Search

Objective: The purpose of this study is to analyse the effect of half canal wall down tympanomastoidectomy in the treatment of chronic otitis media or cholesteatoma. Method: In this retrospective study, the half canal wall down tympanomastoidectomy technique was used at our hospital for chronic otitis media or cholesteatoma removal in 265 adult patients, representing 271 operated ears, with an average follow-up time of 8.4 years. Results: The post-operative cavities were slightly wider and straighter in 91.9 per cent of the ears. Fifteen per cent of the patients needed cavity cleaning every six months, 25 per cent of them needed cavity cleaning every year and 60 per cent of the patients had a self-cleaning cavity. Only one patient with a cleft palate experienced cholesteatoma recurrence in the mesotympanum. Conclusion: The half canal wall down tympanomastoidectomy technique showed a low-recurrence rate and satisfying operative cavities. The half canal wall down tympanomastoidectomy technique is a good choice for middle ear surgery. [ABSTRACT FROM AUTHOR]

Introduction: The facial canal (FC) is an extensive bony canal that houses the facial nerve and occupies a central position in the petrous part of temporal bone. It is of utmost significance to otologists due to its dehiscence and relationship to the inner or middle ear components. The main objectives of current investigation are to detect variations in the reported values ​​of FC anatomy that may occur due to different methodology and to elucidate the influence of age and ethnic factors on the morphological features of FC. Methods: The methodology is adapted to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled weighted estimation was performed to calculate the mean length, angle, and prevalence of dehiscence. Results: The cross-sectional shape of FC varied from circular to ellipsoid index and is 1.45 [95% CI, 0.86–2.6]. The mean length of the FC is 34.42 mm [95% CI, 27.62–40.13 mm] and the mean width or diameter is 1.35 mm [95% CI, 1.013–1.63 mm]. The length of the FC in fetuses and children is 21.79 mm [95% CI, 18.44–25.15 mm], and 26.92 mm [95% CI, 23.3–28.3 mm], respectively. In meta-regression, age is observed as a predictor and accounts for 36% of the heterogeneity. The prevalence of FC dehiscence in healthy temporal bones is 29% [95% CI, 20–40%]. Conclusion: The different segments of the FC exhibit significant variability and an unusually high incidence of dehiscence, which could potentially have clinical implications for the etiopathogenesis of facial nerve dysfunction. [ABSTRACT FROM AUTHOR]

Introduction: The modified nine‐step test is a classical method for evaluating Eustachian tube function. However, clinical interpretation of the increased maximal difference in middle ear pressure (mdMEP) in the modified nine‐step test is unknown. We hypothesised that the different reservoir effects of the mastoid cavity can bias the results of the modified nine‐step test. Methods: A total of 108 consecutive participants (216 ears) were retrospectively screened. Of these, 55 participants (82 ears) who met the inclusion/exclusion criteria were enrolled. The volumetric results of the mastoid cavity, parameters of the modified nine‐step test (mdMEP, middle ear pressure, tympanic membrane compliance), and demographic data were analysed. Results: A significant negative correlation was found between mdMEP and mastoid cavity volume (R =.467, p <.001). Ears with mdMEP >70 daPa showed poor pneumatization in the mastoid cavity, with volumes less than 3000 mm3 (10th percentile of all ears analysed). Ears with mastoid cavity volumes lower than the 25th percentile showed a significantly higher mdMEP (p <.001). Patients with mastoid cavity volumes higher than the 75th percentile were significantly younger (p <.001). Multivariate regression analysis for mdMEP showed a good fit (R =.854) using factors including middle ear pressure, admittance and, most importantly, the reciprocal of mastoid volume (Beta = 0.752, p <.001). Conclusions: The mdMEP, the main parameter of the modified nine‐step test, was negatively correlated with the mastoid cavity volume. Therefore, the results of the modified nine‐step test should be interpreted with consideration of mastoid cavity volume. [ABSTRACT FROM AUTHOR]

Objective: Bone conduction hearing implants are a well-established method of hearing rehabilitation in children and adults. This study aimed to review any changes in provision in England. Methods: The total number of bone conduction hearing implantations performed was analysed from 2012 to 2021 utilising Hospital Episode Statistics data for England. Results: The total number of procedures has increased by 58 per cent. One-stage bone conduction hearing implantations in adults accounts for the largest proportion of this increase (93 per cent of the total). The number performed in children has remained stable and accounts for 73 per cent (n = 433) of all two-stage procedures. Conclusion: The data show that bone conduction hearing implant surgery is becoming increasingly popular, particularly in adults. This has correlated with the increase in availability, national recommendations and choice of devices. [ABSTRACT FROM AUTHOR]

Aim: The surgical success rate of tympanoplasty appears to be influenced by a number of variables. Eustachian tube dysfunction has been shown as one of the factors causing failure in tympanoplasty. It is known that bilateral disease and decreased in mastoid pneumatization are associated with Eustachian tube (ET) dysfunction. In this study, the relationship between the success of type 1 tympanoplasty and mastoid pneumatization, bilateral disease and ET function was investigated. Materials and Methods: A total of 44 patients who were operated for chronic otitis media in our clinic were included. The information of the patients was obtained retrospectively, the direction of the disease (bilateral/unilateral), the status of the graft (intact/perforated), mastoid pneumatization status, and hearing levels (preoperative/postoperative 6th month) were noted. Automatic Williams test was used to tympanometrically evaluate ET functions (ETF) in postoperative period. The relationship between tympanoplasty success and mastoid pneumatization, bilateral disease and ETF was investigated by statistical analysis. Results: The disease aspect was found bilateral in 34.1% (n = 15) of the cases, and unilateral in 65.9% (n = 29) of the cases. Mastoid pneumatization was decreased in 52.2% (n = 23) of the cases, and normal in 45.4% (n = 20). The preoperative air-bone mean difference (gap) of the cases with decreased mastoid pneumatization was found to be statistically significantly higher than the cases with normal mastoid pneumatization (p < 0.05). The closure of the postoperative air-bone gap in patients with unilateral disease direction was found to be statistically significantly higher than in patients with bilateral disease direction (p < 0.05). Also we found significantly worse ET functions both in unilateral and bilateral disease. Conclusion: Preoperative air-bone gap average is higher in ears with decreased mastoid pneumatization, and postoperative air-bone gap closure is higher in unilateral patients. Mastoid ventilation does not make a significant difference in the success of type 1 tympanoplasty. On the other hand, our results support that ET dysfunction can be effective in the occurrence of chronic otitis media (COM). [ABSTRACT FROM AUTHOR]

Background: Congenital cholesteatomas (CCs) are rare epidermal cysts that have been reported to occur most commonly in the middle ear and rarest in the mastoid cavity. They usually present in adulthood and are difficult to detect due to the lack of symptoms. Treatment is usually a canal wall up or down mastoidectomy with good success rates. Case description: We present a rare case of a mastoid CC with posterior external auditory canal wall erosion treated successfully with a simple canal wall-up mastoidectomy. Conclusion: Mastoid CCs still remain a rare entity with a relatively uncomplicated surgical approach. Clinical significance: Clinicians should high index of suspicion and a low threshold for a CT scan in patients with a history of an intermittently discharging ear, a narrowed ear canal, or a posterior canal wall fistula. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the long-term outcomes of trans-mastoid plugging of superior semicircular canal dehiscence (SSCD), focusing on complicated cases. Methods: In this cohort study, we included all patients who underwent trans-mastoid plugging of SSCD between 2009 and 2019. We evaluated the symptoms (autophony, sound-/pressure-induced vertigo, disequilibrium, aural fullness and pulsatile tinnitus) before and 1 year after surgery in the medical records. We systematically assessed the current symptoms 6.2 ± 3 years postoperative (range 2.2–12.3 years) using questionnaires sent by post and validated by telephone interviews. We also documented any complications and the need for further procedures. We compared pure tone and speech audiometry before and 1 year after surgery. Finally, the degree of mastoid pneumatisation and mastoid tegmen anatomy were reviewed on preoperative CT scans. Results: We included 24 ears in 23 patients. No complications were recorded, and none required a second procedure for SSCD. Following surgery, oscillopsia and Tullio phenomena resolved in all patients. Hyperacusis, autophony, and aural fullness were also settled in all patients except one. Balance impairment persisted to some degree in 35% of patients. No deterioration over the years was reported regarding the above symptoms. On average, bone conduction pure tone average pre- and 1 year postoperative were 13.7 ± 17 and 20.5 ± 18 dB, respectively (P = 0.002). Air bone gaps were reduced from 12.7 ± 8 to 5.9 ± 6 (P = 0.001). Two patients had a significant sclerotic mastoid, three had a prominent low-lying mastoid tegmen, and two had both. Anatomy had no effect on outcome. Conclusion: Trans-mastoid plugging of SSCD is a reliable and effective technique which achieves long-lasting symptom control, even in cases with sclerotic mastoid or low-lying mastoid tegmen. [ABSTRACT FROM AUTHOR]

Copyright of Revista Facultad de Medicina de la Universidad Nacional de Colombia is the property of Universidad Nacional de Colombia 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: Microgravity in space causes changes in the physiology of human body and as a result makes them susceptible to various pathology. As a result astronauts suffer from health disorders which includes otorhinolaryngological disorders Aim: To gather information about the various otorhinolaryngological manifestations occuring in microgravity by compiling the available scattered data existing in literature Methods: This is a narrative review article. Using keywords a search was made on the internet, various databases such as googlescholar, pubmed to find out the description of various otorhinolaryngological manifestation in microgravity environment of space. A few proposals or initiatives are given at the end of the discussion so that more research can be conducted on this aspect of otorhinolaryngology Results: Studies have revealed that the microgravity environment leads to mastoid effusion, predisposes tosinusitis, causes cytoskeletal changes and altered gene expression in thyroid cancer cells, decreases salivary secretion,causes difficulty in airway management, affects temporomandibular joint function, causes impairment of balance. Regarding sleep some studies revealed that microgravity improves sleep whileother studies revealed that microgravity causes increase in sleep disturbances. Important future initiatives include establishment of world class health and research facility, National Health Programme forastronauts, Fellowship courses by NBEMS etc. Conclusion: Microgravity has a significant impact on mastoid, sinuses, sleep, thyroid cancer cells, salivation, airway, temporomandibular joint and balance. More research needs to be conducted on this topic.

Background: Mohs micrographic surgery has been considered the gold standard for treating nonmelanoma skin cancers. Approximately 8% to 10% of skin cancers requiring Mohs surgery occur on the auricle. Skin grafts can be used to achieve optimal functional and cosmetic results. Objectives: To describe a skin graft technique using the mastoid area as a donor site for auricular reconstruction following Mohs micrographic surgery, to achieve optimal esthetic results in functionally important areas. Methods: This retrospective study assessed the outcomes of patients who underwent MMS in an out-patient Mohs surgery clinic from 2010 to 2021. All patients had MMS of the auricle with reconstruction using a split thickness skin graft harvested from the mastoid area. Results: A total of 154 patients were included. The average lesion diameter was 13.7 mm (range 5–30 mm), excised in an average of 1.9 rounds of MMS. Skin graft success rate was 96%. Complications included one patient with a hypertrophic scar. The cosmetic appearance of the recipient site was rated as excellent by 87.5% of patients. All patients rated the cosmetic appearance of the donor area as excellent and well-concealed. Conclusions: Split thickness skin grafts harvested from the mastoid area are a quick and efficient reconstruction method for post-Mohs auricular defects. [ABSTRACT FROM AUTHOR]

Background: Postauricular cutaneous mastoid fistula (PCMF) is quite rare. Possible triggers include a radical mastoidectomy, chronic suppurative otitis media (CSOM), or the spontaneous exteriorization of a mastoid cholesteatoma through the postauricular skin surface. Case Report: This study reported a 62-year-old woman who presented with a right-sided discharging postauricular lesion for two years and a history of ear discharge over the past 20 years. Physical examination revealed a 10×8 mm fistula with a pearly white tissue at the opening and mucoid discharge. Otoscopy represented an attic cholesteatoma as the potential underlying cause, and computed tomography demonstrated a soft-tissue density in the middle ear extending into the mastoid cavity and towards the cutaneous postauricular area. The PCMF was surgically closed using a temporalis muscle rotational flap with no recurrence at the 6-month follow-up. Conclusion: Overall, surgical closure with a temporalis muscle rotational flap appears to be an effective technique for treating PCMF.

The differential diagnosis for an isolated lytic mastoid lesion is broad, encompassing various conditions requiring careful consideration. These include granulomatous disorders such as Langerhans cell histiocytosis and sarcoidosis, neoplastic processes like multiple myeloma, leukemia, lymphoma, and metastases, primary bone diseases such as Paget's disease, fibrous dysplasia, and osteitis fibrosa cystica, as well as infectious causes like osteomyelitis. In this report, we present a patient with otalgia and an isolated lytic mastoid lesion. [ABSTRACT FROM AUTHOR]

Introduction: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear cleft with non-healing tympanic membrane perforation leading to conductive hearing loss. Surgery is the definitive management. Myringoplasty with or without cortical mastoidectomy is a matter of discussion among the otorhinolaryngologists society. One hypothesis suggests that myringoplasty combined with cortical mastoidectomy in tubotympanic type of chronic suppurative otitis media (CSOM) is useful, whereas another fraction believes that cortical mastoidectomy combined with myringoplasty has no inconsequential effects on the surgical result. Aim: To compare the surgical outcome of chronic suppurative otitis media of tubotympanic type in patients who underwent myringoplasty alone or with cortical mastoidectomy and myringoplasty. Materials and Methods: A retrospective study includes 300 patients with CSOM of tubotympanic type. Preoperative assessments were done including pure tone audiometry. Patients were divided into two groups. Group I underwent myringoplasty alone and Group II underwent cortical mastoidectomy with myringoplasty. At one month post-operative period, patients were assessed for graft uptake and pure tone audiometry. These values were compared between the two groups. Results: Out of 300 patients the graft uptake was present in 272 patients (90.7%) and graft uptake was absent in 28 patients (9.3%). The significant value is 0.000 which is less than 0.05 at 95% confidence interval. Therefore, there is significant relationship between Pre PTA and Post PTA in group II. Conclusion:There is a statically significant difference in results in both groups. Cortical mastoidectomy with myringoplasty gives better surgical outcomes in graft uptake rate and audiological improvement than myringoplasty alone.

Abstract Objective Present the results of the secondary obliteration of chronically discharging radical cavities using S53P4 bioactive glass (BAG). Study Design Retrospective cohort study. Setting Single‐center study. Methods A single‐center retrospective cohort study was conducted of all patients that underwent secondary obliteration of persistently draining radical cavities using S53P4 BAG between 2011 and 2022. Patients with middle ear cholesteatoma were excluded. The main outcome was postoperative otorrhea, as indicated by Merchant grading. Results In total, 97 patients were included. The median postoperative follow‐up time was 3.9 years (range 0.5‐10.4). Average time between the original canal wall down surgery and the secondary obliteration was 25.3 years (SD 11.7, range 2‐66). At the most recent follow‐up visit, a Merchant grade of 0 to 1 was observed in 95% of the cases. There were no cases of sensorineural hearing loss or facial palsy, one case developed a retro auricular skin defect and 1 patient developed CSF leakage. Minor complications were seen in 10 patients (10%). Ossicular chain reconstruction with a titanium prosthesis was performed in 42 cases, resulting in a median improvement of 11.2 dB in air conduction thresholds. In 9/42 cases (21%), closure of the postoperative air‐bone gap to ≤20 dB was achieved. Twenty‐five percent of cases could be discharged from out‐patient visits. Conclusion Revision of persistently draining radical cavities with BAG obliteration is feasible and results in a dry and safe ear in 95% of the patients, thereby enabling wearing of a conventional hearing aid. Out‐patient visits could be ceased in 25% of the cases.

Purpose: It is unusual to have communication from the external auditory canal (EAC) directly to the mastoid, totally sparing the tympanum. These patients need a different surgical approach, a modified canal wall-down procedure, to completely clear the disease but fully preserve the tympanum. We present one such exceptional case. Case presentation: A 28-year-old lady presented with ear discharge for 1 year. Imaging confirmed the canal-mastoid fistula, but the entire tympanum was normal. We performed a modified-modified radical mastoidectomy. Conclusions: Canal-mastoid fistula is an infrequent entity and may be idiopathic. Despite being evident on clinical examination, imaging aids in assessing size and location of the defect. Although EAC reconstruction may be attempted, the majority require a canal wall-down procedure. [ABSTRACT FROM AUTHOR]

Introduction: Emissary foramina are found in various bones of the skulls. They transmit emissary veins, connecting extracranial veins with the intracranial dural venous sinuses. The mastoid emissary foramen transmits an emissary vein joining sigmoid sinus with the posterior auricular vein and also meningeal branch of occipital artery. This foramen is usually found as a single entity in mastoid region. There are variations in the prevalence and number of the mastoid emissary foramina. Identification of such veins is significant in neurosurgery and otologic surgeries. Objectives: To study the morphology of mastoid foramina of each temporal bone in relation to 1. Presence or Absence of mastoid foramina 2. Number of mastoid foramina 3. Comparison with available data and emphasis on its surgical importance. Materials &Method: Dried adult skulls n=154 (308 temporal bones) have been used in the current study. Each temporal bone is observed for the Presence, Number and Position of the Mastoid emissary foramina. The patency of the foramina is confirmed by passing a probe. The results were tabulated and compared with the available data. Evolutionary aspects and Surgical importance of the study was discussed. Results: Out of the 154 skulls (308 sides), 298 temporal bones showed the presence of Mastoid foramina (97.4%). 10 of the temporal bones didn’t show mastoid foramen. Prevalence of mastoid emissary foramen was 97.4% on the right side and 96.1% on the left side. In four of the skulls, mastoid emissary foramen was absent bilaterally. Conclusion: Knowledge of variable number and prevalence of mastoid emissary foramina is significant in mastoid related surgeries and also in transtemporal approach to the posterior cranial fossa. This study provides an essential data about such foramina, thus will be helpful for surgeons. Further the study can be supported with radiological correlation. [ABSTRACT FROM AUTHOR]

Introduction: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear cleft with non-healing tympanic membrane perforation leading to conductive hearing loss. Surgery is the definitive management. Myringoplasty with or without cortical mastoidectomy is a matter of discussion among the otorhinolaryngologists society. One hypothesis suggests that myringoplasty combined with cortical mastoidectomy in tubotympanic type of chronic suppurative otitis media (CSOM) is useful, whereas another fraction believes that cortical mastoidectomy combined with myringoplasty has no inconsequential effects on the surgical result. Aim: To compare the surgical outcome of chronic suppurative otitis media of tubotympanic type in patients who underwent myringoplasty alone or with cortical mastoidectomy and myringoplasty. Materials and Methods: A retrospective study includes 300 patients with CSOM of tubotympanic type. Preoperative assessments were done including pure tone audiometry. Patients were divided into two groups. Group I underwent myringoplasty alone and Group II underwent cortical mastoidectomy with myringoplasty. At one month post-operative period, patients were assessed for graft uptake and pure tone audiometry. These values were compared between the two groups. Results: Out of 300 patients the graft uptake was present in 272 patients (90.7%) and graft uptake was absent in 28 patients (9.3%). The significant value is 0.000 which is less than 0.05 at 95% confidence interval. Therefore, there is significant relationship between Pre PTA and Post PTA in group II. Conclusion: There is a statically significant difference in results in both groups. Cortical mastoidectomy with myringoplasty gives better surgical outcomes in graft uptake rate and audiological improvement than myringoplasty alone. [ABSTRACT FROM AUTHOR]

Introduction: The facial nerve (FN) follows a complex route in the temporal bone. Successful temporal bone surgery requires knowledge of its course which can be achieved using imaging methods such as computed tomography. This investigation aims to analyze the FN course in its mastoid portion and second genu and the frequency of its atypical course. Material and methods: This is a retrospective study that enrolled 104 CT scans of temporal bones of patients followed up in the outpatient clinic of the Otorhinolaryngology Department of Dentistry Faculty of the Medical University of Warsaw between 2020 and 2022. FN courses were classified as straight, bulging, or letter "S"-like. Other parameters estimated: g position of the second genu according to the prominence of the lateral semicircular canal (classified as lateral, medial, or middle) and its distance from a line adjacent to the lateral semicircular canal was measured; g the distance between the short process of the incus and the outermost point of the second genu; g the course of the mastoid portion of FN and the location of SG in comparison to the tympanic portion of n. VII. The course was later classified as lateral, medial, or middle. Results: Among the 104 assessed temporal bones, the course of the mastoid portion of FN was classified as bulging in 47 cases (45.2%). Straight and letter "S"-like courses were present in 41 (39.4%) and 16 (15.4%) cases, respectively. Deviation of the second genu according to the prominence of the lateral semicircular canal was medial in 86 cases (82.7%), and middle in 4 cases (3.8%). In the rest, second genu was paramedian to the prominence of the later circular canal. The mean distance between the short process of the incus and the outermost point of SG was 4.9 mm (±0.73 mm). The mastoid portion was located laterally, medially, and in the middle of the tympanic portion plane in, respectively, 4.8%, 83.7%, and 11.5%. The second genu was located laterally, medially, and in the middle of the tympanic portion plane in 1.9%, 73.1%, and 25%, respectively. In conclusion, seven temporal bones (6.7%) of five patients presented with a lateral displacement of FN in relation to the established anatomical landmarks. Conclusions: Although the atypical course of FN, including the lateral displacement of the mastoid portion, is rare, screening for it is crucial before surgical exploration. [ABSTRACT FROM AUTHOR]

Objective: Endoscopic hydro-mastoidectomy, in which mastoidectomy is performed underwater, can be employed during transcanal endoscopic ear surgery for cholesteatoma removal. It was hypothesised that endoscopic hydro-mastoidectomy might take less time than endoscopic non-underwater mastoidectomy because the endoscope does not need to be removed for cleaning. Methods: This study compared the mastoidectomy and total operative durations between the endoscopic hydro-mastoidectomy (n = 25) and endoscopic non-underwater drilling (control, n = 8) groups. Moreover, it compared the size of resected areas of the external auditory canal between the two groups. Results: The mastoidectomy time of the endoscopic hydro-mastoidectomy group was significantly shorter than that of the control group (p < 0.01). The total operative time did not differ significantly between the endoscopic hydro-mastoidectomy and control groups (p = 0.17). The resected area was significantly larger in the endoscopic hydro-mastoidectomy group than in the control group (p < 0.05). Conclusion: Endoscopic hydro-mastoidectomy enables more extensive bone resection within a shorter period. [ABSTRACT FROM AUTHOR]

Purpose: To present the first pediatric study on the safety and efficacy of mastoid obliteration using S53P4 bioactive glass (BAG) for cholesteatoma surgery. Methods: A single-center retrospective cohort study was conducted. Inclusion criteria were pediatric cases (≤ 18 years) and at least at least one year of follow-up including non-echo planar diffusion-weighted MRI to assess cholesteatoma recidivism. Both canal wall up (CWU) and canal wall down (CWD) procedures were evaluated. Results: A total of 61 cases (56 patients) were included. Most cases had an otologic history before the development of the cholesteatoma. CWU procedure was performed in 18 cases (30%) and CWD procedure in 43 cases (70%). The cholesteatoma recidivism rate was 33% after a mean follow-up period of 58 months. Kaplan–Meier curve estimated a 5-year recidivism rate of 40%. Few complications were seen that were all minor and resolved spontaneously or after local or systemic treatment. Control of the infection (merchant grade 0–1) was achieved in 98% of the cases. Closure of the air–bone gap within 20 dB was achieved in 22% of the cases with complete audiometric evaluation. Conclusion: In this MRI-controlled study, we show the safety and efficacy of S53P4 BAG for mastoid obliteration in a pediatric cholesteatoma cohort. Postoperative complications were both rare and minor, and a dry ear was achieved in almost all patients. Nevertheless, persistent hearing loss and the apparent high recidivism rate reflect the challenging nature of pediatric cholesteatoma. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to analyse the effectiveness of using the bony sigmoid sinus plate for repair of meato-mastoid fistulae. Method: A retrospective study of all cases between January 2013 and December 2019 at our secondary-tertiary centre was conducted. Inclusion criteria for study were: (1) cases with focal meato-mastoid fistulae and (2) focal meato-mastoid fistulae that were repaired by using bony sigmoid sinus plate using the bony sigmoid sinus plate technique. There were 13 cases that fulfilled these criteria. Results: The outcome of the repair of meato-mastoid fistulae with bony sigmoid sinus plate was very encouraging. All 13 cases did well. Two patients had delayed epithelialisation at 9 and 12 months after surgery. Conclusion: The technique of repairing meato-mastoid fistulae by using bony sigmoid sinus plate is simple, repeatable and provides effective physiological reconstruction of the posterior canal wall. Bony sigmoid sinus plate is easily and locally available in all cases undergoing cortical mastoidectomy. This plate of bone has a curvature, consistency and structure that match well with that of the posterior or superior canal wall. In addition, this technique is cost-effective with good patient compliance. [ABSTRACT FROM AUTHOR]

Background: Reducing nitrogen-absorbing mucosa in the mastoid cavity, preventing cholesteatoma recurrence in patients with dysfunctional eustachian tube and avoiding mastoid cavity problems are The main goals of mastoid cavity obliteration. Platelet rich plasma represents a recent biotechnology providing a high concentration of growth factors, which found to be highly effective in healing acceleration and infection prevention. Our Aim To evaluate using of silicone blocks and platelet rich plasma in canal wall reconstruction and mastoid cavity obliteration after mastoidectomy. Methods: Our study applied on 20 patients with cholesteatoma who underwent mastoid obliteration with silicone blocks and platelet rich plasma, the used surgical technique composed four major steps: First, Mastoidectomy and the middle ear clearing from all pathologic lesions were achieved Then, reconstruction of the canal wall then filling up the the epitympanic space and the mastoidectomized cavity by silicone blocks. Finally, covering the surface of the silicone blocks by Platelet rich plasma and Temporalis fascia ± bone pate and Reinforcing the reconstructed canal wall by anterior based periosteal flap. Results: (90%) of the operated cases maintained a near normal shape and contour with healed ear drum, the air-bone gap mean was improved by about 19 dB (P< .001) Conclusions: Silicone blocks and platelet rich plasma considered as a good material for mastoid cavity obliteration. [ABSTRACT FROM AUTHOR]

Purpose: Few data are available regarding subjective complaints and quality of life (QoL) after subtotal petrosectomy (STP). The purpose of our study was to assess long-term surgical results after STP, and to evaluate disease-specific, patient-reported outcomes including QoL and subjective hearing. Methods: A retrospective cohort study, including a postal survey, was performed in the Amsterdam University Medical Centers (Amsterdam UMC) location Academic Medical Centre (AMC). All patients who underwent a STP between 1990 and 2018 were included. Patient characteristics, indication for surgery, adverse events, disease recidivism, and patient-reported health outcomes were evaluated. Results: 181 patients (183 ears) underwent a STP for several indications. The main indication was chronic otitis media (COM) with or without cholesteatoma (69%). In the total cohort, 8 residual cholesteatoma (5%) and 6 inclusion cholesteatoma 4% were detected. Postoperative (functional) health outcomes showed a significant negative impact on QoL in the STP cohort compared to normative data. Compared to patients without ear problems, the postoperative STP patients scored worse on almost all domains of the Chronic Ear Survey (CES) (p < 0.001). SF-36 scores of postoperative STP data showed negative Z-scores in almost all subscales, indicating lower levels of QoL compared to Dutch reference values. Most subscales of the Amsterdam Inventory for Auditory Disability and Handicap (AIADH) demonstrate a large-effect size in disadvantage of the STP cohort when compared to Dutch reference values. Conclusion: STP is a suitable technique to tackle severe ear disease. Despite its favourable surgical results, STP has a negative impact on several domains of patient's QoL. [ABSTRACT FROM AUTHOR]

Objective: To assess the incidence of radiological inflammation within the paranasal sinuses, middle ear and mastoid in patients with confirmed severe acute respiratory syndrome coronavirus-2. Methods: A retrospective cohort study was conducted to examine consecutive adults (aged over 18 years) with coronavirus disease 2019 (confirmed on polymerase chain reaction within 7 days of imaging) who underwent computed tomography of the head between 1 March 2020 and 24 June 2020. Lund–Mackay and mastoid and middle-ear opacification scores were used to categorise the extent of sinus and mastoid opacification on axial and coronal computed tomography images. Results: Of 147 patients originally identified, only 83 met the inclusion criteria. Sinus opacification was present in 51.8 per cent of patients (n = 43), and middle-ear or mastoid opacification was observed in 24.1 per cent (n = 20). There was no statistically significant difference in sinus or middle-ear and mastoid opacification between patients after stratification based on 30-day all-cause mortality. Conclusion: Radiological computed tomography findings suggest mild mucosal disease within the sinuses, middle ear and mastoid. There was no statistical correlation between such opacification and 30-day mortality. [ABSTRACT FROM AUTHOR]

For a chronically discharging ear open mastoidectomy is the mainstay of treatment, however it can cause high morbidity due a large cavity and complications like discharge, vertigo and difficulty with hearing aids. To avoid such problem, obliteration of mastoid cavity is done. The objective of our study was to compare the post-operative complains, the hearing results and outcomes of open and closed mastoid cavity. The present prospective study was conducted on 40 patients having attico-antral disease in middle ear cleft. Patients were randomly divided into two groups of 20 each. Out of 40 patients, in 20 patients (Group A) mastoid obliteration was done using conchal cartilage, whereas in other 20 patients (Group B) canal wall down mastoidectomy without mastoid obliteration was done i.e.an open cavity. The patients were followed up post-operatively at 6th week, 3rd month and 6th month. Study Design: comparative study. On Pure Tone Audiometry, 13 (65%) patients with closed mastoid cavity had Air–bone Gap < 30 dB, 7 (35%) were in the range 30–60 dB as compared to open mastoid cavity where 10 (20%), 8 (40%), 2(10%) patients had ABG < 30db, 30–60 dB, and > 60 dB respectively, showing better hearing results in obliterated cavities, healing was also better. In obliterated mastoid cavities, there were very few complications of pain, discharge, and giddiness compared to open cavities. Healing as shown by epithelisation was earlier and better in obliterated cavities. Hearing results were better in mastoid cavities with obliteration compared to open cavities. Patients with obliterated mastoid cavity need less cavity care and doctor dependence. [ABSTRACT FROM AUTHOR]

Background: Though osteomas can commonly arise in the cranial bones, an extra canalicular mastoid bone location is a rare entity with less than 200 cases described to date. We present three cases of cortical mastoid bone osteomas and compare them with cases presented in the literature. Methods: In this study, we used a retrospective chart analysis. Results: All three patients presented after years of progressively increasing postauricular swelling without symptoms. Temporal bone non-contrast CT allowed accurate preoperative diagnosis. Surgical treatment was performed for cosmetic issues with minimal postoperative morbidity. Complete excision was achieved in all cases, and to date, there is no evidence of recurrence. Conclusions: Mastoid osteomas are rare benign slow-growing tumors. They usually present as a painless cosmetic disfigurement and are otherwise asymptomatic. Surgical excision is the treatment of choice when they cause esthetic discomfort or are symptomatic. Recurrences are infrequently reported.

Introduction: The goal of modern dentistry is to provide patients with good oral health in a predictable fashion. The edentulous patient may hoot have good masticatory function or aesthetics. When wearing a removable denture the efficiency is reduced to one sixth than natural dentition.An ideal prosthesis can bring back normal muscle activity thereby improving mastication. Implant Prosthetic options just do not rely on alveolar bone. There are many other options too. One such option is the mastoid implants.Our aim is to evaluate the awareness on mastoid implants among dental students. Materials and methods: A set of 10 questions were formulated and distributed among the undergraduate students to determine their awareness on mastoid implants All data were collected and analysis was done. The data were entered in an Excel sheet and were imported to SPSS software by IBM. Results: 80% of the participants were undergraduate students. Also 35% have ideas regarding mastoid implants and very few participants were trained in mastoid implants, only 3%. Almost 60 % of study participants agree that mastoid implants may be highly valued in the future. Conclusion: Within the limitations of the study it can be said that there is very little awareness about mastoid implants among the student population and conducting more educational programs and providing more hands-on training will motivate the upcoming dental professionals to be well aware of future prospects of maxillofacial prosthetic treatment. [ABSTRACT FROM AUTHOR]

Objectives: To present our case series and management of Scedosporium apiospermum infections of the middle ear and mastoid, and review the current literature on this rare yet potentially life-threatening condition. Methods: Medical records of patients treated at the Royal Victorian Eye and Ear Hospital for S apiospermum middle ear and mastoid infections between 2009 and 2019 were reviewed. A literature search was conducted using PubMed, Medline and Cochrane Library databases. Results: Two patients were identified in our institution: a 62-year-old diabetic woman with otogenic skull base osteomyelitis, and a 12-year-old boy with unilateral chronic suppurative otitis media which developed after tympanostomy tube insertion. The persistence of otalgia and otorrhoea despite prolonged antibiotic treatment characterised these cases. Both patients received voriconazole, and achieved disease resolution without complications. Ten relevant cases were identified after review of the literature. Despite treatment, there were three patient deaths, and four patients with otological or neurological complications. Conclusion: The presence of a middle ear or mastoid infection refractory to appropriate topical and systemic antibiotics should prompt clinicians to consider a fungal infection. The role of surgical debridement in the treatment of S apiospermum infection of the middle ear and mastoid is equivocal. [ABSTRACT FROM AUTHOR]

Background: Epithelial migration has been associated with the self-cleansing mechanism of the ear. The rate and pattern of epithelial migration in healthy and pathological ears are reviewed. Methods: Two authors independently screened articles over one month using the following search terms: epithelial migration, epithelial, tympanic membrane, external auditory canal and mastoidectomy cavity. Results: Ten studies were included. The fastest rate of epithelial migration was observed in the external auditory canal, with a mean of 144.75 μm per day, whereas the slowest epithelial migration was seen in post-mastoidectomy cavities, with a rate of 20 μm per day. Epithelial migration was present in both studies involving post-mastoidectomy cavities. Conclusion: Epithelial migration is faster in healthy tympanic membrane than in pathological tympanic membrane. The rate of epithelial migration in the external auditory canal was higher in the pathological group than in the healthy group. Epithelial migration is present in post-mastoidectomy cavities. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to evaluate mastoid volume and dimensions in patients with unilateral microtia using High-Resolution Computed Tomography (HRCT) to enhance the precision of reconstructive surgical planning., Methods: A retrospective analysis of HRCT mastoid scans from patients with unilateral microtia was carried out at Cipto Mangunkusumo General Hospital between May 2020 and August 2022. Parameters such as mastoid volume, height, and surface area were measured at the ear canal, Superior Semicircular Canal (SCC), and lateral SCC levels., Results: The analysis revealed statistically significant decreases in median mastoid air cell volume and mastoid bone volume in the affected ears compared to contralateral ears (p =  0.0312 and p =  0.02, respectively). Additionally, decreased mastoid height and surface areas at the ear canal and superior SCC levels were identified in affected ears (p <  0.05)., Conclusions: Patients with unilateral microtia have diminished mastoid bone volumetric parameters and dimensions on the affected side. These findings offer critical data for surgeons in preoperative planning, enabling the selection of appropriate reconstructive techniques and providing comprehensive patient counselling., Level of Evidence: Level 4., (Copyright © 2024 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier España S.L.U. All rights reserved.)

The purpose of the study is to assess dynamics of level of common and primary morbidity in class of diseases of ear and mastoid in adult population of the Russian Federation in 2018-2022. The analysis of morbidity indicators was carried out on the basis of data from statistical collections of Minzdrav of Russia and the Federal State Budget Institution "The Central Research Institute for Health Organization and Informatics of Minzdrav of Russia". It is established that in the Russian Federation, level of common and primary morbidity in class of diseases of ear and mastoid in adult population in 2018-2022 was decreasing and reached its lowest values in 2022 (2875.3 and 1760.8 cases per 100,000 of population respectively). The similar trend is observed in all Federal Okrugs of the Russian Federation. The increasing of level of common morbidity is established in 18 Subjects of the Russian Federation, with maximal increase in the Ivanovo Oblast (+17.0%). The increase of level of primary morbidity was noted in 21 Subjects of the Russian Federation, with maximal increase in the Penza Oblast (+35.0%). The most of Subjects of the Russian Federation are characterized by decreasing of both level of common morbidity with maximal decreasing the Republic of Adygei (-48.0%) and primary morbidity of adult population in class of diseases of ear and mastoid with maximal decreasing in the Republic of Tuva (-54.0%). The presented trends of indicators of morbidity in class of diseases of ear and mastoid are results of complex and multi-factorial processes. heir identification will permit to develop measures improving otorhinolaryngological care of population.

Abnormal loss of bone in the external auditory canal (EAC) constitutes an underreported condition in paleopathology. Thus far, all reported cases were diagnosed as the result of an external ear canal cholesteatoma (EACC). Here, we report two cases from the medieval period in Germany that show enlarged EACs with perforations of the anterior and posterior EAC walls. The cases were studied macroscopically, with a digital stereo microscope and by conventional X‐ray and computed tomography (CT)‐imaging techniques. In Case 1, the resorption caused a "ballooning" of the EAC while signs of osteonecrosis were missing. We therefore conclude that keratosis obturans (KO) is the most likely diagnosis. In Case 2, the periantral region adjacent to the perforations of the posterior EAC wall exhibits large resorption cavities and sequestrum‐like structures, indicative of osteonecrosis. In this case, we arrive at the diagnosis EACC. Ear diseases encompass a broad spectrum of conditions, many of them with potentially severe impacts on past people. It is therefore suggested to address ear diseases more frequently in paleopathology. Thus far, only a very limited number of entities of ear diseases have been diagnosed in paleopathological studies, and no case of KO has been reported. The present study thus expands the spectrum of paleo‐otopathological diagnoses. [ABSTRACT FROM AUTHOR]

Background: Mastoid Pressure Dressing (MPD) has been commonly used by otolaryngologists from 1960 as a post-operative care after mastoid or middle ear surgeries. MPD may be removed after the first day or 5 days after the surgery but it is not clear whether early or late removal is associated with less side effects. To clarify the optimal time of MPD removal, we conducted this prospective study. Methods: A total of 56 patients, including 19 males and 37 females with the mean age of 38.23±15.9 years, were included in this study. Among these, 31 patients underwent early MPD removal (after one day) and for the other 25 patients, MPD was removed five days following the surgery, Tympanoplasty or Tympanomastoidectomy. Results: There was no significant difference between the two groups in gender distribution or mean age. In addition, no significant betweengroup difference was detected in developing hematoma and sleep disturbance, but patients with late MPD removal showed higher rates of headache and erythema. Conclusion: Current study suggests that MPD may be removed as soon as possible after the surgery due to its side effects inducing headache and irritation. [ABSTRACT FROM AUTHOR]

Background: Though osteomas can commonly arise in the cranial bones, an extra canalicular mastoid bone location is a rare entity with less than 200 cases described to date. We present three cases of cortical mastoid bone osteomas and compare them with cases presented in the literature. Methods: In this study, we used a retrospective chart analysis. Results: All three patients presented after years of progressively increasing postauricular swelling without symptoms. Temporal bone non-contrast CT allowed accurate preoperative diagnosis. Surgical treatment was performed for cosmetic issues with minimal postoperative morbidity. Complete excision was achieved in all cases, and to date, there is no evidence of recurrence. Conclusions: Mastoid osteomas are rare benign slow-growing tumors. They usually present as a painless cosmetic disfigurement and are otherwise asymptomatic. Surgical excision is the treatment of choice when they cause esthetic discomfort or are symptomatic. Recurrences are infrequently reported. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the utility of temporal subtraction computed tomography (TSCT) obtained with temporal bone high-resolution computed tomography (HRCT) for the preoperative prediction of mastoid extension of middle ear cholesteatomas.Methods: Twenty-eight consecutive patients with surgically proven middle ear cholesteatomas were retrospectively evaluated. The presence of black color in the mastoid region on TSCT suggested progressive changes caused by bone erosion. Enlarged width of the anterior part of mastoid on HRCT was interpreted as suggestive of mastoid extension. Fisher's exact test was used to compare the widths and black color on TSCT for cases with and without mastoid extension. The diagnostic accuracy of TSCT and HRCT for detecting mastoid extension and interobserver agreement during the evaluation of black color on TSCT were calculated.Results: There were 15 cases of surgically proven mastoid extension and 13 cases without mastoid extension. Patients with black color on TSCT were significantly more likely to have a mastoid extension (p < 0.001). The sensitivity and specificity of TSCT were 0.93 and 1.00, respectively. Patients in whom the width of the anterior part of the mastoid was enlarged were significantly more likely to have a mastoid extension (p = 0.007). The sensitivity and specificity of HRCT to detect the width of the anterior part of the mastoid were 0.80 and 0.77, respectively. Interobserver agreement during the evaluation of TSCT findings was good (k = 0.71).Conclusions: This novel TSCT technique and preoperative evaluations are useful for assessing mastoid extension of middle ear cholesteatomas and making treatment decisions.Key Points: •TSCT shows a clear black color in the mastoid region when the middle ear cholesteatoma is accompanied by mastoid extension. •TSCT obtained with preoperative serial HRCT of the temporal bone is useful for assessing mastoid extension of middle ear cholesteatomas. [ABSTRACT FROM AUTHOR]

Objective: To assess tomographic features of mastoid cell pneumatization (MCP) using cone beam computed tomography (CBCT). Materials and Methods: To evaluate 659 CBCTs (500 women and 159 men) of the Oral and Maxillofacial Radiology service of Universidad Peruana Cayetano Heredia Dental Clinic, between 2014 – 2015. The age group was between 7 to 79 years-old. The classification of Al Faleh and Ibrahim was also used to assess the degree of pneumatization, and the statistical analysis was performed using the chi-square test. Results: The frequency of MCP was 76.2 % (502 cases). The highest frequency was found for grade 0 and 2, the highest frequency was found in the 6th decade of life and great predominance was found for the female sex. However, no statically significant differences were found with respect to the gender. Conclusion: MCP prevalence was 76.2% and CBCT became the gold-standard that allows an adequate evaluation of this anatomical variant.

Aim:To investigate the possible relationship between morphological changes caused by anatomical structural differences and functional impairment in Vestibular migraine (VM) and Chronic Migraine (CM) disease.Methods:A total of 44 patients (VM group; 23 and CM group; 21) included in the study. The medical records of patients with CM and VM between 2016-2018 were retrieved from the digital database of the otorhinolaryngology and neurology clinics. The mastoid bone and inner ear measurements in temporal bone high resolution computed tomography and inner ear magnetic resonance imaging were performed in our study. The two groups were compared radiologically.Results:Right cochlear height in the VM group was significantly higher than the CM group. The left vestibular height in the VM group was significantly higher than the CM group.Conclusion:The reason why not all patients with CM have vestibular complaints may be due to some differences in the inner ear anatomical structure.

Objective: To examine the effects of mastoid and middle-ear volume on the anatomical and functional success of type 1 tympanoplasty in paediatric patients. Methods: This study included 45 paediatric patients who underwent type 1 cartilage tympanoplasty. Patients' demographic data, pre- and post-operative audiological evaluation results, and post-operative graft status were evaluated. Middle-ear and mastoid cavity volumes were calculated (in cubic centimetres) using temporal bone high-resolution computed tomography. Middle-ear and mastoid cavity volume values were compared between patients with and without post-operative anatomical and functional success. Results: Anatomical success was achieved in 82.2 per cent of patients (n = 37), and functional success in 68.9 per cent (n = 31). When anatomical success and failure groups were compared, a statistically significant difference was found in mean mastoid volume (p = 0.037), while there was no significant difference in relation to mean middle-ear volume (p = 0.827). The comparison of functional success and failure groups revealed no significant difference in mean mastoid volume (p = 0.492) or middle-ear volume (p = 0.941). Conclusion: The study showed that mastoid pneumatisation volume affects surgical success in paediatric tympanoplasty. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate the applicability of the endoscopy-assisted presigmoid retrolabyrinthine approach, advantages, disadvantages, and the applicability of surgery with pre-op radiological parameters; identify important landmarks; and to reveal their relationships with important structures in the surgical field with objective data. Also, we aim to improve the surgical technique for increasing reachable anatomic structure. Methods: Mastoid drilling and endoscopy-assisted presigmoid retrolabyrinthine approach were performed and endoscopic instruments were used to obtain the three-dimensional pictures. Computed tomography images were evaluated to correlate to the anatomic data. Results: In terms of pre-operative radiological evaluation of the applicability of the presigmoid approach were investigated with selected radiological parameters. The endoscopy-assisted presigmoid retrolabyrinthine approach applied to cadavers the relationship, distances between important anatomical landmarks, and anatomical structures in the surgical field recorded. The anatomical structures that could reach with the application of the procedure were recorded. The relationship between pre-operative measured radiological parameters and surgical results was evaluated with objective data. Additional combinations to improve this surgical method discussed and the results of our combination were recorded with photographs. Conclusion: Although the presigmoid retrolabyrinthine approach has facilitated with the assistance of endoscope, it has observed that there are still some difficulties, and it has been concluded that the radiological parameters are useful in evaluating the applicability of this surgery. It observed that this surgery can be performed more effectively with combinations. [ABSTRACT FROM AUTHOR]

We describe the use of calcium sulfate beads as antibiotic carrier in a patient, who suffered from chronic mastoiditis with consecutive otogenic meningitis due to Burkholderia cenocepacia. Our findings suggest a possible role of calcium sulfate matrix as a local antibiotic carrier in the mastoid in complicated mastoiditis cases. [ABSTRACT FROM AUTHOR]

Abstract We describe the use of calcium sulfate beads as antibiotic carrier in a patient, who suffered from chronic mastoiditis with consecutive otogenic meningitis due to Burkholderia cenocepacia. Our findings suggest a possible role of calcium sulfate matrix as a local antibiotic carrier in the mastoid in complicated mastoiditis cases.

Objective: Post-mastoidectomy delayed cavity healing is a challenge to manage. This study aimed to cut down healing time with a simple technique (fascia with a skin graft) and compared it with controls without this technique. Method: The current study was a prospective non-randomised controlled study, conducted in a tertiary referral hospital. Thirty cases and 30 controls with squamosal type chronic otitis media were studied. Results: By the end of first month, 23.3 per cent of cases had healed compared with 3.3 per cent of controls. At the third month follow up, 83.3 per cent of cases and 53.3 per cent of controls had healed. At the sixth month follow up, 93.3 per cent of cases and 86 per cent of controls had healed. Conclusion: Healing of the mastoid cavity, as evidenced by epithelialisation and formation of a dry cavity, was faster in cases that received the graft when compared with controls without the graft. [ABSTRACT FROM AUTHOR]

Objective: Pulsatile tinnitus (PT) caused by an aberrant artery is rare. We report an unprecedented cause of PT resulting from an aberrant artery coursing the mastoid surface, and qualitatively discuss the pathophysiology of PT.Methods: This case study reports a 41-year-old woman who presented with persistent PT at her right retromastoid region. Contrast-enhanced computed tomography revealed an aberrant branch of the artery that coursed over the cortex of the mastoid bone. Surgical ligation of this aberrant artery was performed under local anesthesia.Results: Intraoperative findings suggested that PT transmitted via bone-conduction route due to the direct contact of the vascular and mastoid surface. PT was completely resolved upon surgical removal of this causative segment. Ultrasonographic and hemodynamic analysis showed that the turbulent kinetic energy and high regional wall pressure were the major contributory factors causing PT. Spectro-temporal analysis showed that PT fluctuates at frequency 500~2000 Hz, which differs from those of venous PT.Conclusion: Judicious preoperative and intraoperative assessments of PT ensure the surgical efficacy of PT. Objective ultrasonographic and computational studies can provide detailed hydroacoustic characteristics of PT. [ABSTRACT FROM AUTHOR]

'Bullough lesions', also referred to as protuberant fibro-osseous lesions (PFOL), are rare temporal bone lesions initially described in 1999. Since only 12 cases have been reported, several key issues, such as their origin and recommended management strategies, remain unresolved. This article reports the largest cohort included in the literature to date, comprising four patients with PFOL. PFOL appears to be characterized by female and right-side predominance. These lesions were consistently located regarding the mastoid, generally diagnosed in early adulthood, without functional symptoms, and were always fibro-osseous. Invasive/malignant features were not found on imaging or histology. The main differential diagnosis was malignant low-grade parosteal osteosarcoma. Clinical examination and computed tomography images provided strong elements supporting the diagnosis of PFOL. Biopsy allowed molecular biology investigations (MDM2 and CDK4 amplification), in order to rule out low-grade parosteal osteosarcoma. [ABSTRACT FROM AUTHOR]

Introduction: The aim was to explore the developmental relationships between the angles of septal deviations and the degree of the mastoid pneumatization. Materials and Methods: In total, 143 patients with a diagnosis of septal deviation who underwent septoplasty were included. The patients were divided into three groups in terms of the angles of the septal deviation. The angle of the septal deviations was defined as mild (0.05). The mean left mastoid volumes of each groups did not differ in right-sided deviations subjects (P>0.05). In right-sided septal deviation subjects, the mean volume of the right and left-sided mastoid air cells of each groups did not differ (P>0.05). In left-sided septal deviation subjects, the mean volume of the right and left-sided mastoid air cells of each groups did not differ (P>0.05). Conclusions: No developmental relationships between the angles of septal deviations and the degree of the mastoid pneumatization was observed in the study.

Abstract Mucocele is an accumulation of secretion products, desquamation, and inflammation within a body cavity: Localization in the mastoid is extremely rare. Erosion of bony walls and invasion of surrounding structures expose a patient to intra‐ and extracranial complications. Proper imaging work‐up and complete removal through mastoidectomy is warranted.

Rhabdomyosarcoma (RMS) is a rare soft tissue tumour, accounting for 3% of all childhood cancers. RMS can arise virtually anywhere in the body, as it originates in embryonal mesenchyme. Embryonal Rhabdomyosarcoma (ERMS) and Alveolar Rhabdomyosarcoma (ARMS) are the most prevalent subtypes of RMS but arise through diverse biological mechanisms. RMS generally presents as an expanding mass that tends to be very painful and causes symptoms related to the compression of structures present nearby. Metastases of such tumours are common and can occur in bone, lungs and other organs leading to pain, difficulty with respiration, pleural effusion, anaemia, thrombocytopenia, and neutropenia. In the present report, two unusual presentations of ERMS have been reported. First case is of a 28-year-old adult male who presented in surgical Outpatient Department (OPD) with recurrent episodes of painful acute urinary retention since one year. Another case was of a six-year-old girl presenting with aural fullness and serosanginous discharge from right ear, ear pain and decreased hearing since two years. Since five year survival rate of such tumour is less than 30%, therefore, an awareness of the typical signs and symptoms, radiological features, histomorphological features in a case of paediatric and adult ERMS can help a pathologist to consider this tumour in the differential diagnoses, even at unusual sites.