Canal wall down mastoidectomy: A long term commitment to the outpatients?

BACKGROUND: Canal wall down and canal wall up mastoidectomy represent two surgical approaches to middle ear cleft pathology. Very few studies have examined the effects of these procedures both on the patients' well being and on the resources needed to maintain that state. In this study the authors report the outpatient attendance pattern of canal wall down mastoidectomy patients METHODS: This is a retrospective case-note review of 101 patients who underwent a CWD mastoidectomy at Derriford Hospital, Plymouth, UK. All surgery was performed by the senior author (PCW-T) between 1985 and 1997. The main outcome measures were the frequency of outpatients' visits, clinical problems at visit and the percentage of discharged patients. RESULTS: The studied patients made a total of 1341 outpatient visits between November 1985 and December 1998 with an average of 13.3 visits per patient (median of 11 visits). Almost two thirds of the group still attend for regular follow up. The greatest number of visits occurred in the first 24 months after surgery. The commonest reasons for outpatient visits were the removal of the clinical features of chronic cavity inflammation. Residual/recurrent cholesteatoma, residual perforations and structural cavity problems were infrequent. CONCLUSION: CWD mastoidectomy carries an intrinsic morbidity resulting in a long term attendance in the outpatients

Tuberculous Otitis Media and Lupus Vulgaris of Face: An Unusual Association

Tuberculous otitis media is a rare extra-pulmonary presentation of tuberculosis. Tuberculous otitis media is usually associated with pulmonary tuberculosis or tuberculosis involving nasopharynx and oropharynx. Lupus vulgaris is the most common morphological variant of cutaneous tuberculosis. The disease often affects the face and may be associated with nasal or nasopharyngeal tuberculosis. Lupus vulgaris associated with tuberculous otitis media is not reported in English literature. We report a case of 40 year old female patient who presented with symptoms of chronic suppurative otitis media and non-healing skin lesion of face. The biopsy of skin lesion showed granulomatous pathology and helped us to reach a diagnosis of tuberculous otitis media

Low-grade osteosarcoma of the ethmoid sinus.

Osteosarcoma uncommonly arises in craniofacial bones and has only rarely been reported to arise in the ethmoid sinus. Most primary osteosarcomas arising in paranasal sinuses are high-grade malignancies. A low-grade osteosarcoma arising in the ethmoid sinus has not previously been described. We report the clinical, radiological and histological findings of a case of low-grade (parosteal osteosarcoma-like) osteosarcoma which arose in the ethmoid sinus