OBJECTIVES: Malignant (necrotizing) otitis externa (MOE) is an aggressive form of skin inflammation of the external ear with a tendency to spread infection to the temporal bone. The study aimed to evaluate a causal relationship between treatment responses and clinical features in patients with MOE. MATERIALS and METHODS: In a retrospective, descriptive section study, the database was analyzed between January 2008 and December 2018 in our department, all patients with diagnosed MOE were identified. RESULTS: A total of 30 patients were evaluated, of which 27 men and 3 women. The youngest patient was 52 years old while he was eldest 88 years, (mean-71 years old). As the most common comorbidity, diabetes mellitus was found in 23 (76%) subjects. Median duration of symptoms was about 3 months. The most common isolated pathogen was Pseudomonas aeruginosa (47%). Patients with facial nerve palsy and erosion of temporal bone find on computerized tomography affect prolonged stationary treatment (Mean, SD 29.2±8.5 and 26,7±11.6 days), while 80% of patients with facial nerve palsy had recurrence of disease (p=0.005) with mean duration of clinical remission of 60±17.3 days. Overall length of treatment is also increased in the presence of comorbidities as well as in patients with cranial nerve involvement. CONCLUSION: Patients with cranial nerve involvement, erosion of temporal bone and presence of comorbidities affect prolonged treatment and adverse prognosis. Early diagnosis and initiation of aggressive therapy are essential for stopping the further spread of the disease and prevention of serious complications. Cite this article as: Arsovic N, Radivojevic N, Jesic S, Babac S, Cvorovic L, Dudvarski Z. Malignant Otitis Externa: Causes for Various Treatment Responses. J Int Adv Otol 2020; 16(1): 98-103.

COVID-19 infection is associated with a variety of neurological manifestations. Since the inner ear is vulnerable to viruses, sensorineural hearing loss (SNHL) has been reported to occur following SARS-CoV-2 infection. We present here two cases of profound SNHL following SARS-CoV-2 infection. Pure-tone audiograms confirmed profound SNHL. The tympanogram and Auditory Brainstem Responses showed no abnormal symptoms. MRIs and CTs identified some changes but no significant anatomical nor physiological manifestations explaining the obvious cause for hearing loss. High doses of oral corticosteroids with additional conservative therapy were given with no therapeutic response, and therefore, cochlear implant surgery was performed. One case was bilaterally treated, and the other one received an implantation on one side. Both surgeries were carried out without intra- nor postoperative complications. Interestingly, in both cases, advanced fibrotic tissue was found during surgery. Both cases reported successful rehabilitation and are satisfied with their new sound perception following cochlear implantation.

Extraosseous Ewings sarcoma is extremely rare in the soft tissues of the neck, especially in the sternocleidomastoid muscle. It usually manifests clinically as a rapidly growing mass that shows great potential for local spread. The aim of this paper is to present a rare case of еxtraosseous Ewings sarcoma in the sternocleidomastoid muscle. To the best of our knowledge, this is the first case of extraskeletal Ewings sarcoma at this location. The patient was admitted to our clinic because of a neck tumefaction. The computerized tomography finding showed a tumor mass, most of which was in the V region of the neck, measuring 40×27×35mm. Pathohistological and immunohistochemical findings showed that it was Ewings sarcoma. Unfortunately, the patient passed away nine months after the initial diagnosis. Extraosseous Ewing sarcoma is a rare, fast-growing malignant tumor manifesting histomorphological similarities to bone Ewings sarcoma. Most reports state that extraosseous Ewing sarcoma has a worse prognosis than skeletal. Extraosseous Ewing sarcoma should be borne in mind in the differential diagnosis of soft tissue tumors of the neck.

IgA nephropathy is the most common primary glomerulonephritis, with pathohistological changes described by the Oxford classification, while the Banff classification is used in transplant pathology. This study included 253 patients with IgA nephropathy in native kidneys, divided into the pediatric (n = 105) and adult (n = 148) groups. It aimed to examine clinical, and Oxford and Banff morphological parameters in relation to age, correlations of clinical data with pathohistological parameters, and predictors of the disease outcome. Pediatric patients more frequently presented with macroscopic hematuria, while adults showed higher urea and creatinine levels, and lower eGFR. Examining Oxford classification parameters, chronic glomerular and tubulointerstitial lesions were more common in adults. Banff parameters revealed more frequent chronically active glomerular, inflammatory, chronic tubulointerstitial, and vascular lesions in adults. All inflammatory, chronic tubulointerstitial, and vascular parameters correlated with serum urea levels, eGFR and CKD stage in adults, while less frequent in pediatric patients. Tubulointerstitial Oxford and Banff parameters were strong predictors of CKD and proteinuria progression in children, while such predictors were fewer in adults; segmental glomerulosclerosis predicted hematuria progression in adults. Banff parameters (cg, t, ti, i, i-IFTA, ptc, cv), not in Oxford classification, significantly predict outcomes and are recommended for incorporation into IgA nephropathy reports.

Background: Cochlear dysfunction can arise not only from various factors such as ear diseases but also from systemic disorders of the body. The occurrence of otologic symptoms such as hearing loss, dizziness, and tinnitus can be due to cardiovascular disorders. Therefore, current understandings in the field of the diagnosis and therapy of cardiovascular diseases (CVDs) should include, among others, evidence of otologic disorders. Objective: The aim of this study is to determine the association between risk factors for CVD and cochlear dysfunction. Methods: The cross-sectional study included 128 participants with major CVD risk factors who underwent auditory function examination (pure tone audiometry). Results: There were 52 women (40.6%) and 76 men (59.4%) in total. The mean age of the participants was 58 years (a range of 28–83 years). The mean age among participants with hearing loss was 60 (±10.88), whereas the mean age among participants that had normal hearing thresholds was 54 (±12.18). Sensorineural hearing loss (SNHL) was measured in 59% of participants, of most frequent mild degree hearing loss. The prevalence of SNHL was higher in participants with arterial hypertension (P < 0.001, OR = 5.881, 95% CI 2.694–12.837) and the most common among them was moderate degree hearing impairment (38%). There is also a statistically significant association of SNHL with dyslipidemia and elevated body mass index (P < 0.001, [OR]: 4.118, 95% [CI]: 1.873–9.053 and P< 0.001, [OR]: 1.517, 95% [CI]: 1.237–1.859 ) with moderate and profound hearing loss. Conclusion: Based on the data obtained, it seems that the presence of major cardiovascular risk factors was a significant predictor for cochlear dysfunction.

The readiness to start school includes the emotional and social maturity of the child. In order for a child to master the demands of the school program as easily as possible, a certain harmony is needed in the development of his abilities. The ability of sensory perception and the ability to integrate sensory stimuli specifically determine the development of reading and writing skills. The aim of this study is to analyze the ability to read and write in hypersensitive and hyposensitive types of sensory integration disorders, with special reference to the analysis of individualization measures in the work with these students in the school system. Disorder of sensory integration is expressed in two basic forms: increased sensitivity (hypersensitivity) and decreased sensitivity (hyposensitivity). In the school system, both forms of sensory integration disorders dominate. Hypersensitivity is manifested by rapid mental fatigue compared to other children. These children have difficulty reading and writing at the same time. They can read a word in many different ways without realizing it. Compared to the hypersensitive child who seems inert, the hyposensitive child is in constant motion, craving additional sensory stimuli in the classroom. These children have great problems with reading and writing figures and symbols such as tables, geometric shapes and musical symbols. Adjusting the teaching material for these children means increasing the font and font color before reading, dividing large-scale tasks into smaller units, using different types of writing pens, constantly emphasizing important units in the lesson, providing a summary of the lesson at the end of the lesson, and occasionally checking the legibility of the handwriting. In this way, students are provided with easier visual, auditory and tactile processing, and therefore more successful writing, reading and understanding of the read material. Thus, a student with sensory processing disorder can achieve academic success, but it is necessary to adapt the curriculum to the appropriate level of sensations.