Real ear measurements of hearing impaired children

In this study, 30 children of both sexes were selected to be examined for the evaluation of real ear measurements procedure in the selection of hearing aid for hearing impaired children. Two groups of children with moderate to severe and severe sensorineural hearing loss were evaluated by real ear measurements procedure [insertion gain] and functional gain methods. The actual insertion gain according to NAL formula was better than POGOII formula in providing the nearest match with the predicted insertion gain curve. Speech gain according to both NAL and POGOII formula was in a good correlation with insertion gain and functional gain. Both functional and insertion gain proved to be comparable methods in evaluating the selection process of hearing aid, however insertion gain is preferable in hearing impaired children as an objective and rapid procedure

Aclinicopathological study of nasopharyngeal masses

177 patients with nasopharyngeal masses were studied. The neoplastic lesions constituted about 48% of the nasopharyngeal masses. 39% were malignant and 8.5% were benign. Nasopharyngeal carcinoma was the commonest malignant tumour of the nasopharynx [55.0%] with a peak age incidence between 40-70 years, and a male to female ratio of 2:1. Malignant lymphoma was the second in order of frequency [34.8%], mainly of the non-Hodghin's variety [87.5%]. The mean age was 42.2 years and the male to female ratio was 1.62:1. The rest of the malignant lesions were diagnosed as rhabdomyosarcoma [4.4%], adenoid cystic carcinoma [2.9%] and fibrosarcoma [2.9%]. In this study, angiofibroma constituted 8.5% of nasopharyngeal masses with a mean age of 14.5 years and was only in males. Adenoids or lymphoid hyperplasia formed about 11.3% with a mean age of 19 years and male to female ratio of 1.2:1. The inflammatory lesions of the nasopharynx constituted about 36.15 of nasopharyngeal masses with a male to female ratio of 3:1. Scleroma of the nasopharynx made 23.9% of the inflammatory lesions. One patient was diagnosed as tuberculous nasopharyngitis, the rest of the inflammatory lesions [70.1%] were diagnosed histologically as chronic non-specific inflammation. The differentiation between benign and malignant nasopharyngeal masses depends upon histological examination and therefore accurate biopsy techniques are essential. Transnasal biopsies using topical anaesthesia invite inadequate sampling of tissue with resultant delay in diagnosis. Early recognition and treatment favorable influence survival. Complaints of pain, epistaxis, trismus or cervical mass are uncommon in patients with benign lesions and should alert the clinician to the probability of malignancy. Clinical symptoms suggestive of malignancy demand prompt and conclusive evaluation

Lead poisoning from a retained bullet in the middle ear

A rare case of lead intoxication caused by a bullet lodged in the middle ear for four years was discussed. A review of previously reported cases of lead poisoning from projectiles was presented

Otogenic brain abscess

This review was based on 26 cases of brain abscess complicating middle ear infection, admitted at the E.N.T. and Neurosurgery Departments of Assiut University Hospital from January 1988 to February 1990. The youngest patient was 7 years old and the oldest was 64 years old. 12 cases [46.15%] were below 15 years of age. The sex incidence was 16 males [61.54%] and 10 females [38.46%]. 14 cases [53.85%] presented with temporal lobe abscess and the remaining 12 [46.15%] with cerebellar abscess. The source of infection was acute mastoiditis in 2 cases and chronic suppurative otitis media in the remaining 24 patients. None of the abscesses proved to be sterile and the organisms grown included staphylococci, streptococci, proteus and E. coli. Patients with cerebellar abscess were treated with primary excision after C.T. localization. Patients with temporal lobe abscess were treated with burr hole aspiration. Proper mastoid operation was done directly following neurosurgical treatment. The 2 mortalities were due to cerebellar abscess. These 2 cases [7.8%] were admitted with dilated fixed pupils and signs of cerebellar coning. All patients with temporal lobe abscess including cases with advanced neurological manifestations survived. The computed tomographic brain scanning and the increasing experience in its use have increased the ease and accuracy of diagnosis and follow-up of such lesions and have evidently contributed significantly to reduction of mortality