PubMed · 15678600
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James K Rone. 2004. Are normal thyroid tests normal?. https://pubmed.ncbi.nlm.nih.gov/15678600/
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In very rare cases, acute hearing loss can be caused by a fractured long process of the malleus. Such fractures can be due to head traumas, direct injuries of the tympanic membrane or barotraumas. Clinical findings are: abnormal mobility of the manubrium mallei during the Valsalva maneuvre or pneumomassage of the ear drum, conductive hearing loss, abnormal high compliance in the type A tympanigram. We report on a 48 year old female patient who showed typical symptoms and clinical findings, and discuss possible pathogenic factors. In accordance with the literature, we presume that negative pressure in the external ear canal, caused by a rapidly extracted finger (!), might be responsible. At the very onset of hearing loss, the patient noticed a high frequency tinnitus in the affected ear. Surgically, we tried to re-fix the manubrium by splinting it and the adherent parts of the tympanic membrane with cartilage.
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We describe the case of a 700-g neonate who presented with abdominal discolouration, distension, and rapid clinical deterioration. At laparotomy, a perforation in the neck of the gallbladder was found, which was simply over-seen. Perforation of the gallbladder should be considered in the differential diagnosis in such neonates. The surgical management should be direct repair, without resorting to a cholecystectomy.