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      Contralateral Ear Findings in Chronic Otitis Media

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          Abstract

          Objectives:

          Chronic otitis media (COM) reveals a spectrum of otoscopic findings, and both ears may be affected to a different degree. The analysis of contralateral ear in patients with COM is important to detect the early signs of the disease. This may enable the follow-up and treatment of abnormalities in contralateral ear without delay. Therefore, in this study, we aimed to investigate the otoscopic and audiologic findings of contralateral ears of patients with COM.

          Methods:

          The institutional data of patients who underwent surgical treatment between 2014 and 2017 due to COM were reviewed. Suppurative ears with cholesteatoma, polyps, and otorrhea refractory to medical treatment and ears with dry middle ear mucosa, with otorrhea responsive to medical treatment, and without cholesteatoma were divided into two groups (Group 1 and Group 2, respectively). All patients were examined with regard to the presence of perforation, retraction, myringosclerosis, atrophy, and audiological results before the groups were compared.

          Results:

          Approximately 50% of contralateral ears of patients with COM showed abnormalities at an otoscopic examination in both groups. Tympanic membrane retraction in Group 1 was greater than in Group 2, and the difference was statistically significant (p<0.05). Both the mean air and bone conduction thresholds of the contralateral ears in Group 1 were also found to be elevated when compared with Group 2, and the differences were statistically significant (p<0.05).

          Conclusion:

          COM may be seen bilaterally due to the same predisposing factors affecting the ears. Therefore, detection, follow-up, and early treatment of abnormalities of contralateral ear associated with otitis media have clinical importance in the prevention or delaying progression of these abnormalities to COM.

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          Most cited references9

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          Atelectasis and Secretory Otitis Media

          That condition where the tympanic membrane is displaced toward the promontory is termed atelectasis. Thirty-seven patients (61 ears) showing various degrees of atelectasis graded from stage 1 to stage 4 were studied. Atelectatic drums are an inflammatory phenomenon occurring in underventilated ears. This conclusion is reached by considering the reversibility of the atelectasis upon ventilation; while the inflammatory factor can be deduced from the history and histopathology of the atelectatic drum, as well as the histology of the necrosed incus, the latter occurs in over a third of our cases. Also pneumatization of the mastoid is almost never present. Twelve (21%) of the ears treated did indeed develop a perforation at one time or another (two had cholesteatomas). Chronic granulating external otitis with specific features occurred in 15% of cases. The characteristics of these ears and their case histories lead us to view atelectatic ears as part of the otitis media syndrome, where their place is somehow transitional between secretory otitis media on the one hand and chronic otitis media on the other.
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            Epidemiology of middle ear and mastoid cholesteatomas. Study of 1146 cases

            Middle ear cholesteatoma is an important and relatively common disorder which may have serious consequences. Aim The purpose was to conduct a retrospective study of the statistics of 1,146 middle ear surgical procedures for middle ear cholesteatoma in adults and children of low income living in distant areas from our city. Methods From 1962 to 1988 there were 1,146 surgeries for unilateral or bilateral cholesteatomas in children and adults, which were reviewed for the following criteria: total number of surgeries, sex, onset of the first symptoms, duration of the disease, the site of perforation, the cholesteatoma site, changes in the ossicular chain, the contralateral ear, bilateral cholesteatomas, the site of residual cholesteatoma, and complications. Results Results are shown graphically on a pie chart. Conclusion The etiology of cholesteatomas remains unknown. Epidemiological and statistical data, surgical reports, and conclusions of experimental studies are welcome, as they may provide support for clarifying the pathogenesis of cholesteatoma. Our results were compared with internationally published papers. We found no published papers on the epidemiology of cholesteatoma in the Brazilian literature.
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              Pathogenesis of otitis media.

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                Author and article information

                Journal
                Sisli Etfal Hastan Tip Bul
                Sisli Etfal Hastan Tip Bul
                The Medical Bulletin of Sisli Etfal Hospital
                Kare Publishing (Turkey )
                1302-7123
                1308-5123
                2018
                28 September 2018
                : 52
                : 3
                : 179-183
                Affiliations
                [1]Department of Otorhinolaryngology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
                Author notes
                Address for correspondence: Özlem Ünsal, MD. Department of Otorhinolaryngology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey Phone: +90 532 691 99 93 E-mail: ozlemunsal@ 123456hotmail.com
                Article
                MBSEH-52-179
                10.5350/SEMB.20171129090822
                7315090
                32595395
                b81b4233-5730-43c2-8f33-618cd208ea39
                Copyright: © 2018 by The Medical Bulletin of Sisli Etfal Hospital

                This is an open access article under the CC BY-NC license ( http://creativecommons.org/licenses/by-nc/4.0/).

                History
                : 29 November 2017
                : 04 December 2017
                Categories
                Research Article

                chronic otitis media,contralateral ear,retraction
                chronic otitis media, contralateral ear, retraction

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