Effects of acidic and nonacidic reflux on the eustachian tube: An animal experiment.

We investigated the effects of pepsin/hydrochloric acid and bile acids on eustachian tube function and eustachian tube mucosa in 40 Sprague-Dawley rats. The animals were randomly assigned to groups of 10: one group received pepsin/hydrochloric acid (pepsin/HCl group), another received human bile (human bile group), a third received a mixture of pepsin/HCl and human bile (combination group), and the fourth received isotonic saline solution (control group). Test solutions were applied transnasally three times a day for 10 days. Passive opening pressures and passive closing pressures were measured digitally at baseline and then on days 3, 5, and 10. After 10 days, the rats were sacrificed and histologic changes in the eustachian tube mucosa were analyzed. At study's end, we observed that the increases in passive opening pressures and passive closing pressures in all three experimental groups were significantly greater than those of the control group. Moreover, the increases in passive opening and closing pressures were significantly greater in the combination group than in both the pepsin/HCl and the human bile groups. In the tympanic orifice, the degree of lymphocyte and polymorphonuclear leukocyte infiltration was significantly higher in all three experimental groups than in the control group. In the nasopharyngeal orifice, lymphoid follicle formation was significantly more common in the human bile group than in the control group; also, the presence of subepithelial vasodilation and subepithelial edema was significantly more common in the pepsin/HCl and combination groups than in the controls. Of the three experimental solutions tested, the combination of pepsin/HCl and human bile was the most injurious to eustachian tube function. Reflux of bile acids causes eustachian tube dysfunction, and this damage worsens with the introduction of an acidic compound.

Variations in otological presentation of lightning strike victims: Clinical report of 3 patients.

Lightning strike can cause fatal or nonfatal injuries. Some nonfatal injuries are associated with otological symptoms and findings. Conductive hearing loss due to rupture of the tympanic membrane is the most common audiovestibular lesion of lightning strike. Various forms of sensorineural hearing loss and dizziness have also been reported. Presently described are 3 cases of lightning strike injury. First patient had mid-frequency hearing loss in right ear and high frequency sensorineural hearing loss in left ear. Second patient had high frequency sensorineural hearing loss in left ear, and the third had peripheral facial palsy with perilymphatic fistula on same side. This is the first documented case of mid-frequency hearing loss occurring after lightning strike.

Castleman disease as a giant parapharyngeal mass presenting with dysphagia.

A giant unilateral parapharyngeal mass from the skull base to the vocal folds is presented in this case. A 20-year-old man experiencing dysphagia for 4 years was admitted, and his magnetic resonance imaging and computed tomographic scans showed a giant parapharyngeal ellipsoid mass from the left jugular foramen to the vocal folds. Its craniocaudal length was 9 cm. The left internal carotid artery was lateralized, and posterior glottic airway was narrowed by the mass. In digital subtraction angiography, 2 aberrant branches of the internal carotid artery were going inside the mass. After the excision, histopathologic evaluation showed the diagnosis, Castleman disease. This is the first case in literature presenting with the only symptom of dysphagia.

Temporomandibular joint herniation into the external ear canal through foramen of Huschke.

Foramen of Huschke, which is also known as the foramen tympanicum, is an anatomical variation of the tympanic portion of the temporal bone. This foramen is located on the anteroinferior aspect of the external auditory canal, posteromedial to the temporomandibular joint. Herein, a rare case of foramen Huschke with a herniation of the soft tissues around the temporomandibular joint that result in severe otalgia and its treatment are presented.

Myoepithelioma of the parotid gland in a child: a case report.

Myoepitheliomas of the parotid glands are very rare in the pediatric population. Only a few cases of myoepitheliomas of the salivary glands have been reported in children. They have some similar features with pleomorphic adenoma. However, they may be malignant and infiltrate locally. Hence, histopathologic examination should be considered to differentiate these tumors. The treatment of myoepitheliomas is complete removal of the tumor. We report a child with myoepithelioma of the parotid gland and review the related literature.