Mouret abscess is a rare extracranial complication of suppurative otitis media. It is generally believed to be a deep neck abscess caused by inflammation leading to the rupture of the bony tip of the mastoid tip. The location of Mouret abscess is deep. The symptoms are insidious at the onset, but may eventually spread to the surrounding tissue, and even lead to mediastinal abscess, cavernous sinus thrombosis, meningitis, dyspnea and other serious complications. At present, with the popularization of antibiotics, the occurrence rate of Mouret abscess is very low, and only sporadic cases have been reported.In this paper, a case of Mouret abscess caused by cholesteatoma was analyzed to explore Mouret abscess in terms of the route of infection, clinical manifestations, imaging features, diagnosis and treatment.
Abscess ; diagnosis ; drug therapy ; therapy ; Cholesteatoma ; complications ; Humans ; Mastoid ; pathology ; Meningitis ; Neck ; pathology ; Otitis Media ; Otitis Media, Suppurative ; complications

Omalizumab,as a biological agent targeting IgE,is a recombinant humanized monoclonal antibody and the first targeted drug approved for treating moderate-to-severe bronchial asthma.By reviewing one case of aspirin-induced asthma complicated with nasosinusitis and otitis media,we discussed the value of omalizumab in the treatment of asthma and its complications,aiming to provide a reference for clinical practice.
Humans ; Omalizumab/adverse effects* ; Asthma, Aspirin-Induced ; Asthma/drug therapy* ; Otitis Media/drug therapy*

OBJECTIVE: To investigate the curative effect of corticosteroid on acute otitis media (AOM) with middle ear effusion. METHOD: Forty-three children (43 ears) with AOM and abnormal tympanogram were enrolled in a prospective, randomized trial. Twenty-three cases (23 ears) were treated with Dexamethasone and Cefuroxime Sodium, while the other 20 cases (20 ears) were only treated with Cefuroxime Sodium. RESULT: The period of normalization of tympanometric findings in Dexamethasone treatment group was (54.6+/-6.2) days, which was much longer than that in the group without Dexamethasone treatment (38.5+/-6.1). Three months after treatment, the curative rate of Dexamethasone treatment group was higher than that of the group without Dexamethasone treatment. CONCLUSION Corticosteroid can obviously improve middle ear effusion and shorten the duration of middle ear effusion of AOM in the first 2 weeks. To some extent, corticosteroid can also improve middle ear effusion in long term. It indicates that corticosteroid be used as an effective adjunctive drug in treating AOM with middle ear effusion.
Child ; Child, Preschool ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Infant ; Male ; Otitis Media ; drug therapy ; Otitis Media with Effusion ; drug therapy ; Prospective Studies

Based on the characteristics of clinical symptoms of secretory otitis media in traditional Chinese and Western medicine,by reference to clinical diagnostic criteria,efforts were made to analyze and establish the Western medical diagnostic criteria and traditional Chinese medicine( TCM) syndrome differentiation criteria for secretory otitis media,and summarize the modeling methods and model characteristics of secretory otitis media animal models. According to the clinical diagnostic criteria and symptom characteristics,the coincidence degree between the existing animal models and clinical symptoms was evaluated,and its advantages and disadvantages were defined. On the basis of the statistical results,there were fewer methods for modeling secretory otitis media animal models,and only a specific relevant pathogenic mechanism could be revealed. Among them,the model with a higher coincidence degree was genetic engineering technology modeling and injection into the middle ear vesicles. The two modeling methods of bacterial factors highly coincided with the clinical symptoms of Western medicine,but both failed to reflect the TCM syndrome type. Therefore,establishing an animal model that simultaneously reflects the characteristics of clinical symptoms of secretory otitis media in traditional Chinese and Western medicine,and improving the evaluation criteria of secretory otitis media based on animal models are the main tasks of future studies on secretory otitis media.
Animals ; China ; Disease Models, Animal ; Medicine ; Medicine, Chinese Traditional ; Otitis Media with Effusion/drug therapy*

BACKGROUND AND OBJECTIVES: Tuberculous otitis media is not commonly found nowadays, and therefore, the index of suspicion is often low. However, once contracted, it can cause significant morbidities, such as profound hearing loss, labyrinthitis, facial nerve palsy and so on, if early diagnosis and treatment are not performed. MATERIALS AND METHODS: In the chronic otitis media patients who visited Masan Samsung Hospital from Jan. 1993 to Jan. 1996, 37 cases of pathologically proven tuberculous otitis media were retrospectively reviewed. And temporal bone computerized tomography (TBCT) of 14 cases of tuberculous otitis media were compared to those of chronic suppurative otitis media and choronic otitis media with cholesteatoma. RESULTS: 1) Classic clinical findings of the disease such as multiple perforation, painless otorrhea, young age are not consistent with the clinical findings reviewed here. 2) Unexpectedly severe hearing loss, facial paralysis, eroded malleus handle, polypoid granulation or necrotic debris in middle ear cavity were significant clinical features. 3) In TBCT findings, soft tissue density in the entire middle ear cavity, soft tissue density extension to superior external auditory canal, poor sclerotic change of mastoid air cell were more common than other types of chronic otitis media. 4) Most of cases were confirmed by operative specimen pathologically. 5) Delayed healing of postoperative wound and formation of granulation tissue suggested tuberculous otitis media. 6) Antituberculous chemotherapy provided effective means of treatment. CONCLUSION: Early diagnosis by pathologic examination of biopsied tissue obtained at OPD was mandatory to avoid complication and postoperative morbidity. Postoperative specimen obtained from middle ear surgery must be confirmed pathologically.
Cholesteatoma ; Cytochrome P-450 CYP1A1 ; Drug Therapy ; Ear Canal ; Ear, Inner ; Ear, Middle ; Early Diagnosis ; Facial Nerve ; Facial Paralysis ; Granulation Tissue ; Hearing Loss ; Humans ; Labyrinthitis ; Malleus ; Mastoid ; Otitis Media* ; Otitis Media, Suppurative ; Otitis* ; Paralysis ; Retrospective Studies ; Temporal Bone ; Wounds and Injuries

BACKGROUND AND OBJECTIVES: The incidence of tuberculosis has decreased over the last decades because of antituberculous chemotherapy and this was not an exception in Korea where the tuberculous disorder was once the major problem of public health until 1980. The clinical features of tuberculous otitis media (OM) have a tendency to be changed so that it is different from the description in the textbook. The reports about tuberculuos OM have been very rare until recently. The purpose of this study is to analysis cases of tuberculous OM for 13 years and to be helpful to apply the early diagnosis and differential diagnosis of other OM. MATERIALS AND METHODS: Author reviewed retrospectively 23 patients who underwent middle ear surgery from 1986 to 1998 at Pusan National University Hospital and were comfirmed Tuberculous OM pathologically. RESULTS: The incidence of tuberculous OM was 0.61% of total 3801 cases of middle ear surgery and it was prevalent in age group below thirty. The local findings of tympanic membrane showed variable and multiple perforation was very rare. 56.5% of the cases showed findings suggesting bony destruction. AFB stain revealed no acid fast bacilli in all cases, but 61.6% showed mixed infection with other bacterial organisms. Mostly the tuberculous OM was primary tuberculosis (73.9%). The duration of antituberculous chemotherapy until dry-up state were within 5 months mostly. CONCLUSION: The importance of tuberculous OM as a part of general increase in the incidence and the variable clinical findings were reviewed.
Busan ; Coinfection ; Diagnosis, Differential ; Drug Therapy ; Ear, Middle ; Early Diagnosis ; Humans ; Incidence ; Korea ; Otitis Media ; Otitis* ; Public Health ; Retrospective Studies ; Tuberculosis ; Tympanic Membrane

Objective: To study the effect of the inhibitor of Notch signaling pathway-γ-secretase inhibitor DAPT on the ultrastructures of middle ear in the ovalbumin (OVA)-mediated allergic OME in vivo. Methods: Male Sprague-Dawley (SD) rats, weighing 250-300 g, were completely and randomly divided into three groups (5 rats, 10 ears in each group):(1)Control group(2)OME group(3)OME+DAPT group. Rats in the OME group underwent systemic and local sensitization by intraperitoneal and intratympanic injection of ovalbumin to make the model of OVA-induced OME. Rats in the control group were sensitized with PBS. On the basis of establishing the OME model, OME+DAPT group were intraperitoneal injected with DAPT (10 mg/kg) for seven consecutive days and were administered before intratympanic injection of ovalbumin. After the model was successfully established, endoscopy,H&E staining and scanning electron microscopy were used to study the histology and mucous-ciliary ultrastructures of the non-ciliated and ciliated mucosa in the middle ear of each group. One-way ANOVA and Tukey methods were used for statistical analysis. Results: H&E staining showed that the three groups had statistically significant differences in submucosal thickness both in non-ciliated and ciliated regions (non-ciliated area:(6.83±1.47)μm, (38.58±9.57)μm, (32.17±11.89)μm, respectively. F=107.9;cilia area:(26.69±3.22)μm, (30.41±6.75)μm, (26.76±4.06)μm, respectively. F=5.62,both P<0.01). The thickness of the submucosa in the non-ciliated area and the cilia area of the OME group were significantly thicker than that of control group (F=42.08 and 4.40,both P<0.05); the thickness of the non-ciliated area and the ciliated area in OME+DAPT group were reduced compared to OME group(F=1.55 and 2.77,both P<0.05). Scanning electron microscopy showed that the array of cilia on the middle ear mucosa was disorderly arranged and inversed, this phenomenon was relieved in the OME+DAPT group. The number of goblet cells in the control group, OME group, and OME+DAPT group were 9.87±1.92; 15.67±5.77; 10.33±1.99 respectively and the difference between them was statistically significant (F=11.43, P<0.01). The number of goblet cells in the OME group were significantly higher than those in the control group (F=9.00,P<0.01) and the number of goblet cells in the OME+DAPT group were decreased compared to those of OME group (F=8.41, P<0.01). Conclusions: The study demonstrates the pathological changes of the ultrastructure in middle ear in OVA-induced OME and the effect of the γ-secretase inhibitor on it. In OME group, the cilia are disorderly arranged and inversed, the number of goblet cell is increased and they are swelled which suggest the hypersecretion of the mucus. DAPT can regulate OVA-induced allergic inflammation and relieve pathological changes of ultrastructure in middle ear mucociliary transport system through alleviating submucosal inflammation, reducing the hypersecretion of goblet cell and the morphological damage of cilia through the Notch signaling pathway.
Amyloid Precursor Protein Secretases ; Animals ; Ear, Middle ; Male ; Otitis Media with Effusion/drug therapy* ; Ovalbumin ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo observe the therapeutic effect of the self-prepared ear dropping made by combined Chinese and Western drugs in treating chronic suppurative otitis media caused large tympanic membrane perforation.

METHODSSixty-four patients were randomly divided into two groups, the treated group treated with the self-prepared ear-dropping and the control group treated with ear-dropping made by placebo, to observe the therapeutic effect and adverse reaction.

RESULTSIn the 32 patients of the treated group, 15 patients were cured, the cured tympanic membrane was normal in shape and thickness in 11, scarred in 3, and thin and transparent in 1. The hearing was improved in all patients with cured tympanic membrane. But no one was cured in the control group.

CONCLUSIONThe self-prepared ear-dropping had good effect in treating tympanic membrane perforation, it is simple, cheap and no need of further operation.

Administration, Topical ; Adult ; Aged ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Otitis Media, Suppurative ; complications ; drug therapy ; Phytotherapy ; Tympanic Membrane Perforation ; drug therapy ; etiology

A rare case of ventriculitis associated with the obstruction of aqueduct of Sylvius is reported and the pertinent literature reviewed. A 24 years old male, who had been suffering from a longstanding chronic pyogenic ear disease since childhood, was admitted to our clinic in Dec. 1973 with a comatose state. Contrast radiology showed the obstructive hydrocephalus with the occluded aqueduct of Sylvius, but neither intracerebral or intracerebellar space consuming mass presented. Cerebrospinal and ventricular fluid revealed a marked growth of Escherichia Coli. So ventriculitis complicating obstruction of the aqueduct of Sylvius due to chronic suppurative otitis media and mastoiditis was diagnosed in this patient, and treated by Torkildsen's operation with proper chemotherapy and resulted in good recovery. We experienced that ventriculitis initiated from meningitis might give rise to obstruction of the aqueduct of Sylvius and it could be considered as a brain abscess superimposed raised intracranial pressure from obstructive hydrocephalus.
Brain Abscess ; Cerebral Aqueduct* ; Coma ; Drug Therapy ; Ear Diseases ; Escherichia coli ; Humans ; Hydrocephalus ; Intracranial Pressure ; Male ; Mastoid ; Mastoiditis ; Meningitis ; Otitis Media, Suppurative ; Young Adult

A rare case of ventriculitis associated with the obstruction of aqueduct of Sylvius is reported and the pertinent literature reviewed. A 24 years old male, who had been suffering from a longstanding chronic pyogenic ear disease since childhood, was admitted to our clinic in Dec. 1973 with a comatose state. Contrast radiology showed the obstructive hydrocephalus with the occluded aqueduct of Sylvius, but neither intracerebral or intracerebellar space consuming mass presented. Cerebrospinal and ventricular fluid revealed a marked growth of Escherichia Coli. So ventriculitis complicating obstruction of the aqueduct of Sylvius due to chronic suppurative otitis media and mastoiditis was diagnosed in this patient, and treated by Torkildsen's operation with proper chemotherapy and resulted in good recovery. We experienced that ventriculitis initiated from meningitis might give rise to obstruction of the aqueduct of Sylvius and it could be considered as a brain abscess superimposed raised intracranial pressure from obstructive hydrocephalus.
Brain Abscess ; Cerebral Aqueduct* ; Coma ; Drug Therapy ; Ear Diseases ; Escherichia coli ; Humans ; Hydrocephalus ; Intracranial Pressure ; Male ; Mastoid ; Mastoiditis ; Meningitis ; Otitis Media, Suppurative ; Young Adult