Articles and Abstracts

Additional Information for Interested Patients

Many of the articles below feature Dr. Shohet as an author, editor or contributor.

External Ear, Infections

Background: External ear infections require otoscopic examination that must be performed in conjunction with evaluation of related structures such as the external ear and the head and neck. For example, examine the auricle for swelling, deformity, and erythema; the face for evidence of facial nerve paresis or other cranial neuropathy; and the neck for masses.

View Complete Article: www.emedicine.com/ent/topic202.htm

External Ear, Malignant External Otitis

Background: Toulmouche was probably the first physician to report a case of malignant external otitis (MEO), in 1838.
In 1959, Meltzer reported a case of pseudomonal osteomyelitis of the temporal bone.

In 1968, Chandler discussed the clinical characteristics of MEO and defined it as a distinct clinical disease. He described this external otitis as malignant because he observed an aggressive clinical behavior, poor treatment outcome, and a high mortality rate for the patients affected by this disease.

View Complete Article: www.emedicine.com/ent/topic203.htm

Hearing is Believing

Music, movies and television are getting louder but, sadly, many people aren’t noticing. If you find yourself turning the volume up instead of down, you may be one of the millions suffering sensorineural hearing loss.

View Complete Article: www.ucihealth.com/otolaryngology/otohearingisbelieving.htm

Hearing loss: The invisible disability

Preview: Loss of hearing is a national health problem with significant physical and psychological repercussions. Although there is no cure for certain forms of hearing loss, many patients can be helped, especially when the problem is recognized early. The authors discuss the important role of primary care physicians in early identification, management, and counseling of hearing-impaired patients.

View Complete Article: www.postgradmed.com/issues/1998/09_98/bent.htm

Implantable Hearing Devices

Hearing loss affects up to 10% of the population in the United States. The prevalence increases with age and over one third of people older than 65 years have a significant hearing loss. Only approximately 20% of people with hearing loss seek assistance from hearing aids. Of these, as many as 16.2% do not wear their devices.

View Complete Article: www.emedicine.com/ent/topic479.htm

Inner Ear, Presbycusis

Background: The term presbycusis refers to sensorineural hearing impairment in elderly individuals. Characteristically, it involves bilateral high-frequency hearing loss associated with difficulty in speech discrimination and central auditory processing of information. However, other patterns of presbycusis exist. The association between advanced age and high-tone deafness was first described by Zwaardemaker in 1899. Since then, extensive research has attempted to determine the pathologic changes of presbycusis, but the exact mechanisms remain unknown.

View Complete Article: www.emedicine.com/ent/topic224.htm

Labyrinthitis Ossificans

Background: The human osseous labyrinth is comprised of endosteal, enchondral, and periosteal layers. The endosteal layer consists of bone lined with a single thin layer of cells that have numerous gaps separating them. The enchondral layer is unique in that it reaches adult size by 23 weeks gestation and undergoes minimal remodeling after age 2 years. The periosteal layer consists of lamellar bone and is capable of remodeling and repair.

View Complete Article: www.emedicine.com/ent/topic409.htm

Middle Ear, Cholesteatoma

Cholesteatomas have been recognized for decades as a destructive lesion of the skull base that can erode and destroy important structures within the temporal bone. Its potential for causing central nervous system complications (eg, brain abscess, meningitis) makes it a potentially fatal lesion.

View Complete Article: www.emedicine.com/ent/topic220.htm

Middle Ear, Ossiculoplasty

History of the Procedure: The earliest recorded attempt to reestablish a connection between the tympanic membrane and the oval window in the case of a missing ossicle was in 1901. Since then, numerous materials have been used to recreate the middle ear sound-conducting mechanism. Many materials have been used for ossicular substitution or reconstruction, including both biologic and alloplastic materials. Biologic materials include autograft or homograft ossicles, cortical bone, teeth, and cartilage.

View Complete Article: www.emedicine.com/ent/topic219.htm

Middle Ear, Otosclerosis

Ankylosis of the stapes was first described by Valsalva in 1704. Toynbee described fixation of the stapes to the margins of the oval window in 1841 and found similar cases in 136 of 1,000 temporal bone dissections. The histologic features of otosclerosis were demonstrated by Politzer, who identified the problem as an otic capsule disorder characterized by abnormal new bone formation.

View Complete Article: www.emedicine.com/ent/topic218.htm

Migraine-Associated Vertigo

Background: Migraine is a disease characterized by periodic headaches, but patients often experience other symptoms, including dizziness. In some patients, dizziness can be the only symptom. Since the 19th century, repeated references have been made to the clinical association of migraine and dizziness. Over the years, several syndromes have been reported of episodic vertigo associated with migraine. Some of these syndromes include benign paroxysmal vertigo of childhood and benign recurrent vertigo in adults. Some authors have even suggested an association between migraine and Ménière disease.

View Complete Article: www.emedicine.com/ent/topic727.htm

Putting Ear Rocks in Their Place

A simple, easy treatment promises to stabilize the world for thousands of people suffering from benign positional vertigo (BPV). One of the leading causes of dizzy spells, this inner-ear condition causes short episodes of an intense spinning sensation when a person sits up, lies down, turns over in bed, or tips the head backwards to look up.

 

View Complete Article: www.ucihealth.com/otolaryngology/otoearrocks.htm

Skull Base, Tumors, Other CPA Tumors

Cerebellopontine angle (CPA) tumors are the most common neoplasms in the posterior fossa, accounting for 5-10% of intracranial tumors. Most CPA tumors are benign, with over 85% being vestibular schwannomas (acoustic neuromas), lipomas, vascular malformations, and hemangiomas. The most frequent nonacoustic CPA tumors are meningiomas, epidermoids (primary cholesteatomas), and facial or lower cranial nerve schwannomas. Primary malignancies or metastatic lesions account for less than 2% of neoplasms in the CPA.

View Complete Article: www.emedicine.com/ent/topic241.htm

Sound Advice About Hearing Loss

If you think you're too young to be hard of hearing, listen up! Ear problems affect people of all ages -- from children to the elderly. In fact, hearing loss is America's largest, yet least recognized physical ailment, with one person in a thousand born deaf -- and an equal number developing deafness during their lifetime.

View Complete Article: www.ucihealth.com/otolaryngology/otosoundadvice.htm

Temporal Bone Fractures

The temporal bone is the most complex bone in the human body. It houses many vital structures, including the cochlear and vestibular end organs and the facial nerve, carotid artery, and jugular vein. Involvement of none or all of these structures in temporal bone fractures is possible. A thorough understanding of the epidemiology, classification, complications, and treatment of these fractures is mandatory for health care professionals involved in the care of individuals with such injuries.

View Complete Article: www.emedicine.com/ent/topic477.htm

Which culprit is causing your patient's otorrhea?

Preview: Otorrhea can signal the presence of a common infection, such as otitis media, or a more serious condition, such as cerebrospinal fluid leak. Color of the draining fluid, accompanying otologic symptoms, and other factors are clues to the source of the problem. Drs Shohet and Scherger discuss key questions to ask on history taking and specific physical findings to look for. Then they describe the various disorders often associated with otorrhea and the treatment options available.

View Complete Article: www.postgradmed.com/issues/1998/09_98/shohet.htm