@entity697 and XXXX in adults.

@entity1 @entity697 @entity2172 @entity6 @entity2346 @entity73 @entity2103 @entity869 @entity3541 @entity5899 @entity328 @entity912 @entity288
OBJECTIVE: The pathophysiology and treatment of @entity3541 associated with @entity697 media are still under debate. The objective of this study was to review treatment strategies and extent of recovery in adult @entity1 with the aim of defining a standard treatment protocol for this rare pathologic condition. STUDY DESIGN: Retrospective chart review. SETTING: University hospital, tertiary referral center. @entity1 : Between 1993 and 2000, 11 @entity1 were admitted for @entity3541 secondary to @entity697 media. There were six @entity1 and five @entity1 without a history of chronic @entity2172 , who ranged in age from 21 to 71 years. @entity3541 was graded with the House-Brackmann scale: four @entity1 had @entity912 , six had Grade IV palsy, and one @entity1 had Grade V palsy. Bacteriologic examination of middle ear fluid was performed in four @entity1 @entity328 was observed in one @entity1 , and the remaining three cultures were negative. INTERVENTIONS: All @entity1 were treated with parenteral @entity869 - @entity5899 or a third-generation cephalosporin in conjunction with oral or intravenous @entity288 , except in a single @entity1 with @entity6 who received antibiotics alone. Myringotomy alone or with ventilation tube application was performed in eight @entity1 . A simple mastoidectomy without @entity2103 was used in a @entity1 with @entity73 to Grade VI @entity912 and worsening @entity2346 after an initial improvement. RESULTS: Normal facial function returned in all @entity1 , independently of the grade of the @entity912 , the treatment strategy, or the outcome of the @entity2172 . The time of recovery varied from 2 weeks to 3 months, except for one @entity1 who underwent mastoidectomy and in whom normal function returned in 10 months. CONCLUSIONS: The treatment of @entity3541 @entity2346 media should be as conservative as possible, using antibiotics and corticosteroids. Myringotomy and a ventilation tube should be added when spontaneous perforation of the tympanic membrane is not present. Mastoidectomy should be performed only when it is necessary to treat @entity2346 media. @entity2103 should not be necessary.
