Objective: To evaluate High Resolution Computer Tomography(HRCT) in the diagnosis of external ear canal cholesteatoma.Methods: In this retrospective study, HRCTs of 27 patients with external ear canal cholesteatoma we...Objective: To evaluate High Resolution Computer Tomography(HRCT) in the diagnosis of external ear canal cholesteatoma.Methods: In this retrospective study, HRCTs of 27 patients with external ear canal cholesteatoma were reviewed. The changes in the external ear canal, tympanic membrane(TM), scutum, tympanum and mastoid were measured and categorized.Results: Fourteen patients showed no or mild destruction in the external ear canal(stage Ⅰ group). Eight patients had obvious enlargement in the external ear canal(stage Ⅱ group) but showed limited destructions of the mastoid bone and no damage of the tympanums. Five patients had serious destruction of the mastoid bone and damage of the tympanum(stage Ⅲ group). All patients in the stage Ⅲ group showed a compression of manubriums and TMs, with 3 having damages on ossicular chain. Bone destruction of the vertical section of facial nerve canal was discovered in one case in the stage Ⅲ group.Conclusion: HRCT can provide detail information about the extent of external ear canal cholesteatoma. Such information can be used to identify special situations with serious complications and to differentiate external ear canal cholesteatoma from middle ear cholesteatoma.展开更多
Introduction:Otoacariasis is a rare infestation of the ear canal,which affects the quality of life especially in rural areas.Different types of ticks and mites may cause otoacariasis.Although treatment of otoacariasis...Introduction:Otoacariasis is a rare infestation of the ear canal,which affects the quality of life especially in rural areas.Different types of ticks and mites may cause otoacariasis.Although treatment of otoacariasis is simple,diseases transmitted through ticks and mites should be considered during diagnosis and treatment.Both local and systemic signs and symptoms of such diseases should be followed up.A literature review was conducted in PubMed using the following terms: 'otoacariasis,' 'ticks,' 'mites,' and 'outer ear canal infestations.' Demographic,radiologic,and treatment options were discussed.Treatment hints and pitfalls were also discussed with the literature review.Conclusion:In this paper,we describe otoacariasis in humans and discuss the appropriate interventions.展开更多
By analyzing the differences between binaural recording and real listening, it was deduced that there were some unrevealed auditory localization clues, and the sound pressure distribution pattern at the entrance of ea...By analyzing the differences between binaural recording and real listening, it was deduced that there were some unrevealed auditory localization clues, and the sound pressure distribution pattern at the entrance of ear canal was probably a clue. It was proved through the listening test that the unrevealed auditory localization clues really exist with the reduction to absurdity. And the effective frequency bands of the unrevealed localization clues were in- duced and summed. The result of finite element based simulations showed that the pressure distribution at the entrance of ear canal was non-uniform, and the pattern was related to the direction of sound source. And it was proved that the sound pressure distribution pattern at the entrance of the ear canal carried the sound source direction information and could be used as an unrevealed localization clue. The frequency bands in which the sound pressure distribution patterns had significant differences between front and back sound source directions were roughly matched with the effective frequency bands of unrevealed localization clues obtained from the listening tests. To some extent, it supports the pattern could be a kind of unrevealed auditory hypothesis that the sound pressure distribution localization clues.展开更多
Nodular fasciitis is a benign reactive soft tissue tumor arising from fibroblasts and myofibroblasts.Its incidence is low and misdiagnosis is frequent especially for malignant lesions.This can lead to inappropriate an...Nodular fasciitis is a benign reactive soft tissue tumor arising from fibroblasts and myofibroblasts.Its incidence is low and misdiagnosis is frequent especially for malignant lesions.This can lead to inappropriate and unnecessary invasive treatment.Nodular fasciitis of the external auditory canal is extremely rare.So far,around fifteen cases have been reported.We present here the case of a 90-year-old patient with nodular fasciitis of the right external auditory canal.The lesion extends anteriorly for 6.5 cm and reaches the posterior wall of the maxillary sinus.To our knowledge,this is the first case in the literature of an external auditory canal nodular fasciitis presenting as an inflammatory ear polyp with such a wide extension.展开更多
We report a case of capillary hemangiomsa that involved the entire middle ear space,external auditory canal(EAC) and tympanic antrum.Symptoms in the case included ear fullness,hearing loss,otalgia and otorrhea.The cas...We report a case of capillary hemangiomsa that involved the entire middle ear space,external auditory canal(EAC) and tympanic antrum.Symptoms in the case included ear fullness,hearing loss,otalgia and otorrhea.The case was misdiagnosed as recurrent chronic otitis media with granulation preoperatively.A diagnosis of capillary hemangioma was established by postoperative histological examination.The management of capillary hemangioma of the middle ear and external auditory canal is discussed,with a review of the literature.Because of its variable and sometimes misleading clinical presentation,hemangioma can initially be misdiagnosed as other lesions.Therefore,a high index of suspicion is necessary for early and accurate diagnosis.展开更多
Objective Patients with unilateral ear discharge and hearing loss often have external or middle ear diseases. We present a 55-year-old man who suffered from persistent ear discharge and hearing loss in the left ear. L...Objective Patients with unilateral ear discharge and hearing loss often have external or middle ear diseases. We present a 55-year-old man who suffered from persistent ear discharge and hearing loss in the left ear. Local findings showed that his left ear canal was filled with a large amount of granulation tissue, with purulent, foul-smelling discharge. Computed tomography indicated left middle ear cholesteatoma and mass shadow in the left external auditory canal. Modified radical mastoidectomy was performed. A piece of white plastic stick was found in the middle ear during the operation. Foreign body-induced cholesteatoma and external auditory canal granuloma in adults are very rare. We present this rare case so that these conditions can be better recognized and understood.展开更多
Neurofibroma is a benign tumor of the connective tissue of the peripheral nerves, developed mainly at the endoneurium. The most common localizations are the extremities of the limbs and the head and neck region. Neuro...Neurofibroma is a benign tumor of the connective tissue of the peripheral nerves, developed mainly at the endoneurium. The most common localizations are the extremities of the limbs and the head and neck region. Neurofibromas are often associated with neurofibromatosis type 1. An isolated localization in the auditory canal is exceptional. We report the case of a 45-year-old female patient presenting with a neurofibroma of the auditory canal which had previously caused hearing loss. Examination revealed a tissue mass firm, painless and covered with normal skin obstructing the external auditory canal. The patient’s skin examination revealed no café-au-lait spots. A CT scan of the ear showed a hypodense tissue mass. Surgical removal via the ear canal gave good results. In conclusion, an isolated neurofibroma of the external auditory canal is a rare benign tumor with a good prognosis. The surgical approach depends on the exact location of the mass and the surgeon’s experience.展开更多
Objective To investigate the advantages of canal wall reconstruction(CWR) mastoidectomy, a single-stage technique for cholesteatoma removal and posterior external canal wall reconstruction, over the open and closed pr...Objective To investigate the advantages of canal wall reconstruction(CWR) mastoidectomy, a single-stage technique for cholesteatoma removal and posterior external canal wall reconstruction, over the open and closed procedures in terms of cholesteatoma recurrence. Methods: Between June 2002 and December 2005, 38 patients (40 ears) with cholesteatoma were admited to Sun Yat-Sen Memorial Hospital and received surgical treatments. Of these patients, 25 were male with ages ranging between 11 and 60 years(mean = 31.6 years) and 13 were female with ages ranging between 20 and 65 years (mean = 38.8 years). Canal wall reconstruction(CWR)mastoidectomy was performed in 31 ears and canal wall down(CWD) mastoidectomy in 9 ears. Concha cartilage was used for ear canal wall reconstruction in 22 of the 31 CWR procedures and cortical mastoid bone was used in the remaining 9 cases. Results At 0.5 to 4 years follow up, all but one patients remained free of signs of cholesteatoma recurrence, i.e., no retraction pocket or cholesteatoma matrix. One patient, a smoker, needed revision surgery due to cholesteatoma recurrence 1.5 year after the initial operation. The recurrence rate was therefore 3.2% (1/31). Cholesteatoma recurrence was monitored using postoperative CT scans whenever possible. In the case that needed a revision procedure, a retraction pocket was identified by otoendoscopy in the pars flacida area that eventually evolved into a cholesteatoma. A pocket extending to the epitympanum filled with cholesteatoma matrix was confirmed during the revision operation, A decision to perform a modified mastoidectomy was made as the patient refused to quit smoking. The mean air-bone gap in pure tone threshold was 45 dB before surgery and 25 dB after(p < 0.05). There was no difference between using concha cartilage and cortical mastoid bone for the reconstruction regarding air-bone gap improvement, CT findings and otoendoscopic results. Conclusion CWR mastoidectomy can be used for most patients with acquired middle ear cholesteatoma, including children. The CWR technique provides improved exposure of the middle ear, especially the anterior epitympanum, without creating a mastoid bowl and reduces the incidence of residual and recurrent disease, including cholesteatoma and otorrhea.展开更多
Ear canal exostoses are bilateral, usually symmetric multiple bony growths occurring in the medial portion of the external auditory canal. Also known as surfer's ear, exostosis is thought to be a reactive process ...Ear canal exostoses are bilateral, usually symmetric multiple bony growths occurring in the medial portion of the external auditory canal. Also known as surfer's ear, exostosis is thought to be a reactive process from repeated stimulation by cold water and is much more common than external auditory osteoma. Exostoses are usually asymptomatic and discovered on routine otoscopy. Indications for surgical treatment are recurrent otitis externa, hearing loss, otalgia and other conditions in which access medial to the exostoses is required. Surgery is not risk-free and postoperative complications are the most important factor for negative impact on the patient's health-related quality of life. Thisreview offers an overview of the recent advances in the understanding of this condition, with a special focus on the etiology and physiopathology of this condition, the different surgical procedures and their outcomes, the risk factors for recurrence and the results of preventive measures. Finally, this review suggests the need for the otological surgeon to acquire a great deal of experience before undertaking surgical treatment of exostoses as it is a challenging operation and, besides expertise, demands great patience and extreme care in order to achieve good results.展开更多
目的分析内听道重复畸形(duplication of the internal auditory canal,DIAC)患者CT及MRI影像学表现,提高对该畸形的认识,为人工耳蜗植入提供术前依据。方法回顾性观察20例(24耳)DIAC患者内耳多层螺旋CT(MSCT)及MRI资料,测量并分析病变...目的分析内听道重复畸形(duplication of the internal auditory canal,DIAC)患者CT及MRI影像学表现,提高对该畸形的认识,为人工耳蜗植入提供术前依据。方法回顾性观察20例(24耳)DIAC患者内耳多层螺旋CT(MSCT)及MRI资料,测量并分析病变组与对照组内听道及蜗神经孔宽度。结果DIAC均为内听道狭窄及合并其他颞骨畸形。MSCT示21耳、MRI水成像示16耳内听道由骨性分隔成双管。MRI水成像示前庭蜗神经纤细。病变、对照组内听道宽度及蜗神经孔宽度均有统计学差异(P<0.001)。6例(8耳)行人工耳蜗植入术后听力均有不同程度恢复。结论DIAC均显示内听道狭窄,MSCT所示骨性分隔为其特征性征象,MRI水成像示前庭蜗神经发育不良,联合两种影像检查方法可为本病诊断和人工听觉植入提供客观参考依据。展开更多
Tumors involving the head and neck are uncommon in children. Furthermore, those which involve the external ear are extremely rare. In the external ear itself, the most commonly encountered malignancy is Squamous Cell ...Tumors involving the head and neck are uncommon in children. Furthermore, those which involve the external ear are extremely rare. In the external ear itself, the most commonly encountered malignancy is Squamous Cell Carcinoma, both in the adult and pediatric age groups. We encountered one such case of a 14 years old male with a recurring skin lesion involving the right external ear. In this report, we wish to highlight and address the difficulty in recognizing and managing such an unwonted pathology as Squamous Cell Carcinoma in the pediatric age group.展开更多
Conclusion: Early-stage detection of temporal bone carcinoma improves the survival rate. When detected at an advanced stage, predicted prognosis is poor even with a combination of surgery, radiotherapy and chemotherap...Conclusion: Early-stage detection of temporal bone carcinoma improves the survival rate. When detected at an advanced stage, predicted prognosis is poor even with a combination of surgery, radiotherapy and chemotherapy. Objectives: We evaluated treatment strategies and survival rates in cases of carcinomas of the external and middle ear. Method: Retrospective review of patients treated at Ehime University Hospital during the 32 years from 1977 to 2008. Subjects were 41 patients, consisting of 21 men and 20 women with a mean age of 63.2 years. Modified Pittsburgh staging system: stage I in 11 cases (27%), stage II in 4 (10%), stage III in 6 (15%) and stage IV in 20 (49%). Histopathology: squamous cell carcinoma (SCC) in 35 cases, adenoid cystic carcinoma (ACC) in 3, and adenocarcinoma (AC) in 3. Thirty-eight patients were treated by surgery. Radiation was added postoperatively in 23 patients. Three patients were treated by chemoradiotherapy. Results: The survival rate of carcinomas detected at an advanced stage was poor with a disease-specific 5-year survival rate of 100% in early-stage disease (stage I and II) versus 20.8% in stage III and 27.5% in stage IV disease, irrespective of histopathology of the tumor.展开更多
文摘Objective: To evaluate High Resolution Computer Tomography(HRCT) in the diagnosis of external ear canal cholesteatoma.Methods: In this retrospective study, HRCTs of 27 patients with external ear canal cholesteatoma were reviewed. The changes in the external ear canal, tympanic membrane(TM), scutum, tympanum and mastoid were measured and categorized.Results: Fourteen patients showed no or mild destruction in the external ear canal(stage Ⅰ group). Eight patients had obvious enlargement in the external ear canal(stage Ⅱ group) but showed limited destructions of the mastoid bone and no damage of the tympanums. Five patients had serious destruction of the mastoid bone and damage of the tympanum(stage Ⅲ group). All patients in the stage Ⅲ group showed a compression of manubriums and TMs, with 3 having damages on ossicular chain. Bone destruction of the vertical section of facial nerve canal was discovered in one case in the stage Ⅲ group.Conclusion: HRCT can provide detail information about the extent of external ear canal cholesteatoma. Such information can be used to identify special situations with serious complications and to differentiate external ear canal cholesteatoma from middle ear cholesteatoma.
文摘Introduction:Otoacariasis is a rare infestation of the ear canal,which affects the quality of life especially in rural areas.Different types of ticks and mites may cause otoacariasis.Although treatment of otoacariasis is simple,diseases transmitted through ticks and mites should be considered during diagnosis and treatment.Both local and systemic signs and symptoms of such diseases should be followed up.A literature review was conducted in PubMed using the following terms: 'otoacariasis,' 'ticks,' 'mites,' and 'outer ear canal infestations.' Demographic,radiologic,and treatment options were discussed.Treatment hints and pitfalls were also discussed with the literature review.Conclusion:In this paper,we describe otoacariasis in humans and discuss the appropriate interventions.
基金supported by the Science and Engineering Project of Communication University of China(3132016XNG1625)
文摘By analyzing the differences between binaural recording and real listening, it was deduced that there were some unrevealed auditory localization clues, and the sound pressure distribution pattern at the entrance of ear canal was probably a clue. It was proved through the listening test that the unrevealed auditory localization clues really exist with the reduction to absurdity. And the effective frequency bands of the unrevealed localization clues were in- duced and summed. The result of finite element based simulations showed that the pressure distribution at the entrance of ear canal was non-uniform, and the pattern was related to the direction of sound source. And it was proved that the sound pressure distribution pattern at the entrance of the ear canal carried the sound source direction information and could be used as an unrevealed localization clue. The frequency bands in which the sound pressure distribution patterns had significant differences between front and back sound source directions were roughly matched with the effective frequency bands of unrevealed localization clues obtained from the listening tests. To some extent, it supports the pattern could be a kind of unrevealed auditory hypothesis that the sound pressure distribution localization clues.
文摘Nodular fasciitis is a benign reactive soft tissue tumor arising from fibroblasts and myofibroblasts.Its incidence is low and misdiagnosis is frequent especially for malignant lesions.This can lead to inappropriate and unnecessary invasive treatment.Nodular fasciitis of the external auditory canal is extremely rare.So far,around fifteen cases have been reported.We present here the case of a 90-year-old patient with nodular fasciitis of the right external auditory canal.The lesion extends anteriorly for 6.5 cm and reaches the posterior wall of the maxillary sinus.To our knowledge,this is the first case in the literature of an external auditory canal nodular fasciitis presenting as an inflammatory ear polyp with such a wide extension.
文摘We report a case of capillary hemangiomsa that involved the entire middle ear space,external auditory canal(EAC) and tympanic antrum.Symptoms in the case included ear fullness,hearing loss,otalgia and otorrhea.The case was misdiagnosed as recurrent chronic otitis media with granulation preoperatively.A diagnosis of capillary hemangioma was established by postoperative histological examination.The management of capillary hemangioma of the middle ear and external auditory canal is discussed,with a review of the literature.Because of its variable and sometimes misleading clinical presentation,hemangioma can initially be misdiagnosed as other lesions.Therefore,a high index of suspicion is necessary for early and accurate diagnosis.
文摘Objective Patients with unilateral ear discharge and hearing loss often have external or middle ear diseases. We present a 55-year-old man who suffered from persistent ear discharge and hearing loss in the left ear. Local findings showed that his left ear canal was filled with a large amount of granulation tissue, with purulent, foul-smelling discharge. Computed tomography indicated left middle ear cholesteatoma and mass shadow in the left external auditory canal. Modified radical mastoidectomy was performed. A piece of white plastic stick was found in the middle ear during the operation. Foreign body-induced cholesteatoma and external auditory canal granuloma in adults are very rare. We present this rare case so that these conditions can be better recognized and understood.
文摘Neurofibroma is a benign tumor of the connective tissue of the peripheral nerves, developed mainly at the endoneurium. The most common localizations are the extremities of the limbs and the head and neck region. Neurofibromas are often associated with neurofibromatosis type 1. An isolated localization in the auditory canal is exceptional. We report the case of a 45-year-old female patient presenting with a neurofibroma of the auditory canal which had previously caused hearing loss. Examination revealed a tissue mass firm, painless and covered with normal skin obstructing the external auditory canal. The patient’s skin examination revealed no café-au-lait spots. A CT scan of the ear showed a hypodense tissue mass. Surgical removal via the ear canal gave good results. In conclusion, an isolated neurofibroma of the external auditory canal is a rare benign tumor with a good prognosis. The surgical approach depends on the exact location of the mass and the surgeon’s experience.
文摘Objective To investigate the advantages of canal wall reconstruction(CWR) mastoidectomy, a single-stage technique for cholesteatoma removal and posterior external canal wall reconstruction, over the open and closed procedures in terms of cholesteatoma recurrence. Methods: Between June 2002 and December 2005, 38 patients (40 ears) with cholesteatoma were admited to Sun Yat-Sen Memorial Hospital and received surgical treatments. Of these patients, 25 were male with ages ranging between 11 and 60 years(mean = 31.6 years) and 13 were female with ages ranging between 20 and 65 years (mean = 38.8 years). Canal wall reconstruction(CWR)mastoidectomy was performed in 31 ears and canal wall down(CWD) mastoidectomy in 9 ears. Concha cartilage was used for ear canal wall reconstruction in 22 of the 31 CWR procedures and cortical mastoid bone was used in the remaining 9 cases. Results At 0.5 to 4 years follow up, all but one patients remained free of signs of cholesteatoma recurrence, i.e., no retraction pocket or cholesteatoma matrix. One patient, a smoker, needed revision surgery due to cholesteatoma recurrence 1.5 year after the initial operation. The recurrence rate was therefore 3.2% (1/31). Cholesteatoma recurrence was monitored using postoperative CT scans whenever possible. In the case that needed a revision procedure, a retraction pocket was identified by otoendoscopy in the pars flacida area that eventually evolved into a cholesteatoma. A pocket extending to the epitympanum filled with cholesteatoma matrix was confirmed during the revision operation, A decision to perform a modified mastoidectomy was made as the patient refused to quit smoking. The mean air-bone gap in pure tone threshold was 45 dB before surgery and 25 dB after(p < 0.05). There was no difference between using concha cartilage and cortical mastoid bone for the reconstruction regarding air-bone gap improvement, CT findings and otoendoscopic results. Conclusion CWR mastoidectomy can be used for most patients with acquired middle ear cholesteatoma, including children. The CWR technique provides improved exposure of the middle ear, especially the anterior epitympanum, without creating a mastoid bowl and reduces the incidence of residual and recurrent disease, including cholesteatoma and otorrhea.
文摘Ear canal exostoses are bilateral, usually symmetric multiple bony growths occurring in the medial portion of the external auditory canal. Also known as surfer's ear, exostosis is thought to be a reactive process from repeated stimulation by cold water and is much more common than external auditory osteoma. Exostoses are usually asymptomatic and discovered on routine otoscopy. Indications for surgical treatment are recurrent otitis externa, hearing loss, otalgia and other conditions in which access medial to the exostoses is required. Surgery is not risk-free and postoperative complications are the most important factor for negative impact on the patient's health-related quality of life. Thisreview offers an overview of the recent advances in the understanding of this condition, with a special focus on the etiology and physiopathology of this condition, the different surgical procedures and their outcomes, the risk factors for recurrence and the results of preventive measures. Finally, this review suggests the need for the otological surgeon to acquire a great deal of experience before undertaking surgical treatment of exostoses as it is a challenging operation and, besides expertise, demands great patience and extreme care in order to achieve good results.
文摘目的分析内听道重复畸形(duplication of the internal auditory canal,DIAC)患者CT及MRI影像学表现,提高对该畸形的认识,为人工耳蜗植入提供术前依据。方法回顾性观察20例(24耳)DIAC患者内耳多层螺旋CT(MSCT)及MRI资料,测量并分析病变组与对照组内听道及蜗神经孔宽度。结果DIAC均为内听道狭窄及合并其他颞骨畸形。MSCT示21耳、MRI水成像示16耳内听道由骨性分隔成双管。MRI水成像示前庭蜗神经纤细。病变、对照组内听道宽度及蜗神经孔宽度均有统计学差异(P<0.001)。6例(8耳)行人工耳蜗植入术后听力均有不同程度恢复。结论DIAC均显示内听道狭窄,MSCT所示骨性分隔为其特征性征象,MRI水成像示前庭蜗神经发育不良,联合两种影像检查方法可为本病诊断和人工听觉植入提供客观参考依据。
文摘Tumors involving the head and neck are uncommon in children. Furthermore, those which involve the external ear are extremely rare. In the external ear itself, the most commonly encountered malignancy is Squamous Cell Carcinoma, both in the adult and pediatric age groups. We encountered one such case of a 14 years old male with a recurring skin lesion involving the right external ear. In this report, we wish to highlight and address the difficulty in recognizing and managing such an unwonted pathology as Squamous Cell Carcinoma in the pediatric age group.
文摘Conclusion: Early-stage detection of temporal bone carcinoma improves the survival rate. When detected at an advanced stage, predicted prognosis is poor even with a combination of surgery, radiotherapy and chemotherapy. Objectives: We evaluated treatment strategies and survival rates in cases of carcinomas of the external and middle ear. Method: Retrospective review of patients treated at Ehime University Hospital during the 32 years from 1977 to 2008. Subjects were 41 patients, consisting of 21 men and 20 women with a mean age of 63.2 years. Modified Pittsburgh staging system: stage I in 11 cases (27%), stage II in 4 (10%), stage III in 6 (15%) and stage IV in 20 (49%). Histopathology: squamous cell carcinoma (SCC) in 35 cases, adenoid cystic carcinoma (ACC) in 3, and adenocarcinoma (AC) in 3. Thirty-eight patients were treated by surgery. Radiation was added postoperatively in 23 patients. Three patients were treated by chemoradiotherapy. Results: The survival rate of carcinomas detected at an advanced stage was poor with a disease-specific 5-year survival rate of 100% in early-stage disease (stage I and II) versus 20.8% in stage III and 27.5% in stage IV disease, irrespective of histopathology of the tumor.
