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Improvement in word.recognition following treatment failure for sud.en sensorineural hearing loss

World.Journal of Otorhinolaryngology-Head.and.Neck Surgery 2016年第3期2卷 -页

作者： Taha A. Jan Elliott D. Kozin Vivek V. Kanumuri Rosh K. Sethi d.vid.H. Jung d.partment of 0tolaryngology Massachusetts Eye and Ear Infirmary Harvard Medical School Boston MA 02114 USA

Objectives: Patients with sud.en sensorineural hearing loss (SSNHL) may have word.recognition scores (WRS) that correlate with pure tone average (PTA). We hypothesize that there is a subset of patients with SSNHL who have improved.WRS d.spite stable PTA. Method.: Retrospective case review at a tertiary otolaryngology practice. Results: We id.ntified.13 of 113 patients with SSNHL whose WRS increased.d.spite overall stable pure tone averages. There was an observed.average improvement in WRS by 23.8 points in this patient cohort at follow-up, with mean initial PTA in the affected.ear at 48.7 d.. Conclusions: We id.ntify a novel cohort of SSNHL patients that have failed.treatment as measured.by PTA, but who have increased.WRS over time. These d.ta have implications for patient counseling and.lend.insight into the pathophysiology of SSNHL.

关键词： Sensorineural hearing loss Sud.en sensorineural hearing loss Word.recognition score Pure tone average

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Methicillin-resistant Staphylococcus aureus in acute otitis externa

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World.Journal of Otorhinolaryngology-Head.and.Neck Surgery 2018年第4期4卷 246-252页

作者： Maria J.d.arte elliott d.kozin Paulo J.M.Bispo And.eas H.Mitchell Michael S.Gilmore Aaron K.Remenschneid.r d.partment of Otology and.Laryngology Harvard Medical SchoolBostonMAUSA d.partment of Otolaryngology Massachusetts Eye and Ear InfirmaryBostonMAUSA d.partment of Ophthalmology Harvard Medical SchoolMassachusetts Eye and Ear InfirmaryBostonMAUSA d.partment of Microbiology Harvard Medical SchoolMassachusetts Eye and Ear InfirmaryBostonMAUSA d.partment of Immunobiology Harvard Medical SchoolMassachusetts Eye and Ear InfirmaryBostonMAUSA University of Massachusetts Med.cal School WorcesterMAUSA

Objective:Otologic methicillin-resistant Staphylococcus aureus(MRSA)infection has historically been rare,but given the rise in community-acquired.MRSA carriage and.infection at other bod. sites,prevalence rates may be changing.The goal of this stud. was to d.termine the prevalence of MRSA in recent otologic cultures from patients with acute otitis externa(AOE).Stud. d.sign:Retrospective review of an institutional microbiologic d.tabase.Method.:A retrospective analysis was performed.n serial culture isolates taken fromthe ear at a quaternary care hospital from January 2014 to April 2016.The causative pathogen and.antibiotic sensitivity was d.termined.by culture isolation and.end.point mean inhibitory concentration(MIC)testing.Med.cal record. were reviewed.to d.cument patient characteristics,chronicity of infection,symptomatology,and.previous treatments.Results:Over the stud. period.173 patients were d.agnosed.with AOE and.und.rwent otologic cultures of the ear.Fifty-three(30.6%)of cultures grew S.aureus(SA).Of SA infections,15(28.3%)were id.ntified.as MRSA.MRSA patients were typically old.r than patients with methicillin-sensitive SA(MSSA)(mean age 46.717.9 vs 2919.4,PZ0.003)and.had.more med.cal comorbid.ties(4 vs 1.7,PZ0.001).Compared.to patients with MSSA,patients with MRSAwere significantly more likely to have had.prior ototopical antibiotic exposure(37%vs 73%,PZ0.019).Conclusion:Contemporary ear culture isolates at quaternary care center show higher rates of MRSA compared.to historical reports in the literature.Clinicians should.consid.r ear cultures to id.ntify MRSA AOE.Level of Evid.nce:IV.

关键词： Acute otitis externa Staphylococcus aureus Methicillin-resistant Staphylococcus aureus,MRSA

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