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1
Content available Facial nerve neuroma mimicking chronic otitis
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EN
A 44-year-old male presented with a facial schwannoma extending into both the middle cranial fossa and mastoid processus. Due to hearing loss, facial nerve palsy and inflammatory changes in CT scan, this patient was misdiagnosed as chronic otitis media. Audiogram showed a right mixed hearing loss with 30–40 dB air-bone gap. In MR, features of the facial nerve neuroma were found. The patient was qualified for surgery to remove the tumor via middle fossa approach, with possible conversion to the retroauricular approach. Ossiculoplasty LC was performed. Diagnostic problems and methods of treatment are discussed.
EN
Introduction: Due to the widespread use of antibiotics and the facilitated diagnostic path, complications of otitis media are now a much smaller problem in the practice of otolaryngologists. However, we must remember that certain groups of patients, due to chronic concomitant diseases or a different physiological condition, may be more prone to develop such complications. Case report: Below we present the case of a woman in the 21st week of pregnancy who, as a result of not following the recommended treatment, developed a complication of acute otitis media in the form of a Mouret abscess with progression towards the skull base, and who required surgical intervention for this reason.
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Content available Drainage or paracentesis
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EN
Tympanostomy tube insertion and tympanic membrane incision are two the most frequently performed surgical procedures in otolaryngology, especially in children. The tympanic membrane incision - paracentesis, or myringotomy – is an incision of the tympanic membrane for diagnostic purposes or to allow drainage of pathological secretion from the tympanic cavity. Tympanostomy tube insertion involves incision made in the tympanic membrane and insertion of a ventilation tube (various types and for various periods of time) to improve hearing and aeration of the tympanic cavity. Procedures are performed through the ear canal (transcanal approach), under local or general anesthesia. Complications may occur in some cases of paracentesis and tympanostomy tube insertion.
EN
The aim of this work was to study the effect of middle ear disorder on round window (RW) stimulation, so as to provide references for the optimal design of RW stimulation type middle ear implants (MEIs). Methods: A human ear finite-element model was built by reverse engineering technique based on micro-computed tomography scanning images of human temporal bone, and was validated by three sets of comparisons with experimental data. Then, based on this model, typical disorders in otosclerosis and otitis media were simulated. Finally, their influences on the RW stimulation were analyzed by comparison of the displacements of the basilar membrane. Results: For the otosclerosis, the stapedial abnormal bone growth severely deteriorated the equivalent sound pressure of the RW stimulation at higher frequencies, while the hardening of ligaments and tendons prominently decreased the RW stimulation at lower frequencies. Besides, among the hardening of the studied tissues, the influence of the stapedial annular ligament’s hardening was much more significant. For the otitis media, the round window membrane (RWM)’s thickening mainly decreased the RW stimulation’s performance at lower frequencies. When the elastic modulus’ reduction of the RWM was considered at the same time especially for the acute otitis media, it would raise the lower-frequency performance of the RW stimulation. Conclusions: The influence of the middle ear disorder on the RW stimulation is considerable and variable, it should be considered during the design of the RW stimulation type MEIs.
EN
The diseases caused by vasculitis are rare. The difficulties in diagnosis may be due to this low frequency, as well as to rather slow development and various symptoms and locations of the symptoms. In the diagnosis of the vasculitis one should consider all of the clinical features, for they may include diagnostic criteria for various clinical entities.
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Content available remote Fusing fine-tuned deep features for recognizing different tympanic membranes
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EN
Otitis media (OM) refers to a group of inflammatory diseases regarding the middle ear. Although there are a wide variety of disease types regarding OM, the most commonly seen disorders are acute otitis media (AOM), otitis media with effusion (OME) and chronic suppurative otitis media (CSOM). The examination of OM in the clinics is realized subjec-tively. This subjective examination is error-prone and leads to a limited variability among specialist. For these reasons, computer-aided systems are in demand. In this study, we focus on recognizing normal, AOM, CSOM, and earwax tympanic membrane (TM) conditions using fused fine-tuned deep features provided by pre-trained deep convolutional neural networks (DCNNs). These features are applied as the input to several networks, such as an artificial neural network (ANN), k-nearest neighbor (k NN), decision tree (DT) and support vector machine (SVM). Moreover, we release a new publicly available TM data set consisting of totally 956 otoscope images. As a result, the DCNNs yielded promising results. Especially, the most efficient results were provided by VGG-16 with an accuracy of 93.05 %. The fused fine-tuned deep features improved the overall classification success. Finally, the proposed model yielded promising results with an accuracy of 99.47 %, sensitivity of 99.35 %, and specificity of 99.77 % using the combination of the fused fine-tuned deep features and SVM model. Consequently, this study shows that fused fine-tuned deep features are rather useful in recognizing different TMs and these features can provide a fully automated model with high sensitivity.
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