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This study evaluated type D personality, anxiety, depression and personality traits in patients with isolated itching of the external auditory canal.
Method:
A hundred consecutive out-patients with isolated itching of the external auditory canal and 100 controls were enrolled in the study. The Type D Scale, the abbreviated form of the Eysenck Personality Questionnaire Revised and the Hospital Anxiety and Depression Scale were used for data collection. Patients were also evaluated using the Modified Itch Severity Scale.
Results:
In all, 43 per cent of patients and 15 per cent of controls met the criteria for a type D personality. Patients with a type D personality had higher anxiety and itching severity but lower extraversion compared with those without a type D personality. Multiple linear regression analysis showed that extraversion and type D personality were independently associated with itch severity.
Conclusion:
These data suggest that clinicians should consider psychological and personality features when evaluating and treating patients with isolated itching of the external auditory canal.
This study aimed to investigate the prevalence of otomycosis and aetiological agents in Khouzestan province, south-west Iran.
Methods:
This cross-sectional study examined and cultured 881 swabs from suspected external otitis cases, collected from throughout Khouzestan province. Fungal agents were identified by slide culture and complementary tests when necessary.
Results:
The mean patient age was 37 years. The 20–39 year age group had the highest prevalence of otomycosis: 293 cases, comprising 162 (55.3 per cent) women and 131 (44.7 per cent) men. The seasonal distribution of cases was: summer, 44.7 per cent; autumn, 28.7 per cent; winter, 14.7 per cent; and spring, 11.9 per cent. The fungal agents isolated were Aspergillus niger (67.2 per cent), Aspergillus flavus (13 per cent), Candida albicans (11.6 per cent), Aspergillus fumigatus (6.2 per cent) and penicillium species (2 per cent).
Conclusion:
Fungal otomycosis is still one of the most important external ear diseases. In this study in south-west Iran, Aspergillus niger was the predominant aetiological agent. However, clinicians should be cautious of candidal otomycosis, which has a lower rate of incidence but is more prevalent among 20–39 year olds.
To evaluate the results of one-stage surgical repair of the meatal skin defect in patients with long-lasting osteoradionecrosis of the outer ear canal, using a postauricular, inferiorly pedicled skin flap. All patients were also treated with hyperbaric oxygen both pre- and post-operatively.
Methods:
A prospective study evaluating the results of a one-stage surgical procedure to repair the meatal skin defect in five patients with osteoradionecrosis of the outer ear canal. All patients were treated with hyperbaric oxygen both pre- and post-operatively.
Results:
In four of the five patients, intact canal skin was achieved after surgery and hyperbaric oxygen therapy. One patient needed a second operation to cover a small remaining area of bare bone. In one patient, wound healing was unsatisfactory and an area of bare bone remained.
Conclusion:
In cases of osteoradionecrosis of the outer ear canal, the skin defect can be repaired with an inferiorly pedicled skin flap. Although not yet scientifically proven, the peri-operative application of hyperbaric oxygen may be of additional value to improve wound healing in areas of compromised tissue.
We report an extremely rare variant of first branchial cleft anomaly.
Case report:
A 15-year-old girl presented with a history of recurrent mucopurulent discharge from an opening in the left infra-auricular region, since birth. Computed tomography fistulography showed a tortuous tract measuring approximately 4.61 cm, extending anteroinferiorly and medially from the external inframeatal opening to the lateral nasopharyngeal wall (anterior to the fossa of Rosenmuller). The tract was connected to the deep lobe of the parotid gland and lay 0.67 cm anterior to the carotid artery and posterior to the medial pterygoid muscle.
Conclusion:
This was an extremely rare variant of first branchial cleft fistula. To the best of our knowledge, this is the first case of its type to be reported. Computed tomography fistulography is the imaging modality of choice for the diagnosis of branchial cleft fistula, and will also assist surgical planning.
The aim of this study was to present the management and survival data of patients with squamous cell carcinoma of the temporal bone, and to discuss whether extensive surgery improves survival.
Patients and methods:
Retrospective, case-series review of 17 patients (18 cases) with temporal bone carcinoma (15 primary and three recurrent tumours), over a period of 20 years.
Setting:
Tertiary referral centre – university hospital.
Main outcome measures:
Disease-specific and overall five-year survival.
Results:
The mean age at presentation was 63 years, with a range of 39 to 75 years. Twelve cases of de novo tumour were managed by surgical resection followed by adjuvant radiotherapy in 10 cases, while three such patients were considered incurable from the outset and were given a combination of radiotherapy and chemotherapy. Of the three patients referred to our unit with recurrent disease, two were treated elsewhere with radical mastoidectomy and one with chemoradiation; all were subsequently managed by subtotal petrosectomy. The disease-specific and overall five-year survival for the entire cohort was 64.17 per cent (mean 89 months; 95 per cent confidence interval, 62–117) and 47.06 per cent (mean 70 months; 95 per cent confidence interval, 43–98), respectively. The disease-specific and overall survival for patients with advanced T3 and T4 tumours was 59 per cent (mean 83 months; 95 per cent confidence interval, 53–113) and 40 per cent (mean 62; 95 per cent confidence interval, 33–91 months), respectively. All but one recurrence developed within 12 months of initiating treatment. No deaths occurred after 26 months of follow up.
Conclusions:
A lateral temporal bone resection is adequate treatment for T1 and T2 tumours. Post-operative radiotherapy should probably be offered for large T2 tumours. For T3 and T4 tumours, a subtotal petrosectomy with parotidectomy followed by post-operative radiotherapy is adequate treatment, as it offers a similar outcome to that of more extensive procedures.
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