OBJECTIVE: To study the effect of binaural bi-modal fitting (one cochlear implant and a contralateral hearing aid) on speech recognition of cochlear implant recipients with low frequency electrodes incompletely implanted. METHOD: A total of 15 cochlear implant(CI) users who have low residual hearing (250 Hz 45-90 dBHL, 500 Hz 75 - 100 dBHL) of their non surgery ears. We closed the top three electrodes to simulate the state of low-frequency electrodes incompletely implanted by fitting software. (1) The same tester received twice speech recognition tests in incompletely implanted state, one test used single CI model and the other used binaural bi-modal fitting model. (2)The same tester received above twice speech recognition tests again, but in completely implanted state. Then we compared the results of tests. RESULT: The CI users used binaural bi-modal fitting have higher speech recognition score than the same users used unilateral cochlear implant model in low-frequency electrodes incompletely implanted state(P<0. 05). The gap between the scores of the tests by using two usage patterns in low frequency electrodes incompletely implanted state was more than that in completely implanted state (P<0. 05). CONCLUSION Binaural bi-modal fitting can help CI users to improve their speech recognition ability in low-frequency electrodes incompletely implanted state.
Cochlear Implantation ; methods ; Cochlear Implants ; Electrodes, Implanted ; Hearing ; Hearing Aids ; Hearing Tests ; Humans ; Speech ; Speech Perception

Patient of plasmacytoma of temporal bone often suffered from evident symptom in unilateral ear and obvious damage of bone. Clinical characteristics, imaging examination and histopathology can established an accurate diagnose. The therapy will be surgery and followed radiotherapy.
Bone Neoplasms ; diagnosis ; therapy ; Combined Modality Therapy ; methods ; Humans ; Plasmacytoma ; diagnosis ; therapy ; Temporal Bone

OBJECTIVE: To explore the value of high-resolution temporal bone CT (HRCT) multi-planar reconstruction (MPR) technique for measuring cochlear morpholog in the preoperative evaluation of cochlear implant. METHOD: We retrospectively analyzed the clinical data of 80 cochlear implant recipients. The groups were investigated in our research according to the patient's sex, age and whether the inner ear is malformed or not. Temporal bone HRCT MPR was applied to analyze the measurement parameter in the standard orientation of the cochlea image: the largest distance from the round window to the lateral wall (distance A), the perpendicular distance (B) and angle of the basal turn of the cochlea relative to the midsagittal plane (γ). Reproducibility of the measured data was evaluated and the results between the different groups were compared. RESULT: Measurement of parameter values between the intraobserver and interobserver showed good reproducibility. In normal group, distance A [(8.79±0.34) mm] and perpendicular distance B [(6.58±0.28) mm] of males' cochleae were significantly larger than A [(8.53±0.47) mm] and B [(6.22±0.43) mm] of females' (P<0.05), but the angle γ was not significantly different between the two groups (P>0.05). The A and B values didn't change with age (P>0.05), but the angle γ tended to decrease with increasing age (r=-0.25, P<0.05). In the malformation group, the value B was significantly smaller than that of the normal group (P<0.01), but for value A and angle γ, there was no significant difference between the two groups (P>0.05). CONCLUSION HRCT MPR technique is simple and reliable in measurement of cochlear morphology. It can be used to guide the surgery and provide an objective basis for designing the personalized electrode. More clinical application of this technology is recommended.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cochlea ; diagnostic imaging ; Cochlear Implantation ; Female ; Humans ; Infant ; Male ; Middle Aged ; Retrospective Studies ; Temporal Bone ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

Objective To explore the clinical effect of dorsal digital artery reverse island flap in the repair of distal finger skin defect.Methods From January,2011 to January,2015,60 fingers of 60 cases with dorsal branch of the digital artery were used to repair the defect of the distal finger skin.The 30 refers to the index finger,middle finger 15 fingers,10 ring fingers and 5 little fingers.Harvested area of 1.2 cm ×1.7 cm to 3.2 cm × 3.6 cm,the wrist or distal medial arm full thickness skin graft donor site.Evaluation of sensory recovery by the British Medical Research Association.Results All flaps survived.Twelve finger flap tension blisters,and the flaps survived after the stitches.Follow-up of 60 cases of 60 to hand function according to the Chinese medicine will hand surgery society of upper extremity function evaluation standard trial Tam method to evaluate the:50 excellent,10 fingers good,the excellent and good rate was 100％;48 fingers flap sensation recovery to S4 class,and 12 refers to the recovery to S3.The two-point discrimination perception of 5 to 8 mm,average 6.5 mm;patients far,nearly interphalangeal joint average activity recovery was good.Skin flap skin ruddy,soft texture,no fat,no pigmentation,fearless cold performance.No scar hypertrophy and contracture,skin pain no allergy and reoperation.Conclusion The flap for repair of distal finger skin defect is a simple,no damage to the main artery and nerve and good sensory recovery,less postoperative complications,and excellent method of flap survival.It is worth promotion in primary hospitals.

OBJECTIVE: To evaluate the significance of additional 180-degree roll test (RT) in the determination of affected side in patients with horizontal semicircular canal benign paroxysmal vertigo (HSC-BPPV). METHOD: One hundred and six patients with HSC-BPPV were performed the 90 degree RT. patients whose affected side cannot be determined by 90 degree RT were performed 180 degree roll test. RESULT: The affected side was deter- mined by the 180 degree RT in 10 cases in which the lesion side cannot be determined by the 90-degree RT. CONCLUSION The affected side of HSC BPPV was able to be determined by 180 degree RT when it not possible to be determined by 90 degree RT. 180 degree RT is an effective and simple additional method.
Benign Paroxysmal Positional Vertigo ; diagnosis ; Head Movements ; Humans ; Posture ; Rotation ; Semicircular Canals ; Vertigo

OBJECTIVE: To investigate the correlation betwen varying degrees of non-acute tinnitus and anxiety and depression. METHOD: Seventy-seven outpatients with non-acute tinnitus as their in chief complaint were submitted to Tinnitus Handicap Inventory(THI), Self-Rating Anxiety Scale(SAS), and Self-Rating Depression Scale (SDS). RESULT: THI and its three subscales were found to have significant correlations with SAS and SDS. The group (THI ≥ 38) had more anxiety and depression than the mild (THI < 38). Significant correlations were also observed between THI, SAS and SDS in the group with THI ≥ 38, in contrast with the group of THI < 38. CONCLUSION Patients with THI ≥ 38 suffered from severe anxiety and depression than the mild. Doctors should pay more attention to these patients, especially their psychological disorders.
Anxiety ; complications ; Depression ; Depressive Disorder ; Humans ; Personality Inventory ; Stress, Psychological ; Surveys and Questionnaires ; Tinnitus ; complications ; psychology

Segmentation is a precondition step for modeling and analysis of the cochlea. In this paper, an interactive segmentation approach with a combination of 3D (three-dimensional) narrow-band level set algorithm and visualization technology was adopted to separate the cochlea. The 3D narrow-band level set algorithm was used to separate the objective of interest from volume data, and the visualization technology was used to display the segmented result. Users could modify intermediate parameters based on the direct 3D visual feedback until getting satisfying result. The basic principle and characteristics of level set and narrow-band level set algorithms were described in detail. The 3D narrow-band level set algorithm was successfully used to separate the cochlea from spiral CT images of the temporal bone. The experimental results show that the interactive method combining the narrow-band level set algorithm with visualization technique is capable of segmenting the cochlea from the medical volume data. Compared with the method of segmenting object from image volume slice by slice, our method can save much time.
Algorithms ; Cochlea ; diagnostic imaging ; Computer Graphics ; Humans ; Image Enhancement ; methods ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; Tomography, X-Ray Computed

OBJECTIVE: To study the image data and clinicopathologic features of myoepithelial carcinoma in parapharyngeal space. METHOD: Based on one patient with myoepithelial carcinoma of parapharyngeal space treated in our hospital, image data and clinicopathologic findings were analyzed. The clinical characteristics of myoepithelial carcinoma in head and neck region were discussed. RESULT: CT obviously showed the mass in parapharyngeal space with destruction of temporal bone. Immunohistochemical stain showed positive staining for S-100 protein, Smooth muscle actin, Cytokeratin and Vimentin. There were otalgia, bloody pus, headache and signs of cranial nerve lesion. CONCLUSION Myoepithelial carcinoma was a rare malignant epithelial neoplasm and had a poor prognosis. Myoepithelial carcinoma often occurrence in salivary gland of maxillofacial region. The clinical signs were otalgia and headache in patient with myoepithelial carcinoma in parapharyngeal space. CT image showed malignant neoplasm and surrounding tissues were destroyed. Diagnosis depends on pathology and immunohistochemistry.
Carcinoma ; diagnostic imaging ; pathology ; Humans ; Male ; Middle Aged ; Myoepithelioma ; diagnostic imaging ; pathology ; Pharyngeal Neoplasms ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

Objective To evaluate the abnormal alters of regional homogeneity (ReHo) in patients with end stage renal disease (ESRD) by resting functional-MR imaging (rs-fMRI),and explore its relation with cognitive impairment (CI).Methods A total of 52 patients with ESRD,admitted to our hospital from June 2017 to July 2018,and 36 age-and gender-matched healthy controls were enrolled.All subjects completed rs-fMRI.ReHo analysis method was used to analyze the synchronism of regional spontaneous activity between the two groups.Mini-mental state examination (MMSE),Montreal cognitive assessment (MoCA),digital symbol conversion test and trail marking test were employed to perform neuropsychological evaluations.The relation of ReHo value with neuropsychological evaluation results was analyzed.Results As compared with the healthy control group,the ESRD group exhibited significantly lower ReHo values of bilateral inferior orbital frontal gyrus,bilateral central anterior gyrus,left medial superior frontal gyrus,left medial temporal gyrus,right temporal gyrus,right cerebral island,and right lingual gyrus (P＜0.05).No brain region with increased ReHo values was detected.Bivariate correlation analysis suggested that ReHo values were positively correlated with MoCA scores in right inferior orbital frontal gyrus (r=0.479,P=0.000),left medial superior frontal gyrus (r=0.433,P=0.000),and right cerebral island (r=0.292,P=0.035).Conclusion The decrease of ReHo value in the frontal lobe and insula lobe of ESRD patients is associated with CI.

OBJECTIVE: To determine the efficacy of reversal steps stapedotomy in the treatment of otosclerosis. METHOD: From January 2006 to December 2009, a total of 70 patients (81 ears) with otosclerosis who underwent stapedotomy were retrospectively evaluated. Among these 81 ears, 41 ears underwent classical stapedotomy and 40 ears underwent reversal steps stapedotomy. We compared the postoperative results of pure tone tes , the intraoperative complications of stapes and incus and the incidence rate of postoperative vertigo after surgery between the two groups. RESULT: The rate of postoperative air bone gap < or = 20 dB was 70.7% in the classical stapedotomy group and was 80.0% in reversal steps stapedotomy group. There were no significant differences between the two groups (P =0.181). The reversal steps stapedotomy group seem to had less complications of stapes and incus. The incidence rate of postoperative vertigo in reversal steps stapedotomy group significantly lower than in classical stapedotomy group (P = 0.037). CONCLUSION Reversal steps stapedotomy can effectively improve the hearing of patients with otosclerosis and can reduce the complications of stapedotomy.
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Otosclerosis ; surgery ; Postoperative Complications ; etiology ; Retrospective Studies ; Stapes Surgery ; methods ; Treatment Outcome ; Vertigo ; etiology ; Young Adult