A solitary fibrous tumor (SFT) is an extremely rare, distinct otological soft-tissue tumor. Only two such tumors in the external auditory canal have been reported. A SFT related to hemangiopericytomas (HPC), which commonly arise in the central nervous system. HPCs act malignant in many cases, while SFTs at other sites are mainly benign. A 25-year-old female presented with highly vascular tumor at the right external auditory meatus and bleeding from the mass when a crust was removed from its surface. After excisional biopsy followed by pre-operative embolization, this tumor confirmed with SFT. The recurrence rate of SFT is very low after complete resection, with a slightly increased risk of recurrence with extrathoracic tumors. We describe the third case of SFT in the external auditory canal and review the literature.
Adult ; Biopsy ; Central Nervous System ; Ear Canal* ; Female ; Hemangiopericytoma ; Hemorrhage ; Humans ; Recurrence ; Solitary Fibrous Tumors*

BACKGROUND AND OBJECTIVES: The most common complication of tympanostomy tube (T-tube) insertion is the development of postoperative otorrhea. Post-tympanostomy tube otorrhea (PTTO) is defined as active drainage through an existing T-tube. Many surgeons routinely use topical antibiotics as prophylaxis against early PTTO. Mupirocin calcium ointment is a topical antimicrobial agent with broad-spectrum antimicrobial activity against many Gram-positive organisms. This study evaluated the clinical effectiveness of topical mupirocin ointment in reducing early PTTO. SUBJECTS AND METHODS: The study included 98 ears (67 patients, mean age 32.9 years) that had a T-tube inserted because of chronic middle ear effusion or atelectatic otitis media. A Paparella type-I polyethylene-tube coated with mupirocin was inserted through the tympanostomy. Patients were instructed not to use otic drops or any other medications. All patients were seen by day 14 postoperatively. RESULTS: Early PTTO occurred in one case (1.5%). No early PTTO was seen with a middle ear effusion. Nineteen children were treated under general anesthesia; none developed early PTTO. CONCLUSIONS: Insertion of a T-tube coated with mupirocin ointment could be effective at preventing early PTTO.
Anti-Bacterial Agents ; Calcium ; Child ; Drainage ; Ear ; Humans ; Middle Ear Ventilation ; Mupirocin ; Otitis Media ; Otitis Media with Effusion

BACKGROUND AND OBJECTIVES: The most common complication of tympanostomy tube (T-tube) insertion is the development of postoperative otorrhea. Post-tympanostomy tube otorrhea (PTTO) is defined as active drainage through an existing T-tube. Many surgeons routinely use topical antibiotics as prophylaxis against early PTTO. Mupirocin calcium ointment is a topical antimicrobial agent with broad-spectrum antimicrobial activity against many Gram-positive organisms. This study evaluated the clinical effectiveness of topical mupirocin ointment in reducing early PTTO. SUBJECTS AND METHODS: The study included 98 ears (67 patients, mean age 32.9 years) that had a T-tube inserted because of chronic middle ear effusion or atelectatic otitis media. A Paparella type-I polyethylene-tube coated with mupirocin was inserted through the tympanostomy. Patients were instructed not to use otic drops or any other medications. All patients were seen by day 14 postoperatively. RESULTS: Early PTTO occurred in one case (1.5%). No early PTTO was seen with a middle ear effusion. Nineteen children were treated under general anesthesia; none developed early PTTO. CONCLUSIONS: Insertion of a T-tube coated with mupirocin ointment could be effective at preventing early PTTO.
Anti-Bacterial Agents ; Calcium ; Child ; Drainage ; Ear ; Humans ; Middle Ear Ventilation ; Mupirocin ; Otitis Media ; Otitis Media with Effusion

OBJECTIVES: Intratympanic steroids are being increasingly used in the treatment of sudden sensorineural hearing loss (SSNHL) after the failure of systemic therapy. This study evaluated the efficacy of administering intratympanic dexamethasone (ITD) as a salvage treatment for severe to profound SSNHL. METHODS: We reviewed the medical records of patients who presented with severe to profound SSNHL between January 2007 and December 2009. ITD was given about 14 days after the initial systemic treatment. Successful recovery was defined as complete or partial recovery using Sigel's criteria. We compared the results of treatment between the severe SSNHL (S-SSNHL) and profound SSNHL (P-SSNHL) groups. RESULTS: All the patients in the S-SSNHL group showed significant improvement, as compared to the P-SSNHL group (P=0.017). The recovery rate after the initial systemic treatment was 36% (9/25) in the S-SSNHL group and 18.1% (4/22) in the P-SSNHL group (P=0.207). In comparison, the recovery rate of ITD as a salvage treatment was 37.5% (6/16) in the S-SSNHL group and 5.5% (1/18) in the P-SSNHL group (P=0.03). CONCLUSION: Our comparative study dose not support the efficacy of ITD as salvage treatment for patients with P-SSNHL as compared with that for S-SSNHL. We recommend that patients with P-SSNHL be informed about the low efficacy of ITD as a salvage treatment.
Dexamethasone ; Hearing Loss, Sensorineural ; Humans ; Medical Records ; Steroids

BACKGROUND AND OBJECTIVES: Sudden sensorineural hearing loss (SSNHL) is commonly defined as a loss of at least 30 dB in three contiguous frequencies occurring within 3 days. Systemic steroid administration has become the most widely accepted treatment option for SSNHL. Since viral infection and vascular compromise are considered specific causes of SSNHL, antiviral agents, anticoagulants, and stellate ganglion block have been used for its treatment, although the evidence of their effectiveness is weak. The present study evaluated the hearing recovery rate in the combination therapy group (systemic steroids, antiviral agent, anticoagulants, and stellate ganglion block) in comparison with patients treated with systemic steroids alone. SUBJECTS AND METHODS: A total of 85 patients diagnosed with SSNHL were treated with combination therapy (group A, 46 patients) or systemic steroids only (group B, 39 patients). Hearing improvement was defined as a hearing gain of more than slight improvement using Siegel's criteria. All patients were treated with a 10-day course of systemic steroids (10-mg dexamethasone for 5 days, followed by tapering for 5 days). Acyclovir, heparin, and stellate ganglion block were included in the group A treatment regimen. RESULTS: The overall rate of hearing improvement was 60.9% (28/46 patients) in group A, which was significantly higher than that (38.5%, 15/39 patients) in group B. The distribution of prognostic factors was not significantly different between the two groups with the exception of the degree of initial hearing loss, which was more severe in group A. Upon analysis according to prognostic factors, group A showed a better hearing improvement recovery rate than group B in patients with hearing loss >70 dB, age >41 years, dizziness, and early treatment (<1 week). CONCLUSIONS: Thus SSNHL patients treated with combination therapy have a higher likelihood of hearing improvement than those treated with systemic steroids alone.
Acyclovir ; Anticoagulants ; Antiviral Agents ; Dexamethasone ; Dizziness ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Heparin ; Humans ; Stellate Ganglion ; Steroids

Ameloblastic carcinoma is a rare odontogenic tumor. The histologic classification of odontogenic carcinomas has been debated for many years and is still under revision. The term `ameloblastic carcinoma' is used to describe those ameloblastomas with histological evidences of malignancy in the primary, recurrent or metastatic tumors. The mandible is known to be the most common site of ameloblastic carcinoma. Authors report a very rare case of ameloblastic carcinoma of the maxilla with a review of literature.
Neoplasm Metastasis

The ossification of stapedial tendon is a rare disorder of middle ear that results in conductive hearing loss. It might be easily misdiagnosed as otosclerosis, and only exploratory tympanotomy can indicate cases where the mobility of stapes is not fixed or has increased. Cutting of the tendon results in nearly normal ossicular mobility and hearing improvement. A 41-year-old patient visited our clinic with slowly progressive hearing loss. Hearing evaluation revealed that he had a conductive hearing loss with intact tympanic membrane. The mobility of stapes was enhanced by cutting of the tendon through exploratory tympanotomy ; hearing was improved thereafter.
Adult ; Ear, Middle ; Hearing ; Hearing Loss ; Hearing Loss, Conductive ; Humans ; Otosclerosis ; Stapes ; Tendons ; Tenotomy ; Tympanic Membrane

BACKGROUND AND OBJECTIVES: Antrochoanal polyp (ACP) is defined as a polyp that originates in the maxillary sinus and passes through the sinus ostia. Physical examination and radiologic findings are the two most important aspects in the diagnosis and treatment of ACPs. However, there have been little attempts to describe the OMU CT findings of ACPs. In this study, authors reviewed the preoperative OMU CT findings of ACPS. MATERIALS AND METHOD: A total of 21 patients without the history of any previous nasal operations were entered into the study. The following seven radiologic parameters were reviewed: presence of polyp, origin of ACP, identification of accessory ostium, destruction in the OMU area, bony changes of the medial maxillary sinus wall, shapes of ACP that extended into nasopharynx in relation with sinusitis. RESULTS: ACPs were classified into three stages according to the level of extension. Of those 21 patients, polyps were observed in 20 patients, destructive changes only in 2 patients and bony changes of the medial wall in 17 patients. Lobulated contour in shape was observed in 24% of the patients. CONCLUSION: ACP is originated in the maxillary sinus and it grows into the nasal cavity via the posterior fontanelle area. It may regress due to insufficient blood supply, but its shape is retained.
Cranial Fontanelles ; Diagnosis ; Humans ; Maxillary Sinus ; Nasal Cavity ; Nasal Polyps ; Nasopharynx ; Physical Examination ; Polyps* ; Sinusitis

Primary meningioma of jugular foramen is extremely rare, while paraganglioma or nerve sheath tumor are relatively common in jugular foramen. We reported a case of primary meningioma of jugular foramen. A 79-year-old female who had left tinnitus and hearing loss for three month came to the department of otorhinolaryngology. Temporal bone computed tomography scan showed sclerotic change and slightly irregular margins of left jugular foramen with relatively preservation of bony architecture. Temporal bone magnetic resonance image showed well defined homogeneous enhancing mass in left jugular foramen with extension to carotid space on gadolinium enhanced T1 weighted image. Prominent dural tail was also noted. On T2 weighted image, this mass showed intermediated signal intensity with no vascular signal voids. Meningioma was confirmed by pathology. In this article, we describe a case of primary en plaque meningioma of jugular foramen and review image findings of differential diagnosis.
Aged ; Diagnosis, Differential* ; Female ; Gadolinium ; Glomus Jugulare Tumor ; Hearing Loss ; Humans ; Meningioma* ; Neurilemmoma ; Otolaryngology ; Paraganglioma ; Pathology ; Tail ; Temporal Bone ; Tinnitus

OBJECTIVES: Cisplatin, a widely used chemotherapeutic agent, has serious side effects, including nephrotoxicity and ototoxicity. Minocycline is a semisynthetic second-generation tetracycline that exerts anti-inflammatory and neuroprotective effects. The purpose of this study was to elucidate the protective effect of minocycline against cisplatin-induced ototoxicity in the auditory hair cell. METHODS: The House Ear Institute-Organ of Corti 1 (HEI-OC1) cell line and guinea pigs were used for in vitro and in vivo experiments. Cells were exposed to cisplatin with or without pre-treatment with minocycline. Cell survival was analyzed using MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide). Whole-cell lysates were collected and immunoblotted with antibodies against Bcl-2, p-c-Jun, active caspase-3, cleaved poly (ADP-ribose) polymerase (PARP), and apoptosis-inducing factor (AIF). The guinea pigs received intraperitoneal injections of cisplatin alone or following minocycline pretreatment. The auditory brainstem response was tested and the cochleae were harvested and evaluated using scanning electron microscopy. RESULTS: Survival significantly increased in cells pretreated with minocycline compared with cells exposed to cisplatin alone. Cisplatin treatment increased the expression of active caspase 3, p-c Jun, PARP, and AIF, and pretreatment with minocycline attenuated this response. In animal study, the threshold shift by cisplatin injection in the auditory brainstem response was less pronounced in animals pretreated with minocycline. Scanning electron microscopy revealed more severe damage to the outer hair cells at the basal and middle turns than the apical turn. CONCLUSION: Minocycline partially protects against cisplatin-induced ototoxicity via both caspase-dependent and independent apoptosis pathways.
Animals ; Antibodies ; Apoptosis ; Apoptosis Inducing Factor ; Caspase 3 ; Cell Line ; Cell Survival ; Cisplatin ; Cochlea ; Ear ; Electrons ; Evoked Potentials, Auditory, Brain Stem ; Guinea Pigs ; Hair ; Injections, Intraperitoneal ; Microscopy, Electron, Scanning ; Minocycline ; Neuroprotective Agents ; Tetracycline