简介：Objective:Theototoxicityofpovidone-iodinehasbeendocumentedinanimalstudies.However,thereislimitedevidenceoftheseototoxiceffectsinhumans.Thisisthefirstreporttoshowtheototoxiceffectsofpovidoneiodineinahumansubject.Patient:A36-year-oldwomancametoourhospitalcomplainingofleftunilateralpersistenthearingloss.Onemonthbeforepresentation,herchildhadaccidentallystruckheronherleftear.Sheappliedapproximatelythreedropsofpovidone-iodine(10%weight/volume)intoherleftauditorycanal.Immediatelyafterapplication,shefeltseverepainandvertigo.Anaudiogramrevealedsevereleftunilateralsensorineuralhearingloss.Magneticresonanceimagingshowedmildenhancementoftheleftvestibuleandbasalturnoftheleftcochlea.Conclusions:Evenasingleapplicationofpovidone-iodinecouldcausesignificanthearinglossanddisequilibrium.Itshould,therefore,beusedwithcaution.

简介：Pilotspatialdisorientationisaleadingfactorcontributingtomanyfatalflyingaccidents.Spatialorientationistheproductofintegrativeinputsfromtheproprioceptive,vestibular,andvisualsystems.Vestibularneuritis(VN)canleadtosuddenpilotincapacitationinflight.VNiscommonlydiagnosedbydemonstrationofunilateralvestibularfailure,asunilaterallossofcaloricresponse.Asthistestreflectsthefunctionofthesuperiorpartofthevestibularnerveonly,casesofpureinferiornerveneuritiswillbelost.ThispaperdescribesafighterpilotwithsymptomssuggestiveofVNbutwithnormalcalorictestresults.Furthertestshowedunilaterallossofvestibularevokedmyogenicpotential.Webelievethatthepilotsufferedfrompureinferiornervevestibularneuritis.VEMPplaysamajorroleinthediagnosisofinferiornervevestibularneuritisinpilots.Aeromedicalconcernsarealsodiscussed.

简介：Congenitalcholesteatoma(CC)isararelyseenbenigntumorofthetemporalbone.Therearefivegeneralsitesofextraduraloccurrence:themiddleear,externalauditorymeatus,mastoid,squamousportionandthepetrousapexofthetemporalbone.CCgrowsslowlyandpresentsnosymptomsattheearlystage.Delayedandmis-diagnosisarecommonwiththiscondition~1.CasereportA10-year-oldboypresentedwitha3-monthhistoryofhearinglossonrightside.Therewasnohistoryofotorrhea,facialpalsy,previousotologicalproceduresortrauma.Otoscopyrevealedabulgingposterosuperiorquadrantintheotherwiseintactrighttympanicmembrane(Fig.1).Puretoneaudiometryshowedanaveragethresholdof51dBfor500,1000,2000and4000Hz,witha40dBair-bonegap,suggestingamoderateconductivehearingloss(Fig.4).CTscanofthetemporalboneshowedanisolatedsofttissuedensitylesioninthemiddleear(Fig.2).

简介：ObjectiveTostudyclinicalcharacteristicsofendolymphaticsactumor(ELST)anditsdiagnosisandtreatment.MethodsELSTwasdiagnosedin6casesbasedonsurgicalandhistologicalfindings.Thesecaseswerereviewedfortheirclinicalmanifestations,differentialdiagnosisandsurgicaltreatmenttechniques.ResultsTherewere1maleand5femalesinthisgroup,agedfrom28to59years(meanage=38.7years).Thetumorwasinleftearin4casesandinrightearintheother2cases.Diseasecoursesrangedfrom5to30years(meanduration=12.6years).Clinicalpresentationsincludedsensorineuralhearingloss(n=4),otorrheaandtinnitus(n=2),tinnitusandfacialspasm(n=1),otorrheawithfacialparalysis(n=1),andhearinglosswithtinnitus(n=2).NoneofthecaseswasdiagnosedasELSTpreoperatively.Twocasesweremisdiagnosedasglomusjugularetumor,2aschronicsuppurativeotitismedia,1assweatglandadenomaonbiopsyand1astemporalbonetumor.Tumorsweresurgicallyresectedinall6casesviathemastoidectomy(n=2)orcombinedoto-cervicalorcranio-oto-cervicalapproaches(n=4).Postoperativecerebrospinalfluidotorrheaoccurredin1case.Thetumorswereconfirmedonhistologicalexaminationtobealow-gradeadenocarcinoma.Allpatientshavesurvivedatthetimeofthispaper.ConclusionELSTisrareandcommonlymisdiagnosedandinadequatelytreated.Itsprognosisisrelativelyfavorablebecauseofitsslowgrowthrate.

简介：ObjectivesTostudyclinical,imagingfeaturesandtreatmentoutcomesofcongenitalcholesteatomaofmiddleear(CCME).MethodsThisisaretrospectivereviewof10CCMEcasesselectedfrom952cholesteatomacasestreatedbetweenJanuary1995andDecember2005attheDepartmentofOtolaryngology-HeadandNeckSurgery,ChinesePLAGeneralHospital.Themainoutcomemeasureswerethesiteoforigin,clinicalfeatures,surgicalfindings,imagingcharacteristicsandhearingresults.ResultsThemeanageofthe10patientswas16years(rangedfrom10to24years),with6beingolderthan18years.Therewere7malesand3females.Theaveragedelaytodiagnosiswaslongerthan2years.ThemeanpreoperativePTAwas55dBHL,withameanABGof45dB.Typicalcholesteatomaswereseenbehindthetympanicmembraneinthesuperoposteriorquadrantonotoscopyonlyin2patients.HighresolutionCTwascompletedinallpatients.Mostofthepatients(8/10)werediagnosedwithotosclerosisorossicularabnormalitybeforeoperation.Allpatientsunderwentaone-stagetympanoplastyfollowingtransmeatalexplorativetympanotomyandcompletecholesteatomaremoval,exceptone,whounderwentaCWUmastoidectomyduetoextensivecholesteatomainvolvement.Thecholeasteatomalesionwasconfinedtothesuperoposteriormesotympanuminallpatients.ThemeanpostoperativePTAwas20dBHL.Allpatientswerefollowed-upforatleast1.5yearspostoperatively.Revisionprocedureswereperformedin2patientsforhearingdeterioration.Noresidualorrecurrenceofcholesteatomawasfound.ConclusionCCMEisararediseasethatoftengetsdelayeddiagnosis.Residuallesionsandtheprognosismainlydependontheextentofthelesion.

简介：ObjectiveToreportapopulation-basedsurveyontheprevalence,pathogenicfactorsandmedicalneedsofeardiseasesandhearingloss.MethodsUsingtheprobabilityproportiontosize(PPS)method,6626residentswereinvestigatedin30clustersinaccordancewiththeWHOprotocol.ResultsTheprevalenceofhearinglosswas17.1%(compatiblewiththenatioanalstandardizedrateof17.6%),includingmild(11.0%),moderate(4.2%),severe(1.4%),andprofound(0.5%)impairment.Ofthe1131individualswithhearingloss,663(20.2%)weremaleand468(14.0%)werefemale.Theprevalenceofhearingdisabilitywas6.1%(againcompatiblewiththenationalstandardizedrateof6.5%).Thecausesofhearinglosswereeardiseases(31.4%),non-infectiouseardisorders(42.5%),geneticdisorders(6.7%),infectiousdisease(0.4%)andundeterminedcauses(29.3%).Ofthehearingimpairedpeople,13.8%neededotologicand/oraudiologicinterventionsand9.1%neededhearingaids.ConclusionTheprevalenceofhearinglossandhearingdisabilityhaveincreasedinthepasttwentyyears.Thedataprovideimportantinformationforauthoritiesinformulatingpoliciesforpreventionandmanagementofdeafness.

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简介：Wereportacaseofcapillaryhemangiomsathatinvolvedtheentiremiddleearspace,externalauditorycanal(EAC)andtympanicantrum.Symptomsinthecaseincludedearfullness,hearingloss,otalgiaandotorrhea.Thecasewasmisdiagnosedasrecurrentchronicotitismediawithgranulationpreoperatively.Adiagnosisofcapillaryhemangiomawasestablishedbypostoperativehistologicalexamination.Themanagementofcapillaryhemangiomaofthemiddleearandexternalauditorycanalisdiscussed,withareviewoftheliterature.Becauseofitsvariableandsometimesmisleadingclinicalpresentation,hemangiomacaninitiallybemisdiagnosedasotherlesions.Therefore,ahighindexofsuspicionisnecessaryforearlyandaccuratediagnosis.

简介：Chronicinflammatorydemyelinatingpolyneuropathy(CIDP)isaprogressiveautoimmunedisorderthattargetsperipheralnerves.Itcommonlypresentswithmotor-predominantdysfunctionandenlargementofcranialnerves.Withregardstohearingloss,afewcasesofsensorineurallosshavebeendescribed.WepresentanovelcaseofconductivehearinglosscausedbyamassonthetympanicsegmentofthefacialnerveinthesettingofCIDP.

简介：IntroductionSuddensensorineuralhearingloss(SSNHL)isdefinedasahearinglossofatleast30dBoverthreecontiguousfrequenciesoccurringinlessthan3days[1].VertigoandprofoundhearinglossareconsideredpoorprognosticfactorsinSSNHL[2-4].ThemostcommondiseasesassociatedwithvertigoinSSNHLincludeBPPV,vestibularneu-[3]

简介：ObjectivePorencephaliccystpresentingwithotologicinvolvementisuncommon.Onlyafewcaseshavebeenreported.Wereportararecaseofcerebrospinalfluid(CSF)otorrheacausedbyamassiveporencephaliccystencompassingthelefttemporalandoccipitallobes.TheCSFleakwasrepairedsuccessfullyusingatransmastoidapproachwithfacia,abdomenfatandfibringluetosealtheosseousdefectsinthesinoduralangle.AreviewoftheliteratureconcerningporencephaliccystandCSFotorrheaisalsopresented.

简介：ObjectivePatientswithunilateraleardischargeandhearinglossoftenhaveexternalormiddleeardiseases.Wepresenta55-year-oldmanwhosufferedfrompersistenteardischargeandhearinglossintheleftear.Localfindingsshowedthathisleftearcanalwasfilledwithalargeamountofgranulationtissue,withpurulent,foul-smellingdischarge.Computedtomographyindicatedleftmiddleearcholesteatomaandmassshadowintheleftexternalauditorycanal.Modifiedradicalmastoidectomywasperformed.Apieceofwhiteplasticstickwasfoundinthemiddleearduringtheoperation.Foreignbody-inducedcholesteatomaandexternalauditorycanalgranulomainadultsareveryrare.Wepresentthisrarecasesothattheseconditionscanbebetterrecognizedandunderstood.

简介：AlportsyndromeisanX-linkedsyndromethatresultsinnephritis,renalfailure,sensorineuralhearingloss,andeyedeficits.Asaresultofsensorineuralhearingloss,theseindividualsarelikelytoexperiencedifficultiesintheareaofspeechandlanguage.Whilestudiesinthepasthaveexaminedthespeechandlanguagecharacteristicsofchildrenwithsyndromicsensorineuralhearingloss,toourknowledgetherearenopreviousstudiestohavedocumentedthespeechandlanguagecharacteristicsofthesechildrenonalong-termbasis.Thecurrentstudyaddressesthislimitationbyreportingspeech,language,hearing,andfunctionoftwinbrotherswithX-linkedAlportsyndromeacrossaseven-yearperiod.Informationwascollectedbyexaminingthemedicalrecordsoftheparticipantsaswellasthroughaverbalinterviewwiththeparticipants'guardian.Resultsrevealedthattheparticipants'hearingabilitiesgraduallydeterioratedovertheseven-yearperiodwhichaffectedtheirspeechandlanguagedevelopmentaswell.Thekidneyfunctiontestsrevealedsignificantpresenceofhematuria(bloodintheurine)aswellasproteinuria(proteinintheurine)suggestingchronickidneydysfunction.Thislongitudinalstudydemonstratesthefunctionalrelationshipbetweenthekidneysandthecochlea,althoughtheyappeartobeindependentofoneanother.AsindividualswithAlportsyndromeexhibitsystemiccomplications,interdisciplinarycollaborationisessentialamonghealthcareprovidersincludingaudiologists,speech-languagepathologists,nephrologists,andophthalmologisttopromoteevidence-basedpractice.

简介：Thestudyreportsacaseofa5-year-oldChinesegirldiagnosedwithKabukimake-upSyndrome(KMS).ThepatientshowedclassicKMSappearance:widelyseparatedeyes,ectropionoflateralone-thirdlowereyelids,flatnasaltip,andprominentears.Auditoryfeaturesinthisindividualincludedbilateralseveresensorineuralhearinglossandlackof40HzAERPresponsesidentifiedatIyearofage.Theindividualreceivedcochlearimplant(CI)intheleftearwhen5yearsold.andrehabilitationafterCItreatmentwere3inspeechintelligibilityand5inauditoryperformance.Thus,ourfindingssuggestthatcochlearimplantmaybehelpfultorestorehearingforindividualswithKabukisyndrome.

简介：Metastasisoflungcancertothetemporalboneisaveryrarediseaseandsubjectivetinnitusasthepresent-ingsymptominthesepatientsisevenrarer.Herewereportacaseinwhicha42-year-oldmalepresentedwithsubjectivetinnitusofthreemonths,withnopulmonarydiseasesymptoms.Puretoneaudiometryindi-catedmoderateconductivedeafnessinleftearwithanair-bonegapof21.3dB.HRCTtemporalbonescan-ningindicatedhigh-densityshadowsintheleftepitympaniccavity,sinustympaniandmastoidcavity.Chron-icotitismediawithcholesteatomawassuspectedandsurgicaltreatmentrecommended.However,preopera-tivechestx-rayrevealedhigh-densitymilletlesionsscatteredwidelyinbothlungs.HRCTlungscanningconfirmedthelungslesionsandindicatedlungcancer.Inordertodeterminecorrelationsbetweenthetempo-ralboneandpulmonarylesions,aCT-guidedtrans-mastoidaspirationbiopsyandimmunohistochemicalstudywereconducted,whichconfirmedthatthetemporalbonelesionwasmetastaticfromthelungs.Thepa-tientwasgivenaseriesofchemotherapyimmediatelyandhistinnitussignificantlyimprovedafterthreemonthsoftreatment,withfullrecoveryofhishearingandcompleteresolutionofshadowsinthemastoidcavity.Unfortunately,hesubsequentlydevelopedmultiplebonemetastasesinthe9thmonthandcerebralmetastasisinthe18thmonth.Multipleorganfailureresultedindeathin2.5years.

简介：Objective:Toreportascalatympanidrill-outtechniqueformanagingmalformedfacialnervecoveringtheentireovalwindow(OW).Methods:DatafromthreecaseswithOWatresia,malformedstapesandabnormalfacialnervecourseswerereported,inwhichascalatympanidrill-outtechniquewasemployedwithaTORPbetweenthetympanicmembraneandscalatympanifenestrationforhearingreconstruction.Results:Airconductionhearingimprovedintwoofthethreecasesfollowingsurgery.Inthethirdcase,therewasnoimprovementinairconductionhearingfollowingacanalwallupmastoidectomyandtympanoplasty.Therewerenovertigo,tinnitusorsensorineuralhearinglossinthethreecases.Conclusion:Thescalatympanidrill-outtechnique,whichisbasicallyfenestrationattheinitialpartofthebasalturn,providesachoiceinhearingreconstructionwhentheOWiscompletelycoveredbyabarrentlycoursedfacialnerve.