Low‐cost dual‐action aural foreign‐body extractor

Adequate visualization, appropriate equipment, a cooperative patient, and a skilled physician are keys to successful foreign body removal. The first attempt at removal is critical because success rates markedly decrease after the first failed attempt. Laryngoscope, 119:351–354, 2009     

Detection of paranasal ectopic adrenocorticotropic hormone‐secreting pituitary adenoma by Ga‐68‐DOTANOC positron‐emission tomography–computed tomography

Ectopic adrenocorticotropic hormone (ACTH)‐secreting tumors account for approximately 10% of Cushing's syndrome (CS). We present an extremely rare case of a patient with CS caused by an ectopic ACTH‐secreting pituitary adenoma (EAPA) of the ethmoid sinus. The tumor was identified by positron‐emission tomography–computed tomography (PET/CT) using the somatostatin receptor analogue Ga‐68‐DOTANOC. Transnasal endoscopic resection was performed and the patient showed significant clinical improvement with normalization of the endocrine pituitary axis. Immunostaining showed a somatostatin receptor 2 and 5‐positive ACTH‐producing adenoma. In patients with ectopic ACTH secretion, Ga‐68‐DOTANOC‐PET/CT may play an important role in the localization of EAPA. Transnasal endoscopic resection is the therapy of choice.     

A non‐randomized comparison of earwax removal with a ‘Do‐it‐yourself’ ear vacuum kit and a Jobson‐Horne Probe

Objectives: Do‐it‐yourself ear vacuum kits (ear vacs) have recently been introduced as an effective method of earwax removal. This study assesses the efficacy of ear vacs in comparison with a conventional mechanical method of earwax removal, the Jobson‐Horne probe. Methods: Forty healthy relatives who had accompanied family members to orthopaedic and haematology clinics were screened with otoscopy. Sixteen participants with earwax were selected. Main outcome measures: (i) Weight of earwax removed, (ii) proportion of tympanic membrane visible before and after each intervention, (iii) participants’ subjective assessment of any improvement in hearing. Suction pressure generated by the ear vac was also compared with that of microsuctioning. Results: No earwax was removed with the ear vac but the Jobson‐Horne probe was significantly more effective at removing a greater weight of earwax (P < 0.001, mean weight 92.4 mg). There was no improvement in visibility of the tympanic membrane after the ear vac but the Jobson‐Horne probe restored visibility to 100% (P < 0.001). No participant felt that there was an improvement in their hearing after the ear vac, but the majority (88%) reported an improvement in their hearing after the Jobson‐horne probe. Conclusion: A Jobson‐Horne probe is significantly more effective than an ear vac for the removal of earwax.