简介：<正>Theskullbasegenerallyreferstotheanterior,middleandposteriorcranialfossaandstructuresontheoutsidesideoftheseskullareas.Thecranialroofandskullbaseareseparatedbyalineconnectingtheexternaloccipitalprotuberance,parietalnotchandsupraorbitalridge[1].Theskullbasesupportsthebrainabove,isconnectedto

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简介：Objective:Todescribeseveralapproachesofearsurgeriesforexperimentalstudiesinrats.Methods:Anesthetizedratswerepreparedfordemonstrationofvariousearsurgeryapproachesdesignedtooptimizeexperimentaloutcomesinstudieswithspecificgoalsandexposurerequirements.Thesurgicalapproachesincludedtheposteriortympanum,superiortympanum,inferiortympanumandoccipitalapproaches.Results:Themiddleearcavityandinnerearweresuccessfullyexposedfromdifferentanglesviathementionedsurgicalapproaches.Forexample,electrodeplacementforrecordingofcochlearbioelectricresponseswaseasilyachievedthroughtheposteriortympanumorinferiortympanumapproach.Alternatively,drugdeliveryorgenetransfectionviaroundwindowmembranewasmosteasilyaccomplishedusingtheposteriortympanumapproach.Cochlearperfusionofprotectiveorototoxicdrugswasbestperformedusingtheinferiortympanumapproach.Ossicularchaininterruptiontoinduceaprolongedconductivehearinglosswasreadilyachievedusingasuperiortympanumapproach.Lastly,surgicaldestructionoftheendolymphaticsactoinduceexperimentalendolymphatichydropswasreadilyperformedviaanoccipitalsurgicalapproach.Conclusion:Thesestandardizedsurgicalapproachescanbeappliedinscientificstudiesoftheearwithdifferentpurposescoveringelectrophysiology,conductivehearingloss,intra-cochleardrugperfusionandexperimentalstudiesrelevanttoMeniere’sdisease.

简介：ObjectiveToreportexperienceswithuseofotoendoscopyincerebellopontineangle(CPA)surgeries.MethodsTwentyfivecasesofCPAsurgeriesperformedbetweenNovember2002andDecember2008inwhichmicroscopeenabledotoendoscopywasusedwerereviewed.The25casesincluded19casesofacousticneuroma,3casesofCPAfacialnervetumors,1caseoftrigeminalneurinoma,acaseofglossopharyngealneuralgiaand1caseofhemifacialspasm.Endoscopywasusedinallcasestogetherwithmonitoringofbrainstemauditoryresponsesandfacialelectromyography.Postoperativehearingandfacialnervefunctionwereevaluatedandcomparedtopre-operativelevels.ResultsEndoscopyprovidedimprovedvisualizationoflocalanatomy,revealedhiddenlesionsandreducedunnecessaryanatomicaldistortions.Totalresectionwasachievedin18ofthe19acousticneuromacases,Facialnerveanatomicalintegritywaspreservedinall19cases.OneweekpostoperativeHouse-BrackmanngradingwasIin3cases,Ⅱin10casesandⅢin6cases.Facialnervefunctioncontinuedtoimproveinsomecasesat3months.Totaltumorresectionwasachievedinall3patientswithfacialneurinoma.Thefacialnervewassacrificedin2ofthe3caseswithprimaryfaciohypoglossalnerveanastomosis.FacialnervefunctionwasGradeⅡandGradeIIIoneyearaftersurgery,respectively.Inthecasewithanatomicallypreservedfacialnerve,postoperativefacialnervefunctionwasinitiallyGradeⅢandimprovedtoⅡat3months.ThetumorwascompletelyresectedinthetrigeminalneurinomapatientwithaGradeⅢpostoperativefacialnervefunctionwhichimprovedGradeIIthreemonthslater.Seventeenofthe19patientswithacousticneuromaretainedhearingpostoperatively,ofthese12maintainedpreoperativelevelsofhearing.Preoperativehearingcapacitywaspreservedin2ofthe3patientswithfacialnervetumors,butlostinpatientswithothertumortypes.Glossopharyngealneurotomy(n=1)andmicrovasculardecompression(n=1)resultedinsatisfactorysymptomrelie

简介：Background:Themeasurementofthepistonlengthduringstapedotomyisimportantanditmayhavesignificanteffectsonthesurgicaloutcome.Objective:Todeterminethepistonlengthinagroupofotosclerosispatientswhounderwentprimarystapedotomy.Materialandmethods:BetweenSep2013andSep2014,85patientswithdiagnosedotosclerosisunderwentprimarystapedotomy.Teflonprosthesisof0.6mmofdiameterwasusedinallpatients.Thedistancebetweenmedialsurfaceofthelongprocessofincusandcenterpointofthestapedialfootplatemeasured.Thepistonlengthcalculatedbyadding0.25mmforthethicknessoffootplateand0.50mmforplacementoftheprosthesisintothevestibule.Results:Thedistancebetweenstapedialfootplateandincusrangedfrom3.50to4.50mm.Themeandistancewas3.95±0.16mm.Inmajorityofcases(74.1%)pistonlengthwas4.75mmfollowedby4.50mmin15.3%and5.00mmin5.9%.Pistonlengthwas4.25mmin3.5%and5.25mminonly1.2%ofpatients.Therewasnosignificantpost-operativecomplicationandairbonegapclosureobtainedinallpatients.Conclusion:Themostcommondistancebetweenfootplateandincusis4.00mm.Nocaseneededapistonlongerthan5.25mmorshorterthan4.25mm.

简介：Aims:Thegoalofthepresentstudyistosummarizeourexperienceonsurgicalmanagementofretractionpockets(RP)asapreventivetoolagainstcholesteatomas.Methods:Twenty-fiveearshavebeenfollowedupforameanperiodof6.16±4.35years(from1to17years).Thesamplepresentedameanageof47.56±19.11years(from16to73years).Allpatientsunderwentcartilagegraftsurgery.Furthermore10(40%)underwenttympanoplasty(TPL)typeI,14(56%)TPLtypeIIand1(4%)TPLtypeV.Results:Elevenears(44%)showedcholesteatoma:allthesecaseswerestageIIIaccordingtoCharachonstaging,andstageIVorVaccordingtoGersdorffclassification.Twelvepatients(48%)showederosionoftheossicularchain.Ofthese,fivewereassociatedwithcholesteatomaandsevenonlywithretraction.Therecurrencerateofcholesteatomawas12%.NoneofthepatientswithastageIIorIIIRP(accordingtoGersdorffclassification)developedcholesteatoma.TherecurrenceofRPwas0%.Inregardstoliteraturereview,sevenreferenceswereselected.Thesestudiesshowedasuccessraterangingfrom79.1%to88%,whilerecurrencesofRPvariedfrom6.4%to13%.Onlyonestudyspecifiedarecurrencerateofcholesteatomaof28%.Conclusions:SurgicaltreatmentofstagesIIandIIIRPisaneffectivetooltopreventcholesteatomaformation.ThepresenceofkeratinaccumulationandcholesteatomaattheRP(stagesIVandV,accordingtoGersdorff)aretherealpredictorsofpoorprognosis.

简介：<正>InstituteofOtolaryngologyofChinesePLA(KeyLaboratoryforthePreventionofAcousticTrauma,PLA)KeyLaboratoryofHearingImpairmentScience(ChinesePLAMedicalSchool)MinistryofEducationLedbyfourgenerationsofleadershipfromlateProf.JIANGSichang(academician,ChineseAcademyofEngineering),Prof.YANGWeiyan(HonoraryPresident,DivisionofOtolaryngology

简介：Objectives:Facialnerveaberrationisthemosttroublesomesituationincongenitalmalformationsofmiddleear.Theaimofourstudyistoinvestigateitsimagingandclinicalfeaturesaswellasrelevantchoiceofsurgicaltechniquesforhearingimprovement.Methods:Aretrospectivestudyinvolvingreviewofclinicaldataof227patients(256ears)withcongenitalmiddleearanomalywasundertaken,includingpreoperativecomputedtomography(CT)data,surgicalrecordsandvideos.Results:Aberrationinvolvingintratemporalfacialnervewasfoundin82/256ears(32.03%)withcongenitalmiddleearanomaly.Themostcommonformsofaberrationincludedoverhangingovertheovalwindow(50/82ears,60.98%),bifurcation(3/82ears,3.66%)andtransverseoverthepromontory(3/82ears,3.66%),countingfor68.29%(56/82)ofthecaseswithfacialnerveaberration.Concomitantstapesmalformationwasfoundin76/82ears(92.68%)andatresiaorstenosisoftheovalwindowin27/82ears(32.93%).In9/82ears(10.98%)bothstapesandovalwindowwasabsent.Electivesurgeriesforthepurposeofhearingimprovementincludedstapodotomy+pistonimplantation,labyrinthotomy,labyrinthotomy+totalossicularreplacementprosthesis(TORP)implantationandVibrantSoundbridge(VSB)implantation.Conclusion:Themajorityoffacialnerveaberrationincongenitalmalformationofmiddleearinvolvesdisplacementoffacialnerve,inadditiontoconcomitantmalformationsofthestapesand/orovalwindow,whichmayinfluencethechoiceofsurgeryforhearingimprovement.VSBimplantationmaybeconsideredasausefuloption.

简介：Applicationofsurgicalendoscope,usedaloneorincombinationwiththesurgicalmicroscope,fortheoperativemanagementofearandtemporalboneconditionsmayallowimprovedaccessandclearanceofdisease.Preservationofnormalstructuresmayalsobeimproved.Astheuseofthistoolisincreasing,theneedforbetterunderstandingoftheanatomyoftheearisbecomingevident.Thisisparticularlysoforendoscopicsurgeryaimingatremovaloflesionsinvolvingtheinfra-cochlearcorridorand/orpetrousapex.Humantemporalbone-derivedlabyrinthcasts(molds),originallymadeforendolymphaticductandsacanalysiswhichgenuinelyrepresentthemembranouslabyrinthanditsadjacentsofttissues,weremorphometricallyanalyzedintermsoftheanatomicrelationsbetweenstructuresinandaroundtheinfra-cochlearcorridor.Thedistancebetweenthepetrouscarotidartery(PCA)andthebasalturnofthecochlea,thedistancebetweenPCAandinfra-cochlearvein(ICV)/cochlearaqueduct(CA),andthedistancebetweenthelowersurfaceofbasalcochlearturnandthepointwherethecarotidarteryandjugularvein(JV)meetclosetothejugularforamen,weremeasuredtobearound1.3mm,6mmand8mmrespectively,thusconstitutinganapproximate68mm2infra-cochlearcorridor.Thisanalysisandfurtherstudywithlargersamplesmightbehelpfulforoperationviathiscorridorledtothepetrousapexwherecholesterolgranuloma,cholesteatomaandotherlesionsarenotuncommon.

简介：LedbyfourgenerationsofleadershipfromlateProf.JIANGSichang(academician,ChineseAcademyofEngineering),Prof.YANGWeiyan(HonoraryPresident,DivisionofOtolaryngologyHeadandNeckSurgery,ChineseMedicalAssociation),Prof.HANDongyi(PresidentElected,DivisionofOtolaryngologyHeadandNeckSurgery,ChineseMedicalAssociation)tonowProf.YANGShiming(President,DivisionofOtolaryngologists,