RESUMEN
An elderly woman, two months after chemotherapy for diffuse large B-cell lymphoma, presented with left-sided otalgia, discharge and facial nerve palsy. MRI showed an active left mastoid infection with an ear canal lesion, likely to be a cholesteatoma. However, a biopsy of the mass showed recurrent high-grade lymphoma. Following diagnosis, the patient opted for palliative care within the community and consequently passed away a few weeks later.
Asunto(s)
Dolor de Oído/etiología , Parálisis Facial/etiología , Linfoma de Células B Grandes Difuso/complicaciones , Anciano , Biopsia , Diagnóstico Diferencial , Dolor de Oído/diagnóstico , Parálisis Facial/diagnóstico , Femenino , Humanos , Imagen por Resonancia Magnética , Tomografía de Emisión de Positrones , Tomografía Computarizada por Rayos XRESUMEN
CONCLUSIONS: There has been a reduction in the number of modified radical mastoidectomy and revision mastoidectomy surgeries per head of population in Ontario between 1987 and 2007, we believe that this represents a true reduction in prevalence of cholesteatoma. The increase of cases performed at the University Hospital Network, Toronto (UHN) may represent a shift to subspecialization in the treatment of chronic ear disease. OBJECTIVE: To analyze the trends in mastoid operations for chronic middle ear disease in the Canadian province of Ontario between 1987 and 2007 and to determine whether an increasing proportion of these procedures are being performed in tertiary referral centres. METHODS: The year on year population and number of mastoid procedures performed per year in Ontario and at the UHN between 1987 and 2007 were obtained from Statistics Canada and the Ministry of Health and Long-Term Care, Ontario, respectively. Population-adjusted rates of mastoid surgery for Ontario and the UHN. These data were collated and graphically represented for trend analysis. RESULTS: The population-adjusted number of mastoid procedures for Ontario declined from 7.1 cases per 100,000 in 1986 to 4.1 cases per 100,000 in 2006. During this time the number of both modified radical mastoidectomies and revision mastoid surgeries at UHN increased.
Asunto(s)
Colesteatoma del Oído Medio/cirugía , Apófisis Mastoides/cirugía , Procedimientos Quirúrgicos Otológicos/tendencias , Colesteatoma del Oído Medio/epidemiología , Humanos , Incidencia , Cuidados a Largo Plazo , Ontario/epidemiología , Procedimientos Quirúrgicos Otológicos/estadística & datos numéricos , Prevalencia , Estudios Retrospectivos , Factores de Tiempo , Resultado del TratamientoRESUMEN
Non-accidental caustic injury is a rare form of child abuse usually secondary to forced ingestion. Caustic injury to the ear most commonly arises from battery lodgement in the external canal. This case series represents the first report of non-accidental caustic injury to previously normal ears resulting in profound sensorineural hearing loss, vertigo with horizontal canal hypofunction and in one patient a severe facial nerve paralysis. Both patients required blind-end sac closure of the injured ear and one required sural nerve interposition combined with transfer of the masseteric branch of the trigeminal nerve to the ipsilateral facial nerve.
Asunto(s)
Cáusticos/toxicidad , Maltrato a los Niños , Oído Interno/lesiones , Parálisis Facial/inducido químicamente , Pérdida Auditiva Sensorineural/inducido químicamente , Niño , Cóclea/diagnóstico por imagen , Cóclea/lesiones , Terapia Combinada , Servicio de Urgencia en Hospital , Parálisis Facial/diagnóstico por imagen , Parálisis Facial/terapia , Estudios de Seguimiento , Pérdida Auditiva Sensorineural/fisiopatología , Pérdida Auditiva Sensorineural/cirugía , Humanos , Puntaje de Gravedad del Traumatismo , Medición de Riesgo , Factores de Tiempo , Tomografía Computarizada por Rayos X/métodos , Membrana Timpánica/lesiones , Membrana Timpánica/cirugía , Vértigo/inducido químicamente , Vértigo/diagnóstico , Vértigo/terapia , Vestíbulo del Laberinto/lesiones , Vestíbulo del Laberinto/cirugíaRESUMEN
OBJECTIVES: Children are undergoing cochlear implantation younger than ever before. There has been some concern that young children may have an increased risk of soft tissue complications than older age groups. We aim to review the major and minor soft tissue complications after pediatric cochlear implantation in the age group of younger than 12 months. STUDY DESIGN: Retrospective case review. METHODS: Patients were identified from the cochlear implant program database of more than 1,000 children at the Hospital for Sick Children, Toronto, Canada. Demographic data, cause of hearing loss, and time of the onset of hearing loss were recorded. RESULTS: A total of 66 patients were identified (94 implants) in the age group of younger than 12 months. Of these, there was 1 minor complication (implanted at 8 mo)-skin infection around implant 14 days later treated with antibiotics. There were no major complications. CONCLUSION: Cochlear implantation in children younger than 12 months does not increase the risk of soft tissue complications.