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This document provides statistical data and analyses on the relationship between temporomandibular disorders (TMDs) and various symptoms. The data includes scores for TMDs, orofacial pain, and psychological distress, as well as correlations between these variables. The document also includes the results of multivariate logistic regression analyses, indicating the odds ratios for the presence of painful and "any" TMDs. The findings suggest that there is a significant association between TMDs and symptoms such as tinnitus, dizziness, ear pruritus, hearing loss, headache, eye pain, neck pain, and back pain. Further research is needed to better understand these relationships. [Extracted from the article]

Background: Paracetamol and ibuprofen are the most commonly used drugs for pain treatment in children and their combination has shown improved analgesic effect compared to treatment with either drug alone. Current literature lacks specific guidelines regarding the settings in which this combination should be adopted. Methods: The survey, conducted with Delphi methodology, involved 75 hospital and outpatient pediatricians with clinical experience in the management of pain in children. Pediatricians involved were asked to validate or not the results of the previous NominalGroup Tecnique (NGT) consensus and thus specify the optimal clinical settings in which the paracetamol/ibuprofen fixed-dose combination could be adopted. Results: The results confirm the importance of the fixed-dose paracetamol and ibuprofen combination for the control of mild-to-moderate acute pain in children. Particularly, this association seems to be appropriate in case of headache, earache, odontalgia and musculoskeletal pain, and in specific settings such as post-operative and post-procedural pain. The broadening of the panel brought to slight variations in clinical management practices between hospital and outpatient specialists. Nonetheless, overall consensus supports the notion that the fixed dose combination is more efficacious than monotherapies and it is well tolerated. Moreover, experts unanimously agree on the usefulness of the combination for caregivers, leading to improved adherence and effectiveness. Conclusions: Both the NGT consensus and the broader Delphi consensus confirm the usefulness of the paracetamol-ibuprofen fixed-dose combination in pediatric pain. This is attributed to its superior effectiveness compared to monotherapies, a good tolerability profile, and improved compliance and ease of use. Some pain settings related to chronic, inflammatory and rheumatological pathologies remain to be investigated to evaluate the use of this combination. [ABSTRACT FROM AUTHOR]

Concurrent tuberculosis and fungal otitis media complicated with skull base osteomyelitis is a rare and intricate clinical entity, particularly in well-controlled diabetes mellitus patients with unusual symptomatology. We present the case of an elderly gentleman with well-controlled type II diabetes mellitus who endured four months of chronic left ear pain, left-sided temporal headaches, and left ear pulsatile tinnitus, which persisted despite multiple courses of antibiotics. Initial investigations yielded conflicting suggestions, indicating the possibility of either an infection or the presence of a glomus tumor. However, intraoperative samples sent for microbiological and histological investigation revealed the presence of Aspergillus Niger and Mycobacterium complex. Treatment with antifungal and antituberculosis agents led to a remarkable improvement in the patient's clinical symptoms and radiological and biochemical markers. [ABSTRACT FROM AUTHOR]

Background Current guidance suggests oral antibiotics can be considered for children with acute otitis media (AOM) and ear discharge, but there is an absence of evidence regarding the relative effectiveness of antibiotic-corticosteroid eardrops. Aim To establish whether antibiotic-corticosteroid eardrops are non-inferior to oral antibiotics in children with AOM and ear discharge. Design and setting Open randomized controlled non-inferiority trial set in Dutch primary care. Methods Children were randomized to hydrocortisone-bacitracin-colistin eardrops (five drops, three times per day in the discharging ear(s)) or amoxicillin suspension (50 mg per kilogram of body weight per day, divided over three doses administered orally) for 7 days. The primary outcome was the proportion of children with resolution of ear pain and fever at day 3. Results Between December 2017 and March 2023, 58 of the planned 350 children were recruited due to slow accrual for various reasons. Children assigned to eardrops (n  = 26) had lower resolution rates of ear pain and fever at 3 days compared to those receiving oral antibiotics (n  = 31): 42% vs 65%; adjusted risk difference 20.3%, 95% confidence interval −5.3% to 41.9%), longer parent-reported ear discharge (6 vs 3 days; P  = .04), and slightly higher mean ear pain scores (Likert scale 0–6) over days 1–3 (2.1 vs 1.4, P  = .02), but received fewer oral antibiotic courses in 3months (11 for 25 children vs 33 for 30 children), and had less GI upset and rash (12% vs 32% and 8% vs 16%, respectively). Conclusion Early termination stopped us from determining non-inferiority of antibiotic-corticosteroid eardrops. Our limited data, requiring confirmation, suggest that oral antibiotics may be more effective than antibiotic-corticosteroid eardrops in resolving symptoms and shortening the duration of ear discharge. [ABSTRACT FROM AUTHOR]

Nasopharyngeal cysts are rare benign entity, smaller in size and usually asymptomatic. They are mostly diagnosed incidentally on MRI. Larger cysts commonly presents with spasmodic and obstructive symptoms. Thornwaldt cysts are congenital cysts originating from the mid- line of the nasopharynx just above the upper border of the superior constrictor muscle. They represent primitive communication between notochord remnants and the pharyngeal endoderm. We report this case because of its unique presentation in a 35 year old male. Patient presented with nasal blockage, nasal discharge, snoring, ear pain and aural fullness, intermittent neck pain and neck stiffness. Preoperative evaluation included diagnostic nasal endoscopy (DNE) and Magnetic resonance imaging (MRI-scan). A large cystic mass of size 2.8 cm × 3 cm was diagnosed on DNE and MRI. Transnasal Marsupialisation and excision of the cyst was planned using powered instruments. Post operatively, patient noticed marked improvement in the obstructive symptoms. Regular follow up was done 6 monthly for 2 years. No recurrence was noted on DNE. Although a rare pathology in adulthood, it should be kept as a differential diagnosis for cervical pain and neck stiffness. [ABSTRACT FROM AUTHOR]

Introduction: Global demand for healthcare is escalating, prompting exploration of innovative strategies to augment service capacity. Independent prescribing (IP) helps to address this challenge, allowing non-medical professionals to prescribe medication. Paramedics in the UK were granted prescribing privileges in 2018, yet uptake remains low. Despite qualitative evidence indicating that paramedic prescribing is beneficial, quantitative comparisons of medication provision between prescribers and non-prescribers are lacking. Paramedics provide patients with non-emergency medication by three different routes: IP, using a patient group direction (PGD) or with prescriber support. Advanced paramedic practitioners who are not qualified as independent prescribers, rotating through ambulance and general practitioner out-of-hours services, offered an opportunity to quantitatively compare medication supply. Methods: This study compares medication supply by three advanced paramedic practitioners using PGDs with three prescribing nurses in a Welsh general practitioner out-of-hours service. A cross-sectional design was employed to retrospectively review electronic patient clinical records between 1 December 2019 and 30 November 2020, including patients presenting with one of five generalised clinical conditions (urinary, soft tissue, respiratory, abdominal pain, ear). Descriptive analysis and non-parametric tests compared medications prescribed or supplied, how patients received medication and reasons for seeking prescriber support. Results: A total of 397 patient records were analysed. Paramedics supplied medications more frequently with prescriber support (68.2%) than via PGD (27.9%). Nurses predominantly prescribed medication independently (99.3%). Medication provision was comparable when paramedics had prescriber support. Reasons for paramedic support-seeking included having no PGD available (34.1%) and PGD being excluded from use (28.4%). Conclusions: Advanced paramedic practitioner medication supply using PGDs and prescriber support was comparable to that of prescribing nurse colleagues. However, autonomy restrictions highlight the need for paramedic prescribing in services where prescriber availability is limited. Further research evaluating the efficiency and cost-effectiveness of PGD use versus IP is necessary. Additionally, the qualitative benefits of IP, such as improved patient care and satisfaction, warrant due consideration when implementing future healthcare strategies. [ABSTRACT FROM AUTHOR]

Actinomycosis is an uncommon infection of the middle ear.Actinomycosis of ear can mimic other common diagnosis of middle ear. The treatment of actinomycosis of the middle ear differs from that of otitis media caused by aerobic bacteria, therefore an accurate diagnosis is necessary. We present a case of actinomycosis of middle ear in a 36-year-old female. Cortical mastoidectomy with tympanoplasty was performed and the patient is well on follow up. Because of its rarity, case has been reported. Middle ear actinomycosis is a rare and treatable condition. Early diagnosis and appropriate management are crucial to prevent complications and ensure a favourable outcome. [ABSTRACT FROM AUTHOR]

The article describes a case of parotitis following endoscopy. Topics include the rarity of parotitis, particularly in children, with causes ranging from viral and bacterial infections to noninfectious factors; the occurrence of post-endoscopy parotitis, a seldom-seen complication that can lead to serious conditions such as osteomyelitis and sepsis; and the clinical case of a 4-year-old girl who developed parotitis after an EGD procedure for Helicobacter pylori gastritis.

Objective: The purpose of this study is to describe both the common and uncommon symptoms associated with Eagle syndrome and share our experience treating a large group of patients with surgical intervention, primarily intraoral excision of the calcified stylohyoid ligament. Methods: This retrospective case series included 56 patients at least 18 years of age or older with a diagnosis of Eagle syndrome. All operations were conducted by a single surgeon at a tertiary medical center from 2015 to 2022. Charts were reviewed for demographics, prior medical/surgical history, symptoms, imaging results, operative details, and follow‐up history. A phone survey inquired about presenting symptoms and symptom resolution following surgery. Results: The most common areas of pain were the ear (64.3%), underneath the angle of the mandible (50%), throat (46.4%), and neck (30.4%). Over 70% of patients reported tinnitus, dysphagia, and pain that were exacerbated by head rotation. Fifty‐one of the 56 patients underwent surgical treatment, 92.2% via intraoral and 7.8% via cervical approaches. All patients (100%) reached in a phone survey stated that their symptoms resolved or improved after surgery. Conclusion: Eagle syndrome typically presents with common symptoms. However, healthcare providers must also be vigilant for less common manifestations, such as seizures or episodes of dizziness/fainting. These may be caused by calcification of the stylohyoid ligament. Intraoral surgical resection of the calcified ligament is a safe and effective treatment for most patients. Level of Evidence: Level 4. [ABSTRACT FROM AUTHOR]

Background: The term temporomandibular disorder (TMD) indicates a set of musculoskeletal conditions involving temporomandibular joint (TMJ), masticatory musculature, and related anatomical structures. Pain is the most common clinical manifestation of TMD, and the auditory system might be involved and affected, through tinnitus, dizziness, otalgia and ear fullness sensation. Objectives: The aim of this systematic review of randomised controlled trails (RCTs) was to evaluate the efficacy of rehabilitative approaches on otologic symptoms in patients with TMD. Methods: PubMed, Scopus and Web of Science were systematically searched from the inception until 8th October 2023 to identify RCTs presenting participants with a diagnosis of TMD associated with otologic signs and symptoms, rehabilitative approaches as interventions, and modification of the otological symptoms as outcome. Results: Out of 931 papers suitable for title/abstract screening, 627 articles were assessed for eligibility. Five studies were included reporting the efficacy of occlusal splint therapy, low‐level laser therapies, and physical therapy in patients diagnosed whit secondary otalgia or tinnitus associated with TMD. No RCTs evaluating other otologic symptoms, ear fullness, dizziness or vertigo were found. Conclusions: Results of this systematic review suggested that rehabilitative approaches might be effective in improving secondary otalgia and tinnitus in TMD patients. Thus, further RCTs with a higher level of evidence and more representative samples should be conducted to better understand the effects of TMD therapy on otologic complains. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Owing to the highly contagious nature of SARS-CoV-2, the use of personal protective equipment (PPE) among the healthcare workers (HCWs) is mandatory. However, PPE associated adverse effects are also there. Objective: To study the adverse effects associated with PPE and their preventive measures amongst the HCWs. Material and Methods: A descriptive study was conducted among 200 HCWs working in a Covid center of a tertiary care center. The participants were sent the questionnaires online. Some of them not having smart phones were interviewed telephonically. Their information profile, the various adverse effects associated with PPE, and the preventive measures being practiced by them were noted. Data was analyzed using descriptive and inferential statistics. Results: Total 97% HCWs reported adverse effects with hazmat suit; 96% with N 95 mask; 92% with goggle and 78% with gloves. The adverse effects associated with the prolonged use of the mask were erythema; erosions and scar at the nasal bridge; ear pain; difficulty in breathing; and headache. Sixty-seven percent of the participants had sweating with the use of gloves, which led to cutaneous exfoliation such as dry hands (55%) and skin itching (43%). Moisturizers and natural oils were used to prevent the dryness of hands. For the pressure related injury over the nasal bridge due to N95 mask, participants used to apply Band-Aid (adhesive bandage) and cotton dressing. Conclusion: Adverse skin reactions related to PPE are common among HCWs. Comprehensive assessment of the skin condition and awareness on adverse skin reactions should be advocated. [ABSTRACT FROM AUTHOR]

Infected aneurysms, though rare, present significant challenges in contemporary medical practice. Coined by Sir William Osler in 1885, the term "mycotic aneurysm" encompasses infections of native arteries and preexisting aneurysms, posing life-threatening risks of arterial rupture and recurrence. We discuss a case involving a 51-yearold woman with a giant infected aneurysm, highlighting the complexities in diagnosis. The patient presented with bleeding from her left ear, a fluctuating neck mass, and decreased hearing. Contrast-enhanced computed tomography (CT) played a crucial role in revealing the infected giant aneurysm in the left internal carotid artery, associated with arteriovenous malformation and fistula. Additionally, incidental findings included aneurysms in the right internal carotid and bilateral vertebral arteries. The case underscores the importance of a high index of suspicion and advanced diagnostic tools for timely and accurate diagnosis. The rarity of experienced centers in managing such cases, coupled with a lack of consensus in diagnostic criteria, poses challenges for treatment improvements. [ABSTRACT FROM AUTHOR]

Background: Personal care for body organs is a well-known practice of human beings, especially those organs that need regular care to improve function or hygiene. The ear is a unique sense organ with a specific anatomical shape to perform the function of hearing and balance. Objectives: To determine healthcare practitioners' current knowledge, behavior, and attitude regarding ear care. Subjects and methods: This cross-sectional study was conducted among healthcare practitioners at different hospitals in Najran City, Saudi Arabia, from 25th June to 30th August 2022. A self-administered questionnaire was distributed among healthcare practitioners using an online survey. The questionnaire includes basic demographic characteristics (i.e. gender, speciality, and religion). It assesses the knowledge, behavior, and attitude toward ear care, and the use of mobile headphones and earrings that affect ear health. All statistical data were analyzed using SPSS version 26. Results: Of the 209 healthcare practitioners involved, 60.8% were females, and 46.9% were physicians. The prevalence of self-ear cleaning was 97.6%. Of them, 33% were cleaning their ears every week. Cotton buds were the most preferred method for self-ear cleaning. The proportion of participants who injured their ears while cleaning was 8.6%. The most common treatment method to relieve ear pain was visiting a doctor (44.4%) and utilizing a painkiller (29.7%). Interestingly, respondents who injured their ears during cleaning and those who experienced wax accumulation were significantly more common among physicians. Conclusion: Self-ear cleaning practices are widely prevalent in this study which could be related to the lack of knowledge about ear care among healthcare practitioners. Physicians who experienced wax accumulation tend to use other methods for self-ear cleaning rather than cotton buds. Further research is needed to determine the knowledge, attitude, and practices of the population who are working in healthcare institutions. [ABSTRACT FROM AUTHOR]

Background: Adenoid cystic carcinoma is an uncommon malignancy primarily arising from salivary glands. An extremely rare site for adenoid cystic carcinoma is the skull base. We report a case of adenoid cystic carcinoma of skull base who presented with common complaints of pain and right ear discharge. The discussion is made with emphasis on imaging evaluation simulating infective etiology with adjacent skull base osteomyelitis. Careful observation of the imaging findings and further evaluation of the patient revealed the neoplastic nature of the lesion with the final diagnosis being adenoid cystic carcinoma. Case presentation: A 40-year-old female presented to our department with complaints of pain and right ear discharge since 6 months with progressive, extensive facial swelling and facial nerve palsy. The patient had undergone modified radical mastoidectomy thrice, but the details were not available. On imaging, there was a heterogenous extensive lesion extending from scalp till upper cervical region with extensive destruction of skull base and intra-cranial extension. The possibilities of temporal bone squamous cell carcinoma and extensive skull base osteomyelitis were considered. Further the biopsy of the lesion revealed adenoid cystic carcinoma. Conclusions: Extensive lesions of the skull base can be of infective, neoplastic and inflammatory etiology. Distinguishing between these conditions is crucial, as they have similar imaging characteristics but require different management approaches. The presence of a lesion that displaces or destroys fascial planes, accompanied by solid mass-like enhancement, indicates a higher probability of a neoplastic origin rather than an infectious etiology. With squamous cell carcinoma being the most common neoplasm, adenoid cystic carcinoma of the skull base also needs to be understood due to its propensity for perineural spread and a high likelihood of recurrence. [ABSTRACT FROM AUTHOR]

Primary ectopic meningioma of the middle ear is relatively rare in clinical practice. It is often difficult to distinguish it from chronic otitis media or otitis media with effusion due to its similar and atypical clinical symptoms. We report a case of epithelial tympanic ectopic meningioma with the main complaints of otalgia, aural fullness, and hearing loss. It was accidentally discovered during tympanotomy due to the symptoms of recurring refractory secretory otitis media. This article briefly reviews the relevant literature in recent years, summarizes the characteristics of primary ectopic tympanic meningioma with intact tympanic membrane, and emphasizes the diagnosis and treatment strategy of the middle ear mass. [ABSTRACT FROM AUTHOR]

We present a case of a 68-year-old lady with an insidious progressive history of otorrhea, otalgia, and reduced hearing for 3 months. She was treated for malignant otitis externa and was treated with systemic antibiotic but showed subtherapeutic response to treatment. She underwent examination under anaesthesia and biopsy with tumour debulking of the right ear via posterior auricular approach and histopathological examination revealed squamous papilloma of the external auditory canal. She recovered well after surgery and was asymptomatic during follow-up. [ABSTRACT FROM AUTHOR]

Simple Summary: The hallmark of NF2 is bilateral vestibular schwannomas, which progressively enlarge, leading to sensorineural hearing loss, tinnitus, facial weakness, and pain that translates to social impairment and clinical depression. To better understand disease progression and characterize treatment response, we developed a panel of five tests suitable for the mouse vestibular schwannoma model and investigated how tumor growth and treatment affect gait, coordination, and motor function. These methods, paired with hearing tests, enable a comprehensive evaluation of tumor-induced neurological deficits and facilitate the assessment of the effectiveness of novel therapeutics to improve NF2 treatments. NF2-related Schwannomatosis (NF2-SWN) is a disease that needs new solutions. The hallmark of NF2-SWN, a dominantly inherited neoplasia syndrome, is bilateral vestibular schwannomas (VSs), which progressively enlarge, leading to sensorineural hearing loss, tinnitus, facial weakness, and pain that translates to social impairment and clinical depression. Standard treatments for growing VSs include surgery and radiation therapy (RT); however, both carry the risk of further nerve damage that can result in deafness and facial palsy. The resultant suffering and debility, in combination with the paucity of therapeutic options, make the effective treatment of NF2-SWN a major unmet medical need. A better understanding of these mechanisms is essential to developing novel therapeutic targets to control tumor growth and improve patients' quality of life. Previously, we developed the first orthotopic cerebellopontine angle mouse model of VSs, which faithfully mimics tumor-induced hearing loss. In this model, we observed that mice exhibit symptoms of ataxia and vestibular dysfunction. Therefore, we further developed a panel of five tests suitable for the mouse VS model and investigated how tumor growth and treatment affect gait, coordination, and motor function. Using this panel of ataxia tests, we demonstrated that both ataxia and motor function deteriorated concomitantly with tumor progression. We further demonstrated that (i) treatment with anti-VEGF resulted in tumor size reduction, mitigated ataxia, and improved rotarod performance; (ii) treatment with crizotinib stabilized tumor growth and led to improvements in both ataxia and rotarod performance; and (iii) treatment with losartan did not impact tumor growth nor ameliorate ataxia or motor function. Our studies demonstrated that these methods, paired with hearing tests, enable a comprehensive evaluation of tumor-induced neurological deficits and facilitate the assessment of the effectiveness of novel therapeutics to improve NF2 treatments. [ABSTRACT FROM AUTHOR]

Background: Foramen tympanicum (FT) is a defect located anterior‐inferior to the external acoustic meatus. We evaluated its prevalence, location, size, and relationship with temporomandibular joint (TMJ) disorders. Methods: Cone beam computed tomography was performed for 200 patients who presented to the Karamanoğlu Mehmetbey University Ahmet Keleşoğlu Faculty of Dentistry Hospital. The location and size of the FT in the axial and sagittal planes were evaluated. Descriptive statistics were used to compare the study parameters among age and sex groups. Patients with FT were reevaluated by two maxillofacial surgeons at the study centre. Results: In total, 200 images from 400 joints were examined. Unilateral and bilateral FT (19 [9.5%] and 8 [4%], respectively) was detected in 35 (17.5%) images from 27 (13.5%) patients. Examinations were performed for TMJ disorders in 24 patients. Participants with bilateral defects had the highest rates of presence of sounds and ear pain on the left and right sides (p <.05). Conclusion: Foramen tympanicum can lead to TMJ disorders and spread of tumours or infections from the external auditory canal to the infratemporal fossa. The increased prevalence of such disorders in patients with bilateral FT suggests an association between them. [ABSTRACT FROM AUTHOR]

ObjectivesThe objective of this study is to understand whether the hearing loss laterality in Menière's disease (MD) correlates with migraine symptoms laterality such as headache, neck stiffness, and otalgia.MethodsWe performed a retrospective review of prospectively obtained data on patients presenting between September 2015 and October 2021 with definite or probable MD. A custom-designed, comprehensive questionnaire was used to identify patients' migraine-related symptoms. The clinical and audiometric data were used to diagnose patients with definite or probable MD using criteria set by the American Academy of Otolaryngology-Head and Neck Surgery.ResultsIn total, 113 patients with definite or probable MD were included in the study. The mean age of the patients was 60 ± 15 years with no gender predominance (49.6% male and 50.4% female). A total of 57 (50%) patients were presented with headaches. Among the migraine headache cohort, headache and otalgia were on the same side as the MD ear affected by hearing loss. In addition, in patients who present with otalgia as the primary feature of headache, otalgia was more likely to be on the same side as the ear affected by the hearing loss.ConclusionsThe high prevalence of migraine symptoms on the same side of the ear affected by MD among this cohort could suggest a shared pathophysiology in both MD and migraine, possibly involving migraine-related changes in both the cochlea and vestibule.

The article discusses the cutaneous signs of traditional treatment in Somalis seeking asylum, highlighting the prevalence of scars from indigenous medical practices such as scarification, cauterization, and incisions. The study found that 38% of the subjects had treatment-related scars, with incisions, burns, or both being common. The scars were often geometrically arranged, symmetrical, and varied in distinctness, providing valuable information for practitioners to distinguish their cause from other etiologies, including torture. The article emphasizes the importance of understanding the cultural background of international migrants to provide appropriate medical care. [Extracted from the article]

Necrotizing otitis externa (NOE) is a severe infection primarily affecting the external auditory canal, seen mainly in immunocompromised individuals as patients with diabetes mellitus (DM). This case report highlights unusual complications of NOE: temporal bone and nasopharyngeal abscesses. These complications underscore the severity of NOE, particularly when caused by rare pathogens such as Klebsiella species. We detail the case of a 70-year-old male with uncontrolled DM who presented with severe right ear pain, purulent discharge, and significant postauricular swelling. Laboratory investigations revealed elevated inflammatory markers and poorly controlled diabetes. Cultures confirmed Klebsiella pneumoniae , and imaging showed diffuse edema and abscess formation in the temporal bone and nasopharynx. The patient was treated with intravenous Ceftazidime and ciprofloxacin for 6 weeks, followed by oral ciprofloxacin. Effective management of NOE necessitates a comprehensive, multidisciplinary approach. Early intervention, regular monitoring, and imaging are critical for promptly detecting and managing complications. [ABSTRACT FROM AUTHOR]

Squamous cell carcinoma is the most common pathological type of external and middle ear malignancy. Squamous cell carcinoma of the external auditory canal and middle ear is closely associated with long-term chronic inflammatory irritation. The patient was admitted with a major complaint of a "stuffy feeling in the left ear for more than three months." The results of the otoendoscopic examination were as follows: The left external auditory canal was filled with a granuloma-shaped mass with an unsmooth surface that showed obvious oozing of blood. The tympanic membrane was not visible. After the completion of the relevant examinations, radiofrequency resection of the external auditory canal mass was performed under otoendoscopy and the wound healed well with postoperative dressing changes. Pathological results revealed a well-differentiated keratinizing cutaneous squamous cell carcinoma and there was no recurrence throughout the next 5 years after the operation. Proper preoperative evaluation and the correct selection of surgical approaches can be of great importance. The primary complication of ear squamous cell carcinoma was local recurrence with a low incidence of metastasis. Early and complete resection was determined to be the optimal course of treatment. [ABSTRACT FROM AUTHOR]

Background: During electrochemotherapy (ECT), a chemotherapeutic drug is injected into the tumor and then an electroporation is provided. In horses, ear manipulation may be very painful, and combining a loco-regional technique with sedation might be a good option to avoid anesthesia-related risks. A two-injection-point block of the internal and external pinna and acoustic meatus was described in horse cadavers, and it permitted complete stain of all three branches of the great auricular nerve (GAN), internal auricular nerve branch (IAB), lateral auricular branch (LAB), and caudal auricular nerve (CAN), suggesting a lower risk of intra-parotid injection during the IAB and LAB block. Case Description: An 8-year-old Italian jumping gelding presented for ECT to treat a fibroblastic sarcoid in the left medial pinna. After intravenous sedation with acepromazine, romifidine, and butorphanol, a two-injection-point block was provided as previously described. The block of the GAN was blind, whereas an electrical nerve locator was used for the IAB, LAB, and CAN. A total of 12 ml of 0.5% ropivacaine was injected. The ECT was safely performed without any difficulties. The horse well tolerated the procedure and completely recovered 75 minutes after sedation. No complications were detected. Conclusion: The described approach seems feasible and suitable for the blockade of the sensory innervation of the equine ear in the case of ECT. [ABSTRACT FROM AUTHOR]

Differential screening is a complex process in chronic pain conditions. There is significant uncertainty that surrounds the pathophysiology of many chronic pain syndromes that may lead to misdiagnosis and treatment failures. Such differential screening is even more challenging where there is regional overlapping from surrounding tissues. This case report chronicles the differential screening and treatment of a patient with sternocleidomastoid syndrome (SCMS) originally diagnosed as Eagle's syndrome (ES). A 55-year-old woman, referred to a physical therapist (PT) by an ear, nose and throat (ENT) physician with the diagnosis of ES. The patient complained of yearlong left-sided otalgia, blurred vision, excessive lacrimation, dysphagia, hyperesthesia on the left side of the face, unilateral temporal headaches, and both left mandibular and anterior neck pain. The PT examination revealed the patient did not exhibit hallmark findings for clinical confirmation of ES and instead demonstrated multiple signs consistent with SCMS. Manual therapy techniques and therapeutic exercises resolved the patient's year-long chronic symptoms within 6 sessions. [ABSTRACT FROM AUTHOR]

Copyright of Van Health Sciences Journal / Van Sağlık Bilimleri Dergisi is the property of Van Yuzuncu Yil University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The utilization of fauna and fauna-based byproducts in ethnomedicinal usages has been a longstanding human activity, practiced across various cultures worldwide. This study focuses on investigating the utilization of animal-based traditional medicine by the people of Pakistan, specifically in the Gujranwala area. Methods: Data collection took place from January to September 2019 through interviews with local communities. Ethnomedicinal applications of animal products were analyzed using several indices, including Relative Frequency of Citation (RFC), Relative Popularity Level (RPL), Folk Use Value (FL), and Relative Occurrence Percentage (ROP). Results: The study identified the use of different body parts of 54 species of animals in treating various diseases and health issues. These include but are not limited to skin infections, sexual problems, pain management (e.g., in the backbone and joints), eyesight issues, immunity enhancement, cold, weakness, burns, smallpox, wounds, poisoning, muscular pain, arthritis, diabetes, fever, epilepsy, allergies, asthma, herpes, ear pain, paralysis, cough, swelling, cancer, bronchitis, girls' maturity, and stomach-related problems. Certain species of fauna were noted by informers with high "frequency of citation" (FC), ranging from 1 to 77. For instance, the black cobra was the most frequently cited animal for eyesight issues (FC= 77), followed by the domestic rabbit for burn treatment (FC= 67), and the Indus Valley spiny-tailed ground lizard for sexual problems (FC= 66). Passer domesticus and Gallus gallus were noted to have the highest ROP value of 99. Discussion: The findings of this study provide valuable preliminary insights for the conservation of fauna in the Gujranwala region of Punjab, Pakistan. Additionally, screening these animals for medicinally active compounds could potentially lead to the development of novel animal-based medications, contributing to both traditional medicine preservation and modern pharmaceutical advancements. [ABSTRACT FROM AUTHOR]

Mucormycosis is an opportunistic fungal infection that often affects the nose and paranasal sinuses. The disease prevalence was very high in India during the coronavirus disease 2019 pandemic, thereby raising public awareness about this disease. The general practitioners were updated about the disease characteristics and the requirement for emergency management. Yet, in some instances, the treatment was inadequate due to delayed presentation and low affordability for treatment. The mucormycosis of the ear, on the other hand, is a rare occurrence that demands meticulous study for early diagnosis and management. Here, we discuss the case of a patient with mucormycosis of the middle ear. [ABSTRACT FROM AUTHOR]

Acute mastoiditis, a complication of otitis media, poses significant challenges in diagnosis and treatment, particularly in pediatric populations. This study aims to comprehensively evaluate the demographic characteristics, clinical features, and prognostic factors associated with acute mastoiditis in pediatric patients in Saudi Arabia. Analysis of a multicenter dataset was conducted to assess demographic variables, symptomatology, disease course, and predictors of acute mastoiditis in pediatric patients. Significant associations were found between demographic variables (age group, gender, nationality) and acute mastoiditis risk. Symptomatology analysis revealed consistent frequencies of otalgia across age groups and genders. Disease course analysis highlighted a mean duration from symptom onset to diagnosis of 14.11 days, with frequent complications like mastoid abscess and meningitis. Predictor identification identified symptoms (otalgia, fever, otorrhea), duration of illness, and complications as significant predictors of disease severity. These findings contribute valuable insights into the epidemiology and clinical management of acute mastoiditis, informing targeted interventions to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Noise exposure has impacts on health and workability. There are not enough scoping reviews on how noise exposure affects the health and workability of primary and high school teachers. Therefore, this study provides a scoping review of such a topic. Materials and Methods: A search of Google Scholar, JSTOR, Elsevier, PubMed, and reference lists of literature published between 2000 and 2022 was done to find empirical data in the literature on teachers' exposure to noise and its consequences on their hearing and workability. The PRISMA-ScR protocol was applied. Results: All 20 studies reviewed, used a cross-sectional design. 50% of the studies used a calibrated sound level meter to implement the direct noise level evaluation method, while 75.0% used questionnaires. The main school-related noise source was students' activities (n = 12, 60.0%), and the main non-school-related noise source was vehicles (n = 6, 30%). These led to temporary hearing loss (n = 6, 30.0%). The non-auditory effects, such as shouting and disturbance (n = 8, 40% each) and annoyance (n = 7, 35% each), influenced the workability (performance) of the teachers as well as their interactions in the classroom. The noise levels that produced the effects were 50.0 to 92.1 dBA on primary school teachers and 68.9 to 95.2 dBA on high school teachers. Conclusions: Noise leads to hearing loss and poor workability of teachers. Regular school noise monitoring and surveillance to identify noisy areas and apply interventions is to be done. [ABSTRACT FROM AUTHOR]

Objective: We present the first published case of large foreign body reaction to Biodesign (Cook Medical, Bloomington, IN), an acellular otologic graft matrix derived from porcine small intestinal submucosa, after use in tympanoplasty surgery in a patient without previous exposure to meat products. Methods: A single case report of a 39-year-old female who developed tinnitus, ear drainage, and large fibrotic mass in external auditory canal and extending into middle ear after Type I medial graft tympanoplasty with Biodesign Graft. Left endoscopic microdissection and resection of the tympanic membrane and middle ear fibrotic mass were performed. Main findings: Surgical excision of the fibrous mass required extensive microdissection to ensure preservation of the ossicles and chorda tympani. Postoperatively, hearing improved and otalgia and otorrhea resolved. Conclusions: We report the first case of post-tympanoplasty reaction with the use of Biodesign acellular porcine graft in a patient with no previous known exposure to meat products. Although this presentation appears to be rare, it reinforces the need for careful patient selection and counseling around the use of porcine or other foreign grafts. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Temporomandibular disorder (TMD) has complex symptoms that involve the orofacial region, such as otalgia. Considering the difficult differential diagnoses for associating otological symptoms with TMD. The aim of this study was to verify the diagnosis of TMD in patients with otalgia. METHODS: This is a cross-sectional and descriptive study, where 75 patients diagnosed with otalgia were evaluated. The European Academy of Craniomandibular Disorders’s (EACD) screening questionnaire was initially applied, and those who answered affirmatively to at least one question were evaluated by the Research Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), with a final sample of 50 patients. Data were tabulated and ANOVA verified whether there was a statistical difference between TMD subtypes classified by DC/TMD, considering confidence intervals with 95% significance. RESULTS: The mean age of the participants was 39.9±14.1 years, with a predominance of females (76%) (p<

Ramsay Hunt syndrome (RHS) is a triad of peri-auricular pain, ipsilateral facial nerve palsy and vesicular rash around the ear pinna. It is caused by reactivation of varicella-zoster virus (VZV) that lies dormant in the geniculate ganglia. It can be complicated by VZV encephalitis rarely. We report the case of an 8-year-old previously healthy boy who presented to a tertiary care hospital in Muscat, Oman in 2021 with fever, progressive left ear pain, vesicular rash around his ear pinna and left-sided facial nerve palsy. His course was complicated by VZV encephalitis where he was managed with intravenous (IV) acyclovir and IV corticosteroids. He improved significantly and was asymptomatic with a normal neurology examination at the 6-months follow-up. [ABSTRACT FROM AUTHOR]

We report a case of a 15-year-old Indian girl who presented with tinnitus, pain and ear discharge for one month and was preliminarily diagnosed with Chronic Suppurative Otitis Media (CSOM) with mastoiditis. She underwent a routine presurgical CT scan which revealed an aberrant vein, making it essential to exercise caution during surgery for CSOM. The aberrant vessel was identified as a Petrosquamous Sinus. A Petrosquamous Sinus is a persistent fetal vein that connects the transverse sinus with the retromandibular vein and may regress in an individual by birth. Its importance lies in the risk of haemorrhage it carries during otological surgeries. A Digital Subtraction Angiography proved to be a vital step in isolating the path of the vein for better visualisation of the course, thus giving a better idea about the anatomical relations of the vessel during the surgery. The tympanoplasty was performed with care to prevent damaging the vein. The patient had no complications in the postoperative period and made a quick recovery. [ABSTRACT FROM AUTHOR]

The petrotympanic fissure (PTF) and foramen of Huschke (FH) are anatomical structures in the temporal bone that can connect the temporomandibular joint (TMJ) and the ear. The purpose of this retrospective study was to investigate the association between PTF morphology and otalgia and tinnitus, as well as the prevalence of the FH and otological symptoms, using cone beam computed tomography (CBCT). CBCT images from 114 patients presenting with symptoms of a temporomandibular disorder were examined retrospectively. The PTF was classified into three subtypes (open, semi-open, closed) and the presence of the FH was identified. Symptoms of otalgia and tinnitus were obtained from the patient files. The FH was observed in 12.3% of patients examined, and in 12.0% of those with otalgia and 18.9% of those with tinnitus. There was no significant association between the PTF subtypes or the presence of the FH and otalgia or tinnitus (all P > 0.05). The PTF subtype and presence of the FH alone do not appear to contribute to otalgia or tinnitus in patients with temporomandibular disorders. [ABSTRACT FROM AUTHOR]

Objective: Ear pain (earache) in children and infants often occurs when the ear canal becomes blocked, preventing fluid from draining. This blockage can lead to ear infections, causing pressure on the eardrum and resulting in pain. Other factors contributing to ear pain include infections, inflammation, fluid buildup, injury, and various health conditions. Ear pain is a particularly distressing condition. In Iranian traditional medicine, medicinal plants have long been used to alleviate ear pain in children. The aim of this study is to identify the medicinal plants effective in treating ear pain in children within the context of Iranian traditional medicine. Methods: A comprehensive search was conducted using keywords such as "medicinal plants," "traditional medicine," and "migraine" across reputable scientific databases including Web of Science, PubMed, Scopus, and Google Scholar. In the next phase, the extracted articles were carefully evaluated, and those not directly related to the research topic were excluded. Ultimately, only traditional sources that specifically examined the impact of medicinal plants on treating ear pain in children were selected for further review and analysis. Results: In Iranian traditional medicine, a variety of medicinal plants are used to treat ear pain in children. These include cinnamon, clove, lavender, olive, garlic, licorice, eucalyptus, mint, onion, apple, ginger, radish, basil, echinacea, purslane, and chamomile. Conclusion: Medicinal plants in Iranian traditional medicine are popular and trusted options for treating ear pain in children due to their natural properties and minimal side effects. These plants, with their antiinflammatory, antiseptic, and soothing compounds, can help reduce pain and inflammation in children's ears. Utilizing medicinal plants is not only a natural and cost-effective treatment method but also culturally and historically significant, contributing to the preservation and promotion of Iranian traditional medicine. However, given the sensitivity of treating children, these remedies should be used under the supervision of a physician or a traditional medicine specialist to ensure the safety and effectiveness of the treatment. [ABSTRACT FROM AUTHOR]

Case: A 42-year-old woman presented with left-sided axial neck pain with radiation behind left ear of 3 months unresponsive to conservative treatment. As clinical examination revealed tenderness anterior to the mastoid process, she was referred to an otolaryngologist. Computed tomography showed an elongated left styloid process. Diagnostic local anesthetic infiltration provided complete pain relief confirming the diagnosis of Eagle syndrome (ES) after which a transoral excision of the left styloid process was performed. She was asymptomatic till the final follow-up of 15 months. Conclusion: ES should be considered in differential diagnosis of axial neck pain radiating to ear, and excision of the styloid process in resistant cases provides complete pain relief. [ABSTRACT FROM AUTHOR]

Introduction: Mobile phone usage has become indispensable, especially among the youngsters. This has brought about psychological dependency towards mobile phones leading to addiction in them. Excessive use of mobile phones is known to be associated with headache, earache, warmth sensations and also perceived concentration difficulties. Materials and Methods: A total sample of 150 undergraduate medical students from Government medical college were selected, with 93 female participants and 57 male participants. These students came within the age range of 17-21 years. For this study, we developed a structured questionnaire with items included demographic information like age and gender, self-reported mobile phone usage and effect of its use in academic activities. This survey was conducted offline by filling questionnaire. The students of selected batches were approached in the lecture hall, they were informed about the survey, and their consent to participate in the study was obtained. The questionnaire was given to the students and the we explained the procedure to answer the questions. Then the students were asked to submit the filled forms. Results: The 129 respondents were of age between 17 -19 years followed by 21 students from the age group 20-21 years. It was noteworthy to mention that all the 100 respondents (100%) were using smart phones. Conclusion: The present study group of medical students felt that overuse of smart phone is the main reason for their poor academic performance. They also realise the ill effect of overuse of mobile phones on health. The present study helped us to create awareness among the participants regarding the impact of overuse of smart phones and how it is influencing their academic activities. Universities and colleges can also create awareness regarding mobile phone use. [ABSTRACT FROM AUTHOR]

Symptoms of temporomandibular disorders (TMD) could be present as otologic symptoms like earache and dizziness in some patients. In most cases, these symptoms are not recognized because otolaryngologists fail to diagnose TMD as a source of the problem. This investigation was conducted to evaluate the effect of TMD treatments on the otologic symptoms which after taking history and clinical examinations seemed to be related to TMD. In the present study, the patients who were complaining of otalgia, ear fullness, tinnitus, hearing loss, and dizziness were evaluated by an ear fellow. Forty patients who had no known otologic or other primary causes to explain their symptoms, were referred to the orofacial pain clinic with the possible diagnosis of TMD. If the diagnosis was confirmed by an orofacial pain specialist, a combination of TMD treatments was administered to each case and the patients were followed up. The results showed that following implementation of treatment protocols for TMD, more than 50% of the patients reported complete or partial recovery in the second follow-up (p < 0.05). The most common otologic symptom of the referred cases was earache, and the most common associated complaint was neck pain. All the patients had one or more parafunctional habits. This study showed that TMD treatments were significantly efficient in improving otologic symptoms partially or completely and the authors concluded that for the patients with otolaryngologic unexplained symptoms, an overhaul examination is needed to assess TMD as a possible cause of the patient complaint. It is recommended that in cases with unexplained otologic symptoms, otolaryngologists care more about the neck trigger points (TP) and ask about the patient's parafunctional habits. Otolaryngologists and dentists need to be aware of the risk of developing otologic symptoms caused by these habits or cervical TPs. [ABSTRACT FROM AUTHOR]

Chronic suppurative otitis media (CSOM) is one of the common problems encountered by individuals in India. It can cause permanent hearing loss at a very early age if not treated at earliest. CSOM is a common disease encountered in ENT practice, and proper evaluation and treatment can prevent the morbidity due to its complications. This study was conducted to know the clinical profile of patients with CSOM. It was a cross sectional study of 50 patients with CSOM of all age groups and both sexes, attending the Out Patient Department and those admitted in Otorhinolaryngology wards. 30 % of patients were in age group og 31-40 years. Infection was most common cause of CSOM. 80 % patients had Ear discharge. 44 % had hearing loss. 64 % had pain in ear. 48 % patients had Mucopurulent ear discharge and 22 patients % had Purulent ear discharge. Recurrent ear infection will cause hearing impairment over the years as a result of mucosal changes in the windows and ossicles. CSOM is a common condition in developing countries and requires support and cooperation of both medical professionals and patients for the proper and timely management of the problem. [ABSTRACT FROM AUTHOR]

Acute otitis media (AOM) is one of the most common diseases found in the pediatric population. This disease is characterized by protrusion or bulging of the tympanic membrane which occurs together with otalgia and non-specific symptoms such as fever, irritability and malaise. Risk factors for this disease are related to young age, genetics, a history of recurrent upper respiratory tract infections, immune system disorders and facial anatomical abnormalities that affect the function of the eustachian tube. AOM needs appropriate treatment to prevent future complications such as speech and language disorders in children due to decreased hearing function caused by this disease. This literature review aims to discuss the current diagnosis and management of acute otitis media. [ABSTRACT FROM AUTHOR]

Background: Acute mastoiditis is an intratemporal complication due to acute otitis media (AOM). Common risk factors include young age (often < 24 months), high values of C-reactive protein and previous antibiotic therapy, previous middle ear infection, or history of ear surgery. The main factor of acute mastoiditis is obstruction of the aditus antrum by granulation tissue or mucosa edema, inhibiting purulent drainage from the mastoid. Retained foreign body in the nose is a rare indirect cause of acute mastoiditis. It may be due to mucosal inflammation and accumulation of secretion causing nasal tract or nasopharyngeal infection leading to otitis media and later manifesting as an intratemporal complication. Case presentation: We report a case of acute mastoiditis as a late sequela of retained foreign body in the nose, and we also emphasize the incidental radiological finding of a star-shaped foreign body in the nose, which was a miss during the initial presentation. Further questioning revealed a history of recurrent unilateral blood-stained, foul-smelling nasal discharge, which was left untreated for years, leading to a delayed presentation of acute mastoiditis. After removing the foreign body and broad-spectrum antibiotic administration, complete disease resolution was achieved. Conclusion: Although rare, retained foreign bodies of the nose must be ruled out in certain cases of mastoiditis. A thorough history with a high index of clinical suspicion is recommended for early diagnosis to prevent complications. [ABSTRACT FROM AUTHOR]

Mucormycosis of temporal bone is extremely rare. They are usually associated with host immunodeficiency, are difficult to diagnose, and many cases are fatal. We performed a literature review and found only 10 reported cases of temporal bone mucormycosis. We present a case of temporal bone mucormycosis involving the temporomandibular joint and infratemporal fossa in a 53-year-old woman with diabetes mellitus who presented with unbearable otalgia. Computed tomography and magnetic resonance imaging demonstrate inhomogeneous density mass in the parapharyngeal and retropharyngeal space accompanied with lytic bone destruction on the temporomandibular joint. After undergoing a biopsy of the left infratemporal fossa, the patient's pathology exhibited fungal hyphae consistent with mucormycosis. To our knowledge, this is the first report of temporal bone mucormycosis with extensive involvement of temporomandibular joint and its adjacent structures, which exhibited no otologic or rhinologic signs. A definitive diagnosis is made by biopsy. [ABSTRACT FROM AUTHOR]

Background: Prompt history and clinical examination are mandatory to fix the proper diagnosis of refereed ear pain which sometimes needs the aid of laboratory, radiological assessments, and even examination under general anesthesia. Objectives: To diagnose cases of referred otalgia with the estimation of the incidence according to different age groups and sex. Materials and Methods: A prospective study was done in the ENT clinic in Hillah City, to evaluate 600 patients who presented with ear pain, 136 patients out of them were labeled as referred otalgia cases when the ear showed normal examination. The study started from January 2019 to February 2021. Physical examination with required investigations according to etiologies suspected for referred otalgia was done accordingly. Results: Out of 600 patients who presented with otalgia, 136 patients had referred otalgia (22.6%). The right ear was more affected than the left one (54%), whereas four cases had bilaterally referred ear pain. Of them, 57 patients had temporomandibular (TM) dysfunction (42%), 34 patients had pharyngeal pathologies including tumors (25%), 20 patients had cervical causes (14.7%), 11 patients had dental problems (8%), 8 patients had miscellaneous cases including salivary glands, oral cavity, lymph nodes, and long styloid process (5.8%), and 6 patinets had nasal and sinus problems (4.5%). Conclusion: Ear pain could be due to remote etiologies rather than the ear especially when it is normal by examination. The pain is mainly from adjacent head and neck structures. Physical examination of those structures especially TM joints, teeth, pharynx, nose, and sinuses is important to identify the causes of ear pain. Malignancy may be one of the causes and should not be missed. [ABSTRACT FROM AUTHOR]

The purpose of this study is to study the features of the clinic and the course of acute otitis media in children with type- 1 diabetes mellitus. It is shown that with type-1 diabetes mellitus, children under 14 years old with acute otitis media is 60 patients. Of these, 32 patients are boys, and 28 girls. As a result of the analysis of our data, it was found that the most common signs of acute otitis media in children are: ear pain, suppuration, fever, toxicosis, exsicosis. The peculiarity of the clinical manifestation of acute otitis media in children, in our opinion, is primarily associated with both the biological properties of the virus (damage to immunocomponent cells) and the anatomical and physiological characteristics of the child's body. Summarizing, it should be noted that the clinic and the course of acute otitis media in children with type -1 diabetes mellitus are similar to those in uninfected children, that is, when choosing antibiotic therapy, doctors should follow the same recommendations as in the treatment of acute otitis media in immunocomponent children. [ABSTRACT FROM AUTHOR]

Background: Acute otitis media (AOM) in children aged 5 years old and younger poses a critical health concern, affecting both the general health of children and the emotional well-being of parents. The objective of this study was to evaluate parental understanding, attitudes, and experiences related to AOM and its management, including the use of antibiotics without physician prescription. Method: A cross-sectional study was carried out during the months of May and June of 2023. To collect data for this study, a validated questionnaire was converted into a Google form and given to parents of children aged 5 years and younger who sought healthcare for their children in primary healthcare centers in Abha city, Aseer region, Saudi Arabia. Results: A total of 406 parents participated in this study, 64.8% of them were women and 45.3% of them were in the age range of 25 to 34 years. The majority (90.1%) resided in urban areas and a significant proportion (72.2%) had a university education. Among the respondents, 22.7% agreed that bacteria are the cause of AOM, while 21.7% agreed that it is caused by viruses. A total of 51.0% acknowledged the need for antibiotics in the management of AOM. In terms of treatment, 84.5% and 83.5% believed that analgesics and antibiotics, respectively, were the most effective for otalgia. A substantial portion, 43.1%, 34.7%, and 37.7%, respectively, believed that antibiotics could reduce pain, relieve fever, and prevent recurrence. Almost three-quarters sought medical advice primarily from paediatricians and 37.7% obtained information about AOM from the Internet. Furthermore, almost a third (28.8%) chose not to wait for the physician's appointment and immediately administered antibiotics without the physician's prescription due to concerns about disease progression. Approximately two fifths (38.4%) requested physicians to prescribe antibiotics, a pattern that was in agreement with the actual rate of antibiotic prescriptions (38.4%). Conclusions: A notable deficiency in knowledge and unsafe practices about AOM and its management is evident among parents in the Aseer region. This underscores the pressing need for an educational program aimed at improving parental health literacy regarding otitis media causes and treatments, as well as its preventive measures. [ABSTRACT FROM AUTHOR]

The article describes the case of a 61-year-old make ironworker who presented to the emergency department complaining about left otalgia accompanied by difficulty in swallowing. There was no sign of improvement despite a 5-day course of antibiotics. Symptoms were completely subsided after removal of a metallic iron bar 1.5 centimeter in length from the tongue. Topics include the results of the tests conducted, the common etiologic factors of otalgia and the causes of secondary otalgia.

Complications of chronic suppurative otitis media (CSOM) are still prevalent in developing countries, with some of the patients presenting with rare complications. CSOM can affect the external auditory canal (EAC) in different ways, and the most common affectation is EAC stenosis or atresia. Manifesting with necrotizing fasciitis of the EAC is extremely rare. Only a few cases have been reported in the literature, and none was from otitis media. In this article, we reported a rare case of necrotizing fasciitis of the EAC from CSOM in a malnourished child. [ABSTRACT FROM AUTHOR]