Objective To find out the difference in Multi-channel Cochlear mapping between SPrint speech processor and ESPrit speech processor (ESPrit 3G) for better guidance of the mapping.Methods Nine cases of total deafness patients (aged 2-54 years old) using SPrint changed to using ESPrit 3G after 6 to 24 months. The threshold (T-L) of electro-audiogram using different speech processor, comfortable level, sound field audiometry in various ESPrit 3G programs and questionnaire results were compared and analyzed statistically.Results Using various speech processor programs, four patients(The first group) felt satisfied with hearing effects. There was no difference comparing with SPrint. There was significantly different in T-L and C-L acquired from five patients(The second group) with two speech processors (P0.05). The results of sound field audiometry showed significant difference in the first group and the second group using programs from SPrint(P

OBJECTIVE: This article discusses the clinical features and treatment methods of the inflammatory reaction associated with cochlear implants, and analyzes the possible pathogenesis and related factors. METHOD: We retrospectively analyzed postoperative inflammation cases from February 2002 to October 2013 among 825 cochlear implantation patients. Their symptoms, signs and treatment processes and outcomes were described and summarized. RESULT: Incidence of implants related inflammatory reaction was 1.58%. The onset time ranged from 2 months to 11 years post-operatively. There were 6 cases of implants related non-infectious inflammation, with an incidence of 0.73% (6 of 825). Post auricular swelling and subcutaneous non-infectious discharge were found in all these 6 cases. Pressure dressing with bandage and steroid, antihistamine medications was effective. There were 7 cases of post auricular infection, with an incidence of 0.85%, resulted from flap trauma or acute otitis media. Antibiotics and drainage was used for them to treat the infection, and rotation scalp flaps were used to cover the exposed device. Five of these cases were cured but cochlear implants had to be removed out in the other 2 cases of staphylococcus aureus infection. CONCLUSION Cochlear implantation surgery is safe and effective for profound deafness. However, the implants-related non-infectious and infectious inflammatory reaction impacts the effect of cochlear implants, even lead to removal of the implants.
Child, Preschool ; Cochlear Implantation ; Female ; Humans ; Infant ; Inflammation ; epidemiology ; Male ; Postoperative Complications ; epidemiology ; Surgical Wound Infection ; epidemiology

Objective To investigate the effect of diagnostic ultrasound on cochlear hair cells in fetal guinea pigs. Methods Diagnostic ultrasound was used to irradiate the uteri of early pregnant guinea pigs(the first 15 days of gestion) and late pregnant guinea pigs(the 40th to 45th days of gestion) for 5 minutes daily. The number of cochlear hair cells in fetal guinea pigs was calculated using succinic dehydrogenase (SDH) staining, and computer image analysis system. The morphological change of cochlear hair cells was observed with scanning electron microscope(SEM). Results Compared with non-exposed control group, the number of total hair cells obviously decreased in the two exposed groups (P

Objective:To investigate the efficacy of endolymphatic sac surgery for Meniere's disease,and compare the effects of endolymphatic sac decompression with endolymphatic-mastoid shunting.Method:Twelve patients(13 ears)undergoing endolymphatic-mastoid shunting and eleven patients (11 ears) undergoing endolymphatic sac decompression were retrospectively compared for hearing results and vertigo controlled rates.All of them have been followed up for more than two years after surgery.Result:According to Chinese Meniere's disease diagnosis and curative effect standard evaluation criteria pubilished in 2006,for vertigo symptom of endolymphaticmastoid shunting group,9 cases(69.2%) achieved grade A(eompletely controlled),4 cases (30. 8%) achieved grade B(fundamentally controlled).There were 8 cases(72.7%)with grade A, 2 cases (18.2%)with grade B and one case(90% ) with grade C among 11 patients who received endolymphatic sac decompression.There was not statistically significant differences in postoperative speech pure tone average and vertigo controlled rate between the two groups.Conslnsion:Endolymphatic sac decompression and endolymphatic-mastoid shunting are effective management with less complication for intractable Meniere's disease. Particularly,the vertigo symptoms were controlled signifisantly. Patients with Meniere's disease in advanced clinical stages may also be relieved.

Objective The light and electron-microscopic examination was utilized to study the tissue from middle ears diagnosed as having tympanosclerosis. The main purpose of this article is to understand the clinicopathologic and electron-microscopic characteristics of 68 patients with tympanosclerosis. Methods The material for histopathologic and electron-microscopic studies were taken from the tympanic mucosa in various localities, especially from the whitish sclerotic masses in the tympanum of the patients with tympanosclerosis, during middle ear surgeries between 2006 and 2008. Specimens were divided into two groups: one group of 68 specimens was fixed and stained for light microscopic study with hematoxylin-eosin; the second group of 12 specimens was viewed in the electron microscope. Results The specimens from tympanic mucosa showed granulation tissue with infiltration of chronic inflammatory cells, and slight fibrosis in the submucosal layer. The histopathology of the plaques after haemaoxylin and eosin staining revealed dense bundles of collagen with hyaline degeneration and scattered areas of calcification. An ultrastructural examination of these specimens revealed fibrocytes that were irregularly shaped, elongated, and degenerating. The osmiophilic cytoplasm contained vesicles and collagen bundles. There were clusters of mitochondria in perinuclear cytoplasm and lots of electron dense calcareous deposits within lysosomes and degenerated mitochondria in fibrocyte cells. Conclusion The histopathologic examinations of tympanosclerosis revealed dense fibrous and collagenous connective tissues, poor in cell, with hyaline degeneration and occasional calcification in the tympanic mucosa. Electron-microscopic studies further revealed marked proliferation of collagen fibers and electron dense calcareous deposits within lysosomes and degenerated mitochondria in fibrocyte cells.

OBJECTIVETo investigate the related parameters of the temporal bone structure for determining the position of implanting electrode into the scala tympani in cochlear implantation surgery through the facial recess and epitympanum approach.

METHODSIn a surgical simulation experiment, 20 human temporal bones were studied and measured to determine the related parameters of the temporal bone structure.

RESULTSThe distance 5.91∓0.29 mm between the short process of the incus and the round window niche, 2.11∓0.18 mm between the stapes and the round window niche, 6.70∓0.19 mm between the facial nerve in the perpendicular paragraph and the round window niche, 2.22∓0.21 mm from the pyramidal eminence to the round window, and 2.16∓0.14 mm between the stapes and the round window. The minimal distance between the implanting electrode and the vestibular window was 2.12∓0.19 mm. The distance between the cochleariform process and the round window niche was 3.79∓0.17 mm. The position of the cochlear electrode array insertion into the second cochlear turn was 2.25∓0.13 mm under the stapes. The location of the cochlear electrode array insertion into the second cochlear turn was 2.28∓0.20 mm inferior to the pyramidal eminence.

CONCLUSIONThese parameters provide a reference value to determine the different positions of cochlear electrode array insertion into the scale tympani in different patients.

Adult ; Cochlea ; anatomy & histology ; surgery ; Cochlear Implantation ; Cochlear Implants ; Ear, Middle ; anatomy & histology ; surgery ; Female ; Humans ; Male ; Round Window, Ear ; anatomy & histology ; surgery ; Scala Tympani ; anatomy & histology ; surgery

OBJECTIVE: To investigate the efficacy of endolymphatic sac surgery for Meniere's disease, and compare the effects of endolymphatic sac decompression with endolymphatic-mastoid shunting. METHOD: Twelve patients(13 ears) undergoing endolymphatic-mastoid shunting and eleven patients (11 ears) undergoing endolymphatic sac decompression were retrospectively compared for hearing results and vertigo controlled rates. All of them have been followed up for more than two years after surgery. RESULT: According to Chinese Meniere's disease diagnosis and curative effect standard evaluation criteria published in 2006, for vertigo symptom of endolymphatic mastoid shunting group, 9 cases (69.2%) achieved grade A(completely controlled), 4 cases (30.8%) achieved grade B (fundamentally controlled). There were 8 cases (72.7%) with grade A, 2 cases (18.2%) with grade B and one case (9%) with grade C among 11 patients who received endolymphatic sac decompression. There was not statistically significant differences in postoperative speech pure tone average and vertigo controlled rate between the two groups. CONCLUSION Endolymphatic sac decompression and endolymphatic-mastoid shunting are effective management with less complication for intractable Meniere's disease. Particularly, the vertigo symptoms were controlled significantly. Patients with Meniere's disease in advanced clinical stages may also be relieved.
Adult ; Decompression, Surgical ; methods ; Endolymphatic Sac ; surgery ; Female ; Humans ; Male ; Meniere Disease ; surgery ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To investigate the related parameters of temporal bone structure in the surgery of cochlear implantation through facial recess approach so as to offer a theoretical reference for the avoidance of facial nerve injury and the accurate localization. METHOD: In a surgical simulation experiment, twenty human temporal bones were studied. The correlation parameters were measured under surgical microscope. RESULT: Distance between suprameatal spine and short process of incus was (12.44 +/- 0.51) mm. Width from crotch of chorda tympani nerve to stylomastoid foramen was (2.67 +/- 0.51) mm. Distance between short process of incus and crotch of chorda tympani nerve was (15.22 +/- 0.83) mm. The location of maximal width of the facial recess into short process of incus, crotch of chorda tympani nerve were (6.28 +/- 0.41) mm, (9.81 +/- 0.71) mm, respectively. The maximal width of the facial recess was (2.73 +/- 0.20) mm. The value at level of stapes and round window were (2.48 +/- 0.20 mm) and (2.24 +/- 0.18) mm, respectively. Distance between pyramidalis eminence and anterior round window was (2.22 +/- 0.21) mm. Width from stapes to underneath round window was (2.16 +/- 0.14) mm. CONCLUSION These parameters provide a reference value to determine the position of cochlear inserting the electrode array into the scale tympani and opening facial recess firstly to avoid potential damage to facial nerve in surgery.
Anatomic Landmarks ; anatomy & histology ; Chorda Tympani Nerve ; anatomy & histology ; Cochlea ; anatomy & histology ; Cochlear Implantation ; methods ; Ear, Middle ; Facial Nerve Injuries ; prevention & control ; Humans ; Incus ; anatomy & histology ; Organ Sparing Treatments ; methods ; Round Window, Ear ; anatomy & histology ; Stapes ; anatomy & histology ; Temporal Bone ; anatomy & histology ; Tympanic Membrane ; anatomy & histology

OBJECTIVE: To investigate the effect of different malleus treatments on the postoperative efficacy in the tympanosclerosis patients receiving ossicular chain reconstruction. METHOD: Fifty-nine patients (62 ears) with tympanosclerosis were treated by ossicular chain reconstruction. All the patients were divided into three groups, including malleus removal group (A, 24 ears), retaining only the malleus handle group (B, 18 ears) and the intact malleus group (C, 20 ears). All the patients were followed up 3 months pre-operation, 3 months and 1 year post-operation by audiometric measurement (the average hearing threshold at 0.5, 1.0, 2.0 kHz HI). Tympanic membrane was examined by ear endoscope. RESULT: The pre-operation mean air bone gap (ABG) in these groups were 40.07 +/- 77.56 dB, 37.31 +/- 76.45 dB, and 36.75 +/- 76.72 dB, among which the difference had no statistical significance (P > 0.05). At 3 months after operation, the ABG in all cases was improved at 0.5, 1 and 2 kHz. The difference of ABG improvement among these three groups had no statistical significance (P > 0.05). One year after surgery, the ABG of the three groups were decreased by 17.92 +/- 9.28 dB, 16.76 +/- 5.19 dB and 10.58 +/- 7.38 dB respectively. The hearing improvement in group C is less than the other two groups (P = 0.03, P = 0.016). The difference of hearing improvement between group A and group B had no statistical significance(P > 0.05). Group A and group B each have one case of tympanic membrane perforation and artificial ossicle falling off. CONCLUSION The operating processes of malleus in ossicular chain reconstruction of patients with tympanosclerosis were introduced. In terms of short-term efficacy, the three groups showed no significant difference. However, the long-term efficacy of the patients in the group A and group B were better compared with the group C.
Adolescent ; Adult ; Female ; Humans ; Male ; Malleus ; surgery ; Middle Aged ; Myringosclerosis ; surgery ; Ossicular Replacement ; methods ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVE: To study the normal anatomy of aditus of antrum and antrum on the high-resolution CT (HRCT) and the three-dimensional reconstruction, testing the normal range. And comparison was carried out according to the age, sex and side. METHOD: Ninety cases were randomly selected without ear lesions. Scanning were taken in sagittal, transverse and coronal planes on HRCT respectively. The structure of aditus and antrum was displayed by three-dimensional reconstruction. The left-right distances and up-down distances, antero-posterior distances were measured and analyzed. RESULT: The image of antrum varied with age, while aditus remained constant on the HRCT and the three-dimensional reconstruction. The average of left-right distance of aditus was (5.19 +/- 1.39) mm, and the average of up-down distance of aditus was (5.74 +/- 1.16) mm. The average of left-right distance of antrum was (8.27 +/- 1.41) mm (<6 years old) and (5.41 +/- 1.32) mm (> or = 6 years old). The average of up-down distance of antrum was (11.78 +/- 1.65) mm (<6 years old) and (9.91 +/- 2.04) mm (> or = 6 years old). The average of antero-posterior distance of antrum was (12.25 +/- 1.23) mm (<6 years old) and (10.05 +/- 1.69) mm (> or = 6 years old). No statistically significant differences were seen in left-right distance of aditus by age, sex and side (P > 0.05). Significant differences in up-down distance of aditus was found between male and female, and the distance in male was greater than that in female (P < 0.05). Statistically significant differences were seen in left-right distance and up-down distance, antero-posterior distance of antrum by age (P < 0.05), but no statistically significant differences by sex or side (P > 0.05). CONCLUSION Imaging of aditus ad antrum is relatively constant in the normal persons, while the aditus is more diverse. Significant gender differences were seen in up-down distance. There were significant differences in left-right distance, up-down distance, and antero-posterior distance of aditus among all age groups.
Adolescent ; Child ; Child, Preschool ; Ear, Middle ; anatomy & histology ; diagnostic imaging ; Female ; Humans ; Image Processing, Computer-Assisted ; Infant ; Male ; Tomography, X-Ray Computed