![]() ![]() It is imperative that patients undergoing ear surgery are appropriately counseled that dizziness is a potential complication. ![]() Legal allegations, including physical injury, negligence, and lack of informed consent failed to predict the legal outcome.Īppropriate examination, testing, and referrals within a timely manner are crucial in the management of dizzy patients to avoid misdiagnoses. Two-thirds of cases involved surgery, most commonly stapes surgery. Average payments were higher for jury verdicts in favor of the plaintiff ($1.8 million) as compared to out of court settlements ($545,000). Jury verdicts favored the plaintiff 53% of the time and a payout was made in 57% of cases overall. Of 21 cases meeting inclusion criteria, 17 were decided by a trial jury and four were resolved out of court. Data including patient demographics, plaintiff allegation, procedure performed, and indemnities were analyzed. All lawsuits and out of court adjudications related to the management of dizziness by otolaryngologists were collected. This is a retrospective review of the LexisNexis “Jury Verdicts and Settlements” database. To assess malpractice claims related to the management of dizziness in otolaryngology in order to improve care and minimize the risk of litigation. Sniff test with optional myringotomy may be useful for preoperative diagnosis of Eustachian tube closing failure. Positive results were obtained in five (13.9%) additional cases, and a final total of 17 (54.8%) out of 31 cases were positive for Eustachian tube closing failure. The remaining 19 cases with initial negative test results subsequently received myringotomy and were subjected to Test 2 again. Twelve out of 31 cases (38.7%) were positive for either one of the tests. Test 1 was positive in six (19.4%) and Test 2 was initially positive in nine (29.0%) out of 31 cases. Second step test: For cases with negative First Step Tests, myringotomy was performed and Test 2 was repeated. Test 2: The pressure in the external auditory meatus was found to change synchronously with that of the nasopharynx during respiration or upon sniffing. First Step Tests: Test 1: Positive sniff test identified by retraction of the tympanic membrane upon sniffing was observed. Presence of Eustachian tube closing failure was determined through two Eustachian tube function tests. ![]() Thirty-one cases with acquired middle ear cholesteatoma who received surgery were enrolled. To re-evaluate the incidence of Eustachian tube closing failure in acquired middle ear cholesteatoma. We believe that the cooperation of the muscles contributes to the dilating mechanism of the Eustachian tube, due to the complex topographical structures of the surrounding muscles: the tensor veli palatini, the levator veli palatini, the superior pharyngeal constrictor and the buccinator. The main findings were as follows: 1) the infero-lateral muscle bundles of the tensor veli palatini didn’t turn medially at the pterygoid hamulus but were distributed laterally and continuous with the buccinator 2) the tensor veli palatini attached laterally to the membranous part of the Eustachian tube 3) the superior pharyngeal constrictor was not only adjacent to the buccinator at the pterygomandibular raphe but also had muscular continuation with it laterally and 4) some bundles of the superior pharyngeal constrictor adhered with the palatine aponeurosis. We conducted macroscopic and histological studies of 24 halves of 12 heads from Japanese cadavers. ![]() The aim of this study was to analyze the topographical structures of the muscles surrounding the Eustachian tube. From our study, it could be concluded that eustachian ventilatory test like TTAG was very available in the patient with an ear fullness feeling which is one of the most common symptoms in the otolaryngological field. The eustachian tube dysfunctions like stenotic or patulous tube could not be fully diagnosed by the audiometry and tympanometry because most patients with the eustachian tube dysfunctions showed normal middle ear pressure measured by the tympanometry. Functional unbalance of the both eustachian tubes which results from minimum ventilatory disturbance on the complaining side was also thought to be one of the causes of this symptom. In 74 cases of 194, the eustachian tube dysfunction was thought to cause an ear fullness sensation and patulous tube was found in 19 patients which is more frequent than expected. One hundred and ninety-four patients with a sensation of ear fullness were examined with the audiometry, tympanometry, and tubotympanoaerodynamic graphy (TTAG) as a eustachian tube ventilatory test. ![]()
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