OBJECTIVE To study the clinical features and therapeutic efficacy of middle ear adhesion.METHODS The clinical data of 40 cases of middle ear adhesion collected during 5 years from 2002 to 2007 were studied retrospectively. RESULTS Part or all of the tympanic membrane of the patients did not move under Siegle otoscopy. The lesions of middle ear adhesion were extensive and invaded all middle ear structures including round and oval windows.The lesions were severe, especially in narrow anatomical spaces such as mesotympanum,hypotympanum and interossicular spaces.Pure tone audiometry showed that average air-bone gap (A-B gap) were (35.34?6.99) dB preoperatively.The average A-B gap were (18.47?5.76) dB 6 months after operation.Follow-up observations and postoperative CT scan showed that tympanic membranes and middle ear cavity recovered well.CONCLUSION There are various degrees of tympanic fibrous adhesion and atelectatic tympanum in middle ear adhesion,especially in mesotympanum, hypotympanum and interossicular spaces.The middle ear adhesion can be treated with operation.The key points for a successful operation include preserving normal tympanum mucosa,opening eustachian tubes, making a bigger middle ear cavity,and performing tympanoplasty with perichondrium-cartilage plates.

Objective To discuss the clinical features, diagnosis and therapy of primary adrenal lymphoma (PAL) . Methods Two patients (65-year old and 52-year old respectively) who complained vague pain were analyzed. Occupying lesions in adrenal gland were discovered by computed tomography (CT) and diagnosed by needle biopsy and laparoscopic surgery. Results The two patients in our hospital were diagnosed as nonHodgkin's lymphoma. They were treated with chemotherapy and one of them was partial response. Literatures on PAL were reviewed. In the literature, 7 of the 65 patients achieved complete response, 15 partial response, 43 death or unspecified and the survival duration was 3 days to 26 months. Conclusions Most of PAL are bilateral, without specific clinical characters. Neele biopsy is the first choice to make the diagnosis. The therapeutic modalities for PAL include surgery, chemotherapy, surgery followed by chemotherapy as well as radiation therapy. The prognosis of PAL is poor if other organs are involved.

Objective:To investigate the diagnostic value of high resolution CT for temporal bone traumatic facial nerve paralysis and the guidance significance for surgery.Method:Twenty-nine patients of traumatic facial nerve paralysis were investigated.The predictive diagnosis was made according to the clinical data and the image features of HRCT,then a comparative analysis of the preoperative image features and the surgical findings were carried out.Result:The trend of temporal bone fracture displayed on the CT scan was basically consisted with the surgical findings.The direct CT signs of facial nerve injury include the bone fracture line went through the tube,bone tube rupture or continuity interruption,while the indirect CT signs include local incrassation of the facial nerve,lower bone density of the tube,geniculate fossa expansion,oppressed facial nerve,et al.The predictive diagnostic accordance rates of all the image features were above 90%as to the surgical findings.Conclusion:High resolution CT could localize the trend of temporal bone fracture,and is helpful to estimate the extent of facial nerve injury and other complications.High resolution CT could provide reliable basis for clinical diagnosis and trotment.

Objective To study the effects of the integrity of the tensor tympani muscle on the postoperative hearing recovery and the morphology of tympanic membrane,to provide the reference for the handling of the tensor tympani muscle during the operation.Methods A total of 145 cases of chronic tympanitis were grouped by the integ-rity of the tensor tympani muscle and the implanted types of biological auditory ossicles,the clinical data were ana-lyzed retrospectively.There were 80 cases in the tensor tympani muscle intact group,including 45 cases of PORP group and 35 TORP group.The tensor tympani muscle rupture group of 65 cases consisted of 34 cases of PORP group,and 31 cases of TORP group.The postoperative recovery conditions of tympanic membrane morphology, hearing threshold Ac and air-bone gap(ABG)between the tensor tympani muscle intact group and the tensor tym-pani muscle rupture group were compared 1 month or 3 months,and 6 months after the operation.ResuIts One month after the operation,there was no significant difference in tympanic membrane morphology between the two groups.Three months after the operation,the tensor tympani muscle intact group had a higher ratio about the loca-tion and shape of tympanic membrane ,closer to the normal than the tensor tympani muscle rupture group in which the ratio in the intact group was 81.25% (65/80),while in the rupture group it was 52.31% (34/65 ).After 6 months,with the operation of PORP,the tensor tympani muscle intact group of AC value was 27.48±10.02 dB HL, and ABG value was 13.57±6.36 dB,while the rupture group of AC value was 32.36±9.34 dB HL,and ABG value was 25.73±7.44 dB.With the operation of TORP,the tensor tympani muscle intact group of AC value was 28.76± 7.14 dB HL,and ABG value was 21.02±5.48 dB,while the rupture group of AC value was 39.93 ±5.12 dB HL, and ABG value was 31.41±6.25 dB.The postoperative recovery condition of the tensor tympani muscle intact group was better than those of in the rupture group.ConcIusion The tensor tympani muscle can maintain the morphology and location of the postoperative tympanic membrane.The integrity of the tensor tympani muscle may has a positive effect on the improvement of the postoperative hearing.

OBJECTIVE: To define the clinical and imaging features of external auditory canal cholesteatoma (EACC) and determine the characteristics most important to its clinical management. METHOD: Seventeen cases (21 ears) of EACC were retrospectively reviewed. Clinical data were collected for the history, presentation, physical examination findings and CT scans. The surgical management approaches were reviewed. RESULT: Patients presented with otalgia (n = 21), otorrhea (n = 16), ear-canal stenosis (n = 11), facial nerve dysfunction (n = 4). CT scans showed a soft tissue mass with adjacent bone erosion (n =21). Middle ear and mastoid involvement (n = 9), facial canal erosion (n = 4), sigmoid sinus erosion (n = 1) and jugular bulb dehiscence (n = 1) were observed. EACC excision and canaloplasty through transcanal approaches were performed in 12 ears, while postauricular incision and canal wall down mastoidectomy were used in 9 ears. CONCLUSION The possible causes of EACC and its possible extension may influence clinical management. Preoperative high-resolution temporal bone CT scans can be helpful in the diagnosis and management of EACC.
Adolescent ; Adult ; Aged ; Child ; Cholesteatoma ; diagnosis ; diagnostic imaging ; surgery ; Ear Canal ; diagnostic imaging ; pathology ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

Child ; Cochlear Implantation ; adverse effects ; Hematoma, Epidural, Cranial ; etiology ; Humans ; Male

OBJECTIVE: To investigate the diagnostic value of high resolution CT for temporal bone traumatic facial nerve paralysis and the guidance significance for surgery. METHOD: Twenty-nine patients of traumatic facial nerve paralysis were investigated. The predictive diagnosis was made according to the clinical data and the image features of HRCT, then a comparative analysis of the preoperative image features and the surgical findings were carried out. RESULT: The trend of temporal bone fracture displayed on the CT scan was basically consisted with the surgical findings. The direct CT signs of facial nerve injury include the bone fracture line went through the tube, bone tube rupture or continuity interruption, while the indirect CT signs include local incrassation of the facial nerve, lower bone density of the tube, geniculate fossa expansion, oppressed facial nerve, et al. The predictive diagnostic accordance rates of all the image features were above 90% as to the surgical findings. CONCLUSION High resolution CT could localize the trend of temporal bone fracture,and is helpful to estimate the extent of facial nerve injury and other complications. High resolution CT could provide reliable basis for clinical diagnosis and treatment.
Adolescent ; Adult ; Facial Nerve ; diagnostic imaging ; Facial Nerve Injuries ; diagnostic imaging ; Facial Paralysis ; diagnostic imaging ; Female ; Fractures, Bone ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Temporal Bone ; diagnostic imaging ; injuries ; Tomography, X-Ray Computed ; methods ; Young Adult

OBJECTIVE: To observe the clinical efficacy of intratympanic dexamethasone (IT-DEX) for sudden deafness (SD) which were inefficient and contraindicant for systemic steroid. METHOD: Thirty-four patients who were inefficient and contraindicant for systemic steroid were treated by IT-DEX (5 g/L) for 4 times within 12 days. The improvement of audits, tinnitus and stuffy were observed. And the results between the different influencing factor such as age, sex and course of disease were compared by statistical analysis. RESULT: 1) For total patients, the effective power of audits, tinnitus and stuffy were 52.9%, 58.8% and 82.4% respectively. And the patients who treated within 2 weeks result in higher effective power of audits and tinnitus than those having been treated for more than 2 weeks, but there was no significant difference between these two groups (P >0.05). 2) For the patients who were inefficient and contraindicant for systemic steroid, the audible effective power of them were 44.4% and 62.5% respectively. CONCLUSION IT-DEX can treat refractory SD effectively and safely. It is an effective treatment for the patients who were contraindicant for systemic steroid, and it could be used for salvage for the patients who were inefficient for systemic steroid.
Adolescent ; Adult ; Aged ; Dexamethasone ; administration & dosage ; therapeutic use ; Drug Administration Routes ; Female ; Hearing Loss, Sudden ; drug therapy ; Humans ; Male ; Middle Aged ; Tympanic Membrane ; Young Adult

Butanol is not only an important chemical feedstock but also expected to become a new generation biofuel. Thus, biological butanol production using renewable feedstocks has attracted renewed attention due to the worries of global oil supply and its impact on social and economic development. However, compared with petrochemical-derived butanol, biological butanol production is still not economically competition, because of its major drawbacks: high cost of the feedstocks, low butanol concentration in the fermentation broth and the co-production of low-value byproducts acetone and ethanol. Recently, Shanghai cooperative bio-butanol group (SCBG) developed a simple-to-complex technical route to improve bio-butanol production with a focus on: increasing butanol ratio in the solvent through metabolic engineering of Clostridia spp.; introducing and optimizing the butanol synthetic pathway in the species with high butanol tolerance; overcoming the glucose repression effect to utilize low-cost non-grain based feedstocks. SCBG believes that, through extensive domestic and international industry-university-research cooperation, a sustainable and economically viable process for biological butanol production can be established in the near future.
Biofuels ; Butanols ; metabolism ; Clostridium ; genetics ; metabolism ; Clostridium beijerinckii ; genetics ; metabolism ; Fermentation ; Genetic Engineering ; methods ; Industrial Microbiology ; methods ; trends