Bone-Conducted Sound Lateralization of Interaural Time Difference and Interaural Intensity Difference in Children and a Young Adult with Bilateral Microtia and Atresia of the Ears

Objective—We used multi-slice helical computerized tomography (MSHCT) to evaluate the 3D characteristics of the laryngeal structures in patients with unilateral vocal fold paralysis (UVFP) during phonation, and compared the results with those obtained using an aerodynamic vocal function test. Material and methods—The subjects were 37 patients with UVFP. The region over the larynx was scanned during quiet phonation and again during inspiration using MSHCT, and 3D endoscopic and coronal reconstruction images were produced. Maximum phonation time (MPT) and mean airflow rate (MFR) during phonation were measured. Results—During phonation, the affected fold was thinner than the healthy fold in 30 subjects and located at a higher position than the healthy fold in 21 subjects. Abduction or thinning of the affected fold during phonation (paradoxical movement) was seen in seven subjects. MFR was significantly greater when the affected fold was thinner than the healthy fold during phonation, and MPT was significantly shorter when the affected fold showed paradoxical movement. Over-adduction of the healthy fold during phonation was present in 15 subjects. There were no significant differences in MPT or MFR between subjects with and without over-adduction. Conclusion—The combination of MSHCT endoscopic and coronal reconstruction images enables the 3D characteristics of the unilaterally paralyzed larynx to be visualized during phonation, and some of these characteristics are significantly correlated with vocal function in patients with UVFP.     

复方倍他米松联合盐酸利多卡因辅助治疗突发性聋的疗效观察

目的 探讨复方倍他米松联合盐酸利多卡因耳后乳突骨膜下注射治疗突发性聋的疗效。 方法 对2015年5月至2017年5月间收治的基础治疗方案相同、资料完整的100例单耳伴耳鸣的突发性聋病例进行回顾性研究和统计学分析。按其在基础治疗基础上是否给予复方倍他米松联合盐酸利多卡因耳后乳突骨膜下注射分为注射组50例和非注射组50例。对比治疗前后患者纯音听阈曲线,取0.25~4 kHz听力平均值,对听力提高分贝数进行对比;同时对患者耳鸣改善情况进行对比。 结果 听力疗效:注射组治愈10 例(20% ),显效 20例(40%),有效13例(26%),无效7例(14%);非注射组治愈5例(10%),显效10例(20%),有效18例(36%),无效17例(34%);耳鸣疗效:注射组治愈10例(20%),有效15例(30%),无效25例(50%);非注射组治愈6例(12%),有效13例(26%),无效31例(62%)。 结论 复方倍他米松联合盐酸利多卡因耳后局部注射,对突发性聋患者听力改善具有临床意义。     

An improved draping method for otoplastic surgery

An alternative method of draping of the ears is presented in which a mesh gauze dressing is used as an adjunctive method for restraining hair from the surgical field. It use is rapid and permits exposure and visibility of the ears bilaterally.     

Posterior Canal Wall Reconstruction Tympanoplasty for Operated Ears with Open Mastoid

We investigated the postoperative conditions of ears and the hearing acuity of patients who underwent posterior canal wall reconstruction tympanoplasty for operated ears with open mastoid. The study included 118 ears of 105 patients (57 males, 48 females; age range 5-75 years) and the patients were followed for >1 year after the final operation. Although 114 ears (97%) were dry after the final operation, retraction pockets and eardrums in a lateral position were observed in 5 ears and in 1 ear, respectively. Ossicular reconstruction was performed in 83 ears and in these the mean air conduction hearing levels were significantly improved after the final operation in those that were subjected to type III and IV tympanoplasty. These results indicate that posterior canal wall reconstruction tympanoplasty can be considered to be an effective procedure.     

穴位注射川芎嗪治疗36例耳鸣患者临床疗效分析

目的分析穴位注射川芎嗪治疗耳鸣患者的疗效。方法将我院2010年2月～2011年2月收治的72例耳鸣患者随机分为对照组和治疗组各36例,其中对照组采用常规西药治疗,治疗组采用穴位注射川芎嗪进行治疗,分别统计两组患者的临床疗效并进行比较。结果川芎嗪治疗组患者痊愈12例,显效10例,有效11例,总有效率为91．7％（33／36）,显著高于对照组[75．0％（27／36）]。结论川芎嗪穴位注射治疗耳鸣无不良反应及毒副作用,疗效安全可靠,值得临床推广应用。     

A 2.6 Mb deletion of 6q24.3-25.1 in a patient with growth failure, cardiac septal defect, thin upperlip and asymmetric dysmorphic ears

We report a female patient with neurodevelopmental delay and peculiar facial features. She has postnatal growth failure and an atrial septal defect. Patent duct arteriosis and tricuspidal insufficiency were also noted at birth. Characteristic facial features include medial flare eyebrows, dysmorphic helix of the right ear, cupshaped left ear, anteverted nares, long and smooth philtrum, thin upper lip, high vaulted palate. Array-CGH analysis demonstrated the presence of a 2.6 Mb deletion in 6q24.3-25.1. The phenotypic features of this case are very similar to those previously reported in a patient with a 7Mb overlapping deletion, pointing to a specific new syndrome. Twenty-two genes are present in the common critical deleted region. Among them, there is the PPP1R14C gene that encodes for KEPI, a PKC-potentiated inhibitory protein for type-1 Ser/Thr protein phosphatase. Its selective distribution in brain and heart well correlates with developmental delay and cardiac anomalies observed in the patient.     

自体耳甲软骨游离移植联合硅胶假体置入隆鼻术

目的:探讨自体耳甲软骨与固体硅胶假体联台植入进行隆鼻的方法.方法:取适当的耳甲软骨,固定在L形硅胶假体鼻尖部,置入鼻背筋膜下,进行隆鼻.结果:本组86例,术后随访6月-2年,鼻部外形自然,没有发生假体下滑、移位、脱出,效果满意.结论:应用耳甲软骨联合硅胶假体可以增加鼻尖部自体组织的厚度,从而可避免假体移位、下滑以及外露...     

Plant species richness at archaeological sites suggests ecological legacy of Indigenous subsistence on the Colorado Plateau

Humans have both intentional and unintentional impacts on their environment, yet identifying the enduring ecological legacies of past small-scale societies remains difficult, and as such, evidence is sparse. The present study found evidence of an ecological legacy that persists today within an semiarid ecosystem of western North America. Specifically, the richness of ethnographically important plant species is strongly associated with archaeological complexity and ecological diversity at Puebloan sites in a region known as Bears Ears on the Colorado Plateau. A multivariate model including both environmental and archaeological predictors explains 88% of the variation in ethnographic species richness (ESR), with growing degree days and archaeological site complexity having the strongest effects. At least 31 plant species important to five tribal groups (Navajo, Hopi, Zuni, Ute Mountain Ute, and Apache), including the Four Corners potato (Solanum jamesii), goosefoot (Chenopodium sp.), wolfberry (Lycium pallidum), and sumac (Rhus trilobata), occurred at archaeological sites, despite being uncommon across the wider landscape. Our results reveal a clear ecological legacy of past human behavior: even when holding environmental variables constant, ESR increases significantly as a function of past investment in habitation and subsistence. Consequently, we suggest that propagules of some species were transported and cultivated, intentionally or not, establishing populations that persist to this day. Ensuring persistence will require tribal input for conserving and restoring archaeo-ecosystems containing “high-priority” plant species, especially those held sacred as lifeway medicines. This transdisciplinary approach has important implications for resource management planning, especially in areas such as Bears Ears that will experience greater visitation and associated impacts in the near future.

Local resource abundance is important for determining where in a given landscape humans decide to live. Nearby water, game, soil, and plants provide readily available wild resources for foraging and conditions that allow for cultivation (1–5). However, humans also modify their surrounding environments in order to increase the abundance and diversity of local plant (6–11) and animal (12–15) resources. Such “human niche construction” is a hallmark of ancient and modern societies (16, 17), having positive and negative impacts on global biodiversity while possibly creating enduring ecological legacies (18–21). This may be especially true for more sedentary and dense populations (22, 4) that are more likely to find investment worthwhile (23) and to produce unintentional impacts. Thus, variation in contemporary ecological diversity may in part reflect past land use dynamics and, therefore, be revealed through coupled archaeological and ecological research (24–33).Coupled ecological and archaeological research has led to the discovery of altered patterns of succession resulting from 1) forest clearing and changes in canopy light regime (34, 35), 2) alterations of soil especially linked to food refuse (36, 37), 3) changes in fire regimes (38, 39), and, more rarely, 4) the importation of plant propagules from distant sites of collection (40, 41). Identifying such long-lost dynamics between humans and landscapes can inform conservation aimed at restoring site-specific artifacts, features, and the associated resource base past and present, here termed “archaeo-ecosystems” (42, 43). This would greatly facilitate cross-cultural management of public lands (44) in ways that promote Indigenous health, cultural reclamation, and sovereignty (7, 45). The linkages, however, between ecological legacies, archaeo-ecosystem restoration and cross-cultural management have yet to be systematically tested or practically applied.Here, we offer a formal evaluation of this archaeo-ecosystem approach by using paired archaeological and ecological survey data focused on Puebloan occupation of a region known as Bears Ears on the Colorado Plateau in southeastern Utah (Fig. 1). Puebloan populations modified their environment by constructing terraces and check dams, developing blinds and wing traps, importing exogenous species, and setting fires (4, 22, 46), but investments were not uniform across the region. We test the hypothesis that locations with greater investment indicated by larger and more complex archaeological sites should today have higher richness of culturally significant plant species, here termed ethnographic species richness (ESR), as an enduring legacy of past investment. Our study expands previous work on ecological legacies by using field surveys to develop an explanatory model applied to 265 sites across one million acres of semiarid public lands. It documents the occurrence of uncommon and ethnographically significant plant species associated with those sites and infuses traditional ecological knowledge into proposed management actions for conserving these archaeo-ecosystems. Controlling for underlying environmental variation, our results indicate that past human habitation increases the diversity of plant species important for Indigenous subsistence.Open in a separate windowFig. 1.Location of Bears Ears National Monument in southeastern Utah. The predicted ESR at 265 known archaeological sites across the original and reduced monument boundaries and surrounding region are shown.     

Prominent ears: Evolution of a surgical technique

The prominent ear must always be seen as an aesthetic unity made up of a large number of anatomic details so that a natural and not a surgically corrected result is obtained. To achieve this goal no standard techniques should be used. Each anatomic detail must be treated in each ear.