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 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 vestibular function of motion sickness. Method:VNG, which tests the vestibular function of horizontal semicircular canal,and CPT, which tests vestibulospinal reflex and judge proprio-ceptive,visual and vestibular status, were performed in 30 motion sickness pations and 20 healthy volunteers(control group). Graybiel score was recorded at the same time. Result:Two groups' Graybiel score (12. 67±11. 78 vs 2. 10±6. 23;rank test P<0. 05),caloric test labyrinth value [(19. 02±8. 59)°/s vs (13. 58±5. 25)°/s ;t test P< 0. 05],caloric test labyrinth value of three patients in motion sickness group exceeded 75°/s. In computerized pos-tourgrphy testing(CPT) , motion sickness patients were central type(66. 7%) and disperse type(23.3%);all of contral group were central type. There was statistical significance in two groups' CTP area, and motion sickness group was obviously higher than control group. While stimulating vestibulum in CPT, there was abnormality (35%-50%)in motion sickness group and none in contral group. Generally evaluating CPT,there was only 2 pro-prioceptive hypofunction,3 visual hypofunction, and no vestibular hypofunction, but none hypofunction in contral group. Conclusions Motion sickness patients have high vestibular susceptible, some with vestibular hyperfunction. In posturography,a large number of motion sickness patients are central type but no vestibular hypofunction, but it is hard to keep balance when stimulating vestibulum.

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 evaluate the application of the inlay butterfly cartilage graft technique in myringoplasty.Methods Thirty--eight ears in 38 patients (experiment group) with dry central drum perforations were treated with inlay butterfly cartilage myringoplasty,and 46 ears in 46 patients with underlay temporalis fascia myringoplasty (control group).Results After a mean follow-up of 6 months,the healing rate did not differ between two groups (92.1% in experiment group,91.3% in control group,P＞ 0.05).Average pure-tone hearing threshold improved than 10 dB and closure of the air-bone gap (ABG) within 10 dB were not different (P ＞ 0.05).The cured patients were followed up for 12-38 months,there was no ear perforation of drum in experiment group,but 4 ears in control group.Condusion Inlay butterfly cartilage myringoplasty is the reliable and ideal method for tzeating dry central drum pedoration with high success rate.

Objective To evaluate and characterize tinnitus patients, and provide profiles for further studying tinnitus.Methods This study included 2 171 tinnitus patients seeking treatment between Janurary 2014 and December 2015 from department of head and neck surgery,Sun Yixian Memorial Hospital,Zhongshan University.Tinnitus measurements consisted of pure tone audiometry and tinnitus matching procedures.The characteristics of tinnitus were analyzed by the essential information and auditory checks of the patients.Results Average age was 44.08±15.37 years old.Tinnitus frequently occurred between 41 to 50 years old(491 cases,22.60%).Unilateral tinnitus was more than bilateral tinnitus, while the cranial tinnitus was rare.The patients with mild or moderate tinnitus had the largest population,with higher average hearing threshold at 8 000 Hz in tinnitus ear than non tinnitus ear.The highest frequency of tinnitus matching frequency was high frequency(4~8 kHz).The first three causes for tinnitus were unknown reasons,sudden deafness and middle ear disease.Conclusion Larger population was subjective tinnitus.Tinnitus was closely related with hearing loss.The causes for tinnitus were complex.Tinnitus retraining therapy is a treatment that is worth to be popularized.

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.