Analysis of medium and long term efficacy of ossicle chain bypass technique in treatment of tympanosclerosis / 临床耳鼻咽喉头颈外科杂志

Objective:For tympanosclerosis patients with ossicular chain fixation, we use ossicular chain bypass technique and evaluate its long-term effects. Methods:From June 2017 to June 2019, 147 patients with tympanosclerosis who underwent middle ear surgery with otoscopy in Yinchuan First People's Hospital were reviewed. The subjects were divided into three groups according to the implemented operation plan, 51 cases in the ossicular chain mobilization group（OCM）, 56 cases in the ossicular chain bypass reconstruction group（OCB）, and 40 cases in the malleus-incus complex resection reconstruction group（MICR）. Through a three-year follow-up, the medium and long-term effects of different operation plans were compared and analyzed. Results:There was no significant difference among the three groups in the incidence of tympanic membrane perforation, delayed facial nerve palsy, and the dispatch and displacement of PORP. The incidence of tympanic membrane retraction pocket or cholesteatoma after operation in OCB group（0） was significantly lower than that in OCM group（11.76%） and MICR group（7.5%）（P<0.05）. At 12 months after operation, ΔABG of OCB group and MICR group were better than that in the OCM group（P<0.05）. At 36 months after operation, ΔABG of OCB group was better than that in the OCM group（P<0.05）, and there was no significant difference between OCB group and MICR group. The audiological performance of patients with epitympanic sclerosis（ETS） at 12, 24 and 36 months after operation was better than that of patients with posterior tympanosclerosis（PTS） and total tympanosclerosis（TTS）（P<0.05）. Conclusion:Compared with patients undergoing ossicular chain mobilization and malleus-incus complex resection for ossicular chain reconstruction, patients with tympanosclerosis undergoing bypass technique have better and stable hearing prognosis in medium and long term. This technique can effectively prevent the formation of retracted pocket and cholesteatoma in patients with tympanosclerosis after operation.

Is subfibular ossicle excision necessary in the modified Brostr?m procedure for chronic lateral ankle instability? / 中华创伤骨科杂志

Objective:To investigate the effect of subfibular ossicle excision on the clinical efficacy of Brostr?m procedure for chronic lateral ankle instability (CLAI).Methods:From March 2014 to December 2018, 76 patients were treated by the modified Brostr?m procedure using the suture anchor technique for CLAI at Department of Foot & Ankle Surgery, Wuhan Fourth Hospital. Of them, 33 had subfibular ossicles (SFO group) and 43 did not (NSFO group). In the SFO group, there were 19 males and 14 females, aged (28.4±8.6) years; in the NSFO group, there were 21 males and 22 females, aged (27.8±7.4) years. Subfibular ossicles were excised in the SFO group. The 2 groups were compared in terms of American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores and visual analogue scale (VAS) pain scores at preoperation and the final follow-up.Results:The 2 groups were comparable due to insignificant differences between them in their preoperative general data ( P>0.05). All the patients were followed up for 24 to 72 months (average, 28 months). The AOFAS ankle-hindfoot scores improved significantly from 54.5±3.4 to 95.7±2.1 in the SFO group and significantly from 56.2±2.7 to 95.2±2.4 in the NSFO group at the final follow-up; the VAS scores reduced significantly from 5.7±1.8 to 1.6±1.4 in the SFO group and significantly from 5.7±1.6 to 1.7±1.2 in the NSFO group at the final follow-up (all P<0.05). No significant differences were found between the 2 groups in terms of AOFAS or VAS scores at the final follow-up ( P>0.05). Conclusion:Since the modified Brostr?m procedure plus subfibular ossicle excision may result in similar good clinical efficacy as merely the modified Brostr?m procedure may for the CLAI patients without subfibular ossicle, subfibular ossicle excision should be suggested for the CLAI patients with subfibular ossicle.

The Clinical Effects of Titanic Artificial Ossicle Replacement in Canal Wall -down or Canal Wall -up Tympanopl asty / 听力学及言语疾病杂志

Objective Tostudytheeffectsoftitanicartificialossiclereplacementincanalwall - downandcanalwall-up tympanoplasty for patients suffering from chronic otitis media .Methods A total of 157 cases (164 ears) un-derwent canal wall-down and canal wall -up tympanoplasty at our hospital from Feburary 2014 to Feburary 2016 were retrospectively analyzed ,in which 50 cases in canal wall down tympanoplasty with titanic ossicle replacement , 49 cases without replacement ,42 cases in canal wall -up tympanoplasty with titanic artificial ossicle replacement , and 23 cases without replacement .The average air bone gaps (ABG) before and 3 months after operations were re-corded and the average reduced ABGs were compared between sub -groups to evaluate the effects of titanic artificial ossicle replacement .Results In the canal wall-down tympanoplasty group ,the mean ABGs of 3 months after oper-ations in the replacement subgroup was 15 .72 ± 11 .18 dB ,the reduced ABGs was 17 .45 ± 5 .23 dB ,and the impro-ving rate for hearing was 71 .54％ ,statistically higher than the non -replacement subgroup(P<0 .05) .In the canal wall-up tympanoplasty group ,the mean ABGs of 3 months after operations in the replacement subgroup was 8 .13 ± 5 .37 dB ,the reduced ABGs was 26 .85 ± 11 .03 dB ,the improving rate for hearing was 75 .12％ ,statistically higher than non-replacement subgroup(P<0 .05) .Conclusion The replacement of titanic artificial ossicle in both of canal wall-down and canal wall-up tympanoplasty is helpful to improve hearing .

Meniscal Ossicle / 대한정형외과학회잡지

Meniscal ossicle of the knee, an ossified tissue formed within the meniscus, is rare in humans. We experienced a case of a 48-year-old male with no history of trauma, who presented with intermittent locking symptoms and knee pain upon standing. The patient was diagnosed with meniscal ossicle and cartilage lesion in the medial femoral condyle accompanied by a medial meniscus posterior horn radial tear and treated with arthroscopic resection and microfracture. Therefore, we report on this case with relevant literature.

A Study Of Ossicle At Asterion In Western U.P. Of North Indian Crania.

Background: Studies of non metric cranial variants have been a field of considerable interest to research workers especially because of their racial and regional importance. Methodology: Total of 28 north Indian human crania of western U.P. was studied for the incidence of Ossicle at Asterion a cranial variant. Results: Ossicle at Asterion was found in 4 (14.2%) of total human crania. Conclusion: The presence of Ossicle at Asterion found to be of considerable regional and racial significance.

Curative Effects of Tympanoplasty with Two Different Ossicles Protheses / 听力学及言语疾病杂志

Objective To investigate the therapeutic effects of titanium artificial auditory ossicles in closed type mastoid radical tympanoplasty ,in comparison with ceramic artificial auditory ossicles .Methods A retrospec‐tive analysis was done on of 150 patients (155 ears) with the closed type of mastoid radical tympanoplasty using arti‐ficial auditory ossicles for hearing reconstruction (from January 2008 to December 2012) ,cund were ,and followed up for 12 months .Based on the two kinds of artificial auditory ossicle materials ,the group was divided into two :122 cases (127 ears) for the titanium auditory ossicle group and 28 cases (28 ears) for the ceramic auditory ossicle group .We compared the average air conduction hearing threshold and air bone gaps (ABG) at 0 .5 ,1 .0 ,2 .0 ,and 4 .0 kHz ,at preoperative 6 months and postoperative 6 ,12 months .Results For the Titanium artificial auditory os‐sicle group:117 ears (92 .13% ) had hearing threshold improvement >15 dB HL ,106 ears of the ABG change ≤20 dB ,which were statistically significant .The total success rate of hearing reconstruction was 83 .46% (106/127) . For the ceramic auditory ossicle group:5 ears (17 .86% ) had hearing threshold improvement >15 dB HL ,3 ears (10 .71% ) of the ABG change ≤20 dB ,which was no statistical significance between the two groups .Conclusion The hearing reconstruction effects of titanium artificial auditory ossicle in closed type mastoid radical tympanoplasty is excellent .It is suitable for application in closed-mastoidectomy tympanoplasty ideal artificial auditory ossicle .

A Case of Incudal Osteoma Accompanied by Primary Acquired Cholesteatoma / 대한이비인후과학회지

Osteomas in the middle ear are very rare. To date, there are 23 cases of osteomas of the middle ear reported in the English literature. Of these, five osteomas arose from the ossicles, but those accompanied by cholesteatoma is extremly rare. There are only two cases that are all congenital cholesteatoma. Ossicular osteoma with primary acquired cholesteatoma has not been reported previously. We present a case of osteoma of the incus accompanied by primary acquired cholesteatoma, which was diagnosed incidentally in the middle ear.

The Inferior Accessory Ossicle of the Anterior Arch of the Atlas Misdiagnosed as Anterior Arch Fracture: A Case Report

STUDY DESIGN: Case report. OBJECTIVES: We report a very rare case of the inferior accessory ossicle of the anterior arch of the atlas misdiagnosed as anterior arch fracture. SUMMARY OF LITERATURE REVIEW: It is necessary to know the existence of inferior accessory ossicle of the anterior arch of the atlas, even though it is extremely rare. MATERIALS AND METHODS: A 29-year-old woman was referred to our emergency service unit with symptoms of neck pain and scalp laceration, after being involved in a car accident. She was diagnosed as the inferior accessory ossicle of the anterior arch of the atlas, by multiple diagnostic mordalities. RESULTS: The symptom of neck pain was relieved spontaneously, and her symptom has been relieved at her latest visit, as a follow up within 3 months. CONCLUSIONS: It is important to be aware of cervical anatomical variants because we commonly confuse it with other pathologic conditions, such as a fracture and thus, misdiagnose the condition.

Hearing Outcomes According to the Types of Mastoidectomy: A Comparison between Canal Wall Up and Canal Wall Down Mastoidectomy

OBJECTIVES: The aim of this study was to compare the hearing outcomes between canal wall up mastoidectmy (CWUM) and canal wall down mastoidectmy (CWDM). METHODS: One hundred seventy one chronic suppurative otitis media (CSOM) patients were enrolled in this retrospective study. The patients who underwent the second staged ossiculoplasty at least 6 months after mastoidectomy and who had an intact, well aerated tympanic cavity as well as intact mobile stapes at the time of operation were selected from the medical record. Based on the type of mastoid surgery, the patients were categorized into two groups: the CWUM (n=38) and CWDM groups (n=133). The hearing results of the CWUM and CWDM groups were compared using the pre- and post-operative air-bone gap (ABG) at 3 months after ossiculoplasty. RESULTS: The preoperative ABG in both groups (CWUM and CWDM) were 28.4+/-15.6 dB and 31.8+/-14.5 dB, respectively (P=0.18). Both groups didn't show any significant difference (10.9 dB vs. 13.5 dB, respectively) (P=0.21) for the postoperative ABG closure. The proportion of patients with an ABG less than 20 dB was 58.6% of the CWDM patients and 68.4% of the CWUM patients (P=0.25). CONCLUSION: The type of mastoid surgery (CWUM and CWDM) did not affect the hearing results of CSOM patients. When choosing the type of mastoidectomy procedure for CSOM surgery, the hearing outcomes are basically the same for both types of procedure.

Effect of different connecting methods for artificial ossicle on dynamic response of ear / 医用生物力学

Objective To study the effects of the different connecting mode of artificial ossicle on hearing restoration. Method Geometrical model of human ear was established by an original C++ program based on clinical CT data, and imported this geometrical model into finite element software PATRAN to build up the numerical finite element model of human ear structure. Based on the finite element model, the fluid solid coupling was computed by harmonic response analysis method, and the effect of sound conduction on ear structure was analyzed according to different implantable methods and positions of artificial ossicle. Results The validity of this numerical model is confirmed by comparing the amplitude of umbo and stapes footplate on numerical model which is gained by dynamic response analysis on normal ear structure with published experimental measurements on human temporal bones. ConclusionsConnecting artificial ossicle to tympanic membrane at its central position is optimal for the dynamic response of ear structure as the amplitude of stapes footplate under this situation is slightly higher than other connecting methods since it conforms to physiological function of human ear, and the effect of hearing recovery could be better.

Inferior Accessory Ossicle of the Anterior Arch of the Atlas / 대한정형외과학회잡지

An inferior accessory ossicle of the anterior arch of the atlas is quite rare and should not be confused with other pathological conditions such as a fracture. Here we report a case of an inferior accessory ossicle of the anterior arch of the atlas in a 29-year-old male and a review of literature.

Meniscal Ossicle in the Knee: 2 Case Reports

A meniscal ossicle is an ossified structure embedded in the meniscus of the knee, and it very rarely occurs in human. We present here two cases of meniscal ossicle. The two patients were men in their thirties. They had intrameniscal ossicles from the torn posterior horn of the medial meniscus without having any history of trauma. Both cases were treated by arthroscopic excision.

A Case of Osteoma between the Malleus and Incus / 대한이비인후과학회지

We present a case of osteoma that was diagnosed incidentally in the middle ear. Osteomas are benign tumors and may occur as a solitary lesion in the squama, mastoid, middle ear and petrous pyramid. Even though osteomas in the middle ear are extremely rare, those lesions may be one of the causes of the conductive hearing loss by impinging upon the ossicular chain. There are only 22 cases of osteoma reported in the medical literature to date. In most patients, the diagnosis is confirmed by CT scan or at the time of surgery. CT scanning of these disorders is very useful, especially in examining the extent of the lesion and detailed bone destruction.

Intrameniscal Ossicle of the Knee: A Case Report / 대한정형외과학회잡지

Intrameniscal ossicles are rare lesions in humans. They are usually located in the posterior horn of the medial meniscus and are frequently misdiagnosed on roentgenogram as intraarticular loose body. We report a case of meniscal ossicle that occured in a 58-year-old male who had diffuse pain and intermittent locking sensation in the knee. We successfully treated the case with arthroscopic resection of the intrameniscal ossicle and partial meniscectomy of the surrounding meniscus. There was no recurrence of symptom during more than six months after operation.