An informational survey about actinomycosis is presented. Following this review, the case reports of two patients with actinomycosis of the tympanomastoid are discussed in detail.
The bizarre clinical course and the unusual gross pathological findings during surgery should alert the otologist to consider actinomycosis as the etiologic entity. Effective treatment combines surgery and long‐term chemotherapy.
A facial nerve coursing inferior to the oval window niche was injured during a stapedectomy. In this location, the nerve did not have normal gross characteristics and was not recognized as a vital structure.
The relationship between the facial nerve and the stapes is determined by the fourth week of fetal life. Even when the nerve lies inferior to the stapes, it is postulated that a normal bony facial canal and stapedial muscle can develop.
If the tonsils and adenoids are causing eustachian tube dysfunction with middle ear effusion, the need for a ventilation tube at the time of the T&A and myringotomy is unresolved. Thirty‐one patients with bilateral symmetrical middle ear effusion had T&A and myringotomies. In one ear, a ventilation tube was inserted; the other ear acted as a control.
In addition to the clinical impressions, preoperative and serial postoperative audiograms and tympanograms are compared through a 12month time frame. Discussion is presented regarding middle ventilation at the time of the primary operation.
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