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Otogenic brain abscess as a complication of acute otitis media in an adult female patient – a case report and literature review

100%

Oleksiuk W., Olejnik-Wojciechowska J., Jaworowska E., Radomska K.

Polski Przegląd Otorynolaryngologiczny

2024

vol. 13

issue 2

45-49

Introduction:Ear abscess of the brain occurs in 0.3–1.3/100,000 of the population per year, and about 30% of abscesses are accompanied by other intracranial complications. Such complications can occur in the course of both chronic and acute otitis media, but the latter is extremely rare. Aim: To present a case of temporal lobe abscess in the course of acute otitis media (AOM) in an adult. Case study: The patient was admitted to the Hospital Emergency Department (ED) with symptoms of AOM with purulent leakage from the right ear and disturbance of consciousness. In addition to inflammatory changes in the middle ear, a CT scan showed zones of swelling in the right temporal lobe with suspicion of a forming temporal lobe abscess on the right side. The treatment administered included urgent anthromastoidectomy and right-sided tympanostomy, as well as empirical antibiotic therapy. Six days after admission, a follow-up magnetic resonance imaging (MRI) scan of the brain showed progression of the lesions, complete formation of the abscess, and thrombotic changes in the cerebral venous sinuses were also described. Further treatment included drainage of the temporal lobe abscess. A significant improvement in general and neurological condition was achieved. Conservative treatment was continued and regression of the right temporal lobe abscess was achieved, and a follow-up RM study confirmed stable thrombotic lesions in the right transverse sinus. Conclusions: The occurrence of intracranial complications in the course of AOM in adults is extremely rare. Deterioration of the general condition and the appearance of consciousness disturbances in the course of AOM may indicate developing intracranial complications. Implementation of multidisciplinary diagnostic and therapeutic management makes it possible to achieve good therapeutic results.

Contemporary directions in the therapy of sensory hearing loss

88%

Rzepakowska A., Borowy A., Siedlecki E., Wolszczak M., Radomska K.

Polish Journal of Otolaryngology

2024

vol. 78

issue 4

29-38

Introduction: More than 5% of the world’s population experience hearing impairment. The most common form is presbycusis (age-related hearing loss; ARHL). It affects almost one in three people over the age of 65. The hair cells of the cochlea play an important role in the process of sound registration. Genetic mutations, aging and environmental factors can cause damage that contributes to the hearing loss. Methods and results: The currently explored research directions include drug treatments, gene therapies, and stem cell therapies. To date, no significant differences in the therapeutic effect depending on the route of corticosteroid administration have been demonstrated in patients with moderate to severe hearing loss. New dexamethasone-containing hydrogel formulations, as well as lipid formulations, thermosensitive polymers, and nanoparticles, have been developed to achieve high drug concentrations in the inner ear structures. Otoprotective effects of antioxidants or substances that modify the toxic effects of e.g. cisplatin, are also being studied. Attempts at auditory cells’ regeneration seem promising in hearing loss research. Substances that regulate the central mechanisms of the Notch and Wnt pathways are being explored to this end. The genetic determinants of presbycusis suggest that interference at the level of specific genes may be a promising option for the treatment of this condition. With the CRISPR/Cas9 technology, the functions of inner ear genes can be effectively studied by disrupting normal gene alleles. The CRISPR/Cas9 complexes developed to target specific genes are delivered using cationic lipids, proteins, and viral vectors. They are then transported through the round window membrane by diffusion, without the need to surgically disrupt the inner ear. The potential of using antisense oligonucleotides to treat hereditary deafness caused by hair cell degeneration has also been established. Another research direction is related to stem cells being used for the development of in vitro 3D models of the human inner ear. Studies are also pursued to identify the mechanisms underlying the formation of cochlear organoids from pluripotent cells as well as determine the critical time points and events for cochlear sensory epithelial development and targeted hair cell differentiation. Conclusions: In summary, significant progress has been made over the past decade in the search for novel therapies for sensory hearing loss. This line of research remains an ambitious and important area for further exploration.

Ototoxicity in Immune Checkpoint Inhibitors Therapy

76%

Wierzbicka M., Mielnik J., Kołodziejska E., Klimza H., Szyfter W., Radomska K.

Polish Journal of Otolaryngology

2024

vol. 78

issue 3

38-42

Introduction: Immune checkpoint inhibitors (ICIs) and T-cell therapies are a modern, well-established cancer treatment. The priority of oncological treatment is to cure cancer. However, treatment-related toxicities, i.e. immune-related adverse events (irAEs), continue to emerge and are not that well understood yet. ICIs can cause profound, multiple, and diverse irAEs – the sequelae of unknown mechanisms. One of the organs susceptible to collateral damage is the hearing organ. Complications related to hearing, tinnitus, and balance disorders are extremely burdensome and significantly impair many aspects of the quality of life of patients and survivors. Aim: The aim of the work is to review the literature in the area of ototoxicity of ICIs. Materials and method: A systematic search of the Web of Science, PubMed, and Embase databases for studies published until 1 March 2022 was conducted. Results: Reported clinical symptoms ranged from sudden bilateral hearing loss and imbalance to mild hearing loss or tinnitus with preserved hearing. It was found that the median time from ICI initiation to hearing loss development was 3 months. The hearing impairment was secondary to bilateral sensorineural hearing loss in the majority of patients (>60%), and at least one other irAE accompanied the hearing loss in 2/3 of patients. Hearing loss significantly improved in 45.7% of the patients. Conclusions: The majority of cases of ICI-related hearing loss presented in the literature were reversible. Therefore, it is important to develop and implement routine therapeutic algorithms. Further research is needed to define the true prevalence of ICI-related hearing loss, optimal diagnostics, and management.

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2 Polish Journal of Otolaryngology

1 Polski Przegląd Otorynolaryngologiczny

3 2024

3 Radomska K.

1 Borowy A.

1 Jaworowska E.

1 Klimza H.

1 Kołodziejska E.

1 Mielnik J.

1 Olejnik-Wojciechowska J.

1 Oleksiuk W.

1 Rzepakowska A.

1 Siedlecki E.

1 Szyfter W.

1 Wierzbicka M.

1 Wolszczak M.

Search results

Otogenic brain abscess as a complication of acute otitis media in an adult female patient – a case report and literature review

Contemporary directions in the therapy of sensory hearing loss

Ototoxicity in Immune Checkpoint Inhibitors Therapy