Auricular deformity, a common disease of the external ear in China, can be divided into congenital deformity and acquired deformity caused by trauma or ablative origin. Ear reconstruction with autogenous rib cartilage grafts provides consistent emotional relief and psychological benefits due to the repair. However, autogenous reconstruction is complex and challenging, and can be fraught with complications, in addition sometimes it may not be an option for the patients with poor skin cover, severe craniofacial anomalies, those with microtia who have had a failed previous reconstruction and microtia patients with a very low hairline and residual lobe. As an alternative to the significant surgical morbidity of autogenous reconstruction, osseointegrated implant reconstruction has several distinct advantages. This current essay was to illustrate the superiority, indications, feasibility and complications of osseointegrated implant reconstruction, and provide alternative way to help patient who was deprived of ear(s).
Ear Auricle ; abnormalities ; surgery ; Humans ; Osseointegration ; Prostheses and Implants ; Reconstructive Surgical Procedures ; methods ; Transplantation, Autologous ; Treatment Outcome

Objective To investigate the relationship between Alloiococcus otitidis (A. otitidis) and Secretory Otitis Media (SOM) in adults.Methods The study included 39 adult patients suffering from SOM and 42 samples (middle ear effusion, MEE)were collected. We detected the four organisms(A. otitidis ,S. pneumoniae, H.influenzae and M. catarrhalis) by mutiplex PCR, for comparing the bacterial findings in the patients with or without cold history, with or without antibiotic treatment, with effusion of different characters and durations by chi-square test. Results The DNA of A. otitidis was detected from 5 MEEs(11.9%).To acute SOM, only 1 sample was PCR-positive for A. otitidis; and to chronic SOM,4 samples were positive. There was a significant difference between them. There were 3 serous MEEs and 2 mucous MEEs, which were PCR-positive for A. otitidis, and there was a significant difference between them. Antibiotic therapy didn't contribute to PCR-positive for A.otitidis. Conclusion There is A. otitidis in the MEEs of adult SOM and it may be a pathogenic factor in SOM. A. otitidis may play an important role in chronic SOM.

OBJECTIVE To investigate the clinical results and feasibility of auricular prostheses by osseointegration technique for total auricular defect.METHODS Nineteen patients with traumatic total auricular defect who had underwent operation of bone-anchored auricular prosthesis were studied retrospectively.There were 12 cases with congenital microtia after an unsuccessful total auricular reconstruction,1 case with sulfuric acid burn,1 case with high temperature aluminum liquid burn,4 cases with traffic accident and 1 case with knife trauma.All the cases were followed-up for 3 to 5 years.RESULTS All the patients were cured after operation once.They all had vivid appearances with natural color and luster.The auricular prosthesis by osseointegration technique was stable and had no harm for daily life.CONCLUSION Auricular prosthesis by osseointegration technique is a convenient method with less trauma,short curing time,no complication and good result.It is a salvage treatment for patients after unsuccessful total auricular reconstruction.It is also a priority method for patients with scar formation after total auricular defects.

Objective To explore the difference between the stapes prosthesis surgery with microscope and with otoscope. Methods Fifty-four patients with otoselerosis accepted stapes prosthesis surgery with the same kind of stapes prosthesis, done in the same operative method by the identical surgeon.All the operations were done with microscopes or with otoscopes. The operative difference and therapeutic effects between microscope surgery and otoscope surgery were analysed. Results There was no difference in the postoperative heating improvement between microscope surgery and otoscope surgery; the operative time of microscope surgery [(30±7)] min was much shorter than that of otoscope surgery [(60±5)] min,with significant statistical difference. Conclusions Stapes prosthesis surgery with microscope, which has advantages of bimanualness, easiness, and short operative time, is much better than that with otoscope.Thus, microscope is still the preferred magnifying equipment in stapes prosthesis surgery.

OBJECTIVE: To assess the diagnosis and therapeutic effects for fungal otitis externa by clinical symptoms, endoscopic findings, and fungus culture of the ear discharge. METHOD: Sixty outpatients diagnosed with otitis externa were enrolled in the study. All patients were treated with a thorough debridement of the ear and one antifungal medication regimens (compound resorcinol solution) in case of a positive fungus culture. One subgroup of patients treated with daub glycerol during 2 weeks of follow-up. RESULT: Positive cultures were found in 42 cases. The efficacy was observed in all patients even in those who received only ear endoscopy. CONCLUSION Fungal otitis externa could be easily diagnosed by ear endoscopy. A thorough debridement of the ear and utility of compound resorcinol solution is an easy and effective approach for treatment of fungal otitis externa.
Antifungal Agents ; therapeutic use ; Debridement ; Fungi ; Glycerol ; Humans ; Otitis Externa ; diagnosis ; microbiology ; Otomycosis ; diagnosis ; Outpatients

OBJECTIVE: This research focuses on the psychologic status of children patients with congenital malformation of external and middle ear by Achenbach's Child Behavior Checklist (CBCL) in order to explore the degree of the influence. METHOD: The 66 patients of 4-16 years old were assessed psychologic status with CBCL filled in by their parents according to their performance in half a year. Then calculated the detection rate of behav ioral disorders of these patients. Collected all patients' general information and Marx's grade of malformed ears. Then analyzed the relationship between the detection rate and these factors. RESULT: The detection rate of behavioral disorders of 4-16 years old patients, 21.21%, which is higher than that of Chinese norm. The Marx's grade and parents' mental stress relate with the behavioral disorders. In Logistic regression analysis, the value of Cox & Snell coefficient of the regression model is 0. 153. The detection rate of behavioral disorders in grade III patients (36.4%) is greater than that of grade II (4.3%), P = 0.004. CONCLUSION Congenital malformation of external and middle ear has an absolute influence on the patients' psychologic status, but its effect is only about 15% parts of the multitudinous influential factors. And grade III patients carry a high-risk for behavioral disorders.
Adolescent ; Child ; Child Behavior Disorders ; epidemiology ; Child, Preschool ; Ear, External ; abnormalities ; Ear, Middle ; abnormalities ; Female ; Humans ; Male ; Psychology, Child

Objective To explore the possible mechanism of miR 34a/Bcl-2 apoptotic pathway in the mouse model of age-related hearing loss.Methods A C57BL/6 mouse model of age-related hearing loss was conducted,and 4-week-old and 12-month-old mice were considered as the objects.The auditory brainstem response (ABR) was used to test the hearing function.The TdT-mediated dUTP nick end labeling (TUNEL) was used to observe the apoptosis of neuron in auditory cortex.The mRNA and protein levels of miR-34a,Bcl-2 and caspase 3 were detected by real-time PCR and Western bloting,respectively.Results The ABR showed that the hearing threshold level at 4,8,16,32 kHz were higher in 12-month-old mice than in 4-week-old mice [(80.0±2.5) dBHL vs.(32.0 ±4.5) dBHL,(74.0±3.5) dBHL vs.(51.0±1.2) dBHL,(86.0±4.6) dBHL vs.(51.0±3.5) dBHL,(87.0±6.6) dBHL vs.(56.0±1.5) dBHL,all P＜0.05].Compared with 4 week-old mice,the total number of neurons in auditory cortex was decreased,the number of apoptosis neurons was increased,the expressions of miR-34a (t=6.02,P=0.001),Bax (t=6.51,P=0.012) and Caspase 3 (P=0.023) rised,and the expression of Bcl-2 (t=7.12,P=0.032) declined in 12 month-old mice.Conclusions The activation of miR-34a/Bcl-2 apoptotic pathway may be one of the mechanisms of age-related hearing loss.

Objective To investigate the NAD+ - dependent protein deacetylase SIRT1 expression in the cochlea of C57BL/6 mice ,a mouse model of age - related hearing loss(AHL) .Methods A total of 46 C57BL/6 mice were used ,and were divided into 2 groups ;according the age ,there were young group (1 ~ 2 months old ,23 mice) and old group (12 ~ 16 months old ,23 mice) .ABR measurements were performed on young and old C57BL/6 mice . The expression of SIRT1 in the cochlea was detected by qRT - PCR and immunofluorescence .Results The ABR thresholds in the old mice(4 kHz :82 .7 ± 7 .32 dB SPL ,8 kHz :80 .9 ± 7 .8 dB SPL ,16 kHz :89 .3 ± 5 .5 dB SPL ,32 kHz :89 .9 ± 4 dB SPL) were significantly higher than those in the young C57BL/6 mice(4 kHz :52 .1 ± 8 .3 dB SPL ,8 kHz :40 .5 ± 6 .1 dB SPL ,16 kHz :50 .7 ± 9 .4 dB SPL ,32 kHz :57 .6 ± 11 .9 dB SPL)(P < 0 .001) .SIRT1 mRNA expression was significantly decreased in the cochlea of old C57BL/6 mice in comparison with young mice ( P <0 .01) .SIRT1 protein was abundantly expressed in the inner hair cells ,outer hair cells ,supporting cells ,strial marginal cells ,strial intermediated cells ,and spiral ganglion neurons .The positive area and the average flourescence intensity of SIRT1 protein were reduced in old C57BL/6 mice(P< 0 .001) .Conclusion The down - regulation of SIRT1 mRNA and protein expression in the older C57BL/6 mouse cochlea may be correlated with the pathogenesis of AHL .

OBJECTIVE To evaluate the short-term efficacy of ear molding in the treatment of congenital auricular deformation. METHODS Twenty-four infants(twenty-eight ears) were treated with ear molding devices(EarWell Infant Ear Correction System). Doctors and parents were surveyed 1 months after treatment. RESULTS All cases were treated successfully without severe complications. 25 ears(89％) and 26(92％) were rated as very satisfied or satisfied by doctors and parents, respectively. CONCLUSION Ear molding is a noninvasive treatment, and effectively corrects congenital auricular deformation.

OBJECTIVE To explore the expression of Bcl-2, on mRNA and protein levels, in the different age of C57BL/6 mice cochleae and the expression localization in the cochleae.METHODS Using ABR to test the hearing level in C57BL/6 mice. Surface preparation of cochlear basil membrane is used to observe the morphology and amout of the outer and inner hair cells in different age of C57BL/6 mice. Fluorescent quantitative real time PCR, immunofluorescence histochemical method and western blot are used to detect the expression of Bcl-2 on the mRNA and protein levels in the C57BL/6 mice cochlea of different age groups ('young group', 'elderly group').RESULTS ABR results showed that the hearing threshold of 'older' C57BL/6 mice is much higher than that in the 'young' mice, and surface preparation of cochlear basil membrane showed the hair cell localized in the cochlear basil turn of 'old' mice arranged in a disorder station and part of hair cells were lost. Also, the spiral ganglion cells arranged sparsely and messily. Fluorescence quantitative real-time PCR results suggest the expression of Bcl-2 on/at the mRNA level of the 'old' mice cochleae decreases significantly, compared to that in the 'young' mice. The results of Immunofluorescence and Western blot suggest the expression of Bcl-2 on/at the protein levels of the 'old' mice cochlea decreased, compared to that in the 'young' mice. Also, the Bcl-2 is located in the cytoplasm, and the expression of Bcl-2 in the inner hair cells seems higher than that in the outer hair cells. CONCLUSION The expression of Bcl-2 significantly deceased in the 'old' C57BL/6 mice cochleae, both on mRNA and protein level, which may be related to the hearing loss and loss of hair cells.