Age, size, and site of perforation, condition of the ear, status of the contralateral ear, grafting materials, and more are considered factors influencing the success rates in myringoplasties in children. The ambivalence in results is mainly due to nonhomogeneous patient groups. In an effort to compose groups as homogeneous as possible for analysis of influencing factors, a retrospective study of 51 pediatric myringoplasty cases (51 ears) was undertaken. All patients had perforations caused by simple chronic otitis media. The overall surgical success rate was 82.3% at 18 months, and for young (5 to 10 years) and older (11 to 16 years) children it was 77.2% and 86.2%, respectively. Anterior, central, and total perforations healed without significant differences. Outcome in unilateral perforations was better than bilateral: 96.9% and 55%, respectively ( p < 0.01). Discharging ears (100%) healed better compared with dry ears (75%) ( p < 0.05). Analysis of the literature also revealed significant difference in success rates of discharging and dry ears: 92.5% and 80.6%, respectively ( p < 0.01). We conclude that, contrary to comments in the literature, discharging ears in children favor good outcome and they should be operated on regardless of age and site of perforation. However, in bilateral perforations results may not be so rewarding. (Otolaryngol Head Neck Surg 1998;118:709–13.)
In this study, we compared the incidence of facial canal dehiscence in patients with idiopathic peripheral facial paralysis (Bell's palsy) with a healthy population.Forty-five patients who were defined as idiopathic peripheral facial paralysis between May 2011 and June 2012 were enrolled the study. The clinical and demographic characteristics of the patients were noted. Spiral computed tomography (CT) was used for the study with a slice thickness of 1 mm and slice gap of 0.5 mm. Fifty patients having no middle ear pathology who underwent temporal CT due to other reasons were enrolled in the study as control group. The both groups were compared by means of demographic characteristics and the presence of the facial canal dehiscence.The incidence of facial canal dehiscence was 42% in the control group, while the incidence of the facial canal dehiscence in the study group at the paralyzed side was 46.7%. Although the incidence of the facial canal dehiscence in the study group was higher than the control group, the difference between the groups was not statistically significant (p=0.802). When the incidence of bilateral facial canal dehiscence in the study group (22.2%) and the control group (0%) was compared, the difference between the groups was statistically significant (p<0.001).Although the incidence of the facial canal dehiscence in the patients with Bell's palsy was higher than the control group, the difference between the groups was not statistically significant. The incidence of the bilateral facial canal dehiscence of the study group was significantly higher than the healthy population.
A 53-year-old woman presented with a complaint of a sore throat. Examination showed a left-sided atrophy of the tongue. Upon protrusion, the tongue deviated to the left, suggestive of a unilateral hypoglossal nerve palsy. Computed tomography revealed enlarged hypoglossal canals. Magnetic resonance imaging (MRI) demonstrated bilateral hypoglossal canal masses, with enhancement following gadolinium administration. Magnetic resonance angiography and MRI with fat suppression revealed nonvascular masses in both hypoglossal canals. Radiological diagnosis of bilateral hypoglossal nerve schwannoma was made and the patient was scheduled for MRI monitoring with six-month intervals. The size of the masses and the clinical manifestations remained unchanged during a two-year follow-up period.
In two large Turkish consanguineous families, a locus for autosomal recessive nonsyndromic hearing loss (ARNSHL) was mapped to chromosome 6p21.3 by genome-wide linkage analysis in an interval overlapping with the loci DFNB53 (COL11A2), DFNB66, and DFNB67. Fine mapping excluded DFNB53 and subsequently homozygous mutations were identified in the lipoma HMGIC fusion partner-like 5 (LHFPL5) gene, also named tetraspan membrane protein of hair cell stereocilia (TMHS) gene, which was recently shown to be mutated in the "hurry scurry" mouse and in two DFNB67-linked families from Pakistan. In one family, we found a homozygous one-base pair deletion, c.649delG (p.Glu216ArgfsX26) and in the other family we identified a homozygous transition c.494C>T (p.Thr165Met). Further screening of index patients from 96 Turkish ARNSHL families and 90 Dutch ARNSHL patients identified one additional Turkish family carrying the c.649delG mutation. Haplotype analysis revealed that the c.649delG mutation was located on a common haplotype in both families. Mutation screening of the LHFPL5 homologs LHFPL3 and LHFPL4 did not reveal any disease causing mutation. Our findings indicate that LHFPL5 is essential for normal function of the human cochlea.
