Objectives: Evaluate the relationship between clinical findings and course of disease among patients with necrotizing otitis externa (NOE). Study Design: Retrospective case series review. Setting: Tertiary referral center. Patients: Adult patients with no previous history of chronic ear disease, hospitalized due to NOE between the years 1990 to 2015. Main Outcome Measures: 1) Duration of hospitalization and 2) necessity for surgery. Results: Eighty-one patients were included in the study, corresponding to 83 effected ears. Thirty-two patients (38.5%) were hospitalized longer than 20 days and 20 patients (24.0%) underwent surgery. Otalgia was the most common complaint (n = 71, 85.5%). Pseudomonas Aeruginosa (PA) was the most common isolated bacteria (n = 40, 48.1%). Shifting incidence of culture results was noted, as rates of PA NOE decreased and rates of sterile culture and fungal NOE increased. Duration of complaints and presence of aural discharge at admission were associated with prolonged hospitalization (p = 0.010, p = 0.011, respectively). Advanced age, duration of hospitalization, and rates of readmission were associated with surgery (p = 0.037, p < 0.001, p < 0.001 respectively). Conclusions: Duration of complaints and presence of aural discharge may indicate advanced NOE and require longer in-hospital treatment. Elderly patients are at increased risk for conservative treatment failure and are more likely to require surgery. With shifting incidence of pathogens, a wider empirical treatment covering nontraditional pathogens should be considered.

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A PubMed search was conducted using the key words 'otitis externa', 'necrotising otitis externa', 'malignant otitis externa', 'osteomyelitis' and 'diabetic foot'.Results and conclusionThe similarities regarding patient population and pathophysiology between necrotising otitis externa and diabetic foot osteomyelitis raise basic questions concerning the effects of long-standing diabetes on the external ear. The concordance between local swabs and bone cultures in diabetic foot osteomyelitis is less than 50 per cent. If this holds true also to necrotising otitis externa, the role of deep tissue cultures should be strongly considered. Similar to diabetic foot osteomyelitis, magnetic resonance imaging should be considered in selected necrotising otitis externa subgroups.

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Background: Since the outbreak of the coronavirus disease 2019 pandemic, there has been a decline in pediatric emergency department visits. Our aim was to assess the pattern of pediatric foreign body aspiration (FBA) during the first year of the COVID-19 pandemic, in comparison to the prior years. Methods:In this retrospective multicenter study, we compared the number of children who presented with FBA during the COVID-19 year (March 1, 2020 to February 28, 2021) to the annual average of the years 2016-2019. We also compared the lockdown periods to the postlockdown periods, and the percentage of missed FBA, proven FBA, and flexible bronchoscopy as the removal procedure.Results: A total of 345 children with FBA from six centers were included, 276 in the pre-COVID-19 years (average 69 per year) and 69 in the COVID-19 year. There was no difference in the prevalence of FBA between the COVID-19 year and any of the prior 4 years. Examining the lockdown effect, the monthly incidence of FBA dropped

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check up system was also useful to detect congenital cholesteatoma in Japan.We present the recent congenital cholesteatoma cases in our hospital and describe the check up system for hearing from newborns to infant in Japan.Study design: retrospective chart analysis of consecutive patients with congenital cholesteatoma.Patients: Between September 2004 and August 2015 conclusive 47 patients underwent primary procedure.Intervention: The diagnosis of congenital cholesteatoma with Potsic staging system and the therapeutic operation were performed. Main outcome measures:The chance of detecting the congenital cholesteatoma, the patient age, the stage of the disease, the pathology of the ossicles and the hearing result of the surgery were studied.Results: Twenty two percent of the patients belonged to the Stage I and II without ossicular involvement. They showed normal hearing. Eighty eight percent of the patients belonged to the Stage III or IV and 76% of the patients showed good hearing result postoperatively. Thirty percent of the patients had diagnosed by the hearing check up and 32 % of the patients had found accidentally with microscopic examination at the ENT office. Learning Objectives: 1.Anatomical variants of tympanic compartments and their aeration patterns are one of the relevant pathogenetic factors involved in type of cholesteatoma occurrence. 2.The isthmus blockage theory could be a condition for the epitympanic type while tubal dysfunction is mandatory for mesotympanic type of cholesteatoma since the contralateral ear abnormalities are more frequent in the last one.Introduction: In the recent years the incidence of chronic otitis media with cholesteatoma has decreased but remain a major challenge for surgeons due to the destructive characteristic of the disease. Although the pathophysiology of the acquired cholesteatoma remains to be clearly elucidated, it is presumed to be multifactorial, as many theories have been proposed and investigated. Anatomical variants of tympanic compartments and their aeration patterns are one of the contributing factors. Retraction pocket theory is the most widely accepted but the contralateral ear in patients with cholesteatoma is less studied. The purpose of this study was to evaluate the contralateral ear in patients with cholesteatoma and to determine whether the characteristics of it differ according cholesteatoma growth patterns.Methods: The charts of 924 operations for cholesteatoma performed from January 2000 to December 2013 at the Department of Otorhinolaryngology-Head and Neck Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, ClujNapoca were analyzed retrospectively. Otomicroscopy was performed on both the affected and the contralateral ear. Cholesteatoma extension was noted during surgery.Results: The age average for patients included in the study was of 41 ± 6.5 years (95%CI [39.32-42.85]). The frequency of significant changes in the contralateral ear was 49.2 %. 6.5% of patients presented with bilateral cholesteatoma. Other abnormalities were retrac...