Earmold Foreign Bodies in the Middle Ear Necessitating Surgical Removal: Why Otology Specialists Should Screen Candidates for Hearing Aids.
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ABSTRACT:
SUBMITTER: Cho SD
PROVIDER: S-EPMC8111396 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Ear and nose foreign bodies are common problems affecting the children but adults are not an exception. A prospective study involving 87 patients is undertaken concentrating on presentation of patients with various types of ear or nasal foreign bodies. In the present study common presenting complaints and uncommon presentation scenarios encountered by us like a nasal foreign body with intra cranial complications, an impacted middle ear foreign body with mastoiditis is discussed. The present article emphasizes the need of considering presence of foreign bodies even in the absence of appropriate clinical signs and symptoms suggestive of a foreign body in ear or nose.
| S-EPMC3244580 | biostudies-literature
Project description:This is a prospective clinical assay that included six patients who were diagnosed with penetrating corneal injury, traumatic cataract, and posterior segment intraocular foreign body (IOFB). Following anterior segment repair and extraction of traumatic cataract by clear cornea phacoemulsification, a standard 25-gauge transconjunctival pars plana vitrectomy was performed to find and release the IOFB. With active suction using a 25-gauge silicone tipped cannula, the foreign body was retrieved and safely placed in the anterior chamber. After stabilization of the anterior chamber with viscoelastic injection, IOFB extraction through the main phaco incision was easily performed, followed by placement of an intraocular lens. Of the six patients, 66.6% showed a significant improvement of visual acuity. No complications associated directly with the surgical procedure occurred. Our surgical technique is a safe alternative for handling and removing a posterior IOFB. There was no need for a scleral incision.
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Project description:Sonography provides excellent detection, localization, and characterization of soft-tissue foreign bodies. Ultrasound guided foreign body removal is a safe and highly successful minimally invasive procedure that facilitates effective treatment and avoidance of complications in patients with soft tissue foreign bodies. Focused laboratory training is critical to successful implementation of a sonographic foreign body management practice.
| S-EPMC7754500 | biostudies-literature
Project description:Electrophysiological feedback on activity in the auditory pathway may potentially advance the next generation of hearing aids. Conventional electroencephalographic (EEG) systems are, however, impractical during daily life and incompatible with hearing aids. Ear-EEG is a method in which the EEG is recorded from electrodes embedded in a hearing aid like earpiece. The method therefore provides an unobtrusive way of measuring neural activity suitable for use in everyday life. This study aimed to determine whether ear-EEG could be used to estimate hearing thresholds in subjects with sensorineural hearing loss. Specifically, ear-EEG was used to determine physiological thresholds at 0.5, 1, 2, and 4?kHz using auditory steady-state response measurements. To evaluate ear-EEG in relation to current methods, thresholds were estimated from a concurrently recorded conventional scalp EEG. The threshold detection rate for ear-EEG was 20% lower than the detection rate for scalp EEG. Thresholds estimated using in-ear referenced ear-EEG were found to be elevated at an average of 5.9, 2.3, 5.6, and 1.5?dB relative to scalp thresholds at 0.5, 1, 2, and 4?kHz, respectively. No differences were found in the variance of means between in-ear ear-EEG and scalp EEG. In-ear ear-EEG, auditory steady-state response thresholds were found at 12.1 to 14.4?dB sensation level with an intersubject variation comparable to that of behavioral thresholds. Collectively, it is concluded that although further refinement of the method is needed to optimize the threshold detection rate, ear-EEG is a feasible method for hearing threshold level estimation in subjects with sensorineural hearing impairment.
| S-EPMC6291863 | biostudies-literature
Project description:Foreign bodies within the sinuses, orbit, and skull base (FBSOS) are rare; hence, diagnosis and management guidelines are lacking. Endoscopic sinus surgery (ESS) removal is preferred because of the less invasiveness and minimal morbidity. This study was designed to summarize clinical experience with ESS management of FBSOS.We retrospectively reviewed clinical manifestations, imaging findings, treatment, and outcomes in consecutive patients with ESS removal of FBSOS between 2004 and 2015 at a tertiary academic medical center. The Chi-square test was performed to compare the infection rate between wooden and nonwooden FBSOS.There were 23 male and five female patients, with median age of 11 years. FBSOS were located within the sinuses (86%), orbit (75%), and skull base/intracranial region (46%). Wooden FBSOS had a significantly higher risk of infection (78%) compared with nonwooden FBSOS (5%, P < 0.05). Contrast-enhanced computed tomography (CT) plus three-dimensional reconstruction was sensitive in all cases. Twenty-seven (96%) FBSOS were removed by ESS alone, while 1 (4%) FBSOS was removed using the combined ESS and lateral cervical approach. Four of the nine intracranial penetrating FBSOS patients had intraoperative cerebrospinal fluid (CSF) leak and received endoscopic CSF leak repair. Twelve (43%) patients suffered complications (meningitis, diplopia, and vision loss).ESS is a minimally invasive, safe, and promising surgical approach for FBSOS removal. Contrast-enhanced CT is effective in preoperative diagnosis and intraoperative guidance. Wooden FBSOS had higher risk of infection, thus antibiotics are recommended.
| S-EPMC5547834 | biostudies-literature
Project description:BACKGROUND:Dacryocystitis is an inflammation of the lacrimal drainage system. One of the most common causes of dacryocystitis in dogs is due to plant-based foreign bodies typically located in the lacrimal sac. The aim of this case series was to describe an ultrasonography-guided technique for dogs with plant-based foreign bodies in the lacrimal sac, as both a diagnostic and therapeutic tool. CASE PRESENTATION:Four dogs with clinically suspected plant-based foreign body in the lacrimal sac (with a total of five eyes affected) were evaluated by ultrasound with a multifrequency (8-14?MHz) linear probe. Under general anesthesia, the foreign body was removed using Hartmann alligator forceps inserted thorough the upper puncta. Ultrasound was used to guide the forceps in grasping the foreign body. Ultrasound was positive in four out of five lacrimal sac diseases. All identified foreign bodies were successfully removed by the ultrasonography-guided technique. CONCLUSIONS:The results show that ultrasound is a fast, non-invasive, and inexpensive method for the assessment of dacryocystitis due to foreign bodies in dogs. Ultrasound is also useful not only for identification, but also in the non-invasive removal of the foreign body from the lacrimal sac. To the best of authors' knowledge, this is the first study to describe the sonographic approach to the palpebral medial cantus as an initial diagnostic step in canine dacriocystitis.
| S-EPMC6402165 | biostudies-literature
Project description:ObjectiveWe described the technique of ultrasound (US)-guided percutaneous removal of the foreign bodies (FB) with hydro-dissection in the radiologic department and presented video files of several cases.Materials and methodsFour patients referred to the radiology department for US evaluation and US-guided percutaneous removal of the FBs in the upper and lower extremities between November, 2006 and November, 2013 were included in this study. The procedures started with US evaluation for the exact location and shape of the FB. A 5 mm-sized skin incision was made at the site of the nearest point from the FB where no passing arteries or tendons were present. We adopted a hydrodissection technique to separate the FB from adjacent tissue using a 2% lidocaine solution. Injected anesthetics detached the FBs from surrounding tissue and thereby facilitated removal. After the tip of the mosquito forceps reached the FB, the wooden FBs were removed.ResultsThe mean time required for the entire procedure was approximately 20 minutes. There were no significant complications during the US-guided removal or long-term complications after the procedure. All 4 FBs were successfully removed from the soft tissue under US guidance.ConclusionUltrasound-guided percutaneous removal of the FBs with hydro-dissection in the radiology department is a less invasive and safe method over surgical removal in the operating room. Additionally, the use of a guide wire and serial dilator may help minimize soft tissue injury and facilitate the introduction of forceps.
| S-EPMC4644755 | biostudies-literature
Project description:A 28-year-old male presented with three full-thickness stromal wooden foreign bodies vertically oriented in the left cornea. An innovative intracameral approach was used. Paracentesis was done and healon was injected into the anterior chamber. Iris repositor was introduced into the anterior chamber and the area of foreign bodies was pushed up to compress the stroma. The wooden foreign body projected above the corneal surface and were picked up one by one using McPherson forceps. One of the foreign bodies has penetrated through the Descemet's membrane resulting a corneal perforation. A corneal perforation was confirmed by observing egress of the irrigating solution, injected into the anterior chamber through the paracentesis opening. The corneal perforation was sealed with corneal glue. He achieved 6/9 BCVA (OS) at 8 weeks and maintained it during18 months follow-up.
| S-EPMC8012963 | biostudies-literature
Project description:BackgroundA substantial fraction of dizzy patients are assessed by neurologists and ear-nose-throat (ENT) physicians. With the differential diagnosis being broad and often different specialties involved, we aimed to assess the interaction with generalists from the specialists' perspective to identify limitations and needs and to define strategies for improvement in patient care and education by the specialist.MethodsOne hundred eleven board-certified neurologists (n = 62) and ENT physicians (n = 49) working in Switzerland participated in an online survey. Here, we focused on limitations faced in the diagnostic workup and treatment of the dizzy patient and potential strategies to improve the standard of care and the interaction between generalists and specialists. Descriptive statistical analyses were performed. We hypothesized that those specialists applying modern concepts in history-taking and bedside examination techniques reach a specific diagnosis more often and request fewer referrals.ResultsSpecialists indicated higher confidence in reaching a specific diagnosis for patients presenting with acute dizziness than episodic/chronic dizziness (80% vs. 60%) at the first consultation. Knowledge of the timing-and-trigger concept [odds ratio (OR) = 0.81 (0.67-0.98), p = 0.034], as well as of subtle oculomotor/vestibular signs [OR = 0.80 (0.68-0.94), p = 0.007] was predictive of the self-reported probability of reaching a specific diagnosis in patients with episodic/chronic dizziness, while no such differences were observed in the care of acutely dizzy patients. Further referrals of acutely dizzy patients were significantly higher in neurologists than in ENT physicians (17% vs. 10%, p < 0.001) and in specialists located in the Latin part of Switzerland [OR = 2.84 (1.63-4.93), p < 0.001], while this was not the case for patients with episodic/chronic dizziness. Identified unmet needs included regular communication between physicians (27%/53%; always/often true) and sufficiently detailed information on the previous workup from the referrals (27%/53%). Specialists expressed most interest in hands-on courses/workshops, webinars, and practical guidelines for education.ConclusionIn our survey, bedside state-of-the-art assessments were key in reducing the fraction of unclear dizzy cases. Several gaps were identified that should be addressed. Specifically, referring physicians should provide more comprehensive details regarding urgency, prior diagnostics, and treatment. Specifically, when promoting the knowledge of neurologists and ENT physicians, this should be preferentially done by offering a combination of hands-on courses and webinars.
| S-EPMC10800397 | biostudies-literature
Project description:PurposeAn important outcome measure of patient care is the impact on the patient's health-related quality of life (HRQoL). Current ear-specific HRQoL instruments are designed for one diagnosis and emphasize different subdivisions such as symptoms, hearing problems, psychosocial impact, and the need for care. The optimal length of the recall period has not been studied. For these reasons, a new survey is needed that would cover most chronic ear diseases.MethodsA preliminary 24-item survey (EOS-24) was created. Untreated adult patients (included n = 186) with one of seven different chronic otologic conditions from all university hospitals in Finland were recruited to respond to EOS-24 and the 15D general HRQoL instrument. The recruiting otologists evaluated the severity of the disease and the disability caused by it. A control group was recruited. Based on the patients' responses in different diagnosis groups, the items were reduced according to pre-defined criteria. The resulting survey was validated using a thorough statistical analysis.ResultsThe relevance and necessity of the original 24 items were thoroughly investigated, leading to the exclusion of 8 items and the modification of 1. The remaining 16 items were well-balanced between subdivisions and were useful in all seven diagnosis groups, thus constituting the final instrument, EOS-16. The most suitable recall period was three months.ConclusionsEOS-16 has been created according to the HRQoL survey guidelines with a versatile nationwide patient population. The survey has been validated and can be used for a wide range of chronic ear diseases as a HRQoL instrument.
| S-EPMC8241709 | biostudies-literature