Humans ; Carcinoma, Squamous Cell/pathology* ; Chromosomal Proteins, Non-Histone/genetics* ; Ear, Middle/pathology* ; Poly-ADP-Ribose Binding Proteins ; Nuclear Proteins

Ear/pathology* ; Ear Diseases/therapy* ; Ear, Middle ; Humans

Objective: To collect the clinical cases of middle ear hairy polyp, and to summarize the imaging features. Methods: We retrospectively analyzed the clinical data of four cases middle ear hairy polyp confirmed by surgical and pathologic between January 2007 and January 2020 at the Affiliated Eye & ENT Hospital of Fudan University. There were three females, one male, with two left ears and two right ears, aged from 1 to 59 years. The CT and MRI imaging of the patients, and the corresponding clinical manifestations were analyzed. Results: Hairy polyps originated from tympanum in one case, originated from Eustachian tube in two cases, exhibiting recurrent otorrhea without evident inducement. The other case, hairy polyps originated from the Eustachian tube pharyngeal orifice and protruded into the nasopharyngeal cavity, with pharynx discomfort and aural fullness, endoscope showed offwhite polypoid mass with a little hair. All the four cases presented polypoid soft tissue masses on CT and MRI imaging, containing soft tissue wall and a large amount of adipose tissue, with soft tissue in the center of the mass which liked the core, and enhanced. MRI showed stratified arrangement of fat and soft tissue in the wall of the mass. Four cases all had surgical treatment, postoperative pathology examination presented that hair follicles, mature sebaceous glands and other skin appendages were found under squamous epithelium. A large amount of adipose tissue, part of muscle tissue, cartilage tissue, and some fibro-collagenous tissue were proliferated in the mass, accompanied by collagen degeneration. Conclusion: The middle ear hairy polyps has imaging characteristics, the polypoid soft tissue mass usually looks smooth and contains a large amount of adipose tissue, with a soft tissue in the center, and can be suggestively diagnosed by CT and MRI.
Adolescent ; Adult ; Child ; Child, Preschool ; Ear Diseases ; Eustachian Tube/pathology* ; Female ; Humans ; Infant ; Male ; Middle Aged ; Nasopharynx/pathology* ; Polyps/pathology* ; Retrospective Studies ; Young Adult

Child ; Choristoma ; pathology ; surgery ; Ear, Middle ; pathology ; surgery ; Female ; Hamartoma ; pathology ; surgery ; Humans ; Pharyngeal Neoplasms ; pathology ; surgery ; Salivary Glands ; pathology ; surgery

Malignancy of the middle ear is rare and its estimated incidence is 0.18 cases per million people in the US, with its most common type being squamous cell carcinoma. Squamous cell carcinoma in situ is thought to be a precursor to squamous cell carcinoma, which is extremely rare in the middle ear. The pathology reports of squamous cell carcinoma have not been well-characterized as it has not been reported to date in Korea. Here, we report a case of squamous cell carcinoma in situ of the middle ear in a 66-year-old man, who presented with otorrhea and tympanic membrane perforation.
Aged ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Ear, Middle ; Epithelial Cells ; Humans ; Incidence ; Korea ; Pathology ; Tympanic Membrane Perforation

Adult ; Cholesterol ; Dilatation ; Ear Canal ; Ear Neoplasms ; surgery ; Ear, Middle ; pathology ; Eustachian Tube ; Female ; Granuloma ; surgery ; Humans ; Male ; Mastoidectomy ; Middle Aged ; Treatment Outcome

Conventional impedance audiometry uses only specific tympanometric frequencies (e.g., 226 Hz) and cannot test above 1500 Hz. As many hearing frequencies must be evaluated when diagnosing middle ear pathologies, wideband clicks stimulating tympanometric receptors from 226 to 8000 Hz are commonly delivered. Since wideband tympanometry (WBT) was introduced in 1993, several studies have explored its clinical utility. WBT yields information on absorbances at various frequencies and pressures. Recently, WBT has become increasingly used to diagnose and monitor the hearing of newborns and patients with otosclerosis, ossicular chain disruptions, tympanic perforations, superior semicanal dehiscence syndrome, and middle ear effusions. WBT is also employed for pre/postoperative monitoring using non-pressurized wideband absorbance. Here, we review the concept of WBT, the basic mechanism, and the clinical applications.
Acoustic Impedance Tests* ; Ear, Middle ; Hearing ; Humans ; Infant, Newborn ; Otitis Media with Effusion ; Otosclerosis ; Pathology

BACKGROUND AND OBJECTIVES: The use of endoscope has led to new treatment options for middle ear pathologies. The aim of this study is to report on endoscopic ear surgeries for the removal of middle ear cholesteatoma and discuss about the usefulness of endoscopic approach to congenital cholesteatoma in children. SUBJECTS AND METHOD: Five pediatric patients with congenital cholesteatoma were enrolled in this study. Cholesteatoma was removed via transcanal endoscopic approach in all patients. Medical records were reviewed retrospectively. We analyzed the clinical characteristics, surgical management and treatment outcomes. RESULTS: The average age of patients was 3.7 years. Cholesteatoma was observed in the anterior portion of tympanic membrane in four patients, and in the posterior portion in one patient. Endoscopic techniques were used exclusively in four patients, but one patient was treated by microscopic approach using a combined technique. Cholesteatoma was fully removed and we confirmed by endoscopic examination that no remnant lesions remained. Surgical complications such as vertigo, sensorineural hearing loss, infection, or bleeding were not seen postoperatively. Average hospital stay was 1.2 days. CONCLUSION: Results showed that this technique was beneficial for treating cholesteatoma in limited cases. Endoscopic surgical techniques produced good intraoperative and postoperative results in removing pediatric congenital cholesteatoma and will gain importance in the otological surgery in the future.
Child* ; Cholesteatoma* ; Cholesteatoma, Middle Ear ; Ear ; Ear, Middle ; Endoscopes ; Hearing Loss, Sensorineural ; Hemorrhage ; Humans ; Length of Stay ; Medical Records ; Pathology ; Retrospective Studies ; Tympanic Membrane ; Vertigo

Child ; Cholesteatoma, Middle Ear ; diagnosis ; pathology ; Ear, Middle ; physiopathology ; Humans ; Otitis Media with Effusion ; diagnosis ; pathology

OBJECTIVETo analyze the clinical characteristics of unilateral conductive hearing loss with intact tympanic membrane, and summarize the key diagnostic points, differential diagnosis and observe the effects of surgical treatment.

METHODSWe reviewed data from 82 patients with unilateral conductive hearing loss with intact tympanic membranes who accepted the exploratory tympanotomy from April 2011 to September 2013. There were 41 males and 41 females, aged from 7 to 66( averaged 26.5±13.7)years, with a history of one month to 50 years. The history, clinical symptoms, audiological evaluation, high resolution temporal bone CT, the results of surgical exploration and hearing reconstruction were analyzed.

RESULTSThe exploratory tympanotomy revealed 43 cases of congenital middle ear malformations (52.4%), 22 cases of otosclerosis (26.8%), eight cases of congenital cholesteatoma (9.8%), six cases of trauma induced conductive hearing loss (7.3%), three cases of congenital ossicular malformations with congenital cholesteatoma (3.7%). Progressive hearing loss was common in patients with otosclerosis and congenital cholesteatoma, and patients with congenital middle ear malformations described their hearing loss since childhood. High resolution temporal bone CT of congenital middle ear malformation, trauma induced conductive hearing loss, congenital cholesteatoma diagnosis rate was 40.0%, 50.0%, and 83.3% respectively. The preoperative air-conductive threshold of patients with absence of the oval window were increased to (66.9±1.1)dBHL, the preoperative bone-conductive threshold achieved (28.3±10.4)dBHL at 2 000 Hz. While patients with stapes fixation and that with ossicular chain discontinuity were (27.2±9.7)dBHL and (17.8±8.8)dBHL(P=0.000)respectively. Through the tympanic exploration with endaural incision under the microscope, different hearing reconstruction were applied according to different lesions. After the operation, the hearing level of 52 patients with return visit were improved, the mean air-conductive threshold were decreased from (60.0±11.4)dBHL to (32.2±12.1)dBHL(P=0.000); and the mean ABG were decreased from (43.2±12.0)dB to (16.3±9.4)dB(P=0.000).

CONCLUSIONSCongenital middle ear malformations, otosclerosis, congenital cholesteatoma are the most common causes in unilateral conductive hearing loss with an intact tympanic membrane. The diagnosis rate can be improved by analyzing the clinical features. Through exploratory tympanotomy and hearing reconstruction, we can clarify the diagnosis and achieve a satisfying hearing recover.

Adolescent ; Adult ; Aged ; Audiometry ; Child ; Cholesteatoma ; congenital ; pathology ; Diagnosis, Differential ; Ear Ossicles ; pathology ; Ear, Middle ; abnormalities ; Female ; Hearing Loss, Conductive ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Middle Ear Ventilation ; Otosclerosis ; pathology ; Tympanic Membrane ; Young Adult