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.

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.

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.

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.

Middle ear foreign body causing cholesteatoma and external auditory canal granuloma: a case report

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.

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.

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.

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

Clinical characteristics of patients with labyrinthine fistulae caused by middle ear cholesteatoma

Background Labyrinthine fistula （LF） is a very common clinical complication mainly caused by middle ear cholesteatoma. Whether the presence of different degree LF caused by middle ear cholesteatoma aggravates neurosensory hearing loss （NSHL） and what is the degree of the hearing loss caused by LF were still under controversial. This study aimed to investigate whether the LF degree is correlative with the age distribution, disease duration and hearing loss degree for cholesteatomatous patients. Methods The files of 143 patients with middle ear cholesteatoma were selected and reviewed in a retrospective study. Seventy-eight patients with LF were divided into three types according to the degree of destruction of labyrinth. Sixty-five patients without LF were randomly chosen for control. Then, we compared the clinical characteristics of patients with or without labyrinthine fistulae caused by middle ear cholesteatoma. Results According to the study, cholesteatomatous patients with LF were older and suffered longer disease duration than those without LF. Hearing loss is severe with high frequencies both in patients with and without LF. Moreover, inner ear impairment is correlative with the degree of destruction in labyrinth, and more severe destruction in labyrinth follow the more severe symptoms correlative with inner ear impairment. Conclusion Surgical intervention should be performed as early as possible for these cholesteatomatous patients.

Including video and novel parameter-height of penetration of external anal sphincter-in magnetic resonance imaging reporting of anal fistula

The main purpose of a radiologist’s expertise in evaluation of anal fistula magnetic resonance imaging(MRI)is to benefit patients by decreasing the incontinence rate and increasing the healing rate.Any loss of vital information during the transfer of this data from the radiologist to the operating surgeon is unwarranted and is best prevented.In this regard,two methods are suggested.First,a short video to be attached with the standardized written report highlighting the vital parameters of the fistula.This would ensure minimum loss of information when it is conveyed from the radiologist to the operating surgeon.Second,inclusion of a new parameter,the amount of external sphincter involvement by the anal fistula.This parameter is usually not included in the MRI report.This can be evaluated as the height of penetration of the external anal sphincter(HOPE)by the fistula.The external anal sphincter plays a pivotal role in maintaining continence.This parameter(HOPE)is distinct from the‘height of internal opening’and assumes immense importance as its knowledge is paramount to prevent damage to the external anal sphincter by the surgeon during surgery.

Spontaneous External Digestive Fistula of Tuberculosis Origin, Medical Treatment: About a Case at the Timbuktu Hospital

In the literature, the management of enterocutaneous fistula of tuberculosis origin is rare. The aim of this work was to report a case of external digestive fistula of tuberculosis origin in a 10-year-old girl in northern Mali in a situation of armed conflict. She was a 10-year-old patient who was admitted to our general surgery ward for external digestive fistula evolving for more than (4) four years, at admission the general. The karnofsky index was at 40%, she could not sit or hold a cup to drink water. A 3 cm enterocutaneous fistula deafened foul-smelling liquid stools, on clinical examination, the conjunctivas were pale, the lips were dry, the eyes were sunk in the eye sockets, the ribs visible from a distance. The paraclinical aspects (Itra-Dermo-Reaction (IDR) to tubercria, anatomopathology) were positive, specifying the place of medical treatment and evolution under medical treatment. Digestive fistula of tuberculosis origin is a rare condition in surgical settings.

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.

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.

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.

先天性外中耳畸形整形再造与功能重建诊疗体系的建设与进展

先天性外中耳畸形是头面部最常见的出生缺陷之一,临床主要表现为耳廓外观异常,常伴发传导性或混合性听力损失,除需关注外中耳畸形的诊断分类及整形再造外,还要同时考虑听觉功能的评估和重建。本文将从耳廓畸形的分类、耳模矫正、耳整形、耳廓再造、外耳道与中耳畸形的成形和再造以及功能性耳再造技术等方面,具体阐述先天性外中耳畸形功能耳再造诊疗体系的发展、建设历程以及相关技术进展。

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。

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。

耳穴压豆联合耳部全息铜砭刮痧治疗失眠临床观察

目的探析耳穴压豆联合耳部全息铜砭刮痧技术治疗失眠的临床效果。方法选取启东市中医院2021年11月—2022年11月收治的失眠患者70例,随机分为对照组和观察组,各35例。对照组给予耳穴压豆,观察组在此基础上增加耳部全息铜砭刮痧技术,比较两组治疗效果、睡眠质量、生活质量。结果观察组临床总有效率为97.14%(34/35),高于对照组的77.14%(27/35)(P<0.05)。治疗前,两组睡眠质量评分比较,差异无统计学意义(P>0.05);治疗后,观察组低于对照组(P<0.05)。治疗前,两组生活质量评分比较,差异无统计学意义(P>0.05);治疗后,观察组高于对照组(P<0.05)。结论在失眠的治疗中,耳穴压豆联合耳部全息铜砭刮痧技术临床效果理想,能够快速改善患者睡眠及生活质量,值得推广。