Application of high resolution computer tomography in external ear canal cholesteatoma diagnosis

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.

Capillary Hemangioma of the Middle Ear and External Auditory Canal:a Case Report

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.

Squamous Cell Carcinoma of the External Ear in a Child

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.

First branchial cleft cyst accompanied by external auditory canal atresia and middle ear malformation:A case report

BACKGROUND We report a rare case of first branchial cleft anomaly(FBCA)accompanied by bony atresia of the external auditory canal,middle ear malformation,and location malformation of the facial nerve according to the intraoperative findings.CASE SUMMARY A 19-year-old male patient presented to our department with a mass behind the right earlobe and recurrent postauricular swelling and pain since childhood,he also had severe hearing loss in the right ear since birth.The patient underwent surgery including mass removal,mastoidectomy,and simultaneous meatoplasty and ossiculoplasty under microscopy.No facial palsy or recurrence was noted during postoperative follow-up.CONCLUSION FBCAs are rare,and to our knowledge,this is the first report of FBCA accompanied by external auditory canal bony atresia,middle ear malformation,and location malformation of the facial nerve.An effective postauricular approach under microscopy facilitated complete lesion removal and simultaneous otologic reconstruction.

Survival in Primary Carcinoma of the External and Middle Ear Is Strongly Dependent on Stage at Diagnosi

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.

Chromsome and pedigree analysis of congenital malformation of external and middle ear

Objective:Using chromosome analysis of a Chinese pedigree to investigate the genetic relationship between chromosome and congenital malformation of the external and middle ear combined with pre-auricular fistula.Methods: Clinical data of all members from 3 family with congenital malformation of the external and middle ear combined with pre-auricular fistula were collected. A pedigrees chart of each family was draw Venous blood samples of all participants were taken for karyotype analysis.Results: A total of 21 members in three generations from three families were screened. Chromosomal abnormalities were detected in 9 people, including 3 patients and 6 carriers. The carriers were fathers and paternal grandparents. Structural abnormalities in chromosomes 1, 2 and 11 were identified.Conclusion:The genetic patterns of congenital malformation of the external and middle ear combined with the pre- auricular fistula in these three families are consistent with autosomal recessive inheritance. Family survey is helpful for further study of this disease.

Role of the mental foramens in dolphin hearing

The role of mental foramens in dolphin hearing was studied in the present work. To this effect the mental foramens’ morphology features which are essential from acoustical viewpoint have been studied. The patterns of relationship between the location of mental foramens and their sizes are found. The affinity of the mental foramens’ morphology and acoustics that the nature had created testify acoustical expediency of the mental foramens’ architecture. This natural inference in the main is confirmed in this work by the experimental data. The mean values of detection thresholds of short broadband stimuli with spectral maximum on frequencies 8, 16, 30 and 100 kHz at acoustical shielding the mental foramens increased on 30, 34, 40 and 50 dB, respectively. Results obtained testify that the mental foramens are the unique sound-conducting pathway into the fat body of the mandibular canal for the sounds of all frequencies used in the experiment, approximately 6?150 kHz (in view of stimuli broadbandness). The left and right row of the mental foramens together with respective mandibular canal plays the role of pinna and external auditory meatus if to use conventional terminology of a land mammal ear. But it is already qualitatively the new external ear implemented by the nature as the receive array and acoustical horn. The new external ear has apparently appeared in result of the dolphins’ ancestors’ adaptation to new environment conditions, as evolutionary adaptation of the ear to the water and as functional adaptation of the ear in order that to fulfill the new more sophisticated functions in the structure of sonar. The findings give good reason to suppose existence of the same external ear in Odontoceti.

Solitary Neurofibroma of External Aural Canal

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.

Treatment of Hordeolum by Bloodletting at Ear Apex

Hordeolum, the acute pyogenic infection of staphylococci in the palpebral glands, is one of the most commonly seen disorders of the external eye diseases. According to the location of the lesion, it can be divided into internal and external hordeolum. The early symptoms are redness, swelling, and pain in the eyelid. In severe cases, the condition can be accompanied with ipsilateral headache and swelling of the pre-auricular lymph node. Since TCM bloodletting has remarkable effect for treating hordeolum at the early stage, we would like to recommend this simple, easy and effective treatment to doctors who are interested in physiocracy.

Nodular fasciitis of the external auditory canal: Clinical case report and review of the literature

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.

A CLINICAL OBSERVATION ON CORONARY HEART DISEASE TREATED BY OTOPUNCTURE AT HEART OTOPOINT

In the clinical study of acupuncture for treatment of coronary heart disease, body acupuncture was primarily used, and otopuncture was seldom used. Under the premise of guarantee of therapeutic effects, screening out relatively specific acupoint for treatment of coronary disease is a

Keeping an ear out:size relationship of the tympanic bullae and pinnae in bandicoots and bilbies(Marsupialia:Peramelemorphia)

Bandicoots and bilbies(Order Peramelemorphia)occupy a broad range of habitats across Australia and New Guinea,from open,arid deserts to dense forests.This once diverse group has been particularly vulnerable to habitat loss and introduced eutherian predators,and numerous species extinctions and range retractions have occurred.Understanding reasons for this loss requires greater understanding of their biology.Morphology of the pinnae and tympanic bullae varies markedly among species.As hearing is important for both predator avoidance and prey location,the variability in ear morphology could reflect specialization and adaptation to specific environments,and therefore be of conservation relevance.We measured 798 museum specimens representing 29 species of Peramelemorphia.Controlling for phylogenetic relatedness and head length,pinna surface area was weakly negatively correlated with average precipitation(rainfall being our surrogate measure of vegetation productivity/complexity),and there were no environmental correlates with effective diameter(pinna width).Controlling for phylogenetic relatedness and skull length,tympanic bulla volume was negatively correlated with precipitation.Species that inhabited drier habitats,which would be open and allow sound to carry further with less obstruction,had relatively larger pinnae and tympanic bullae.In contrast,species from higher rainfall habitats,where sounds would be attenuated and diffused by dense vegetation,had the smallest pinnae and bullae,suggesting that low-frequency hearing is not as important in these habitats.Associations with temperature did not reach statistical significance.These findings highlight linkages between hearing traits and habitat that can inform conservation and management strategies for threatened species.

外耳再造耳后皮肤软组织扩张器植入后并发症现状及危险因素分析

目的探讨外耳再造耳后皮肤软组织扩张器植入后并发症现状及危险因素,为临床干预措施的制定提供参考。方法对2020年1月至2023年3月在我院接受耳后皮肤软组织扩张器植入的151例(163耳)外耳再造患者临床资料进行回顾性分析,了解其并发症发生现状;根据耳后皮肤软组织扩张器植入后是否发生并发症,将其分为并发症组和无并发症组,并运用多因素Logistic回归分析外耳再造耳后皮肤软组织扩张器植入后并发症的危险因素。结果本研究163耳有37耳发生并发症,并发症总发生率为22.69%,其中血肿18例,占总并发症的48.65%,感染10耳,占比27.03%,切口裂开4耳,占比10.81%,扩张器外漏3耳,占比8.11%,扩张器不张1耳,占比2.70%,皮瓣坏死1耳,占比2.70%;并发症发生平均时间为扩张器植入后(6.82±1.65)天。单因素分析结果显示,并发症组和无并发症组在年龄、居住地、引流管放置方式、扩张器容量、注水速度等方面存在组间差异,具有统计学意义(P﹤0.05);多因素Logistic回归分析显示,居住在农村(OR=2.079,95%CI:1.166~3.707,P=0.013)、引流管平位放置(OR=1.898,95%CI::0.962~3.748,P=0.065)、扩张器容量﹥100ml(OR=2.092,95%CI:1.128~3.878,P=0.019)、注水速度每周≥3次(OR=1.962,95%CI:1.049~3.667,P=0.035)是耳后皮肤软组织扩张器植入后并发症发生的危险因素。结论外耳再造耳后皮肤软组织扩张器植入后并发症发生率较高,居住在农村、引流管平位放置、扩张器容量>100 ml、注水速度每周≥3次是并发症发生的危险因素,临床应根据患者实际情况选择合适的引流方式、扩张器容量,并实施科学的注射速度,以降低并发症发生率,为外耳再造提供充足皮瓣。

中医外治单元疗法治疗胡蜂蜇伤的疗效观察

目的观察中医外治单元疗法对胡蜂蜇伤急诊患者的疗效。方法将2021年4月至2023年9月安徽中医药大学第一附属医院急诊科收治的70例胡蜂蜇伤患者采用随机数字表法分为观察组与对照组,各35例。对照组采用基础治疗方法,观察组在对照组基础上加用中医外治单元疗法,疗程为5 d。比较两组患者治疗前后疗效、数字疼痛评分(NRS)和毒效应指标[天门冬氨酸氨基转移酶/丙氨酸氨基转移酶(AST/ALT)、总胆红素(TBIL)、肌酐(SCr)、部分凝血酶原时间(APTT)、超敏C反应蛋白(hs-CRP)],并记录两组蜇伤处肿胀开始消退时间。结果观察组总有效率(85.71%)高于对照组(62.86%),肿胀消退时间短于对照组,差异有统计学意义(P<0.05)。两组患者治疗前后NRS评分、AST/ALT、TBIL、SCr、APTT、hs-CRP差值比较,差异均有统计学意义(P<0.05)。结论中医外治单元疗法能加速胡蜂蜇伤局部肿胀消退,缓解疼痛,降低毒效应指标,促进炎症吸收,加速患者康复。

耳穴压豆联合耳尖放血治疗高血压急症临床观察

目的观察耳穴压豆联合耳尖放血治疗高血压急症的临床效果。方法采用随机数字表法将90例高血压急症患者分为两组,各45例;对照组采用西医常规治疗,观察组在对照组基础上采用耳穴压豆联合耳尖放血治疗,两组均治疗48 h。观察并比较两组临床疗效及治疗前后症状评分、血压情况。结果治疗后,两组患者头痛、眩晕、急躁的症状评分均低于治疗前,且观察组各症状评分均低于对照组(P<0.05);两组患者治疗后0.5 h、1 h、6 h、24 h、48 h收缩压及舒张压均低于治疗前,且观察组各时间点收缩压及舒张压均低于对照组(P<0.05)。观察组临床总有效率为97.78%(44/45),高于对照组的93.33%(42/45)(P<0.05)。结论耳穴压豆联合耳尖放血治疗高血压急症患者能够快速改善其临床症状,平稳、有效降低血压,提高临床效果。

耳廓再造术后听觉植入皮瓣并发症的临床分析及处理策略

目的探讨耳廓再造术后听觉植入手术患者的皮瓣并发症发生原因及处理措施。方法回顾分析2017年1月~2022年7月在首都医科大学附属北京同仁医院耳鼻咽喉头颈外科接受人工听觉植入体取出术的5例患者的临床资料,其中男性3例,女性2例;年龄14~36岁,中位年龄20岁。均为耳廓再造术与人工听觉植入术分期进行者,间隔时间为2~21年。听觉植入术后2~4个月后出现植入体暴露。所有患者均取出植入体,充分清创并减张后,将清洁骨粉填入骨床后分层减张缝合伤口。结果术后7~10 d间断拆线、切口一期愈合;经过6~70个月随访,未再发生皮瓣并发症。结论耳廓再造术后患者行人工听觉植入,需充分考虑覆盖植入体表面皮瓣的张力及血供情况;出现植入体暴露后需取出植入体并对骨床进行填塞修复、促进愈合。

Shin Ⅱ期、Ⅲ期外耳道胆脂瘤的个体化手术方式探讨

目的 探讨ShinⅡ期、Ⅲ期外耳道胆脂瘤(EACC)的手术方式选择及疗效。方法 回顾性分析2018年8月至2022年9月收治无锡市第二人民医院耳科病房的55例(56耳) ShinⅡ期、Ⅲ期外耳道胆脂瘤患者的临床资料。结果 根据胆脂瘤侵及的范围,Ⅱ期36耳均行耳内镜下EACC切除术,其中12耳同时行外耳道成形术,3耳同时行外耳道成形术+鼓室成形术;Ⅲ期18耳行耳内镜下EACC切除术+鼓室成形术+外耳道成形术,Ⅲ期2耳行乳突根治术+鼓室成形术+乳突缩窄术。术后3~10周干耳。所有患者术后随访5个月至2年,均未见胆脂瘤复发。结论 Ⅱ期EACC首选耳内镜下手术,术后恢复快、创伤小。Ⅲ期EACC的手术方式需根据术前高分辨率颞骨CT进行个性化选择。对于胆脂瘤广泛侵及乳突的Ⅲ期EACC宜采用显微镜下乳突改良根治术+鼓室成形术+乳突缩窄术,而乳突气房受累范围局限的Ⅲ期EACC,可采用耳内镜下外耳道胆脂瘤切除术+鼓室成形术+外耳道成形术,可达到良好的疗效。

个性化护理对耳畸形患儿行外耳再造术围术期的影响

目的探究在耳畸形患儿行外耳道再造术的围术期过程中应用个性化护理方法对患儿恢复的影响。方法简单随机选取2019年1月—2022年9月期间在福建省立医院接受外耳再造术的80例耳畸形患儿为研究对象,采用随机数表法分为两组,对照组40例在围术期过程中应用常规护理干预,研究组40例则给予围术期个性化护理干预。对比分析两组患儿护理前后的心理评分、患儿家属的护理满意度。结果护理前,两组心理情绪评分比较,差异无统计学意义(P>0.05);护理后,两组心理情绪评分均降低,且研究组的SAS评分、SDS评分(37.67±3.23)分、(40.76±3.22)分均低于对照组,差异有统计学意义(t=10.080、9.844,P<0.05)。研究组患儿家属的护理满意度为95.00%,高于对照组,差异有统计学意义(χ^(2)=5.165,P<0.05)。结论对耳畸形患儿行外耳道再造术的围术期过程中应用个性化护理的效果显著,可改善患儿的不良心理状态,提高护理满意度,具有一定临床应用价值。

3D打印技术在个性化一期耳廓再造术中的应用

目的:比较3D外耳模型与外耳模片在一期耳廓再造中的临床应用效果,探讨3D打印技术在一期耳廓再造中的临床应用价值。方法:回顾性分析2018年1月-2020年12月在郑州大学第一附属医院医学美容中心行自体肋软骨一期耳廓再造术患者43例,其中25例术前通过激光三维扫描技术,对患侧耳进行数字模型重建,并借助3D打印技术制备患侧3D外耳模型,以此为模板行一期耳廓再造术(3D组);18例行外耳模片行一期耳廓再造术(模片组)。结果:经6个月随访,两组患者术后均恢复良好,再造耳外形满意逼真,未出现感染,支架暴露等并发症。两组再造耳形态耳宽/健侧耳形态耳宽及再造耳耳垂宽/健侧耳耳垂宽比较差异有统计学意义(P<0.05);但两组再造耳容貌耳长/健侧耳容貌耳长、再造耳容貌耳宽/健侧耳容貌耳宽和再造耳耳垂长/健侧耳耳垂长比较差异无统计学意义(P>0.05)。结论:在3D打印技术辅助下制备合适的3D外耳模型使用自体肋软骨对小耳畸形患者进行耳廓再造,术后患侧耳与健侧耳匹配,形态逼真,值得在临床上推广应用。