Skull fractures that go through the part of the skull containing the ear structures (the temporal bone) can also cause damage to the middle ear. A cholesteatoma is a cyst of squamous skin cells that may develop from birth or secondary to other causes such as chronic ear infections. It may impair hearing or cause dizziness or vertigo, and is usually investigated by otoscopy and may require a CT scan. The treatment for cholesteatoma is surgery. Inner earThere are two principal damage mechanisms to the inner ear in industrialised society, and both injure hair cells. The first is exposure to elevated sound levels (noise trauma), and the second is exposure to drugs and other substances (ototoxicity). A large number of people are exposed to sound levels on a daily basis that are likely to lead to significant hearing loss. The National Institute for Occupational Safety and Health has recently published research on the estimated numbers of persons with hearing difficulty (11%) and the percentage of those that can be attributed to occupational noise exposure (24%). Furthermore, according to the National Health and Nutrition Examination Survey (NHANES), approximately twenty-two million (17%) US workers reported exposure to hazardous workplace noise. Workers exposed to hazardous noise further exacerbate the potential for developing noise-induced hearing loss when they do not wear hearing protection. Tinnitus
Tinnitus is the hearing of sound when no external sound is present. While often described as a ringing, it may also sound like a clicking, hiss or roaring. Rarely, unclear voices or music are heard.
Alclometasone is a synthetic corticosteroid for topical dermatologic use, possessing anti-inflammatory, antipruritic, and vasoconstrictive properties.The prodrug alclometasone dipropionate was originally marketed under the brand name Aclovate by GlaxoSmithKline as a topical cream and ointment. However, generic versions of the drug are available. Medical uses
Alclometasone cream and ointment are indicated for the relief of corticosteroid-responsive dermatoses, including:

atopic dermatitis
eczema
psoriasis
allergic dermatitis
contact dermatitis
actinic dermatitis
kiss-type allergy
skin itchAlclometasone may be used on sensitive skin sites (face, skinfolds); in pediatric patients 1 year or older and in geriatric patients. Contraindications
hypersensitivity to alclometasone or any of ingredients in pharmaceutical forms
cutaneous tuberculosis
chicken pox
perioral dermatitis
acne
rosacea
open wounds
trophic ulcers
viral infection of skin
skin manifestations of syphilis

Side effects
Adverse reactions (sometimes, less than 1-2% cases) include:

burning
itching
erythema
skin reddening
xerodermia
skin irritation
acne
hypopigmentation
prickly heat
folliculitis
white atrophy
hypertrichosis
reinfection of skin

Pharmacology
Alclometasone induces the production of lipocortins, formally known as annexins, which inhibit phospholipase A2 – the enzyme responsible for the synthesis of arachidonic acid. Without the oxidation of arachidonic acid, eicosanoids, such as prostaglandins, thromboxanes, and leukotrienes, cant be produced. Alclometasone also inhibits the release of pro-inflammatory mediators from leukocytes (e.g., cytokines, histamine, leukotrienes, serotonin). Formulations
Alclometasone as Aclovate is supplied in:

Cream; Topical; 0.05%
Ointment; Topical; 0.05%


== References ==