Quantitative imaging analysis of transcanal endoscopic Infracochlear approach to the internal auditory canal

Purpose

A transcanal endoscopic infracochlear surgical approach to the internal auditory canal (IAC) in a human temporal bone model has previously been described. However, the proportion of patients with favorable anatomy for this novel surgical technique remains unknown. Herein, we perform a quantitative analysis of the transcanal endoscopic infracochlear corridor to the IAC based on computed tomography.

Endoscopic classification of the external auditory canal for transcanal endoscopic ear surgery

ObjectiveEvaluation of an endoscopic anatomic classification of the external auditory canal (EAC) for transcanal endoscopic ear surgery.Materials and methodThe EAC Canal Endoscopic Scale (CES) was initially defined according to total or partial EAC narrowing on 0° transcanal endoscopy. A retrospective study was then conducted between September 2013 and March 2015 in a series of consecutive patients fulfilling the study inclusion criteria.ResultsA total of 83% of 5000 patients (10000 ears) were classified as CES 0: i.e., total visualization of the tympanic membrane. Various kinds of EAC narrowing were described. Results were comparable between right and left ears.Conclusions0° endoscopy provided total visualization of the tympanic membrane in most cases, thanks to its magnified lateral view. Preoperative CES classification allows use of angled endoscopes, curved instruments or drilling for canalplasty to be planned in the first step of transcanal endoscopic ear surgery.     

经耳道皮下径路人工耳蜗植入术

目的:探讨经耳道皮下径路爱益声人工耳蜗植入手术的可能性.方法:40例双耳重度或极重度聋患儿采用经耳道皮下径路行爱益声人工耳蜗植入,术中行电极阻抗测试和电诱发听性脑干反应,术后拍耳蜗位X线片,术后4周开机验证电极植入位置及工作情况.结果:所有患儿电极全部顺利植入耳蜗内,人工耳蜗装置工作状态正常,术后随访6个月无电极脱出或其它严重并发症发生.结论:爱益声人工耳蜗可以安全地经耳道皮下径路植入.     

Five cases of chondroma involving the external auditory canal

A cartilaginous tumor located in the external auditory canal is a rare finding. Only 48 cases of chondromas of the external auditory canal have been documented in the literature. The natural course of these tumors as well as the diagnosis and management has not been well established.We have encountered five cases of external auditory canal chondroma. The patients consisted of three males, ages 12, 14, and 29, and two females, ages 2 and 3, respectively. Otoscopic examination demonstrated a tiny firm tumor protruding from the anterior wall of the bony external auditory canal. Surgery was performed all cases, and the tumor proved to be a chondroma histologically. All cases could be approached through the ear canal. The postoperative courses were uneventful and no recurrences were found during the follow-up periods.From our experiences, it is important to recognize that chondromas are in the differential of small exophytic tumors on the anterior or superior wall of the external auditory canal and can be removed safely and effectively through the transcanal approach.     

外耳道癌和中耳癌诊断、治疗的探讨

为探讨外耳道癌及中耳癌的诊断、治疗，对１７例患者的临床资料进行了分析，分析表明外耳道癌与中耳癌的症状相似，主要有耳内疼痛、耳漏及听力下降，大多数常两处同时受侵作为在原发病灶复致死外，尚未见其它因素对本病的预后有明显影响。鉴于手术治疗对局部解剖结构破坏性大，且对浸润范围较广泛的癌，多娄吓亦难以将其切除干净，故主张；（１０对局限于我耳道或中耳腔癌，可先行耳道切除或扩大乳突根治术加术后放疗；（２）对略超     

Isolated myxoma of the external auditory canal

The majority of neoplasms within the external auditory canal are benign. Management of these primary tumors and their local recurrences are discussed herein. We present a case of an isolated myxoma of the external auditory canal with a review of the common histopathological and radiographic features. Although rare, this highlights the possibility of encountering benign tumor types that carry associated morbidity or mortality due to manifestations outside of the head and neck. Laryngoscope, 124:1220–1222, 2014     

Tick bites in the external auditory canal

We report a case of Ixodes ovatus tick in the external auditory canal. Chief complaints of earfullness and pruritis appeared after the contact with dog. Using a removal method consisting of excising the abdomen of the tick and suctioning its body fluids, followed by removal of the tick body 3 days later, the patient was successfully treated without the development of complications.     

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.     

Classification of the external auditory canal cholesteatoma

OBJECTIVES/HYPOTHESIS: The external auditory canal cholesteatoma (EACC) is a rare disease in the field of otolaryngology. Only 1 in 1,000 new otologic patients present with this entity, which was first described by Toynbee. The aim of this article is to classify EACC by different histopathologic and clinical findings of patients presenting to the Department of Otolaryngology at the University of Mannheim, Germany. METHODS: From 2000 to 2004, 17 patients presented to our clinic with EACC. The cholesteatoma were treated surgically, and the specimens were investigated histologically. Clinical findings were also recorded. We classified four stages: stage I with hyperplasia of the canal epithelium, stage II including periosteitis, Stage III including a defective bony canal, and stage IV showing an erosion of adjacent anatomic structure. RESULTS: Eight patients presented with stage II, five patients with stage III, three with stage I, and only one patient presented with erosion of the mastoid cells, which was determined as stage IV. CONCLUSION: In summary, our classification serves to describe the different histopathologic and clinical stages of EACC.     

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.     

Repair effect of xenogeneic acellular dermal matrix during external auditory canal reconstruction after canal wall down mastoidectomy

Abstract

Background: In some cases, there is insufficient external auditory canal (EAC) skin to cover the reconstructed canal wall after canal wall down (CWD) mastoidectomy. Acellular dermal matrix (ADM) can help to repair the skin, mucosa and other epidermal tissue defects.

Aims: To investigate the repair effect of xenogeneic ADM (xeno-ADM) for EAC skin defects.

Material and Methods: We retrospectively analyzed 28 patients who underwent open mastoidectomy combined with canal wall reconstruction and mastoid obliteration in our hospital. The xeno-ADM was used to repair the EAC skin defect. The epithelialization time, dressing change times, complications and hearing improvement post-operation were summarized and analyzed.

Results: Reasons for using xeno-ADM included: 11 (39.3%) cases suffered from extensive middle ear cholesteatoma, three (10.7%) cases suffered from advanced EAC cholesteatoma, eight (28.6%) cases to solve the cavity-related problems, and six (21.4%) patients had a narrow EAC. The postoperative epithelialization time was 5.8?±?1.6?weeks, and the number of dressing changes was 4.8?±?1.6 times. There was no xeno-ADM rejection and related complications, the postoperative hearing improvement was statistically significant (p?=?.013).

Conclusions and Significance: Xeno-ADM could be a safe, effective and simple method for repairing skin defect in the reconstruction of EAC after CWD mastoidectomy.     

外耳道狭窄或闭锁的手术治疗

目的：探讨外耳道狭窄手术治疗的经验及体会。方法：回顾性分析我科10例外耳道狭窄或闭锁患者的临床资料,其中单纯骨部狭窄1例、软骨部病变3例、软骨部＋骨部病变2例、外耳道及中耳病变4例。本组6例患者采用耳道内切口入路或（和）耳后切口入路去除狭窄性病变,扩大外耳道腔;4例合并慢性中耳炎患者则同时行鼓室成形术。结果：所有患者随访8~50个月,8例患者恢复良好,2例患者再次出现外耳道狭窄或闭锁。结论：外耳道成形术要选择合适的手术入路,彻底清除狭窄性病变。     

Endoscopic resection of a chorda tympani schwannoma: A novel approach for an exceedingly rare entity

We present a novel approach for a rare chorda tympani schwannoma. A case report as well as special considerations in all phases of care are reviewed. Laryngoscope, 129:1188–1190, 2019     

Fibro-osseous lesions of the external auditory canal

OBJECTIVES: To differentiate a novel type of benign circumscribed bone lesion of the external auditory canal from those described previously, such as exostoses and osteomas. STUDY DESIGN: Information was obtained from computed tomography (CT) images, surgical findings, and pathologic study. METHODS: Five patients (26 to 82 years old) who presented a hard, round, unilateral, skin-covered mass occluding the external auditory canal to varying degrees were studied. A CT study carried out before resection of the lesions by curettage disclosed the absence of a bony connection to the underlying structures. All the tissue specimens underwent pathologic study. RESULTS: CT and surgical findings demonstrated the absence of a connective pedicle. The pathologic findings showed lesions consisting of an osteoma-like bone formation with sparse osteoblastic areas; mature lamellar bone was observed in three cases, bone marrow containing adipose tissue and hematopoietic remnants in two, and a dense, collagenous stroma in another. They all showed irregular trabeculae, bordered by osteoid osteoblasts. In no case was there evidence of a relationship to the cartilaginous tissue or to the bony structures of the external auditory canal. CONCLUSIONS: The data obtained from the clinical, CT, surgical, and pathologic findings suggest the existence of a lesion unlike those previously known, possibly related to ossifying reactions in other parts of the organism.