INTRODUCTIONHearing plays a important role in speech development in children. Most common cause of hearing loss in children especially below 12 years of age is otits media with effusion (OME). It is defined as the presence of fluid in the middle ear without signs or symptoms of acute ear infection.1,2 Persistent middle-ear fluid from otitis media with effusion results in decreased mobility of the tympanic membrane and serves as a barrier to sound conduction.3 This accumulation of non-purulent effusion in the middle ear which leads to conductive hearing loss ( Figure 1).Prevalence of otitis media with effusion also known as serous otitis media or glue ear ranged between 2 to 50%. 4The duration of the effusion can be acute (less than three weeks), subacute (three weeks to three months) or chronic (longer than three months). 5 The aetiology of otitis media is multifactorial which include adenoids hypertrophy, infection (viral or bacteria), allergy, environment and social factors overcrowding, poor diet ABSTRACT Background: Hearing plays a valid role in speech development in children. Otitis media with effusion is one among the commonest causes of hearing loss in children especially below 12 years. Methods: A prospective study was carried out in Lourdes Hospital, Kochi, over a period of 1 year from January 2013 to December 2013. 30 patients with chronic middle ear effusion below the age of 12 years were selected. Results: Of 30 patients 59.5% of patients were in age group of 5-7 years, 16.6 % of patients were in age group of 9-11 years, 60% were male children, 40% patients were female children, majority of them had grade 3 adenoid hypertrophy by endoscopic assessment, 66.6 % of them had eustachian tube blockade by adenoid mass, 100% of them with eustachian tube blockade found to have fluid on doing myringotomy. Significant association was found between type B tympanogram and presence of fluid on myringotomy revealing that type B tympanogram and eustachian tube blockade better predictor of otitis media with effusion than grade of adenoid hypertrophy Conclusions: The present study showed that chronic middle ear effusion was found to be most common in the age group of 3-5 years of age group. Tympanogram type B was found to be strongly associated with fluid on myringotomy. All the children with chronic middle ear effusion in the study group were found to have, grade 3 grade 2, and grade 4 adenoid hypertrophy in the descending order of frequency. Grade 3 adenoid hypertrophy was present in majority of the children in the study group. Lateral adenoid hypertrophy, abutting on the nasopharyngeal orifice of Eustachian tube was present in majority of children. Eustachian tube obstruction was found to be strongly associated with fluid on myringotomy and grommet insertion.
<p class="abstract">This is a case report of 57yrs old gentleman who presented to accident and emergency department with complaints of sudden onset of left earache, tinnitus, feeling of fullness in the ear which he claimed to start following an episode of sudden sneezing, while he was trying to blow his nose by pinching it with 2 fingers. The tympanic membrane was ruptured. He was managed conservatively with analgesics. Spontaneous and complete healing of the perforated tympanic membrane occured within one month of follow up. It was shown that an episode of sneezing with nose closed can build up such a high pressure in the middle ear which can perforate a tympanic membrane.</p>
<p class="abstract">Rhinosporidiosis is an infective chronic granulomatous lesion caused by an organism rhinosporidium seeberi, which is seen endemic in some parts of Asia. This organism is difficult to culture and the diagnosis is based on histopathological examination. This disease is more commonly seen in men, in second to third decade..<strong> </strong>This case report is regarding a case of a 55 years old lady with history of recurrent rhinosporidiosis in nose. The lesion was found to arise from the inferior meatus and was pale smooth glistening in appearance, insensitive and does not bleed on touch. Site of origin of the polyp and the appearance was atypical of that of rhinosporidiosis. Patient was subjected for endoscopic excision and cauterisation of the base of the lesion and sent for histopathological examination .Biopsy confirmed the diagnosis of rhinosporidiosis.</p>
<p class="abstract">Benign calcifying epithelioma of Malherbe or pilomatricoma is rare benign skin tumours, typically seen in head and neck region. This is supposed to arise from hair follicle matrix cells. Though head and neck is the commonest area involved by this tumour, only 4.5% cases have been reported in the pinna. Neck is most commonly involved followed by cheek, scalp, pre auricular and peri orbital areas. Here we report a case of pilomatricoma over medial surface of pinna in a 20 years old female. She had the swelling which was gradually increasing for the past 5 years. Histopathological examination following excision biopsy confirmed the diagnosis.</p><p class="abstract"> </p>
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