[Hyaluronidase as a therapeutic alternative in perforated tympanum]. / La hialuronidasa como alternativa al tratamiento de las perforaciones timpánicas.

There are many causes of tympanic perforation but usually only one treatment, surgical. However, many patients cannot or will not undergo surgery. In such cases, treatment with sodium hyaluronidate may be satisfactory. In our group of 20 patients with 21 tympanic perforations who underwent this treatment, 15 evolved favorably. The drawbacks and patient selection are discussed.

[Malignant otitis externa]. / Otitis externa maligna.

This is an aggressive infectious disease caused by Pseudomonas aeruginosa, especially seen in diabetics and elderly, sometimes coming to and end in those cases in which the diagnosis has been protracted or the treatment misleading. But it must be said that the diagnosis is not easy, either because of the insidiousness of the onset or the hidden difficulties when dealing with malignant growths of the meatus. The AA report a case of the kind emphasizing the importance of the real diagnosis as well as the right treatment. This should be prudently prolonged beyond the apparent healing until the cultures show a total sterilization.