Intracranial abscess is a serious, life-threatening condition with a dire prognosis. Although the advent of the antibiotic era has drastically reduced the incidence of the disease, predisposing factors such as untreated ear infections, poor personal hygiene, significant trauma with violation of the sterile cranial environment as well as existing co-morbidities such as an immunocompromised state make intracranial abscess a horrifying reality. Ear infections, in particular, are notorious for being the origin of roughly 50% of cerebellar abscesses.1 Chronic suppurative otitis media (CSOM) is one of the leading causes of brain abscess. Shaw and Russell2 reviewed 47 cases of cerebellar abscess and showed that 93% were caused by CSOM; the most common mechanism of entry into the brain parenchyma being direct extension. Chronic infection in the middle ear space could erode through the tegmen tympani and into the temporal lobe or through the tegmen mastoidei into the cerebellum. Neurological symptoms may be delayed as the abscess ‘grows’ in areas around the cerebellum that are regarded as ‘silent’, until vital areas such as those responsible for coordination and balance are violated. We describe a case of cerebellar abscess secondary to CSOM and discuss the possibility of performing ear surgery with simultaneous drainage of a contiguous abscess through a transmastoid approach in cases of chronic suppurative otitis media with intracranial complications.
Human ; Male ; Young Adult ; EAR DISEASES ; OTITIS ; Otitis Media, Suppurative ; OTITIS MEDIA-COMPLICATIONS, suppuration, SURGERY ; CHRONIC EAR DISEASE ; pain ; Headache

Actinomycosis is a chronic granulomatous disease caused by the species of Actinomyces. Although it has become a rare disease in the present antibiotics era, it still needs long term antibiotic treatment and often mis- or delayed- diagnosed due to no typical sign and symptoms. Most often, it occurs in the cervicofacial region. Middle ear is not a common site for Actinomycosis, and the inner ear involvement is extremely rare. Here, we report a case of middle ear Actinomycosis involving facial nerve and lateral semicircular canal.
Actinomyces ; Actinomycosis* ; Anti-Bacterial Agents ; Ear, Inner ; Ear, Middle* ; Facial Nerve* ; Granulomatous Disease, Chronic ; Rare Diseases ; Semicircular Canals* ; Temporal Bone

OBJECTIVETo study the therapeutic effect of ventilation tube insertion in the middle ear and the external auditory canal on chronic secretory otitis media in children.

METHODSA retrospective study on 30 patients (40 ears) with chronic secretory otitis media and who underwent the operation of middle ear exploration and ventilation tube insertion in the middle ear and the external auditory canal was performed. Poor tympanic membrane, even with adhesion, was seen in 23 ears. Ten patients had evidence of bilateral secretory otitis media. From this group one ear was first injected with drugs (dexamethasone, mucosolvin, etc) and then tube insertion into the auditory tube was performed; the other ear only received drug injections into the auditory tube. The remaining 20 patients who had evidence of unilateral secretory otitis media only received drug injections into the auditory tube.

RESULTSThe tubes inserting into the auditory tube all dropped out 5-8 days after operation. None of the ventilation tubes into the middle ear dropped out and the patients' tympanum recovered after the ventilation tubes were removed (6-8 months after operation). The total cure rate was 87.5% (35/40) and the improvement rate was 12.5% (5/40). The operation of inserting tubes into the auditorytube did not improve the therapeutic effects. In the 0.5-2 years postoperative follow-up, middle ear effusions recurred in one ear, and three ears were transferred from type C to type A.

CONCLUSIONSThe surgery of ventilation tube insertion in the middle ear and the external auditory canal for chronic secretory otitis media can prevent the tympanic membrane from damage and dropping out of the ventilation tube and reduce recurrence in children. It is a preferred selection for the patients with poor tympanic membrane or adhesive tympanic membrane. It is no use to insert the tube into the auditory tube for the improvement of therapeutic effects.

Adolescent ; Child ; Chronic Disease ; Ear Canal ; surgery ; Ear, Middle ; surgery ; Female ; Humans ; Male ; Middle Ear Ventilation ; methods ; Otitis Media with Effusion ; surgery ; Retrospective Studies

Acupuncture Points ; Acupuncture, Ear ; Adolescent ; Adult ; Aged ; Child ; Chronic Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Urticaria ; therapy ; Young Adult

We present a case of subarachnoid hemorrhage induced by chronic suppurative otitis media and discuss the possible mechanism here. Chronic suppurative otitis media is a common suppurative inflammation of middle ear, which can cause sorts of extracranial and intracranial complications in the situation of lower resistance or higher virulence. However, the condition of subarachnoid haemorrhage caused by chronic suppurative otitis media is quite rare. According to this case and previously published articles, we consider that meningitis may be the main reason of subarachnoid hemorrhage induced by chronic suppurative otitis media.
Chronic Disease ; Ear, Middle ; Female ; Humans ; Meningitis ; complications ; Middle Aged ; Otitis Media, Suppurative ; complications ; Subarachnoid Hemorrhage ; complications

Tympanosclerosis is the middle ear tissue hyalinization and calcification caused by chronic middle ear inflammation, which mainly results in conductive deafness with unobvious clinical symptom. Etiology is unclear. The treatment is given priority to surgical treatment at present, while long-term effect reported mostly poor. This article analyzed etiology and treatment of the tympanic cavity sclerosis.
Calcinosis ; Chronic Disease ; Ear, Middle ; Hearing Loss, Conductive ; etiology ; Humans ; Myringosclerosis ; complications ; etiology ; therapy ; Otitis Media ; Sclerosis

OBJECTIVE: Analyse the effect of the treatment of infection in posterior tympani cavity in 168 cases with chronic otitis media. METHOD: Infection was eliminated in posterior tympani cavity of all 168 cases after surgical procedures of otitis media, and 102 tympanoplasty with autoplastic bone were operated in all cases. 22 tympanoplasty were operated without mastoidectomy, 53 with transmastoid approach, 27 with mastoidectomy and tympanoplasty. RESULT: All cases were followed up for more than one year. 160 cases were cured, the effective rate was 95% and no recurrence appeared except for 8 cases. The average threshold of hearing improvement of 87 cases > 15 dB, the effective rate was 85%. CONCLUSION To eliminate infection, the exploratory surgery of posterior tympani cavity should be done during surgical procedures of otitis media, for improving the effect of the treatment of otitis media.
Adolescent ; Adult ; Chronic Disease ; Ear, Middle ; surgery ; Female ; Humans ; Male ; Middle Aged ; Otitis Media ; surgery ; Tympanoplasty ; methods ; Young Adult

OBJECTIVETo discuss the etiological factors of facial nerve paralysis due to chronic inflammation of middle ear.

METHODSThis retrospective research included 41 patients operated for facial nerve paralysis due to chronic inflammation of middle ear. Careful exploration was made in facial canal in order to identify pathological tissue involvement. Pathological examination was performed in all operative specimens.

RESULTSFour intact fallopian canals were observed. There was a defect on the fallopian canal in 37 patients (90%) and it was most commonly located on the tympanic segment of the canal (89%). Pathological report was cholesteatoma, granulation and tuberculosis, which was found in 24 cases (59%) 14 cases (34%) and 3 cases (7%), respectively.

CONCLUSIONSFacial nerve paralysis due to chronic inflammation of middle ear was frequently relevant with cholesteatoma,the tympanic segment of the fallopian canal was most location to be involved in. Its major factor was the infection spreading along the nerve tissue, but not atrophy due to compression. The defect on the fallopian canal was not necessary for infection diffusion.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cholesteatoma, Middle Ear ; complications ; Chronic Disease ; Facial Paralysis ; etiology ; Female ; Humans ; Male ; Middle Aged ; Otitis Media ; complications ; Retrospective Studies ; Young Adult

OBJECTIVE: To explore the clinic characteristic and curative effect of staging tympanoplasty for chronic suppurative otitis media and cholesteatoma otitis media. METHOD: Curative effects of 132 patients cured by staging tympanoplasty and 325 patients cured by no staging tympanoplasty were retrospectively analyzed. Curative effects include ABG value (the reduced value of air-bone conduct gaps after operation), recrudescence of cholesteatoma, tympanic membrane reperforation and wet ear after operation. RESULT: In staging tympanoplasty group, ABG is 28.4 dB, rate of tympanic membrane reperforation is 1.5%, recrudescence of cholesteatoma is 0% and rate of wet ear after operation is 0%. In no staging tympanoplasty group, ABG is 21.3 dB, rate of tympanic membrane reperforation is 2.2%, recrudescence of cholesteatoma is 4.0% and rate of wet ear after operation is 1.2%. CONCLUSION The ABG, the rate of recrudescence of cholesteatoma in staging tympanoplasty group is much better than that in no staging tympanoplasty group. Tympanic membrane reperforation and wet ear after operation rate have no significant difference in statistic between two groups. We can conclude that staging operations will maintain and improve hearing level more effectively compare to no staging operation.
Adolescent ; Adult ; Aged ; Child ; Cholesteatoma, Middle Ear ; surgery ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Otitis Media, Suppurative ; surgery ; Retrospective Studies ; Treatment Outcome ; Tympanoplasty ; Young Adult

OBJECTIVE: To study the effectiveness of tympanoplasty for treatment of chronic otitis media and cholesteatoma in children. METHOD: Twenty-three cases with chronic otitis media and cholesteatoma treated by tympanoplasty were retrospectively studied, among which 15 cases had complete clinical data. The condition of surgical cavities, the duration of getting dry ears, the hearing improvements, the growth of new ear drums and whether the recurrence of cholesteatomas occurred or not were observed. RESULTS: In all patients, the chief complains were ear discharging and hearing loss. The tympanum membranes(pars flaccid or pars tensa) became retracted or perforated and CT scan showed mastoid processes were poor developed in some cases with lesions mainly located at attic, middle tympanum cavity and/or petrous parts. The duration of getting dry ear was (6.0 +/- 1.5) weeks after surgery. The effective rate was 80%. The hearing of 12 cases has been improved, that of 2 cases has no changed, that of 1 case has been descended, and 1 case exhibited recurrent cholesteatoma after surgery. CONCLUSION This study demonstrated that children's chronic otitis media and cholesteatoma have their own clinic features of wide erosiveness and strong aggressiveness, and tympanoplasty has been proved to treat this disease effectively, also been proved to improve these patients' hearing cognitions and eventually improve their life qualities.
Adolescent ; Child ; Child, Preschool ; Cholesteatoma, Middle Ear ; surgery ; Chronic Disease ; Female ; Humans ; Male ; Otitis Media ; surgery ; Retrospective Studies ; Treatment Outcome ; Tympanoplasty