Predictors of tympanostomy tube extrusion time in otitis media with effusion.

OBJECTIVES: To investigate the impact and predictors of tympanostomy tube (TT) extrusion. METHODS: A retrospective study on 258 ears underwent TT insertion during 2016-2018 at King Abdullah Specialized Children's Hospital, Riyadh, Saudi Arabia. Patients were followed for 36-48 months postoperatively to detect the recurrence rate. The sample was divided into 2 groups based on extrusion time and were compared to determine the predictors of TT extrusion. RESULTS: Otitis media with effusion (OME) recurrence after TT insertion was detected in 28.7%. A shorter TT extrusion time was associated with a higher recurrence (p=0.002). Small TTs increased the probability of early TT extrusion (odds ratio = 5.144; 95% confidence interval: [1.602-16.519]). CONCLUSION: More than one-fourth of the patients who underwent TT insertion for OME developed recurrence. Tympanostomy tube extrusion earlier than 12 months was associated with a higher recurrence rate. Small TTs increased the probability of early TT extrusion.

Bezold's Abscess: A Case Report and Review of Cases Over 20 Years.

Bezold's abscess (BA) is a severe and rare extracranial complication of suppurative acute mastoiditis. The diagnosis of BA requires a high index of suspicion due to its rarity. In this study, we present a rare case of BA, in addition to a review of literature over 20 years. We searched for all cases in English literature from 2000 to 2020 in PubMed and found 27 cases (28 cases including the current case). BA was more prevalent in males (17/28, 60.7%) and adults (17/28, 60.7%). Of the 28 cases, six were associated with cholesteatoma and another six cases occurred with concomitant sinus thrombosis.

Predictors of Otitis Media with Effusion Recurrence Following Myringotomy.

Otitis media with effusion (OME) is the most common cause of acquired pediatric hearing loss. The treatment of persistent OME includes myringotomy with or without tube insertion, with a reported recurrence rate of 19.9-40%. This study aims to investigate the recurrence rate of OME and its predictors following myringotomy. A retrospective study that included 345 ears that underwent myringotomy for persistent OME in 179 pediatric patients during 2016-2018. Patients were followed for 36-48 months post myringotomy procedure to detect the recurrence rate. The study sample was divided into two groups based on recurrence status, and the groups were compared using chi-square test and independent T-test. Significant variables (p-value ≤ 0.05) were included in the logistic regression model to determine the predictors of OME recurrence after myringotomy. OME recurrence was detected in 85 ears (24.64%). The OME recurrence rate is higher in patients who underwent myringotomy alone compared to myringotomy with tube insertion (44.1% vs. 22.8%). The insertion of a tympanostomy tube decreases the recurrence rate of OME by 59.9% (OR 0.401; 95% CI 0.162-0.933). The other socio-demographic and clinical characteristics such as age, siblings, daycare attendance, passive smoking, previous acute otitis media, atopy, and adenoidectomy did not significantly influence OME recurrence (p-value > 0.05). The recurrence rate of OME following myringotomy is high. Myringotomy with tube insertion significantly decreases the recurrence rate and the need for further surgeries compared to myringotomy alone. Adenoidectomy and the patient's age have no impact on the recurrence rate of OME.

A Case of Giant Ethmoid Sinus Osteoma.

Paranasal sinus osteomas are slow-growing benign tumors. They are generally asymptomatic in most patients and usually diagnosed incidentally with a sinus radiograph or more frequently with a CT scan of the paranasal sinuses. Osteomas can cause various signs and symptoms, depending on the location of the mass. Giant osteomas of the paranasal sinuses are very rare, with only a handful of case reports in the literature. Due to the rarity of giant osteomas, the clinical presentation and treatment are unclear. In this article, we present a case of giant ethmoid sinus osteoma, which was removed with an endoscopic endonasal approach, as well as a review of the literature.

Concha Bullosa of the Inferior Turbinate: Report of Two Cases.

Concha bullosa (CB) is defined as pneumatization and the presence of air cells within the nasal turbinates. Inferior concha bullosa (ICB) is a rare anatomical variation of the lateral nasal wall, with only a handful of case reports published in the literature to date. In this article, we present two additional cases of ICB and a review of the literature regarding this rare anatomical variation.