Nasopharyngeal tuberculosis.

Isolated nasopharyngeal tuberculosis is a rare disease with very few cases having been reported in recent years. We report a case presenting in the United Kingdom with unilateral otalgia and otorrhoea.     

Retrospective study of the prevalence of bilateral sensorineural deafness in childhood.

This retrospective study was undertaken to estimate the causes of severe sensorineural deafness (greater than 40 dB HL) in children. The children were identified from case notes of all referrals made to the Children's Hearing Assessment Centre during a 5-year period (from 1st January 1981 to 31st December 1985). Results were tabulated and conclusions drawn following a literature search. It was deduced that following better antenatal screening, a more active immunisation program and improvements in resuscitation of small preterm infants, there was a shift of cases from prenatal to perinatal causes. The proportion of cases of severe sensorineural deafness was much the same as in previous studies.     

Wilms tumor: ultrasonic features, pathologic correlation, and diagnostic pitfalls

The gray-scale ultrasonic features of Wilms tumor are reported with pathologic comparison. The most consistent ultrasonic features are large size, sharp margination, and echogenic heterogeneity. The frequently observed anechoic areas correlated with hemorrhage and necrosis. A rare case of mesoblastic nephroma is included for comparison. Pitfalls in diagnosis are discussed.     

Surgery and functional outcomes in deaf children receiving cochlear implants before age 2 years.

OBJECTIVE: To examine the feasibility of cochlear implantation in children younger than 2 years regarding surgery and functional outcomes. DESIGN: Prospective study. SETTING: Tertiary pediatric cochlear implant center. PATIENTS: A consecutive sample of 12 children younger than 2 years at the time of cochlear implantation (8 boys and 4 girls). The cause of hearing loss was meningitis in 6 children and congenital in 6. INTERVENTIONS: Multichannel cochlear implantation using the Nucleus C124M (Cochlear Co, Sydney, Australia) device. Functional outcome was assessed using the Listening Progress Profile and the Categories of Auditory Performance. MAIN OUTCOME MEASURES: Perioperative and postoperative surgical complications and functional outcome. RESULTS: Eight children had a completely patent cochlea. Four children required a 3- to 5-mm drilling to reach the scala tympani because of ossification after meningitis. Full insertion was achieved in 11 patients; the other child received 18 electrodes. One patient had temporary facial nerve weakness; 2 others had wound edema and serous discharge that resolved with conservative management. In the longer term, 1 child experienced a single episode of acute otitis media; another had recurrent episodes of otitis media. Mean Listening Progress Profile scores increased from 1 to 42 and median Categories of Auditory Performance scores increased from 0 to 5 at 2 years postsurgery. Comparison with the scores in the 2- to 5-year group showed no significant differences. No significant tuning difficulties were experienced with all children. CONCLUSIONS: Cochlear implantation is feasible in children younger than 2 years without significant surgical complications or particular tuning difficulties. Functional results 2 years after implantation were as good as or better than those of children who underwent implantation between ages 2 and 5 years.