Objective To observe the opening movement of eustachian tube pharyngeal orifice in patients with secretory otitis media(SOM) by cine CT to mearsure the thickness of the lateral ET wall ,and to evaluate the roles played by those peri-tube structure in the pathogenesis of ET obstruction .Methods Twenty -seven SOM patients as experiment group underwent low -radiation dose cine CT scans of the ET ,the image were reconstructed into a cine image to see the opening movement of the eustachian tube pharyngeal orifice .The CT scan of sixty-four non-SOM patient as control group was performed .The images were reconstructed to show the relationship among the in‐ferior turbinate ,the nasopharyngeal soft tissue and the eustachian tube .These serial images were analyzed to meas‐uring the thickness of the lateral wall of ET cartilage segment and to find out whether the gas exist in the pharyngeal recess .Results The opening movement of the pharyngeal orifice was observed in 23 SOM patients ,the mean thick‐ness of the lateral wall of ET cartilage segment in ithe ears studied and healthy ears of SOM patients are 8 .93 ± 1 .6 mm and 8 .89 ± 1 .2 mm ,respectively ,much larger than those of in non-SOM patients ,but with no static signifi‐cance .The pharyngeal recess in 69 .0% (29/42) affected ears of som patients and 58 .3% (7/12) in healthy ears were gas free .This rate in som patients was significantly higher than that in the non-SOM patient group .Conclusion The etiologies of dysfunction of eustachian tube may include hypertrophic inferior turbinate ,chronic inflammation of eustachian tube mucosa ,compression of the nasal pharyngeal soft tissue .The compression of the nasal pharyngeal soft tissue may play an important role in the obstruction of the specific cartilage segment of the ET .

Objective To establish a rat model of tympanosclerosis(TS) by myringotomy and inoculation of streptococcus pneummoniae, and to observe the morphological change in the tympanic membrane (TM) and middle ear mucous.Methods Forty Sprague-Dawley rats were randomly divided into two groups (n=20/group) and then ten in each group were chosen to serve as the control and the other ten were set up for the TS model.Group A (myringotomy): myringotomy was performed on the bilateral TMs of all rats except the control group.Group B (bacterial inoculation): streptococcus pneumoniae was inoculated into the bilateral middle ear cavity of all rats except the control group.The condition of the TMs and the middle ears in the two groups were respectively examined at 2 weeks after myringotomy and at the five time points (1 week, 2 weeks, 4 weeks, 6 weeks, and 8 weeks) after bacterial inoculation.Then the rats were decapitated and the morphological changes were observed by hematoxylin and eosin staining.Results One rat in group B died two weeks after the inoculation.In the two experimental groups, the calcifications were observed in 70%of the TMs (14/20) in group A and in 33.33%of the TMs (6/18) at 8 weeks in group B.At the same time, the inflammatory infiltration and hyaline degeneration markedly appeared in the tympanic membrane and middle ear mucous membrane.In the two control groups, neither morphological changes nor calcifications occurred.Conclusion The current study indicated that the animal model of TS was successfully accomplished by myringotomy and inoculation of streptococcus pneummoniae, and their morphological changes were basically consistent.However, the method of myringotomy is easier to use and can obtain a higher modeling rate in a relatively short time.

Objective To investigate why benign, paroxysmal positional vertigo (BPPV) recurs.Methods Three hundred persons diagnosed with BPPV who had been treated at Tongji Hospital of Huazhong University of Science and Technology between April 2012 and April 2014 were given a telephone follow-up at least one year after their manual repositioning treatment.The respondents were divided into a healthy group and a recurrence group according to whether they said their vertigo had recurred.The age and gender distributions of the two groups were compared, along with their underlying diseases and living-related factors.Causes of the recurrence were then hypothesized.Results Single factor analysis and binary logistic regression analysis showed that overwork, an age over 45, travelling frequently, long use of computers, sleep disorders, oral intake of calcium tablets, posterior circulation ischemia and hyperlipidemia were all closely related to the BPPV recurrence.Age over 45 showed the strongest correlation.Conclusion Aging is the greatest risk factor for the recurrence of BPPV.Posterior circulation ischemia, hyperlipidemia, overwork, sleep disorders, long use of computers and being on business frequently are also predictors of relapse.