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Objective: Studies on feeling of ear fullness (FEF) related to sudden sensorineural hearing loss(SSNHL) are limited. The mechanisms of FEF are unclear. This study aimed to explore the characteristics and related brain activation of SSNHL with FEF. Methods: A total of 269 SSNHL patients were prospectively observed and divided into two groups, with FEF and without FEF. Fifteen SSNHL patients with FEF and 20 healthy controls (HCs) were recruited and underwent 18F-SynVesT-1 static PET. Standardized uptake values ratios (SUVr) of 18F-SynVesT-1 were computed between regions of interest. Results: The occurrence of FEF was not related to the audiogram type or severity of hearing loss. There was a positive correlation between the degree of FEF and the degree of hearing loss. Recovery from FEF was not related to the audiogram shape, the degree of hearing loss or recovery. Fifteen SSNHL patients with FEF had relatively low 18F-SynVesT-1 uptake in the right middle frontal gyrus, right inferior frontal gyrus, right middle temporal gyrus, bilateral parietal lobe sub-gyral and left medial frontal gyrus, as compared with HCs. There was no relatively high 18F-SynVesT-1 uptake in the cerebral cortex. Conclusion: The occurrence and recovery of FEF in SSNHL patients are not related to the classification, degree and recovery of hearing loss. The 18F-SynVesT-1 uptake in the cerebral cortex of patients experiencing SSNHL and FEF has shown alterations. This indicates that FEF may be related to cortical reorganization after the sudden impairment of unilateral auditory input. [ABSTRACT FROM AUTHOR]

Abstract Background According to National Institute for Health and Care Excellence (NICE), UK, common audiovestibular symptoms of COVID-19 include dizziness, tinnitus, and otalgia. The pathogenesis of otologic disorders ranges from direct damage to the inner ear structures to immune-mediated damage. Since the start of the pandemic, the prevalence of audiovestibular symptoms linked to COVID-19 has not been thoroughly investigated in Egypt. Our objective is to study and analyze the prevalence of the audiovestibular symptoms in the Egyptian population with history of COVID-19 infection. Methods A cross-sectional study was conducted among Egyptian adults on the presence and nature of the audiovestibular manifestations in COVID-19 patients. An online questionnaire was used. The questionnaire was developed using Google Form. It was disseminated to the target population through social platforms from October 2021 till February 2022. Results Data from 245 respondents were collected through online assessment of a convenient sample. The following de novo audiovestibular symptoms were experienced by the participants: Vertigo 20.8%, hearing loss 13.9%, tinnitus 12.7% and ear fullness 11.4%. No correlation was found between the investigations done (D-Dimer, CT chest) and the audiovestibular symptoms. Conclusion Audiovestibular symptoms are fairly common among COVID-19 patients, with higher prevalence, particularly of vertigo, in our study sample compared to the literature. It is recommended that patients with audiovestibular symptoms undergo early testing so that prompt interventions can be taken.

Background: According to National Institute for Health and Care Excellence (NICE), UK, common audiovestibular symptoms of COVID-19 include dizziness, tinnitus, and otalgia. The pathogenesis of otologic disorders ranges from direct damage to the inner ear structures to immune-mediated damage. Since the start of the pandemic, the prevalence of audiovestibular symptoms linked to COVID-19 has not been thoroughly investigated in Egypt. Our objective is to study and analyze the prevalence of the audiovestibular symptoms in the Egyptian population with history of COVID-19 infection. Methods: A cross-sectional study was conducted among Egyptian adults on the presence and nature of the audiovestibular manifestations in COVID-19 patients. An online questionnaire was used. The questionnaire was developed using Google Form. It was disseminated to the target population through social platforms from October 2021 till February 2022. Results: Data from 245 respondents were collected through online assessment of a convenient sample. The following de novo audiovestibular symptoms were experienced by the participants: Vertigo 20.8%, hearing loss 13.9%, tinnitus 12.7% and ear fullness 11.4%. No correlation was found between the investigations done (D-Dimer, CT chest) and the audiovestibular symptoms. Conclusion: Audiovestibular symptoms are fairly common among COVID-19 patients, with higher prevalence, particularly of vertigo, in our study sample compared to the literature. It is recommended that patients with audiovestibular symptoms undergo early testing so that prompt interventions can be taken. [ABSTRACT FROM AUTHOR]

Abstract Objective To investigate the factors that may contribute to the rare disease process of benign osteonecrosis of the temporal bone and to differentiate this poorly understood disease from other disorders. Methods A retrospective chart review using tertiary academic medical center electronic medical records (EMR) for otolaryngology was performed in August 2021. The study included data from January 1, 2014, to June 30, 2020. The patients were identified by a series of predetermined criteria. Their demographic information and clinical course were qualitatively compared. Patients with a history of radiation to the head or neck or who had other otolaryngologic comorbidities were excluded from the study. Inclusion/exclusion criteria were used to filter patients and a thorough chart review was conducted among the patients identified. Results A total of three patients were identified that met criteria for the study upon thorough chart review. Out of these patients, all were male, fell within the age range of 67–78 years old and had a history of hypertension. Two out of three had diabetes. In all cases, the plan included supportive care and regular follow up appointments. Conclusion Benign osteonecrosis of the temporal bone is a rare disease that is difficult to diagnose and even more complicated to document. There is no specific ICD‐10 code for this disease making it exceedingly difficult to identify patients with a simple EMR search. Several previously hypothesized risk factors were studied in this review. The limited patient population makes it difficult to confidently identify risks. In the patients studied, the commonalities included that they were all men, above the age of 67 when diagnosed, and all had a history of hypertension. To fully understand this rare entity further research must be conducted and more patients must be studied to aid with the identification of risk factors and clinical diagnosis of this condition. Level of Evidence: 4.

Aims: To determine differences between TMD subtypes in terms of clinical characteristics, dizziness, tinnitus, and ear fullness according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and to investigate the clinical conditions associated with dizziness, tinnitus, and ear fullness. Methods: Participants having TMDs aged 18 to 45 years were included in this study. They were classified and divided into three groups according to the DC/TMD Axis I criteria: group 1 = pain-related TMDs and headache; group 2 = intraarticular joint disorders; and group 3 = degenerative joint disease. Demographic data and dizziness, tinnitus, and ear fullness were assessed. Maximum mouth opening, opening/closing click, lateral click, fine/coarse crepitation, bruxism, and presence of pain were evaluated by physical examination. Results: A total of 129 participants were included: 68 (52.7%) in group 1, 40 (31%) in group 2, and 21 (16.3%) in group 3. In the comparison of all three diagnostic groups, there was a significant difference only in educational level (P = .013). The presence of dizziness, tinnitus, or ear fullness was not found to be significantly different among the three groups. When all participants were divided into two groups according to the presence of dizziness, low education levels (P = .007), being married (P = .040), presence of pain (P = .002), tinnitus (P = .008), ear fullness (P = .017), and presence of thin crepitation (P = .015) were related to having dizziness symptoms. In addition, patients with ear fullness (P = .042), dizziness (P = .008), and female sex (P = .008) reported more tinnitus. Conclusion: TMD subtype was not associated with dizziness, tinnitus, or ear fullness. Painful conditions were associated with dizziness in participants with TMDs. [ABSTRACT FROM AUTHOR]

Abstract Objectives Ear symptoms coincident with TMD symptoms have been noticed for a long time. The aim was to investigate the relationship between reported ear symptoms in TMD patients and different TMD symptoms, dental occlusion, oral parafunction and habits. Material and methods Consecutive patients, ≥18 years of age and referred to a specialist clinic for orofacial pain and dysfunction during a three‐month period, were considered for the study. Patients with poor general or psychiatric health were excluded. One hundred thirty‐two patients were included and studied with regard to reported ear symptoms in relation to clinical dysfunction, occlusion, habits and subjective rating of their symptoms. A clinical examination was performed according to RDC/TMD and extended with occlusal factors, parafunctions and habits. Results Ear symptoms were reported by 72% of the TMD patients, with ear fullness in 49% as the most frequent symptom. The patients with ear symptoms were significantly older and proportionally more often females. Ear symptoms were significantly correlated to the subjective index, to myalgia (p = 0.003), decreased opening capacity (p = 0.01), TMJ pain (p = 0.02), parafunctions (p = 0.007), and some occlusal factor (p = 0.018–0.003). Muscle pain on palpation was significantly associated with ear fullness, and changed hearing and sensitivity to sound, on the same side (p

The aim of this article is to discuss the scientific evidence available on the pathophysiology and management of otologic complaints in patients with temporomandibular disorders (TMDs). The authors conducted an electronic search in MEDLINE, Web of Science and ScienceDirect and retrieved all the relevant peer-reviewed journal articles available in English on the topic. No time restriction was applied. No consensus exists on the management of otologic symptoms in patients with concomitant TMD. The scientific evidence suggests that conservative or reversible TMD therapy might provide relief. However, this evidence is scarce and low, thus further studies with larger sample sizes and better designed methodological frameworks are needed. Until such evidence is available, dentists and orofacial pain specialists should treat TMD patients using current guidelines and refer those with otologic symptoms to an otolaryngologist. Given the wide range of potential pathophysiologies and treatments for each otologic symptom described in the TMD patient, close collaboration with otolaryngologists is essential to achieve the best patient care. [ABSTRACT FROM AUTHOR]

In this case series, we set out to describe the clinical entity of isolated, prolonged aural fullness (AF) and its relationship with migraine. Patients with isolated, persistent AF for 6 months or more were included with all possible etiologies ruled out. Migraine dietary and lifestyle changes and medical migraine prophylactic therapy were prescribed to all. Eleven patients were included (mean age, 52 years). Six (54%) patients fulfilled International Headache Society criteria for migraine with or without aura. Changes in perceived sensation of AF using the visual analog scale and quality of life questionnaires resulted in a statically significant improvement ( P < .001, 95% confidence interval [CI], 4.7 to 6.72, and P < .001, 95% CI, -5.3 to -2.7, respectively). As such, an improvement of isolated, prolonged AF with migraine lifestyle changes and prophylactic treatment may suggest an etiological association between migraine and prolonged aural fullness.

Objective: To investigate the factors that may contribute to the rare disease process of benign osteonecrosis of the temporal bone and to differentiate this poorly understood disease from other disorders. Methods: A retrospective chart review using tertiary academic medical center electronic medical records (EMR) for otolaryngology was performed in August 2021. The study included data from January 1, 2014, to June 30, 2020. The patients were identified by a series of predetermined criteria. Their demographic information and clinical course were qualitatively compared. Patients with a history of radiation to the head or neck or who had other otolaryngologic comorbidities were excluded from the study. Inclusion/exclusion criteria were used to filter patients and a thorough chart review was conducted among the patients identified. Results: A total of three patients were identified that met criteria for the study upon thorough chart review. Out of these patients, all were male, fell within the age range of 67–78 years old and had a history of hypertension. Two out of three had diabetes. In all cases, the plan included supportive care and regular follow up appointments. Conclusion: Benign osteonecrosis of the temporal bone is a rare disease that is difficult to diagnose and even more complicated to document. There is no specific ICD‐10 code for this disease making it exceedingly difficult to identify patients with a simple EMR search. Several previously hypothesized risk factors were studied in this review. The limited patient population makes it difficult to confidently identify risks. In the patients studied, the commonalities included that they were all men, above the age of 67 when diagnosed, and all had a history of hypertension. To fully understand this rare entity further research must be conducted and more patients must be studied to aid with the identification of risk factors and clinical diagnosis of this condition. Level of Evidence: 4. Benign osteonecrosis of the temporal bone is a rare and under‐recognized disease that is difficult to diagnose. Patients with this condition were identified through a set of specific inclusion/exclusion criteria and a retrospective chart review was performed to investigate the factors that may be involved with this disease process. [ABSTRACT FROM AUTHOR]

Objectives: Ear symptoms coincident with TMD symptoms have been noticed for a long time. The aim was to investigate the relationship between reported ear symptoms in TMD patients and different TMD symptoms, dental occlusion, oral parafunction and habits. Material and methods: Consecutive patients, ≥18 years of age and referred to a specialist clinic for orofacial pain and dysfunction during a three‐month period, were considered for the study. Patients with poor general or psychiatric health were excluded. One hundred thirty‐two patients were included and studied with regard to reported ear symptoms in relation to clinical dysfunction, occlusion, habits and subjective rating of their symptoms. A clinical examination was performed according to RDC/TMD and extended with occlusal factors, parafunctions and habits. Results: Ear symptoms were reported by 72% of the TMD patients, with ear fullness in 49% as the most frequent symptom. The patients with ear symptoms were significantly older and proportionally more often females. Ear symptoms were significantly correlated to the subjective index, to myalgia (p = 0.003), decreased opening capacity (p = 0.01), TMJ pain (p = 0.02), parafunctions (p = 0.007), and some occlusal factor (p = 0.018–0.003). Muscle pain on palpation was significantly associated with ear fullness, and changed hearing and sensitivity to sound, on the same side (p < 0.005). Conclusions: Ear symptoms are frequently reported by TMD patients. Concomitant ear symptoms are associated with oral parafunction and muscle pain on palpation on the same side as the ear symptoms. [ABSTRACT FROM AUTHOR]

Background: Chronic rhinosinusitis (CRS) has long been a suspected risk factor for Eustachian tube dysfunction (ETD). However, there have been few studies quantifying the presence of ETD in CRS patients. We sought to determine the prevalence of ETD symptoms in patients undergoing functional endoscopic sinus surgery (FESS) for CRS using the validated 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) and to correlate the ETDQ-7 scores with scores of CRS symptom severity based on the 22-item Sino-Nasal Outcome Test (SNOT-22). Methods: Patients for FESS were preoperatively administered both the ETDQ-7 and the SNOT-22 validated quality of life instruments. Pearson and Spearman correlation coefficients were calculated. Changes in ETDQ-7 were measured at 3 months and differences were compared via paired t test. Results: A total of 82 patients completed the surveys. Thirty-nine (47.6%) patients had ETDQ-7 score ≥14.5, signifying clinically significant ETD symptoms. The mean ETDQ-7 score of the study population was 15.8 ± 8.8, and the mean SNOT-22 score was 37.5 ± 19.7. The Pearson and Spearman correlation coefficients between ETDQ-7 and the total SNOT-22 score were 0.52 (P >.0001) and 0.51 (P <.0001), respectively. There was significant improvement in ETDQ-7 scores postoperatively. Conclusion: While the association between ETD and CRS has long been known, this is one of the few prospective patient studies evaluating otologic symptoms in a CRS population. We found that a significant percentage of CRS patients suffer from ETD symptoms based on patient-reported subjective outcome measures. This study demonstrates that otologic symptoms increase with CRS severity and improve after FESS. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: Ear fullness and pressure is a common complaint seen in otolaryngology clinics and frequently is attributed to eustachian tube dysfunction (ETD). In addition to traditional tympanometry and physical examination, the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) has recently been used to aid in the diagnosis of ETD and to assess its severity. Temporomandibular joint disorder (TMJD) is a common condition that causes similar symptoms to ETD and has been recognized as a potential confounding condition in patients presenting with ETD symptoms. We sought to determine the cross-sectional prevalence of ETD symptoms in patients with TMJD using the ETDQ-7.Study Design: Prospective cross-sectional analysis.Methods: An analysis was performed of ETDQ-7 scores in patients diagnosed with TMJD.Results: A total of 21 patients with confirmed TMJD completed the ETDQ-7 at routine consult or follow-up for their TMJD. The mean ± standard deviation ETDQ-7 score for the cohort was 24.5 ± 12.5. Two-thirds of patients had an ETDQ-7 score of >14.5, which has been used in the literature to denote clinically significant ETD. No single question was scored significantly higher than the others.Conclusions: Symptoms of ETD are highly prevalent among patients with TMJD determined by patient-reported outcome measures. It is not clear if these symptoms reflect true derangement of eustachian tube function in these patients or whether there is only clinical similarity between ETD and TMJD. However, future research efforts may resolve this dilemma.Level Of Evidence: 4 Laryngoscope, 130:E233-E236, 2020. [ABSTRACT FROM AUTHOR]

Patients with patulous Eustachian tube （PET） chiefly complain of ear fullness, autophonia, and audition of breathing sound. Because these symptoms change from moment to moment, it is difficult to diagnose the disease.　For treatment of PET, spraying diluted Lugol's solution to induce transient mucosal edema in the pharyngeal orifice of the Eustachian tube, or injection of oral moisturizing gel is performed.　However, these treatments do not provide long-term symptom improvement.　We, therefore, made a mixture of diluted Lugol's solution and moisturizing gel, namely Lugol gel, and injected into the Eustachian tube for the purpose of diagnosis and treatment of PET with expectation of longer symptom improvement. From October 2013 to December 2017, Lugol gel was injected into the pharyngeal orifice of the Eustachian tube in 14 patients with possible PET based on the clinical course. Subjective symptoms were improved in 12 patients, resulting in a diagnosis or strong suspicion of PET. However, the duration of the treatment effect was between several hours and 12 days, and was not as long as we expected. Conservative treatment was initiated for these 12 patients. Among them, symptoms disappeared during follow-up only in two patients, and were improved by herbal medicine in two cases and by using an adhesive tape on the tympanic membrane in another two cases. Two of the remaining six patients without symptomatic improvement by conservative treatment were referred to other hospitals for surgical treatment. Long-term effect of Lugol gel injection cannot be expected for PET, but the injection is considered useful for diagnosis of the disease. It also helps a patient to understand the pathophysiology of the disease. [ABSTRACT FROM AUTHOR]

Keywords: Eustachian tube dysfunction; ear fullness; aural fullness; ear pressure; intranasal corticosteroids EN Eustachian tube dysfunction ear fullness aural fullness ear pressure intranasal corticosteroids 204 206 3 02/24/21 20210201 NES 210201 The most common treatment for chronic Eustachian tube dysfunction (ETD) is intranasal corticosteroid sprays (INCS) despite no current INCS being U.S. Food and Drug Administration (FDA)-approved for this disease. Furthermore, the only adult study investigating INCS efficacy in ETD, a randomized, double-blinded, placebo-controlled study, demonstrated no benefit over placebo.1 Surgical options for ETD include myringotomy as well as the relatively new balloon dilation of the Eustachian tube (BDET). Although no single test has been accepted as a perfect evaluator of ETD status, demonstrating ETD pathology using multiple methodologies is preferable and would decrease the possibility of patients with other etiologies of ear symptoms being misdiagnosed with ETD. [Extracted from the article]

Background: While Eustachian tube dysfunction (ETD) is a known comorbidity of chronic rhinosinusitis (CRS), the prevalence of ETD symptoms in the CRS population is poorly understood. We sought to determine the cross‐sectional prevalence of ETD in patients with CRS using the validated Eustachian Tube Dysfunction Questionnaire (ETDQ‐7) and to correlate ETDQ‐7 scores with 22‐item Sino‐Nasal Outcome Test (SNOT‐22) scores, endoscopy scores, and computed tomography (CT) scores. Methods: A total of 101 patients with confirmed CRS completed the ETDQ‐7 and SNOT‐22 at their initial visit to our rhinology clinic. Lund‐Mackay CT and Lund‐Kennedy endoscopy scores were also obtained. Spearman's correlation coefficient (ρ) was calculated. Results: Among the 101 patients, 49 patients (48.5%) had an ETDQ‐7 score of ≥14.5, signifying clinically significant ETD. The mean ± standard deviation (SD) ETDQ‐7 score of the entire cohort was 17.8 ± 10.1. There was a moderately strong correlation between ETDQ‐7 and the SNOT‐22 ear subdomain (ρ = 0.691, p < 0.001). The correlation coefficient between ETDQ‐7 and total SNOT‐22 scores was ρ = 0.491 (p < 0.001), indicating moderate correlation. ETDQ‐7 scores were poorly correlated to objective measures of sinonasal disease, including Lund‐Mackay CT score (ρ = −0.055, p = 0.594) and Lund‐Kennedy endoscopy score (ρ = −0.099, p = 0.334). Conclusion: Symptoms of ETD are highly prevalent among patients with CRS as documented by patient‐reported outcome measures. The correlation between ETDQ‐7 scores and SNOT‐22 ear subdomain scores is moderately strong, while the correlation between ETDQ‐7 scores and SNOT‐22 scores is moderate. ETD severity does not correlate with CT score or nasal endoscopy score. [ABSTRACT FROM AUTHOR]

OBJECTIVE: 1) To determine if unexplained ear fullness might be a symptom of endolymphatic hydrops (EH) by using Electrocochleography (ECochG) SP/AP area and amplitude ratios. 2) To assess if individuals with unexplained ear fullness without vertigo differ significantly from individuals with ear fullness due to Ménière's disease (MD). MATERIALS and METHODS: In a case-control study in our tertiary care center, we evaluated 62 ears across 49 patients, including 18 normal healthy ears across 12 control patients, 26 ears with unexplained ear fullness across 20 patients (6 had bilateral symptoms of ear fullness), and 18 ears with definite MD across 17 patients (1 bilateral disease). Outcome measures were SP/AP amplitude and area ratio, hearing threshold, and air-bone gap. RESULTS: The analysis of auditory thresholds revealed a significant group effect for air conduction [F(2,50)=49.627; p<0.001] and for bone conduction [F(2,50)=45.625; p<0.001]. We observed significant differences between MD (36.36±4.87) and control patients (19.85±2.55) (p=0.015) for amplitude ratio. Moreover, significant differences were noted between MD (5.32±1.06) and controls (1.36±0.07) (p=0.035) and between ear fullness (5.16±1.17) and controls (p=0.026) for the area ratio parameter. No significant correlation was observed between SP/AP area or amplitude ratios and air-bone gap at any of the tested frequencies. The amplitude ratio was not significantly different between the ear fullness and control groups (p=0.406). The area and amplitude ratios did not reveal significant differences between MD and ear fullness (p=1.00). CONCLUSION: EH can be present even in the absence of vertigo and when patients report unexplained ear fullness. This study, to our knowledge, is the first to possibly allow early identification of cochlear EH in patients suffering from ear fullness without vertigo. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the quality of life (QOL) of patients treated by endolymphatic duct blockage (EDB) for Ménière's disease with a dedicated questionnaire. This is a retrospective cross-sectional study which included 54 patients diagnosed with severe, refractory Ménière's disease according to the AAO-HNS criteria and treated with EDB between 2010 and 2013. Answers to the first 38 questions have assigned scores from 0 to 4 (0 corresponding to the poorest QOL). A preoperative score called S1 was calculated as follows: S1 = sum of preoperative question scores/maximum possible preoperative score ×100. The same formula was used to calculate the postoperative score S2. The change in QOL score, S3, was then calculated (S3 = S2−S1). All answers were analyzed anonymously. Statistical analysis was done using Student t test and Chi square test. A response rate of 89 % was obtained with the Ménière's disease outcome questionnaire. The preoperative (S1) score was 21.4 (±12.6) and the postoperative score (S2) was 64.6 (±21.6) with a change in QOL (S3) of 43.3 ( p < 0.001). Postoperatively, 89.9 % reported no Ménière's attacks ( p < 0.001). Seventy-nine percent (15/19) of the questions showed a significant improvement after surgery. These results show that EDB is associated with a significant improvement of the QOL of patients suffering from severe Ménière's disease. [ABSTRACT FROM AUTHOR]

Aim: In the revised criteria of the International Classification of Headache Disorders (ICHD-III beta) the following items are added to the diagnostic criteria of cluster headache: ipsilateral sensation of fullness in the ear and ipsilateral forehead/facial flushing. We evaluated the possible additional value of these symptoms for diagnosing cluster headache.Methods: In this cross-sectional cohort study of (potential) cluster headache patients we investigated these additional symptoms using a Web-based questionnaire. Patients not fulfilling the ICHD-II criteria for cluster headache but fulfilling the ICHD-III beta criteria were interviewed.Results: Response rate was 916/1138 (80.5%). Of all 573 patients with cluster headache according to ICHD-II criteria, 192 (33.5%) reported ipsilateral ear fullness and 113 (19.7%) facial flushing during attacks. There was no difference in reporting ipsilateral ear fullness and facial flushing between patients who received a diagnosis of cluster headache and patients who did not. None of the patients who did not fulfill all ICHD-II criteria could be categorized as cluster headache according to the ICHD-III beta criteria.Conclusion: The results of this study do not support the addition of ear fullness and facial flushing to the new ICHD-III beta criteria. [ABSTRACT FROM AUTHOR]

Conclusion: This study revealed that endolymphatic hydrops (EH) reduced in some cases with Ménière's disease (MD) treated conservatively. It appears that the EH reduction was associated with improvement of the clinical symptoms. Objectives: The relationship between the degree of EH and clinical symptoms is not clear at present. The purpose of the present study was to investigate the time course of the relationship in patients with MD treated conservatively. Patients: Twelve patients with MD treated conservatively for more than 1 year in a university hospital. Methods: Twenty ears of 12 patients with MD treated conservatively were evaluated. The presence or absence of vertigo, tinnitus and ear fullness was confirmed when magnetic resonance imaging (MRI) was performed. Using a 3 T MRI scanner, three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) MRI was performed 2 or 3 times 24 hours after intra-tympanic gadolinium injection or 4 hours after intravenous gadolinium injection. Results: In the three ears in which the symptoms alleviated, EH was reduced in two ears, but EH was reduced in only one of 17 ears in which the symptoms did not alleviate. The Fisher exact test revealed that EH reduction occurred more frequently in ears with alleviation of the symptoms ( p < 0.05). [ABSTRACT FROM AUTHOR]

While fibromyalgia is frequently associated with ear-related symptoms such as feeling of ear fullness, earache, and tinnitus, the pathogenesis of these ear-related symptoms in fibromyalgia patients is unknown. Here, we focused on clarifying the pathogenesis of ear fullness, a particularly common symptom observed in fibromyalgia patients. Twenty patients diagnosed with fibromyalgia on outpatient psychosomatic treatment complaining of ear-related symptoms answered our questionnaire and underwent neurotological examination, including pure tone audiometry and Eustachian tube function testing. While ear-related symptoms were significantly exacerbated after onset of fibromyalgia, we noted no correlation between the presence or absence of feeling of ear fullness and abnormal findings on neurotological examination. Given our findings, we suspect that onset of ear fullness may be associated not with abnormal findings in the middle and inner ear function tests but with other causes, such as central desensitization. [ABSTRACT FROM AUTHOR]

Conclusion: Contrary to our expectation, that the clinical characteristics of temporal bone fracture would differ in children and adults, we found that the two groups were similar. Objectives: Most studies of temporal bone fractures have been performed in adults. To our knowledge, no study has investigated differences in temporal bone fractures in children and adults. We therefore investigated differences in temporal bone fractures in adults and children by examining the manifestations and clinical symptoms of temporal bone fractures in pediatric patients. Methods: The demographic and clinical characteristics were assessed in 32 children and 186 adults with temporal bone fractures. All patients underwent computed tomography of the temporal bone. Results: Causes of fracture, gender distribution, manifestations of temporal bone fracture, and clinical symptoms were similar in adults and children (p > 0.05 each). Petrous fracture, ear fullness, dizziness, and tinnitus were significantly more frequent in adults than in children (p < 0.05 each). [ABSTRACT FROM AUTHOR]

The article presents a study which compares the efficacy of intratympanic injections of methylprednisolone (ITMP with intratympanic injections of gentamicin (ITG) in controlling the symptoms of Ménière's disease and their impact on hearing level. The mean result measurement included the control of vertigo attacks, aural fullness, and tinnitus. Results suggest that ITG are more efficient compared to ITMP in controlling Ménière's disease symptoms.

Abstract: Objective: This study aimed to investigate how the symptoms of ear fullness, tinnitus and otoacoustic emissions (OAE) change in relation to the recovery course of pure tone audiometry thresholds (PTA) in sudden deafness (SD). Methods: This study analyzed follow-up data on ear fullness, tinnitus and otoacoustic emissions of eight SD patients with good hearing improvement (Group A) and eight SD patients with poor hearing improvement (Group B) in an attempt to elucidate the behavior of these symptoms in their recovery course. This study was done until there was no change in the PTA for more than 1 week and hearing recovery was no longer expected. Results: All patients from both groups had ear fullness and tinnitus in association with the onset of SD. However, these symptoms improved only in Group A. showing a significant relationship between PTA recovery and the improvement of ear fullness annoyance (P <0.05), presence of tinnitus (P <0.01), improvement in tinnitus loudness (P <0.01) and in tinnitus annoyance (P <0.01). No patients (Group A or B) had OAE responses at their first examination. In Group A, OAE responses appeared simultaneously with improvement of hearing levels in five patients (63%) and it appeared later than hearing levels improvement in the other three patients (37%) from Group A. No patient from Group B showed OAE response on follow-up. Conclusion: SD patients with good hearing improvement (Group A) tended to have OAE responses and the sensations of the ear fullness and tinnitus improved almost simultaneously with hearing level improvement. Their PTA improvement occurred primarily in the low to mid frequencies, with high frequencies showing less recovery. When hearing recovery was not full, OAEs did not reappear for these frequencies. Patients with poor hearing improvement tended to have absent OAEs and persistent ear fullness and tinnitus. [Copyright &y& Elsevier]

Objective: The characteristics and prognosis of ear fullness feeling in patients with all-frequency sudden deafness were explored. Method: 104 patients (104 ears) with unilateral all-frequency sudden deafness were collected in study from June 2015 to March 2019, including 50 males and 54 females, the mean age ranged from 23-65 years, and the disease duration ranged from 1-9 days. Of those, 56 patients accompanied with the feeling of ear fullness (FEF) were enrolled into'the ear fullness group', and 48 patients without FEF were included in'the without ear fullness group'. Patients' treatment strategy followed the Chinese Medical Association Guidelines for the diagnosis and treatment of sudden deafness (2015). Moreover, VAS scale scores and subjective grading of FEF were acquired in patients with FEF. We analyzed the clinical characteristics and prognosis of FEF with SPSS 23.0 software. Results: There were no differences between the two groups in terms of age, gender, duration of disease, the side of deaf ear, degree of hearing loss, and auditory brainstem evoked potential results (age, t =1.566; gender,χ(2)=0.001; duration, t =0.057; side,χ(2)=0.033; degree of hearing loss Z =-0.180; ABR,χ(2)=0.001;all P >0.05) . There was a positive correlation between the subjective grading of FEF and the degree of hearing loss in patients with FEF ( r =0.599, P <0.001) . The total rate of hearing improvement following one month of treatments in patients with FEF vs with no FEF was 35/56(62.5%) vs 28/48(58.3%) ( Z =-0.641, P =0.521). After one month of treatment, the total effective rate of FEF was 94.6%(53/56), and the improvement of FEF had nothing to improvement of hearing ( r =0.040, P =0.769) . Conclusions: The degree of hearing loss is positively correlated with the degree of FEF in patients with all-frequency sudden deafness. Hearing recovery is not related to FEF. The recovery effect of FEF is good, and has no correlation with hearing recovery.

Acute coronary syndrome usually presents with retrosternal chest pain, nausea, vomiting, sweating, and jaw and arm pain. Some patients only present with neck, epigastric, or ear discomfort. A 47-year-old male with a history of hypertension and coronary artery disease presented to the emergency department complaining of bilateral otalgia. He never felt chest pain, jaw pain, nausea, diaphoresis, or shortness of breath. He had a history of 2 acute coronary events and had a stress test 2 months prior to admission, which was unremarkable. The initial electrocardiography was sinus rhythm with Q-waves in the inferior leads and nonspecific ST changes in the lateral leads. His troponin on admission was normal but subsequently elevated to 20.00 mg/mL after 24 hours. He underwent left heart catheterization, which found significant occlusive disease of the second and fourth obtuse marginal branches and 2 drug-eluting stents were placed. His ear pain resolved soon after cardiac catheterization. The pathophysiology of this referred pain is thought to be related to the neuroanatomy of the nerves innervating the heart and ear. The auricular nerve branch of the vagus nerve supplies the inner portion of the external ear. Only a few cases with the complaint of otalgia have been reported. Patients were older, more frequently women, and with diabetes or heart failure. Clinicians should be aware of the atypical presentation of angina that may be life-threatening cardiac ischemia. Ear pain and fullness could be the sole presenting symptom in a patient with acute coronary syndrome., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.