Head and Neck Surgery, Clinical Medical Center University of Rijeka in the period between 2004 and 2009. They all had a documented unilateral or bilateral CSOM lasting at least 3 months.

Journal of Cranio-Maxillofacial Surgery, 2016

Introduction: Septic arthritis of the temporomandibular joint (TMJ) is a rare condition known to result in significant morbidity if diagnosis is delayed. Acute otomastoiditis is a typical complication of acute otitis media but few cases of acute otomastoiditis complicated with TMJ arthritis have been reported in the international literature. Furthermore, otomastoiditis reports and studies rarely analyzed TMJ CT-scans. The aim of this study was to determine the incidence of TMJ arthritis in acute otomastoiditis, based on the analysis of CT scans. We conducted a prospective study from 2014 to 2015, including all consecutive pediatric patients admitted to the Pediatric Otolaryngology department for acute otomastoiditis. A craniofacial injected CT-scan was performed in all patients. The imagery was prospectively blind analyzed by two independent investigators screening for the criteria of TMJ arthritis. Finally, during the long-term follow-up we noted the number of patients presenting a clinical TMJ ankylosis. Results: We included 45 patients. The analysis showed 15 patients with TMJ effusion. Of those, 6 (13.33%) had an abscess and 2 clinical ankyloses. This study showed a high rate of TMJ arthritis complicating otomastoiditis. Our results demonstrate that systematic TMJ analysis in the CT-scan of patients with M

Acta Otorhinolaryngologica Italica, 2016

Neurofibromatosis type 2 [NF2; MIM # 101000] is an autosomal dominant disorder characterised by the occurrence of vestibular schwannomas (VSs), schwannomas of other cranial, spinal and cutaneous nerves, cranial and spinal meningiomas and/or other central nervous system (CNS) tumours (e.g., ependymomas, astrocytomas). Additional features include early onset cataracts, optic nerve sheath meningiomas, retinal hamartomas, dermal schwannomas (i.e., NF2-plaques), and (few) café-au-lait spots. Clinically, NF2 children fall into two main groups: (1) congenital NF2 -with bilateral VSs detected as early as the first days to months of life, which can be stable/asymptomatic for one-two decades and suddenly progress; and (2) severe pre-pubertal (Wishart type) NF2-with multiple (and rapidly progressive) CNS tumours other-than-VS, which usually present first, years before VSs [vs. the classical adult (Gardner type) NF2, with bilateral VSs presenting in young adulthood, sometimes as the only disease feature]. Some individuals can develop unilateral VS associated with ipsilateral meningiomas or multiple schwannomas localised to one part of the peripheral nervous system [i.e., mosaic NF2] or multiple non-VS, non-intradermal cranial, spinal and peripheral schwannomas (histologically proven) [schwannomatosis]. NF2 is caused by mutations in the NF2 gene at chromosome 22q12.1, which encodes for a protein called merlin or schwannomin, most similar to the exrin-readixin-moesin (ERM) proteins; mosaicNF2 is due to mosaic phenomena for the NF2 gene, whilst schwannomatosis is caused by coupled germ-line and mosaic mutations either in the SMARCB1 gene [SWNTS1; MIM # 162091] or the LZTR1 gene [SWNTS2; MIM # 615670] both falling within the 22q region and the NF2 gene. Data driven from in vitro and animal studies on the merlin pathway [e.g., post-translational and upstream/downstream regulation] allowed biologically targeted treatment strategies [e.g., Lapatinib, Erlotinib, Bevacizumab] aimed to multiple tumour shrinkage and/or regression and tumour arrest of progression with functional improvement.

Advances in health sciences research, 2022