scholarly journals Cephalic Tetanus: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-2 ◽  
Author(s):  
M. A. Alhaji ◽  
U. Abdulhafiz ◽  
C. I. Atuanya ◽  
F. L. Bukar
Keyword(s):  
Case Report ◽  
Otitis Media ◽  
High Mortality ◽  
Management Strategy ◽  
Booster Vaccination ◽  
Effective Management ◽  
Primary Immunization ◽  
Suppurative Otitis Media ◽  
Prompt Treatment ◽  
Cephalic Tetanus

A case report of cephalic tetanus in a 2-year-old girl who was not immunized against tetanus following suppurative otitis media (SOM) is presented. This case is reported because of the rarity of cephalic tetanus associated with high mortality, to highlight the risk of cephalic tetanus as sequelae of SOM and the need for proper aural care and prompt treatment of SOM. Primary immunization of all eligible children as well as booster vaccination at appropriate time as an effective management strategy for tetanus is emphasized.

Lateral sinus thrombosis following myringoplasty: a rare complication

2012 ◽  
Vol 127 (S1) ◽  
pp. S39-S41 ◽  
Author(s):  
G Sim ◽  
F Lannigan
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Otitis Media ◽  
High Mortality ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Lateral Sinus ◽  
Lateral Sinus Thrombosis ◽  
Life Threatening ◽  
Life Threatening Complication

AbstractObjective:We report lateral sinus thrombosis occurring as a rare complication following a routine and uneventful otological procedure.Case report:Lateral sinus thrombosis is a rare but known complication of otitis media. It has not been documented as a complication of routine otological surgery. We present a case of this rare complication following a myringoplasty. We also discuss the presentation, investigation and treatment of lateral sinus thrombosis. It is essential to be able to recognise and treat this rare complication early, due to its high mortality rate.Conclusion:Lateral sinus thrombosis is a rare but potentially life-threatening complication. It is therefore essential for clinicians to be able to recognise and treat this condition early.

scholarly journals A Cotton Wick Improves Hearing in a Patient with Profound Hearing Loss

2015 ◽  
Vol 30 (2) ◽  
pp. 56-58
Author(s):  
Ryner Jose D. Carrillo ◽  
Precious Eunice R. Grullo ◽  
Maria Luz M. San Agustin
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Hearing Aids ◽  
Ossicular Chain ◽  
Oval Window ◽  
Suppurative Otitis Media ◽  
The Right ◽  
Cotton Wick

Dear Editor,   The tympanic membrane and the ossicular chain contribute roughly 28 dB in hearing gain. In chronic suppurative otitis media, loss of tympanic membrane and lysis of the ossicular chain are significant causes of hearing loss.1 Through the years, hearing impairment has been augmented using various devices such as ear trumpets, carbon hearing aids, vacuum tube and transistor hearing aids, bone anchored hearing aids, and cochlear implants.2 This case report describes how a cotton wick was used to amplify sound.   Case Report A 65-year-old man consulted for hearing loss. He had a childhood history of recurrent ear discharge and hearing loss and was diagnosed with chronic suppurative otitis media. At age 55, he underwent tympanomastoidectomy of the left ear. While surgery stopped the left ear discharge, there was complete hearing loss in this ear. For this reason, he opted not to have surgery on the right ear. There was subsequent recurrent ear disease of the right ear. He would clean his ear with a cotton wick and apply antibiotic drops during bouts of ear discharge. He observed that leaving the ear wick with a few drops of topical otic preparations (polymyxin-neomycin-steroid or ofloxacin) would lessen the frequency of ear discharge and improve his hearing.  He found that morning application and positioning of the cotton wick in his right ear using tweezers and a toothpick allowed him to hear adequately to conduct his daily activities as an architect. (Figure 1, 2) The fear of hearing loss from another surgery, cost of a commercial hearing aid, and great utility of a simple cotton wick made him continue his practice for these ten years. Examination of the right middle ear without the cotton wick showed thickened mucosa, absent malleus and incus structures, a patent Eustachian tube and a near – total tympanic membrane perforation. There was no keratinous material or foul smelling discharge. (Figure  3) Pure tone audiometry confirmed that with the cotton wick, the right air-bone gap decreased at 500 hz, 1kHz, 2Kh and 4KHz by 30db, 40dB, 35dB and 25dB respectively.  (Table 1) DISCUSSION At different anatomic levels, mechanical sound energy is amplified and transmitted to the functional parts of the ear. The tympanic membrane and oval window ratio of 21:1 and malleus-incus lever mechanism ratio of 1.3:1 provide a 28 dB amplification of conductive hearing.1 This gain is reflected by frequency specific air-bone gaps, which can range between 25-40 dB. With the contribution from the external ear, the overall conductive gain is 60 dB.1,3 Damage to the auditory system often results in a loss of hearing sensitivity that is frequency – specific.  The presence of a frequency – specific wide air-bone gap suggests ossicular chain discontinuity among patients with chronic otitis media.4 Narrowing of the air-bone gap, which in this case was provided by insertion of the cotton wick, may lead to at least partial restoration of ossicular coupling. The ability of the cotton wick to improve hearing may be attributed to its possession of characteristics for sound conduction and acoustic impedance, such as stiffness, resistance and mass.  The effectiveness of the cotton wick was reported to be dependent on its positioning in the ear; the patient would have to insert the wick down to the level of the promontory or oval window, occasionally blow his nose, or reposition the cotton wick to achieve an acceptable hearing level. However, for a patient with completely deaf contralateral ear, a 32.5 dB gain in hearing is very pronounced and significant.  The hearing gain produced by the cotton wick only amplified the air conductive component of hearing but not bone conduction. While it afforded amplification of sound and a route of medicine administration, it may also have contributed to sensorineural hearing loss brought about by ototoxicity of medications and thickening of the oval and round window from chronic irritation. For this reason, utmost caution must be advised before considering use of a “cotton wick” to amplify hearing in this manner-- a practice we do not endorse. The cotton wick may have served as a vibrating piston on top of the oval window which amplified hearing. Such a mechanism may conceivably prognosticate potential gain from a contemplated tympanoplasty in the same way that the “paper patch test”5 predicts simple myringoplasty outcomes. Having said that, the diagnostic utility of such a cotton wick requires further investigation before potential clinical applications such as prognostication of tympanoplasty are theorized. Could future studies show that a preoperative cotton wick (or equivalent device) may approximate potential gains from a good tympanoplasty with ossiculoplasty in a patient with total tympanic perforation and ossicular chain loss?   Sincerely, Ryner Jose D. Carrillo, MD, MSc Precious Eunice R.  Grullo, MD, MPH Maria Luz M. San Agustin, RN, MClinAudio    

Ketamine in the management of generalised cephalic tetanus

2007 ◽  
Vol 122 (12) ◽  
pp. 1389-1391 ◽  
Author(s):  
O Obanor ◽  
H O Osazuwa ◽  
J E O Amadasun
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Airway Obstruction ◽  
High Mortality ◽  
Adjunctive Therapy ◽  
Anaesthetic Agent ◽  
Purulent Discharge ◽  
Clostridium Tetani ◽  
History Of ◽  
Cephalic Tetanus

AbstractBackground:Tetanus is a fatal infection caused by the neurotoxin tetanospasmin released by the vegetative spores of Clostridium tetani. The high mortality rate is related to frequent tetanic fits with laryngeal spasm and airway obstruction. Numerous anticonvulsants are in use, with varying efficacy in controlling fits. This case report highlights the use of ketamine as adjunctive therapy in the management of tetanus.Case report:A 20-year-old woman was admitted with a history of recurrent left ear pain, with bloody, purulent discharge, following a self-inflicted injury. She developed tetanic spasms 24 hours after admission. She had received no immunisations. A tracheostomy was established to relieve airway obstruction, and ketamine was added to the medication when breakthrough seizures were refractory to diazepam.Conclusion:Ketamine is of proven safety as an anaesthetic agent, especially in cases in which an anaesthetist is not readily available. Its effectiveness in this case, in combination with diazepam, warrants further evaluation.

scholarly journals Cerebellar venous infarction in chronic suppurative otitis media. A case report with review of four other cases.

Stroke ◽  
1994 ◽  
Vol 25 (5) ◽  
pp. 1058-1060 ◽  
Author(s):  
A K Nayak ◽  
D Karnad ◽  
M V Mahajan ◽  
A Shah ◽  
Y V Meisheri
Keyword(s):  
Case Report ◽  
Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Venous Infarction ◽  
Suppurative Otitis Media

scholarly journals The Importance of Duration in the Prognosis of Facial Nerve Palsy and Its Treatment-A Case Report

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Paramita Debnath
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Otitis Media ◽  
Social Life ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Chronic Suppurative Otitis Media ◽  
Good Effect ◽  
Surgical Approaches ◽  
Suppurative Otitis Media

Background: Facial nerve palsy is considered to be one of the most common consequence of untreated chronic suppurative otitis media. The incidence has significantly reduced over the decade due to better imaging technology and use of early antibiotics and better surgical procedures but if left untreated, it has a significant impact over the patient’s day to day life and markedly affects patient’s social life and causes serious psychological damage. An appropriate and prompt management ensures healing of the palsy without sequelae. Case Report: We report a case of bilateral chronic suppurative otitis media with unilateral right grade 4 facial nerve palsy which happened within a duration of 1 month for which patient underwent right modified radical mastoidectomy following which she had steady improvement. Conclusion: This case highlights that in patients with middle-ear cleft cholesteatoma the surgical approaches vary according to duration of palsy and post-operative improvement in facial nerve function can be anticipated in cases of acute palsy. Surgical interventions have been proved to have a good effect in restoration of facial nerve palsy in cases of shorter duration as compared to those of sudden onset and longer duration.

Challenges encountered in the diagnosis of tuberculous otitis media: case report and literature review

2011 ◽  
Vol 125 (7) ◽  
pp. 738-740 ◽  
Author(s):  
O T Dale ◽  
A R Clarke ◽  
A J Drysdale
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Otitis Media ◽  
Rare Case ◽  
Mycobacterial Infection ◽  
Microbiological Diagnosis ◽  
Suppurative Otitis Media ◽  
Tuberculous Otitis Media ◽  
The Uk ◽  
Rule Out

AbstractObjective:To report a rare case of tuberculous otitis media, and to highlight barriers to clinical and microbiological diagnosis.Method:Case report and literature review.Results:Tuberculous otitis media is a rare cause of chronic ear infection in the UK. Its symptoms may mimic a range of other otological conditions, including otitis media, chronic suppurative otitis media, cholesteatoma and necrotising otitis media.Conclusion:This case report highlights the challenges of obtaining a clinical diagnosis of tuberculous otitis media, and emphasises the fact that screening for acid-fast bacilli is not sufficient, in isolation, to rule out mycobacterial infection.

scholarly journals Anaerobic Brain Abscess following Chronic Suppurative Otitis Media in a Child from Uganda

2009 ◽  
Vol 20 (3) ◽  
pp. e91-e93 ◽  
Author(s):  
KA Cox ◽  
G Al-Rawahi ◽  
TR Kollmann
Keyword(s):  
Brain Abscess ◽  
Otitis Media ◽  
High Mortality ◽  
Developing World ◽  
Surgical Excision ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media

Brain abscess, while rare, confers high mortality, especially in the developing world. The case of a Ugandan child with a polymicrobial brain abscess including infection withTissierella praeacuta/Clostridium hastiformerequiring repeated drainage and eventual surgical excision is reported. The case demonstrates the importance of considering anaerobic organisms in the treatment of children with brain abscess from the developing world.

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