OBJECTIVE

To describe a practical surgical approach for mastoid cavity obliteration and canal wall reconstruction using autologous bone dust and conchal cartilage applied either during primary canal wall up (CWU) surgery or in revision of prior canal wall down (CWD) mastoid cavities, with the aim of restoring a self-cleaning, waterproof ear that retained its natural acoustic resonance.

METHODS

The indications, surgical technique, and follow up and imaging surveillance were described, detailing patient selection, harvesting and application of autologous materials, and the key technical steps for cavity obliteration and posterior canal wall reconstruction. The importance of preserving the ear canal’s standing wave resonance (~2000–2500 Hz) for optimal hearing was emphasized. Postoperative monitoring with non-echo planar diffusion-weighted imaging (DWI) MRI was recommended at least 1.5 years after surgery to detect residual or recurrent cholesteatom.

RESULTS

This technique was performed successfully in 88 patients (32 males and 56 females, aged 6–80 years) across four hospitals in Metro Manila from January 2020 to July 2025. All patients had unremarkable postoperative courses and healed within three months. Among the 67 who underwent DWI MRI after 18 months, two required revision mastoidectomies with mastoid obliteration for cholesteatoma recidivism—one with residual and one with recurrent disease.

CONCLUSION

Mastoid obliteration and reconstruction using autologous bone dust and cartilage has proven to be a safe, effective and cost-efficient technique. It converts problematic open cavities into dry, self-cleaning ears suitable for swimming while preserving the acoustic benefits of a near-normal ear canal. Long-term follow-up with diffusion-weighted imaging (DWI) MRI is essential to ensure durable disease control.

Human ; Mastoidectomy ; Reconstructive Surgical Procedures ; Bone Transplantation ; Cartilage ; Cholesteatoma ; Ear, Middle ; Magnetic Resonance Imaging ; Postoperative Care ; Hearing

Objectives: To determine the initial clinical diagnoses of patients with tuberculous otitis media (TBOM), to determine the value of PCR test, biopsy, and ancillary diagnostic procedures in detecting middle ear TB infection, and to establish the differences in treatment outcomes. Methods: The clinical records of twenty-eight patients identified with middle ear TB infection by PCR test and biopsy, from January 2010 to December 2016, were reviewed to determine their initial clinical diagnoses. The positivity rates of PCR test and biopsy were compared. The records of 12 patients included in a previous publication were revisited and included in the present study population. The combined cases were classified according to clinical diagnosis to constitute a summary of demographic characteristics, clinical diagnoses, laboratory tests, and treatment outcomes. Results of diagnostic and surgical procedures were reviewed and analyzed. Clinical findings and hearing test results before and after treatment were compared. Results: Of the 28 patients, eight different clinical diagnoses of patients confirmed with middle ear TB were determined. PCR test diagnosed most cases belonging to the early and chronic stages of the disease process. Biopsy diagnosed mostly the chronic cases but failed to diagnose acute cases and late cases with diagnosis of chronic suppurative otitis media with cholesteatoma. By including the twelve cases that were published in 2011, the range of clinical diagnoses was expanded and an outcome of eleven clinical diagnoses confirmed with TB infection was established. Analysis of treatment outcomes showed that the clinical and hearing outcomes were better for patients managed at the early stage of the disease than for those presenting at the late stages of the disease process who underwent more complicated surgical procedures. Conclusion Our study supports the concept of tuberculous otitis media (TBOM) clinical spectrum, implying a paradigm shift in the established thinking that TBOM presents only as a chronic disease. The combined use of PCR and biopsy is a potential diagnostic tool to improve case detection rate, further broaden the scope of the clinical spectrum, and develop better control and preventive strategies for TBOM.
Otitis Media, Suppurative ; Polymerase Chain Reaction

Literature has reported the existence of cholesteatoma in chronic suppurative otitis media with tuberculosis. This report demonstrates that a cholesteatoma can be associated with an acute otitis media with tuberculosis. The importance of a high index of suspicion for tuberculous otitis media and its consequent meticulous management including diagnostic tests, medical and surgical procedures and monitoring are discussed.

Tuberculosis ; Cholesteatoma

OBJECTIVES: To determine the effect of age, ex and body index on selected static tests of balance and to generate referance normtive data among the different population groups.

METHODS: In this cross-sectional study, 100 asymptomatic normal adult Filipino volunteers, aged 20 to 69 years were tasked to perform selected static balance tests. These tests included classic Romberg (CR), Romberg with Jendrassik (RJ) maneuver, tandem Romberg (TR), standing on foam with feet apart (SOFFA), standing on foam with feet together (SOFFT) and standing on one leg (SOL). All tests were done with eyes opened (EO) followed by eyes closed (EC) for 30 seconds each. Volunteers were grouped into age groups by decades, normative values were obtained and effects of age, sex and body mass index, if any, on performance of the various tests were determined.

RESULTS: All volunteers were able to do the CR and RJ maneuver for 30 seconds. All were able to perform for 30 seconds the TREO, SOFFA EO and SOFFT EO procedures. Some volunteers were unable to complete the TREC, SOFFA EC, SOFFT EC, SOL EO and SOL EC procedures. The mean performance duration values for TREC, SOFFA EC, SOFFT EC, SOL EO AND SOL EC were significantly negatively correlated with age. Although majority of tests were negatively correlated with body mass index, the correlations were not statistically significant.

CONCLUSION: Age significantly affects selected static balance performance whereas sex and body mass index do not significantly affect selected static balance performance. The normative values generated in this study are inconclusive because of inadequate sample size, particularly in the older age group. The results, however, showed the potential value of the 5th percentile as a normative norm in systematically assessing the involvement of the vesticular, visual and proprioceptive organs i balance function.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Sample Size ; Body Mass Index ; Posture ; Foot ; Volunteers

OBJECTIVE: The purpose of this review is to improve the detection of TB otitis media cases and its treatment outcome by describing the varied clinical presentations, discussing the importance, limitations and frontiers of possible diagnostic tests and illustrating the roles of medical and surgical interventions

METHOD: A review of available literature was done. The search included published researches on TB Otitis Media and related articles on tuberculosis.

RESULTS: The review included aspects of the clinical presentation, diagnostic considerations, and treatment options, both medical and surgical, of tuberculous otitis media.

CONCLUSION: Tuberculous otitis media presents with a variety of clinical features so that a high index of suspicion is very important. Diagnostic examinations are available but are varied depending on the clinical presentation. Definitive treatment is mainly medical with anti- Koch's medications.

Diagnostic Tests, Routine ; Otitis Media ; Tuberculosis ; Treatment Outcome ; Research

OBJECTIVES. The goal of the study is to find a reasonable aIternative test that can be utilized in the Philippine setting to operationalize the Universal Newborn Hearing Screening Act. Thus the components of the Voice Test were studied. The objectives of the study are to determine: (1) which of the two words "Baah" and "Psst" is better for newborn hearing screening rocedure as far as their physical characteristics are concerned, ~) how do the two words "Baah" and Psst" differ between genders and distance from sound source, (3) to determine the proportion of the participants who could recite the words at intensity of 80db or louder.

METHODS. Frequency characteristics and sound intensity differences of two words "Baah" and "Psst" were determined and ompared.

RESULTS. The word "Baah" exhibited more favorable physical attributes over the word 'Psst" for purposes of being a screening tool for newborn hearing assessment.

CONCLUSION. This study reports the results of an initial step in the search for an inexpensive, feasible, and valid tool for neonatal earing screening. Correlation studies with speech developmental milestones may eventually enhance the usefulness of the voice test.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Neonatal Screening ; 1012-s-acetamide Adipic Hydrazide Sepharose 4b ; Benzodiazepines ; Sepharose