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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

If malignant external otitis is not treated properly and until all evidence of infection has disappeared, it is likely to recur either in the external auditory canal and/or in the bone marrow at the base of the skull. Unremitting headache is the only early symptom of the latter and may occur in the absence of any signs of local ear disease. A conductive hearing loss is the most common additional symptom and is caused by fluid in the middle ear. If not diagnosed and treated adequately and properly, the infectious process in the bone marrow involves the soft tissues at the skull base and results in a progressive paralysis of the lower cranial nerves. Treatment must be vigorous and continuous until the gallium scan is normal or shows great improvement (i.e., for a minimum period of 2 months). Intravenous antibiotics with a proven record of success and effectiveness against this organism are recommended, although newer antimicrobial agents give promise of being effective when administered orally.
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PMID:Malignant external otitis and osteomyelitis of the base of the skull. 273 80

Otorhinolaryngological manifestations of 13 patients with von Recklinghausen's disease appearing at Lagos University Teaching Hospital over a five-year period have been studied. Among patients with ENT manifestations of the disease, the most common general features exhibited were cutaneous neurofibromas (100 per cent), headache (69.23 per cent) and pruritus (46.15 per cent). But the head and neck findings included external meatal canal stenosis (30.77 per cent), conductive deafness (30.77 per cent), nasal discharge (30.77 per cent), cranial nerve involvement (30.77 per cent) and disfigurement of the soft tissues of the face (30.77 per cent). Involvement of pinna (23.31 per cent), rhinolalia aperta (15.38 per cent), mental retardation (15.38 per cent) and pharyngeal swelling (7.69 per cent) also featured. Clinically detectable bilateral acoustic neurofibromas in adults or astrocytomas in children were not found in this series. Involvement of the frontoparietal bone (7.65 per cent) presented with skull bossing which had to be differentiated from that due to sickle cell disease in the African. There was also a singular case of phrenic nerve involvement. However, malignancy occurred in one (7.69 per cent) of these patients. Thus, it is important always to follow-up these patients closely so as to detect malignant transformation in time.
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PMID:Otorhinolaryngological manifestations of von Recklinghausen's disease in Nigerians. 308 May 40

An unusual presentation of bilateral otogenic cerebellar abscesses observed in two of our patients is reported. Both gave a history of otorrhoea, fever, headache, vomiting and had bilateral cerebellar signs and conductive hearing loss. The abscesses were detected on computerised tomography. X-rays revealed bilateral mastoiditis. The therapy followed was excision of abscesses, mastoidectomy and antibiotic therapy.
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PMID:Bilateral otogenic cerebellar abscesses. 829 47

Isolated cases of spontaneous cerebrospinal fluid (CSF) leakage with and without middle ear encephalocele have been reported. These leaks are usually accompanied by episodes of recurrent meningitis, hearing loss, or chronic headache. In this article, we report seven new cases of spontaneous CSF leakage. Six of these patients had conductive hearing loss and serous otitis media, and three had recurrent meningitis. Prior to a definitive diagnosis, six patients had received myringotomy tubes, which produced profuse clear otorrhea. Three patients had positive beta-2 transferrin assays. Computed tomography and magnetic resonance imaging confirmed a defect in the temporal bone tegmen. A combined transmastoid and middle fossa surgical approach with a three-layer closure was used to repair the tegmen defect. All patients had a lumbar drain placed prior to surgery. In addition to describing the seven new cases, we review the history of CSF leakage and discuss diagnostic methods, surgical findings, and our recommendations for management.
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PMID:Spontaneous cerebrospinal fluid leakage and middle ear encephalocele in seven patients. 1083 3

Brain abscess is one of the life-threatening complications of otitis media. Mortality and morbidity have decreased with the advent of antibiotic therapy. More frequently encountered in cases of acute otitis media in the preantibiotic era, in recent years otogenic brain abscess was noticed almost only in patients of chronic otitis media with cholesteatoma. A case of brain abscess in a 49-year-old female was initially diagnosed as a headache. A high resolution computed tomography (HRCT) scan of the temporal bones later revealed that there were two abscesses over the right side temporal lobe. A modified radical mastoidectomy was performed. Cultures of the middle ear cholesteatoma later grew Pseudomonas aeruginosa and Strenotrophomonas maltophilia. Antibiotic therapy was carried on for three months postoperatively. The patient improved but retained a conductive hearing loss.
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PMID:Otogenic brain abscess--a case report. 1084 53

Cerebellar abscess is a serious complication of ear disease that requires early diagnosis and treatment. Computerized axial tomography with contrast enhancement is very useful for the diagnosis of these abscesses. This fact is illustrated by a case report of a cerebellar abscess secondary to chronic otitis media with cholesteatoma detected in one of our patients. On examination otorrhoea, fever, headache, vomiting and had hemilateral conductive hearing loss. The therapy included radical operation, excision of the abscess and antibiotic therapy.
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PMID:[A case of otogenic cerebellar abscess]. 1242 Mar 47

Primary myxoma in the head and neck region occurs mostly in the maxilla and mandible, and rarely in the temporal bone. A 32-year-old female patient with temporal bone myxoma manifested as acute vertigo, headache, and tinnitus on the right ear. Audiometry and auditory brainstem response revealed normal responses, bilaterally. Vestibular function test displayed spontaneous nystagmus beating toward the left side. Absent ice water caloric response was disclosed on the right ear, whereas vestibular evoked myogenic potential test showed normal responses, bilaterally. MRI scan demonstrated a well-enhanced mass at the anterior middle portion of the right temporal bone with intracranial extension. Tumor excision via craniotomy was performed, and the histopathological study confirmed as myxoma. One year after operation, follow-up audiovestibular function tests revealed normal responses, except for 23 dB conductive hearing loss on the right ear.
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PMID:Audiovestibular evolution in a patient undergoing surgical resection of a temporal bone myxoma. 1661 11

A cholesteatoma can be a complication of ear infection, eustachian tube dysfunction, prior ear surgery, or tympanic membrane perforation. It is typically associated with otorrhea and conductive hearing loss; sensorineural hearing loss, dysequilibrium, facial nerve paralysis, and altered mental status signify advanced disease. The treatment is surgical and recurrences are common. A case of cholesteatoma is presented that was associated with extension into the posterior fossa and presented with only a headache and localized pain.
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PMID:Intracranial cholesteatoma: a case report and review. 1749 90

Giant cell tumors of the bone are rare, locally aggressive lesions that primarily affect the epiphyses of long bones. These tumors can occur in the skull, principally in the sphenoid and temporal bones. Symptoms of these tumors depend on their site of origin but typically include headache, pain, visual field defects, and conductive hearing loss. Histologically, these tumors consist of three cell types: osteoclast-like multinucleated giant cells; round mononuclear cells resembling monocytes; and spindle-shaped, fibroblast-like stromal cells. Radiographically, the tumors appear osteolytic and radiolucent without a sclerotic border. These tumors typically present in the third to fourth decades of life and rarely occur in patients under 20 years of age. The small number of studies of giant cell tumors of the skull has focused on the adolescent and adult populations. The authors report two cases of giant cell tumors of the skull in pediatric patients. In the first case, a 2-year-old girl presented with swelling behind the right ear. In the second case, a 7-week-old girl presented with a mass within the external auditory canal. Both patients underwent metastatic workup and biopsy procedures before resection of the tumor. Both case reports contribute to the literature of giant cell tumors of the skull by describing this condition in pediatric patients. To the authors' knowledge, these cases represent the youngest two patients with giant cell tumors of the skull yet described.
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PMID:Giant cell tumor of the skull in pediatric patients. Report of two cases. 1764 25

The objective of this study is to increase awareness of the rare presentation, diagnostic difficulties and management of glomus tympanicum of the middle ear. A 49 years old male, with a background of hypertension and epilepsy, presented with a two month history of left sided conductive hearing loss, pulsatile tinnitus and headache. Clinically and radiologically a diagnosis of glomus tympanicum was made. Intraoperatively, extensive osteogenesis of the middle ear resulting in ossicular fixation and erosion was found. This patient required a two stage operation for full clearance of disease. A stapedectomy drill was used to drill off the bony overgrowth surrounding the ossicles resulting in improved hearing thresholds and full clearance of the disease at two year follow up. Glomus tympanicum can result in new bone formation in the middle ear with resultant ossicular fixation and conductive hearing loss. This can be effectively treated surgically with restoration of hearing.
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PMID:Unusual presentation of glomus tympanicum tumour: New bone formation in the middle ear. 2523 51


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