ABSTRACT
This study was to determine whether routine examination under anaesthesia and nasopharyngeal biopsy in adults presenting with deafness due to secretory otitis media (SOM) is necessary for detection of nasopharyngeal malignancy. Two patient groups were studied. The first comprised 72 adults with SOM. Of these patients, 3 had nasopharyngeal tumours, 2 of whom also had cervical lymphadenopathy. The prevalence of malignancy in patients with SOM but no other suspicious signs was 1/72 (1.4%). The second group comprised 66 patients receiving treatment for nasopharyngeal neoplasms. In this group, 8 patients had SOM at presentation, 7 of whom had other features suspicious of malignancy. SOM as the sole presenting feature of nasopharyngeal malignancy was 1/66 (1.5%). EUA and biopsy of the nasopharynx is a cost effective investigation which continues to be indicated in adults presenting with deafness due to SOM.
Subject(s)
Nasopharyngeal Neoplasms/pathology , Nasopharynx/pathology , Otitis Media with Effusion/complications , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy , Carcinoma/diagnosis , Child , Deafness/etiology , Female , Humans , Male , Medical Audit , Middle Aged , Nasopharyngeal Neoplasms/diagnosisABSTRACT
The following hypothesis is presented: that the susceptibility of an individual patient to hearing loss as a result of cis-platinum administration can be predicted on the basis of eye colour. The rationale is that the melanin content of the inner ears is related to that of the eyes; dark eyes contain more melanin than light-coloured eyes; and melanin causes the accumulation of the ototoxic drug within the inner ear. Hence those with dark eyes will suffer greater damage to the hearing than those with pale eyes. An investigation that confirmed this hypothesis is reported. In addition to cochlear damage there is a significant likelihood of damage to the auditory nerve as a result of the treatment.
Subject(s)
Cisplatin/adverse effects , Eye Color/physiology , Hearing Loss, Bilateral/chemically induced , Adult , Audiometry, Evoked Response , Audiometry, Pure-Tone , Cisplatin/metabolism , Cochlea/drug effects , Cochlea/metabolism , Disease Susceptibility , Female , Humans , Male , Melanins/metabolism , Middle AgedABSTRACT
Thirty-seven patients with chronic otitis externa were investigated for contact hypersensitivity to 49 agents using standardized patch testing. Positive reactions were found in 22 (58%) patients. This incidence is higher than the 40% found in the only previous similar study and is within the range of 32-72% found in patients with contact dermatitis. The average age of subjects showing sensitivity was 56.7 years compared with 34.9 years for those with negative tests. This significant age difference suggests that contact hypersensitivity is not an aetiological factor in the younger patient. There was no significant difference in the duration of otitis externa between those with positive and negative tests. This feature has not been previously examined or reported. Neomycin was the commonest sensitizing agent, sensitization occurring in 12 (32%) patients.
Subject(s)
Dermatitis, Contact/immunology , Otitis Externa/immunology , Adolescent , Adult , Aged , Dermatitis, Contact/epidemiology , Female , Framycetin/adverse effects , Humans , Incidence , Male , Middle Aged , Neomycin/adverse effects , Skin TestsABSTRACT
This study followed on from a recent national publicity campaign aiming to get earlier provision of hearing aids for elderly people, improve both patient and general practitioner awareness of hearing impairments and increase knowledge of alternative environmental aids among sufferers. The study intended to examine present patterns of patient presentation and general practitioner management within a major Scottish city. A random sample of patients over the age of 55 years referred to a hearing aid clinic were questioned on the nature of their hearing difficulty. Patients who attended their general practitioner at the suggestion of a relative were less likely to be referred at their initial visit and significantly less likely to have had their ears syringed than those who were self-motivated. Respondents had little knowledge of alternatives to hearing aids, although these are relevant to the disability experienced by the majority of these subjects.
Subject(s)
Hearing Aids , Hearing Disorders/therapy , Outpatient Clinics, Hospital , Referral and Consultation , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Quality of Health Care , Random Allocation , ScotlandABSTRACT
A case of malignant otitis externa occurring in a fit 25-year-old non-diabetic male is reported. The clinical and histological findings support this diagnosis but neither identification nor culture of Pseudomonas aeruginosa was made and the condition was bilateral. The only pathogen identified was Staphylococcus aureus which has been reported in only two previous cases.
Subject(s)
Otitis Externa/etiology , Staphylococcal Infections , Adult , Humans , Male , Otitis Externa/pathology , Staphylococcal Infections/pathologySubject(s)
Frontal Sinus/injuries , Skull Fractures/complications , Adult , Cellulitis/etiology , Female , Humans , Male , Meningitis/etiology , Osteomyelitis/etiology , Time FactorsABSTRACT
A 5-year longitudinal study into hearing levels of 261 randomly selected elderly people was performed between 1968 and 1973. From 47 survivors, 37 subjects have been traced and their hearing retested with pure tone audiometry. The age range of those followed up was 80-85 years. The results indicate that the rate of hearing loss found after 5 years remained the same over the next 12 years. The deterioration rate is very much greater for the higher frequencies with losses of 1.89 dB annually at 6 KHz compared with 0.35 dB per annum for 1 KHz. The findings confirm that hearing loss continues steadily into the ninth decade, information previously not established.
