Clinical characteristics of nasal respiratory epithelial adenomatoid hamartoma / 临床耳鼻咽喉头颈外科杂志

〓 Objectives: To analyze the pathological and clinical features of nasal respiratory epithelial adenomatoid hamartoma（REAH）, and summarize the diagnostic points, to improve the experience of diagnosis and treatment. Methods:The clinical data of 16 patients with REAH were analyzed retrospectively. The clinical manifestations, pathological features, imaging features, surgical treatment and prognosis were summarized. Results:16 cases of REAH were studied, 10 cases（62.50%） were associated with sinusitis, 1 case（6.25%） was associated with inverted papilloma, 1 case（6.25%） was associated with hemangioma. 5 cases（31.25%） had a history of nasal sinus surgery, including 1 case with 3 times of nasal sinus surgery, 1 case with 2 times of nasal sinus surgery, 3 cases with 1 time of nasal sinus surgery; 10 cases（62.50%） occurred in the bilateral olfactory cleft, 2 cases（12.50%） in the unilateral olfactory cleft, 3 cases（18.75%） in the unilateral middle turbinate, 1 case（6.25%） in the nasopharynx. All 16 patients were pathologically diagnosed as REAH. In the patients with lesions located in bilateral olfactory fissures, symmetrical widening of olfactory fissures and lateral displacement of middle turbinate were observed on preoperative sinus CT. The average width of bilateral olfactory fissures was （9.9±2.70） mm. The ratio of wide to narrow olfactory cleft was 1.21 ± 0.19. There was no significant difference in Lund-Mackay score between the two sides（P>0.05）. All patients underwent surgery under general anesthesia and nasal endoscopy. The follow-up period ranged from 1 to 66 months, and no recurrence occurred. Conclusion:Preoperative diagnosis of REAH is facilitated by the combination of clinical manifestations and endoscopic and imaging features. Endoscopic complete resection can achieve a good therapeutic effect.

The relization of EABR test out of cochlea and the effects of different location of electrode on EABR wave / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the feasibility of the round window stimulation electrical evoked auditory brainstem response (EABR) test, and optimize the parameters of recording and stimulation electrodes positions.@*METHOD@#Ten healthy Hartley guinea pigs (20 ears) were used for the EABR test. The positive stimulation electrodes were placed into the round window niche, the animals were divided into three group according to the negative electrodes position, group A: the electric field was parallel with the projection of cochlear modiolus on the tympanic membrane, group B: the electric field was perpendicular to modiolus projection toward to the mastoid, group C: the electric field was perpendicular to modiolus projection toward to the zygomatic process. A series of optimized recording and stimulation parameters were uesed to reduce the electrical artifact.@*RESULT@#All the 20 ears were normal in the ABR testing, and EABR waves were stable and well-differentiated in the EABR tests out of cochlea. But EABR waves of group A were more stable and differentiated than those of group B and C. In group A, the threshold of EABR was (0.54 ± 0.11) mA, and latency of wave III was (1.71 ± 0.05) ms when the stimulus intensity was 0.8 mA. In group B, the threshold of EABR was (0.62 ± 0.12) mA, and latency of wave III was (1.77 ± 0.03) ms. In group C, the threshold of EABR was (0.70 ± 0.14) mA, and latency of wave III was (1.86 ± 0.04)ms. The threshold of EABR and latency of wave III were significantly different among the three groups by statistic analysis.@*CONCLUSION@#EABR waves were stable and well-differentiated in the EABR tests out of cochlea. The EABR waves were recorded more stably and differentiated when the stimulating electrode and recording electrode were paralleled with the projection of modiolus on the tympanic membrane.

Development of electrically evoked auditory brainstem response modules of REZ-I domestic cochlear implant device / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To develop electrically evoked auditory brainstem response(EABR) modules of REZ-I domestic cochlear implant device, and testify the reliability and validity of the modules.</p><p><b>METHODS</b>Postoperative EABR were recorded in guinea pigs by using the self-designed EABR module.</p><p><b>RESULTS</b>EABR waves were recorded in all 15 ears of 9 guinea pigs with normal hearing. The threshold was (159.00 ± 50.21) current level (CL) and eIII wave latency was (2.36 ± 0.46) ms of 100 µs pulse width stimulation; for 150 µs pulse width stimulation, the threshold was (131.44 ± 49.25) CL and eIII wave latency was (2.59 ± 0.46)ms; for 200 µs pulse width stimulation, the threshold was (119.63 ± 52.56) CL and e III wave latency was (2.62 ± 0.44)ms.</p><p><b>CONCLUSION</b>According the preliminary results of the study, the reliability and stability of the EABR modules of domestic cochlear implant device can meet the demands of EABR recording.</p>

Canal-wall-down mastoidectomy and tympanoplasty surgery preserving chorda tympani nerve integrality / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To report the way for searching the chorda tympani nerve and the significance for preserving the chorda tympani nerve during canal-wall-down mastoidectomy and tympanoplasty surgery.@*METHOD@#Sixty-six cases with chronic suppurative otitis media underwent canal-wall-down mastoidectomy and tympanoplasty surgery. According to the marker of the short crus of incus, the posterior wall of auditory canal was lowered and crista of the chorda tympani nerve was found through tracing the facial nerve contour. The chorda tympani nerve was preserved after clearing the surrounding tissue.@*RESULT@#Among the 66 cases, 24 cases had middle ear cholesteatoma, 42 cases had granulation in middle ear. The cholesteatoma and granulation on the surface of the chorda tympani nerve were cleared thoroughly. No neurotmesis or obvious change of taste occurred after operation.@*CONCLUSION@#Canal-wall-down mastoidectomy and tympanoplasty surgery preserving chorda tympani nerve integrality may preserve the structure and function of the chorda tympani nerve, reduce the risk of ossicle extrusion above the head of stapes and serve as a frame for transplanting fascia.