Patulous eustachian tube（PET） is an otolaryngological disorder caused by various factors, characterized by the loss of normal closure function of the eustachian tube in a resting state, resulting in persistent patency. Surgical treatment is recognized as an effective method for the management of refractory PET, but the surgical approaches for PET are diverse, with therapeutic outcomes varying significantly. The surgical procedure involving the occlusion of the tympanic ostium of the eustachian tube through the tympanic membrane, using specially designed silicone plugs, has shown excellent therapeutic outcomes. This minimally invasive procedure is considered highly safe and is considered as the preferred surgical option for patients with refractory PET. The purpose of this article is to review the current status and progress of endoscopic trans-tympanic eustachian tube plug implantation surgery in the treatment of patulous eustachian tube syndrome.
Humans ; Eustachian Tube/surgery* ; Endoscopy ; Tympanic Membrane/surgery* ; Ear Diseases/surgery*

A 27-year-old female patient suffering endolymphatic sac tumor with intralabyrinthine hemorrhage was reported. The patient had hearing loss in the left ear with continuous tinnitus, and MRI showed the soft tissue shadow of endolymphatic sac. Considering that the tumor involved semicircular canal and vestibule,endolymphatic cyst tumor resection was performed by labyrinth route. After surgery, there was no cerebrospinal fluid leakage and facial nerve function was normal. More importantly, enhanced MRI of temporal bone showed no tumor recurrence 1 year after surgery.
Female ; Humans ; Adult ; Endolymphatic Sac/surgery* ; Neoplasm Recurrence, Local/pathology* ; Labyrinth Diseases ; Tinnitus ; Ear Neoplasms/pathology* ; Bone Neoplasms ; Hemorrhage

Patients with patulous Eustachian tubes(PET) usually suffer from annoying symptoms, such as tinnitus, autophony and aural fullness, due to the excessive opening of the Eustachian tube. There is no uniform standard of treatment, and conservative therapy combined with"Stepup"surgical intervention strategy is the main treatment. In this article, we reviewed various surgical treatments of patulous Eustachian tube in recent years, including key points of surgical operation, effectiveness, safety and complications. Full communication and evaluation are needed to establish appropriate patients' expectations preoperatively. A "Stepup" treatment strategy will be carried out, including conservative treatment, tympanic membrane surgery, Eustachian tube pharyngeal orifice constriction surgery, Eustachian tube tympanic orifice plug surgery and Eustachian tube muscle surgery, which aims to maintain normal Eustachian tube function and good middle ear ventilation.
Humans ; Eustachian Tube/surgery* ; Ear Diseases/diagnosis* ; Ear, Middle ; Tympanic Membrane/surgery* ; Tinnitus ; Otitis Media

Choristoma/surgery* ; Ear Diseases/surgery* ; Eustachian Tube ; Face ; Humans

OBJECTIVE: To explore and quantify the intervention effect of auricular point sticking on perioperative psychological stress in patients with anorectal diseases. METHODS: Eighty patients who underwent anorectal surgery were randomly divided into an observation group (40 cases) and a control group (40 cases). The routine preoperative guidance, preoperative visits, and informed of the postoperative condition were received in the control group. On the basis of the treatment in the control group, auricular point sticking was immediately applied at Shenmen (TF), Shen (CO), Wei (CO), Gan (CO), Pi (CO), Pizhixia (AT), E (AT), Nie (AT) and Zhen (AT) in the observation group.The patients were pressed by themselves, 3 to 5 min per point each time, 5 times a day, and the contralateral auricular points were replaced every 2 or 3 days until 1 week after surgery. The Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), and Pittsburgh sleep quality index (PSQI) scores were compared between the two groups before and 7 days after surgery. RESULTS: There was no significant difference in the total HAMA scores between after and before surgery in the observation group (>0.05). The total HAMA score in the control group was higher than that before surgery (<0.05). The total HAMA score in the observation group after surgery was lower than that in the control group (<0.05). There was no significant difference in the total HAMD scores between the two groups before and after surgery (<0.05). There was no significant difference in the total HAMD scores between the two groups after the surgery (>0.05). The scores of somatic anxiety factor in the two groups were higher than those before surgery (<0.05). The scores of somatic anxiety factor in the observation group were lower than those in the control group (<0.05). The scores of psychotic anxiety factors in the two groups were lower than those before surgery (<0.05). There was no significant difference in the score of psychotic anxiety factors between the two groups (>0.05). The total score of PSQI in the two groups was lower than that before surgery (<0.05), and the total score of PSQI in the observation group was lower than that in the control group (<0.05). CONCLUSION Auricular point sticking can effectively improve some psychological stress problems during perioperative period in patients with anorectal diseases.
Acupuncture Points ; Acupuncture, Ear ; Anxiety Disorders ; therapy ; Humans ; Rectal Diseases ; surgery ; Stress, Psychological

To evaluate the clinical value of submucosal injection of pharyngeal ostium of Eustachian tube in diagnosing patulous Eustachian tube(PET).Twenty-six patients(32 sides),whose the symptoms were consistent with PET,were enrolled from March 2014 to May 2016.The symptoms and signs of all patients were evaluated after submucosal injection of saline into the Eustachian tube.Immediately after submucosal injection of saline into the Eustachian tube,the symptoms and signs disappeared in 24 cases(29 sides),and improved in 2 cases(3 sides).The resolution and/or improvement of symptoms and signs lasted for less than 24 hours in 12 patients,for more than 24 hours in 9 patients,and for more than 48 hours in 4 patients.No adverse reactions were observed.Submucosal injection may be a simple and practical method for auxiliary diagnosis of PET,and may be used in preoperative evaluation of Eustachian tuboplasty.
Ear Diseases ; diagnosis ; Eustachian Tube ; physiopathology ; surgery ; Humans ; Injections ; Otitis Media ; Pharynx ; Preoperative Care

OBJECTIVES: To evaluate the efficacy of balloon Eustachian tuboplasty (BET) combined with grommet insertion in the treatment of chronic dilation Eustachian tube dysfunction (CDETD). METHODS: A retrospective study was performed in 19 patients with CDETD who underwent BET at the Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital Affiliated with Shanghai Jiaotong University School of Medicine, from October, 2014 to September, 2016. The ages of these patients ranged from 10 to 67 years. All the patients underwent the preoperative assessment of oto-endoscope, tympanometry, pure tone audiometry, fiber nasopharyngeal endoscopy, Eustachian tube pressure measurement (TMM), CT and MRI. These patients had failed to respond to medicine, multiple tympanic membrane puncture and at least 2 times grommet insertion before our study. BET was performed in 5 patients (5 ears), and BET+grommet insertionwas performed in other 14 patients (23 ears). The changes of Eustachian tube function in these patients was assessed using the Eustachian tube score (ETS) and Eustachian tube dysfunction questionnaire-7 (ETDQ-7) preoperatively and 1, 3, 6, 9 and 12 months after surgery, respectively. In addition, subjective symptoms including the difficulty level of valsalva, aural fullness and earache were assessed by visual rating scale (VAS score) preoperatively and at 1, 6, and 12 months after surgery. The mean scores before surgery were compared with that at 1, 3, 6, 9 and 12 months. Postoperative adverse reactions and complications were recorded, such as earache, nosebleeding and so on. RESULTS: Valsalva score and VAS score for aural fullness before surgery were 8.286±0.189 and 8.571±0.221, respectively. Valsalva score and VAS score for aural fullness were 3.714±0.317, 2.393±0.434, respectively, at one month after surgery, which were decreased significantly, as compared with the scores before surgery (<0.05). VAS score at 6 months and 12 months after surgery were statistically significant compared with those before surgery (<0.05). ETS score after surgery was significantly higher than that before surgery (<0.05). ETDQ-7 score after surgery was significantly lower than that before surgery (<0.05). The subjective satisfaction in these patients was 84.2%. CONCLUSIONS BET is simple and safe, with fewer complications, and effective for the treatment of CDETD combined with grommet insertion.
Adolescent ; Adult ; Aged ; Child ; China ; Dilatation ; Ear Diseases ; Eustachian Tube ; physiopathology ; surgery ; Humans ; Middle Aged ; Middle Ear Ventilation ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVE: To summarize pseudocyst of auricle governor square included surgical curative effect, the advantages of the analysis of the operation. METHOD: The governor of the central square in auricle pseudocyst incision, 56 cases were retrospectively analyzed clinical data, surgical curative effect and advantages were summarized. RESULT: Adopt the auricle pseudocyst governor of the central square of incision, postoperative follow-up of 6 months did not relapse. CONCLUSION Rectangle window method effective method of treating pseudocyst of auricle, able to cure pseudocyst of auricle, is a kind of simple, practical, and value in the basic-level hospital surgical method.
Cysts ; surgery ; Ear Auricle ; pathology ; Ear Diseases ; surgery ; Humans ; Otologic Surgical Procedures ; methods ; Postoperative Period ; Retrospective Studies

OBJECTIVE: To investigate the reconstruction method of lateral attic wall with tragal cartilage and temporalis fascia graft. And analyze the postoperative result of its clinical application. METHOD: From Jan 2005 to Jul 2014, 45 patients whose middle ear disease were limited to attic received this surgery in our department. Among 31 cases of cholesteatoma otitis media and 14 cases of external auditory canal cholesteatoma were included. In order to expose the attic fully, we operated epitympanotomy through retroauricular incision and then removed the scutum and lateral attic bone wall. After eliminating the lesions, we reconstructed the lateral attic bone wall with tragal cartilage, covered the cartilage with temporalis fascia and then repaired the tympanic membrane and external ear canal skin. After surgery, all patients were followed up at 10 days, 1 month, 2 months, 6 months and 1 year. RESULT: Two months after surgery, 45 patients' achieved one-stage wound healing. Six months later, all of the patients' operation area had epithelized completely. After 1 year, 37 patients had recovered the normal shapes and stable audition; 7 cases patients have different level tympanic membrane retraction; 1 patient suffered from tympanic membrane retraction and recurrent cholesteatoma. CONCLUSION With regard to the lesion limited to the attic, we can remove it by operating epitympanotomy through retroauricular incision, and then reconstruct the lateral attic wall with tragal cartilage and temporalis fascia. By the support of the cartilage, we can keep the epitympanic aeration, reduce the retraction of pars flaccida membrana tympani, and maintain the fundamental shape of lateral attic wall.
Cartilage ; transplantation ; Cholesteatoma ; surgery ; Ear Auricle ; Ear Canal ; Ear Diseases ; surgery ; Ear, Middle ; pathology ; Fascia ; transplantation ; Humans ; Mastoid ; Otitis Media ; surgery ; Tympanic Membrane ; surgery ; Tympanic Membrane Perforation ; surgery

PURPOSE: To introduce autologous tragal perichondrium transplantation as a novel surgical modality for the management of intractable symptomatic bullous keratopathy. METHODS: In three eyes of three patients with painful bullous keratopathy, autologous tragal perichondria were transplanted on the corneal surface with the human amniotic membrane transplanted above. We included an additional three eyes of three patients with painful bullous keratopathy who received amniotic membrane transplantation only to serve as controls. Clinical symptom outcomes were assessed using a visual analogue scale at postsurgical months 1, 3, 5, 7, and 9. In addition, transplanted tragal perichondrium and amniotic membrane complex tissue button obtained from one patient who underwent penetrating keratoplasty was evaluated by immunohistochemical analysis of CD34, vimentin, and alcian blue staining. RESULTS: All three patients who underwent autologous tragal perichondrium and human amniotic membrane co-transplantation showed improvements in pain and tearing. However, all three patients in the control group experienced aggravation of tearing and no further improvement of pain 3 months after surgery. In addition, one patient in the control group developed premature degradation of the amniotic membrane. Histopathologic and immunohistochemical analysis showed intact surface epithelization and positive CD34, vimentin and alcian blue staining of transplanted tragal perichondria. CONCLUSIONS: The tragal perichondrium has a high mechanical structural force and high potency due to well-organized epithelization and the presence of mesenchymal stem cells. Autologous tragal perichondrium transplantation may be an effective modality for the management of painful bullous keratopathy.
Adult ; Aged ; Amnion/*transplantation ; Corneal Diseases/*pathology/*surgery ; Ear Cartilage/*transplantation ; Female ; Humans ; Keratoplasty, Penetrating/*methods ; Male ; Middle Aged ; Transplantation, Autologous ; Treatment Outcome