Ear, Inner ; physiopathology ; surgery ; Humans ; Vertigo ; surgery

Cochlear Implantation ; Ear, Inner/surgery* ; Hearing Loss, Sensorineural ; Humans

Evaluation of postoperative hearing acuity and equilibrium was performed in four patients with labyrinthine fistula caused by iatrogenic procedure. Surgical trauma inflicted upon the membranous labyrinth is an uncommon, but often catastrophic, complication of chronic ear surgery. The most vulnerable areas are the oval window and the lateral semicircular canal. Methods of injury include subluxation of the foot plate, fracture of the lateral canal by drill or chisel, and accidental opening of the labyrinth. Three cases of fistula of the lateral and posterior canal during ear surgery are presented. All of three occured while drilling. The other one occured due to iatrogenic stapedectomy. The interrupted semicircular canals were obliterated firmly with autologous materials such as fascia, perichondrium, bone chips, and cartilage. These cases were documented by pre and post operative audiograms, vestibular function tests. One interesting finding was that none of these cases were compromised cochlear function. The dictum that an accidentally opened labyrinth will automatically result in a dead ear is shown to be not necessarily true. These cases indicates that manipulation of the semicircular canal with awareness can be conducted without damaging the cochlear function, and that the treatment of labyrinthine fistulas shoud be performed very carefully but not so conservatively as to lead to future problems.
Cartilage ; Ear ; Ear, Inner ; Fascia ; Fistula* ; Foot ; Hearing* ; Humans ; Semicircular Canals ; Stapes Surgery ; Vestibular Function Tests

Pneumolabyrinth or pneumocochlea is an uncommon condition in which the vestibule or cochlea is filled with air. Although there have been several reports about pneumolabyrinth after stapes surgery, it is rarely found in temporal bone fractures. The presence of air inside the inner ear is a definite proof of a pathological connection between the inner ear and the air-filled mastoid or middle ear cavities. We encountered a rare case of a 45-years-old male with a pneumolabyrinth that resulted from a blunt head trauma. A pneumolabyrinth was resolved spontaneously.
Cochlea ; Craniocerebral Trauma ; Ear, Inner ; Ear, Middle ; Fractures, Closed ; Humans ; Male ; Mastoid ; Stapes Surgery ; Temporal Bone*

OBJECTIVE: To estimate the value of endoscope on postlabyrinthine approach of cerebellopontine angle surgery. METHOD: Transpostlabyrinthine endoscopic excision of glossopharyngeal nerve to treat 2 glossopharyngeal neuralgia patients. Observe the endoscopic eyespot and estimate the appliance and virtue of the surgery. RESULT: The two patients both have satisfied outcomes and remained free of disease after surgical treatment. We got a wide eyespot from trigeminal to vagus nerve. The internal acoustic porous is a fixed structure of the cerebellopontine angle and it is also a perfect landmark during the surgery. CONCLUSION Endoscopic postlabyrinthine approach provides a shorter path to cerebellopontine angle and endoscope provides a unique way to explore the cerebellopontine angle and to identify the exact location of the pathological changes, including a multipoint of view. Complicated and skilled operation restricts the surgery.
Cerebellopontine Angle ; surgery ; Ear, Inner ; surgery ; Endoscopy ; methods ; Humans ; Male ; Middle Aged ; Trigeminal Neuralgia ; surgery

Ear, Inner ; surgery ; Humans ; Neuroma, Acoustic ; surgery ; Otologic Surgical Procedures ; methods

OBJECTIVE: To study the microanatomy by endoscope-assisted via retrolabyrinthine approach. METHOD: Nineteen cadaveric heads fixed with formalin were dissected in our study. The data that endoscope could be extent and the distance between the important point were measured. By simulated the retrolabyrinthine approach, endoscope was placed to observe the nerves and vessels, the distance between nerves and the central point of the anterior edge of sigmoid sinus were measured. RESULT: The distance from the inferior margin of petrous ridge to the upper bound of endolymphatic sac was (9.93+/-1.52)mm; and from superior margin of petrous ridge to the inferior margin common bony crus was (4.64+/-0.91)mm;and from the intersection of posterior semicircular canal to the anterior wall of sigmoid was (7.85+/-1.47)mm on the left, and (5.69+/-1.68)mm on the right. The distance from inferior margin common bony crus to the anterior wall of sigmoid was (13.9+/-1.71)mm on the left, and (11.31+/-2.03)mm on the right. The trochlear nerve and abducent nerve could be observed under endoscope. The relationship between the trigeminal nerve, acoustic nerve and the vessels could be identified clearly. The distance from the central point of the anterior edge of sigmoid to the roots of the trigeminal nerve, facial nerve, vestibulocochlear nerve and glossopharyngeal nerve were (29.88+/-2.77) mm, (32.04+/-2.04) mm, (29.17+/-1.65) mm, (35.49+/-1.53) mm respectively. CONCLUSION The visual field of the cerebellopontine angle appear wider by the endoscope assisted retrolabyrinthine approach. Nerves, vessel, internal acoustic pore, jugular foramen region can be clearly seen. Some minimal invasive surgery can be done by this approach.
Adult ; Cerebellopontine Angle ; anatomy & histology ; surgery ; Ear, Inner ; surgery ; Endoscopes ; Female ; Humans ; Male

Cerebellopontine Angle ; anatomy & histology ; Ear, Inner ; anatomy & histology ; Humans ; Microsurgery ; Neuroma, Acoustic ; surgery

Cerebellopontine Angle ; anatomy & histology ; Ear, Inner ; anatomy & histology ; Humans ; Microsurgery ; Neuroma, Acoustic ; surgery

OBJECTIVE: To improve the possibility of diagnosis of the Mondini dysplasia. METHOD: The clinical manifestation and the examination of CT and MRI and surgical treatment of the Mondini dysplasia were discussed. RESULT: Because Mondini dysplasia with cerebrospinal fluid leak would occur recurrent meningitis, the patients were often difficult to be diagnosed. Especially. if the defect was unilateral, it was frequently unrecognized. CONCLUSION The patients with recurrently unclear cerebrospinal fluid leak and meningitis would be suspected. The diagnosis of the disease is based on the examination of the temporal bone CT and MRI. To the patients with cerebrospinal fluid leak, a transtympanic closure is one of very effective management.
Adolescent ; Cerebrospinal Fluid Otorrhea ; diagnosis ; etiology ; surgery ; Ear, Inner ; abnormalities ; Humans ; Male ; Tympanoplasty ; methods