ABSTRACT
First branchial cleft anomalies are congenital rare lesions that can sometimes be difficult to diagnose. During the normal embryonic development the outer ear canal derives from the first branchial cleft. Abnormal development can result in production of a cyst, sinus or fistula with recurring infections. Early and correct diagnosis is necessary for the correct choice of surgical set-up in which identification and preservation of the facial nerve is an important step. A case of first branchial cleft sinus is presented with further discussion of classification, diagnostics and treatment.
Subject(s)
Branchial Region/abnormalities , Congenital Abnormalities/diagnosis , Branchial Region/surgery , Child , Child, Preschool , Congenital Abnormalities/surgery , Diagnosis, Differential , Fistula/congenital , Fistula/diagnosis , Fistula/surgery , Humans , MaleABSTRACT
OBJECTIVES: Chronic otitis media (COM) with hearing loss (HL) occurs frequently in many populations with limited access to specialized treatment. This article reports on the hearing outcomes following mobile ear surgery in Greenland. STUDY DESIGN: The study was longitudinal and prospective with pre- and post-operative followup data compiled at 1- and 2-year intervals. METHODS: Selection criterion included individuals with COM with or without suppuration (CSOM) and with associated HL. Hearing tests were obtained by using a simple air-conduction (AC) audiometry. The median age of the 274 participants was 27 years (8-60 years), and 45% were males. Sixty-one percent had COM and 34% had CSOM. Myringoplasty or tympanoplasty type I was performed in 88% of the cases. RESULTS: The median pre-operative AC pure-tone average was 38 dB. The follow-up rate was 75% and 61% at 1- and 2-years. Hearing gain was found in 78% at both follow-ups and was > or = 10 dB in 62% and 56%, respectively. The median hearing gain was 15 dB and 12 dB, respectively. Independent predictors of hearing gain were pre-operative tympanic membrane atrophy and closure of perforations. CONCLUSIONS: Long-term hearing gain can be achieved with mobile ear surgery and this, in addition to tympanic membrane closure, is important for hearing rehabilitation in populations with poor access to health care.
