Presence of hBD-1 and hBD-2 in human cerumen and external auditory canal skin

CONCLUSION: Human beta-defensin-1 (hBD-1) and human beta-defensin-2 (hBD-2) antimicrobial peptides present in the cerumen, which is composed of exfoliated epithelial keratin and gland secretion, might provide the first line of defense against microbes in external auditory canal (EAC) skin. OBJECTIVES: Cerumen (earwax) plays a primary role in protecting the EAC skin and tympanic membrane. Even though the protection by antimicrobial peptides present in the skin secretion has been well established, little is known about the intrinsic role of the peptides in the EAC skin and cerumen. The aim of this study was to examine the presence of important antimicrobial peptides, hBD-1 and hBD-2, in the cerumen and EAC skin. MATERIALS AND METHODS: Cerumen was collected from 20 healthy adults, and the EAC skins were obtained from 12 patients who underwent middle ear surgery with canaloplasty. The presence of hBD-1 and hBD-2 was analyzed using immunohistochemistry and Western blotting. RESULTS: In the immunohistochemical study of the EAC skin, expression of hBD-1 and hBD-2 was observed in both the epithelium and the glands. The presence of hBD-1 and hBD-2 peptides in the cerumen was confirmed by Western blotting.     

A case of external auditory canal chondroma

The differential diagnosis for an external auditory canal mass is relatively broad, with exostosis, osteoma, fibroma, keratoma, and congenital cholesteatoma among the more common diagnoses. However, an additional diagnosis, external auditory canal chondroma, should also be considered in the differential. These rare lesions are most often found in individuals of Asian ancestry. However, this is not always the case as demonstrated by this case report of an external auditory canal chondroma in a Caucasian teenager.     

Pleomorphic adenoma of the external auditory canal

Pleomorphic adenoma of the external auditory canal is a rare disease. It is considered to derive from the ceruminous glands. The objective of this study is to familiarize the clinician with the clinical presentation and treatment of this disease. We report the case of a 58-year-old woman. Complete resection should be applied for cases in which magnetic resonanace imaging (MRI) and computerize tomography (CT) examination indicate no erosion in the bone and cartilage tissue. The patient should be seen regularly for recurrence.     

Ceruminous adenoma mimicking furunculosis in the external auditory canal

Tumors arising from the ceruminous glands are very rare. Herein, we report a case of ceruminous adenoma mimicking furunculosis in the external auditory canal (EAC), along with a discussion of the various pathological types and a review of their management.     

Morphological characteristics of external auditory canal in congenital aural stenosis patients

ObjectiveTo investigate characteristics of congenital aural stenosis (CAS) patients' external auditory canal (EAC) (position, length, orientation, etc.) and compare them with normal EAC.

Reconstruction of the external auditory canal using full-thickness rolled-up skin graft after lateral temporal bone resection for T1 and T2 external auditory canal cancer

ObjectiveTo present our results of the external auditory canal (EAC) reconstruction procedure using rolled-up full-thickness skin graft with tympanoplasty after lateral temporal bone resection (LTBR) for early-stage EAC carcinoma.Patients and MethodsA retrospective review of 15 patients who had undergone LTBR with reconstruction of the EAC for T1 and T2 EAC cancer between 2016 and 2020.ResultsPostoperative mean air-bone gap was 30.7 decibel hearing level. Although a few patients experienced chronic granulation, persistent otorrhea, and/or laterization of the tympanic membrane, most patients showed no serious complications related to the EAC reconstruction.ConclusionEAC reconstruction using a full-thickness skin graft in combination with tympanoplasty is useful for minimizing the hearing loss, maintaining the cosmetic appearance, and facilitating the observation into the ear cavity.     

改良耳道皮瓣耳道口扩大成形的研究

目的:探索耳内切口乳突根治术时行改良耳道皮瓣法扩大耳道口的新方法。方法:1999-2009年我科选择行开放式乳突根治术或同期行鼓室成形术的病例421例(428耳),随机分为A、B组。A组为对照组,行传统耳道皮瓣法;B组为改良组,行改良的耳道皮瓣法。所有病例观察术后的出血、渗出情况,干耳时间及1年后耳道口的变化情况。结果:统计学分析表明,改良组较对照组在术后出血、渗出、干耳时间及耳道口缩小方面均有显著性差异有统计学意义。结论:改良耳道皮瓣法扩大耳道口成形后,消灭了外耳道的创面,形成了无创面的耳道口,比传统皮瓣法有较多优点。     

Clinical management for T1 and T2 external auditory canal cancer

ObjectiveThe purpose of this study was to clarify the impact of superficial parotidectomy and postoperative radiotherapy (PORT) for the surgical treatment of early stage squamous cell carcinoma (SCC) in external auditory canal (EAC).Materials and methodsThirty-seven patients with T1 (n = 14) or T2 (n = 19) SCC in EAC treated between 2000 and 2016 at Kobe University Hospital were enrolled in this study. Thirty-three patients were operated with sleeve resection or lateral temporal bone resection.ResultsThe 5-year overall survival and disease-specific survival rates were 95% and 100%, respectively. Surgical margin was positive in 4 patients, who were treated by PORT and have been alive without disease. Prophylactic superficial parotidectomy was simultaneously performed at the time of initial surgery in 15 patients, in whom no lymph node (LN) metastasis was observed. Among the other 22 patients, regional recurrence in parotid LN was observed in one patient, who was successfully salvaged by total parotidectomy. Potential parotid lymph node metastasis rates of T1 and T2 SCC in EAC was 0% (0/14) and 5% (1/19) respectively.ConclusionsComplete resection without positive surgical margins is essential for the treatment of the patients with T1 and T2 ear cancers. Prophylactic superficial parotidectomy or neck dissection is not mandatory for T1 and T2 diseases, as long as precisely extent of disease is assessed preoperatively. PORT should be performed for the patients with positive surgical margins.Levels of evidence: 4.     

广基型外耳道乳头状瘤切除合并耳道成形

目的 提高广基型外耳道乳头状瘤手术疗效,防止复发及外耳道狭窄。方法 对21例广基型外耳道乳头状瘤采用显微镜下切除合并外耳道成形加带蒂或游离皮瓣移植治疗。结果 随访2年,21耳均无复发及外耳道狭窄。结论 显微镜下切除合并外耳道成邢加带蒂或游离皮瓣移植治疗广基型外耳道乳头状瘤可减少复发,避免中耳损伤,防止外耳道狭窄。     

伴皮肤窦道的先天性外耳道狭窄及胆脂瘤的诊断与治疗

目的 探讨先天性外耳道狭窄合并胆脂瘤的临床特征,提高其诊治率.方法 回顾性分析2003年3月至2006年6月间收治的伴有窦道形成的先天性外耳道狭窄合并胆脂瘤患者的临床资料,共10例(10耳).结果 10耳均有耳后皮肤破溃流脓史,外耳道口直径约2 mm,颞骨CT显示10耳均有外耳道区域骨质吸收缺损,致骨性耳道增宽,增宽的外耳道内被软组织密度影填充.术中见10耳之外耳道内均充满胆脂瘤,且伴有耳道后上壁及下壁骨质压迫吸收.10耳均行外耳道成形术,其中8耳同时行听力重建术.术后病理报告均为胆脂瘤组织,未见腮裂囊肿及瘘管组织.10耳术后外耳道均通畅,行听力重建术的8耳,听力改善(听力级)20～35 dB.随访1～3年,未见胆脂瘤复发.结论 先天性外耳道狭窄伴发胆脂瘤者,其外耳道骨壁极易受累及,从而出现外耳道骨壁缺损及耳后或颈部窦道形成,颞骨CT检查可发现外耳道骨壁缺损及胆脂瘤密度影.     

A case of hemodialysis-associated amyloidosis localized to the external auditory canal

Amyloidosis of the external auditory canal is extremely rare. Only 12 cases, including the present case, have been reported, and this is the second reported case attributed to dialysis. This case involved a 56-year-old man who had been on dialysis for 12 years. A tumor was visible in the right external auditory canal and caused pain. The tumor was resected at another hospital, but subsequently recurred with rapid increase in size due to infection. We therefore performed further resection at our hospital. We report our experiences herein, together with a discussion of the literature.     

Diagnosis and treatment of carcinoma in external auditory canal

ObjectivesTo evaluate outcomes in treating carcinoma of external auditory canal (EAC) and to analysis factors which effect the prognosis of this disease.MethodsA retrospectively review of 16 patients treated for carcinoma of EAC at our department between April 2000 and April 2014 was conducted. All patients underwent surgical treatment and the diagnosis confirmed by pathological examination.ResultsThere were adenoid cystic carcinoma (ACC) in 8 patients, squamous cell carcinoma (SCC) in 5 patients, adenocarcinoma (AC) in 2 patients, and verrucous carcinoma (VC) in 1 patient. The tumors were classified as Stage I in 4 cases, Stage II in 2 cases, Stage III in 3 cases, and Stage IV in 7 cases. Five patients underwent extensive tumor resection (ETR), 2 patients underwent lateral temporal bone resection (LTBR), 5 patients underwent modified LTBR, 2 patients underwent subtotal temporal bone resection (STBR), and 2 patients underwent only open biopsy. Besides, adjunctive procedures, including neck dissection, parotidectomy and pinna resection were performed when indicated. Ten patients received postoperative radiotherapy. By the end of follow up, two patients had died of their disease, 2 lost to follow up, 2 survived with the disease, and the rest survived disease-free. The median follow-up period was 24 months.ConclusionComplete tumor resection appears to be an effective treatment for carcinoma of the EAC. Patients with SCC seem to have worse prognosis than those with ACC. Radiation therapy seems less effective for the disease than surgical treatment.     

外耳道胆脂瘤的诊断和治疗

目的探讨外耳道胆脂瘤的临床特征和治疗方法。方法回顾性分析1990年1月至2005年1月期间共42例（44耳）外耳道胆脂瘤的临床资料。结果本组因外耳道骨性狭窄所致2耳，骨瘤阻塞所致2耳，其余主要与炎症、耵聍、挖耳损伤等有关。按Holt分期，Ⅰ期7耳．Ⅱ期22耳，Ⅲ期15耳。单纯外耳道胆脂瘤清除术25耳（门诊20耳）中．随访1-5年，外耳道胆脂瘤复发3耳，1耳上鼓室侵犯行改良乳突根治术；9耳伴有外耳道肉芽者，行外耳道肉芽切除术及外耳道胆脂瘤清除术后恢复良好，2耳伴有外耳道狭窄行外耳道成形术；改良乳突根治术5耳．乳突根治术2耳，随访6月～11年，无胆脂瘤复发，1耳术后外耳道口狭窄；先天性外耳道狭窄行外耳道成形术1耳，外耳道骨瘤切除及鼓膜成形术1耳，乳突骨瘤切除并外耳道成形术1耳。结论外耳道胆脂瘤多为自发性．具有破坏性，治疗原则是早期彻底清除胆脂瘤。     

角化细胞生长因子及受体在鼓膜穿孔邻近皮肤的研究

目的观察鼓膜穿孔部位邻近皮肤中角化细胞生长因子（keratinocyte growth factor,KGF）及其受体角化细胞生长因子受体（keratinocyte growth factor receptor,KGFR）的表达情况,分析其在慢性化脓性中耳炎不同转归中的作用。方法应用免疫组化SP染色方法和多媒体图像分析系统,观察20例继发性胆脂瘤型中耳炎鼓膜穿孔部位邻近皮肤、胆脂瘤上皮以及耳道深部正常皮肤的KGF和KGFR表达,并和20例非胆脂瘤型中耳炎鼓膜穿孔部位邻近皮肤作对比。结果胆脂瘤型中耳炎鼓膜穿孔邻近皮肤KGF和KGFR的阳性表达率分别为（33.135±6.364）%和（19.965±10.570）%,介于胆脂瘤上皮与耳道正常皮肤之间,明显高于非胆脂瘤型中耳炎患者相应部位（19.380±2.827）%和（13.145±7.935）%。结论KGF和KGFR在慢性化脓性中耳炎不同部位的表达依次上升,在胆脂瘤型中耳炎鼓膜穿孔邻近皮肤的表达明显高于非胆脂瘤型中耳炎,说明胆脂瘤型中耳炎该处皮肤增生更活跃。