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 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients referred from an otorhinolaryngologist with a chief complaint of earache or other ear symptoms are common in a temporomandibular disorders (TMD) clinic. These patients often complain of other symptoms, such as headache, facial pain, and limited mouth opening, all of which can be present in a patient suffering from a nasopharyngeal carcinoma (NPC). The aim of this case report was to describe the signs and symptoms of NPC and discuss possible causes for the misdiagnosis of NPC as TMD. The characteristics of 8 NPC patients reported in the literature whose cancer was initially misdiagnosed as TMD and those of an NPC patient with TMD-like symptoms treated at the clinic of 1 of the authors are described, and the reasons for misdiagnosis are discussed. A revision of Trotter's syndrome for the differential diagnosis of TMD is proposed. There is a need for detailed exclusion criteria to be applied prior to the assignment of a clinical diagnosis based on the Research Diagnostic Criteria for TMD.
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PMID:Nasopharyngeal carcinoma mimicking a temporomandibular disorder: a case report. 1648 23

Sino-orbital aspergillosis in a 61-year-old male with uncontrolled non-insulin dependent diabetes mellitus presented with three months history of left ear pain, left side headache with mucopurulent nasal discharge and one week history of progressive swelling and pain with difficulty in opening of the left eye and sudden loss of vision. In spite of surgical debridement and medical management with amphotericin B and itraconazole his visual outcome was poor and the infection was unabated at one month follow up.
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PMID:Sino-orbital aspergillosis in a diabetic patient. 1668 69

The issue of possible health effects of cellular phones is very much alive in the public's mind where the rapid increase in the number of the users of cell phones in the last decade has increased the exposure of people to the electromagnetic fields (EMFs). Health consequences of long term use of mobile phones are not known in detail but available data indicates the development of non specific annoying symptoms on acute exposure to mobile phone radiations. In an attempt to determine the prevalence of such cell phones associated health manifestations and the factors affecting their occurrence, a cross sectional study was conducted in five randomly selected faculties of Alexandria University. Where, 300 individuals including teaching staff, students and literate employee were equally allocated and randomly selected among the five faculties. Data about mobile phone's users and their medical history, their pattern of mobile usage and the possible deleterious health manifestations associated with cellular phone use was collected. The results revealed 68% prevalence of mobile phone usage, nearly three quarters of them (72.5%) were complainers of the health manifestations. They suffered from headache (43%), earache (38.3%), sense of fatigue (31.6%), sleep disturbance (29.5%), concentration difficulty (28.5%) and face burning sensation (19.2%). Both univariate and multivariate analysis were consistent in their findings. Symptomatic users were found to have significantly higher frequency of calls/day, longer call duration and longer total duration of mobile phone usage/day than non symptomatic users. For headache both call duration and frequency of calls/day were the significant predicting factors for its occurrence (chi2 = 18.208, p = 0.0001). For earache, in addition to call duration, the longer period of owning the mobile phone were significant predictors (chi2 = 16.996, p = 0.0002). Sense of fatigue was significantly affected by both call duration and age of the user (chi2 = 24.214, p = 0.0000), while burning sensation was only affected by frequency of calls/day (chi2 = 5.360, p = 0.020). According to the 95% confidence interval of frequency and duration of calls, the study recommended not to increase the call duration more than four minutes and limit their frequency to less than seven calls/day with total duration of exposure less than 22 min./day.
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PMID:Cellular phones: are they detrimental? 1691 47

Vertigo and imbalance are believed to be rare manifestations of skull base neoplasms. Patients with skull base neoplasms can present with vague otolaryngological complaints, including diplopia, facial numbness, facial weakness, hearing loss, tinnitus, hoarseness, headache, and otalgia. Physical examination of these patients can sometimes reveal paralysis or paresis of cranial nerves. Magnetic resonance imaging (MRI) is the gold standard for evaluation of cranial nerve involvement in skull base diseases. Vertigo and imbalance can be manifestations of a neuropathy or lesion within the vestibular system and may be subtle or overlooked findings in patients with skull base diseases. The purpose of this article is to review the clinical manifestations of patients presenting with vertigo and imbalance who were found to have skull base neoplasms. We will also highlight the importance of MRI in diagnosis and management of these patients.
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PMID:The importance of magnetic resonance imaging in the evaluation of vertigo and imbalance. 1717 Nov 43

Patients with an endolymphatic sac tumor (ELST) typically present with palsy of cranial nerves VII and/or VIII; other presenting symptoms include hearing loss, otalgia, occipital headaches, cranial nerve palsies, vertigo, gait ataxia, tinnitus, and otorrhea. ELSTs are extremely vascular, and they can invade and destroy temporal bone. Because of these characteristics, they are often mistaken for glomus tumors of the skull base. We describe the clinical presentation, evaluation, and management of ELSTs based on our review of the limited literature and our experience with 3 adults who presented to our tertiary care referral center with large ELSTs. Although these patients presented late in the course of their disease, their symptoms were relatively minor. Preoperative tumor embolization was performed, anda near-complete resection was achieved via an extended transotic approach in all 3 patients. The facial nerve was preserved without transposition in the first patient, the second patient underwent a primary nerve anastomosis, and the third required a cable graft of the facial nerve. Postoperative radiation therapy was administered to 2 of these patients. Follow-up by MRI detected no evidence of recurrence in any of the 3 patients.
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PMID:Endolymphatic sac tumor: a report of 3 cases and discussion of management. 1731 32

A case of giant cell reparative granuloma concurrent with squamous cell carcinoma of the right temporal bone in a 44-year-old man with clinically presenting otorrhea from the mass of the right acoustic canal with hearing loss is reported. The histopathological examination of the lesion characterizes by multinucleated giant cells with in a fibroblastic stroma and area of keratinizing squamous cell carcinoma. GCRG may have been a local reaction provoked by the squamous cell carcinoma. Clinical and pathological features with briefly reviewed relevant literatures of temporal GCRG describing 24 cases are discussed. The patients have the mean age of 34.8 years. The ages of the patients ranged from 4 months to 72 years old. Temporal bone GCRG shows a male predilection of approximately 3:1. The frequently presenting symptoms of temporal bone GCRG are hearing loss, mass, tinnitus, otalgia, otorrhea, vertigo, headache, facial weakness, and diplopia. This is the first reported description in the literature of temporal bone GCRG concurrent with squamous cell carcinoma.
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PMID:Giant cell reparative granuloma concurrent with squamous cell carcinoma of the temporal bone: a case report and review of the literature. 1737 45

Facial nerve hemangioma is a rare benign tumor that originates from the venous plexus surrounding the facial nerve. A case of facial nerve hemangioma in the geniculate ganglion was reported. A 47-year-old man was referred with a left progressive facial palsy over 1 year. There were no complaints of associated hearing loss, tinnitus, headache, dizziness or otalgia. He had a left-side grade VI (House and Brackmann) facial palsy. Audiometry revealed normal hearing thresholds in conversation area bilaterally. CT imaging demonstrated a tumor at the left first genu of the facial nerve with expansion to the cochlea wall and middle skull base. MRI imaging demonstrated a centrally enhancing lesion measuring 5 mm x 10 mm in the geniculate ganglion. The tumor was totally removed by the middle cranial fossa approach. At the time of surgery the facial nerve was destroyed by the tumor in the geniculate ganglion. Histopathological examination diagnosed a hemangioma.
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PMID:A case report of facial nerve hemangioma. 1754 81

Heinrich Schliemann was a German classical archaeologist who devoted his life to the historical reality of places mentioned in the epics of Homer and to the discovery of Troy, Mycenae, and other ancient Aegean cities. He was born in Germany in 1822 and died in Italy in 1890. During his life, Schliemann suffered from frequent episodes of ear pain, progressive hearing loss and burning headaches. When his ear problem became intolerable he underwent an operation by the famous otologist Dr H. Schwartze and he finally died from a left temporal lobe brain abscess 1 month later. From a number of bibliographic sources, the details of his life as well as his ear history with the final months of his illness are presented. An analysis is made on the ear pathology that probably led to his death taking into account the existing medical means of that time (nineteenth century).
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PMID:The otologic problem and death of Heinrich Schliemann. 1794 98

Pain is very frequent in otolaryngology disease: headaches, facial pain, earaches, and neck pain. The search for nasal pathology with maxillary sinus, sphenoidal, or ethmoidal involvement is part of the workup for headache. Facial pain should first suggest symptomatic neuralgia through involvement of the cranial nerves - trigeminal, glossopharyngeal, superior laryngeal - even if asymptomatic neuralgia are the most frequent. Earaches should be investigated through a search for involvement of the ear at the pinna, the external acoustic conduit, and the tympanic membrane. If the ear examination is normal, pain irradiating from the masticatory apparatus, the parotid, or the oropharynx is undertaken, with a systematic search for a tumoral cause.
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PMID:[Pain as a symptom in otolaryngology conditions]. 1804 57

Diagnostic criteria for acute otitis media include rapid onset of symptoms, middle ear effusion, and signs and symptoms of middle ear inflammation. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the most common bacterial isolates from the middle ear fluid of children with acute otitis media. Fever, otalgia, headache, irritability, cough, rhinitis, listlessness, anorexia, vomiting, diarrhea, and pulling at the ears are common, but nonspecific symptoms. Detection of middle ear effusion by pneumatic otoscopy is key in establishing the diagnosis. Observation is an acceptable option in healthy children with mild symptoms. Antibiotics are recommended in all children younger than six months, in those between six months and two years if the diagnosis is certain, and in children with severe infection. High-dosage amoxicillin (80 to 90 mg per kg per day) is recommended as first-line therapy. Macrolide antibiotics, clindamycin, and cephalosporins are alternatives in penicillin-sensitive children and in those with resistant infections. Patients who do not respond to treatment should be reassessed. Hearing and language testing is recommended in children with suspected hearing loss or persistent effusion for at least three months, and in those with developmental problems.
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PMID:Diagnosis and treatment of otitis media. 1865 13


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