Objective To investigate the clinical value of otoendoscopic surgery for cholesteatoma of middle ear mastoid process through external auditory canal.Methods A C-shaped incision was made in the external auditory canal and then the external auditory canal flap was separated to expose the tympanic anulus.If the flaccid part of the eardrum was perforated,the tympanic anulus was lifted.If the pars tensa membranae tympani was perforated,the anterior inferior tympanic anulus was preserved to expose the tympanic cavity,and the granulation tissue was removed within the tympanic cavity.Under the continuous perfusion,the bone of the lateral wall of the upper tympanic cavity was grinded,the cholesteatoma around the attic and auditory ossicles was removed,the bone of the mastoid was grinded,and the mastoid cavity cholesteatoma was removed.Gelatin sponge support was placed in mastoid cavity and tympanic cavity.According to the degree of destruction of the auditory ossicles,different types of artificial ossicles were placed.Tragus cartilage covered with perichondrium or biofilm was placed on the surface of mastoid cavity and attic.The tympanic membrane was repaired by tragus perichondrium built-in method or tragus cartilage-perichondrium dissection method.Finally,the external auditory canal flap was paved and the surgical cavity was filled.Results The median threshold of airway hearing was 52.0 dB HL (range,33.8-67.5 dB HL) before surgery,which was significantly higher than that at 6 months after surgery[25.0 dB HL (range,15.0-50.0 dB HL),Z=-6.454,P=0.000].The median threshold of airway bone conduction hearing before the operation was 35.0 dB HL (range,21.2-52.5 dB HL),which was significantly higher than that at 6 months after surgery[15.0 dB HL (range,3.8-27.5 dB HL),Z=-6.453,P=0.000].All the patients were followed up at 2 weeks,and 1,3,and 6 months after surgery.Afterwards,follow-ups were performed every 3 months until 24 months after surgery.All the patients had good tympanum healing,and 2 patients had recurrence at 1 year after surgery.All the patients had no complications such as facial paralysis or sensorineural deafness.Conclusions Combining continuous and non-continuous perfusion,otoendoscopic surgery for cholesteatoma of middle ear mastoid process through external auditory canal has a high healing rate of eardrum,few complications,and significant postoperative hearing improvement.It is a minimally invasive,safe,and effective surgical method.

Objective To investigate the clinical value of otoendoscopic surgery for cholesteatoma of middle ear mastoid process through external auditory canal.Methods A C-shaped incision was made in the external auditory canal and then the external auditory canal flap was separated to expose the tympanic anulus.If the flaccid part of the eardrum was perforated,the tympanic anulus was lifted.If the pars tensa membranae tympani was perforated,the anterior inferior tympanic anulus was preserved to expose the tympanic cavity,and the granulation tissue was removed within the tympanic cavity.Under the continuous perfusion,the bone of the lateral wall of the upper tympanic cavity was grinded,the cholesteatoma around the attic and auditory ossicles was removed,the bone of the mastoid was grinded,and the mastoid cavity cholesteatoma was removed.Gelatin sponge support was placed in mastoid cavity and tympanic cavity.According to the degree of destruction of the auditory ossicles,different types of artificial ossicles were placed.Tragus cartilage covered with perichondrium or biofilm was placed on the surface of mastoid cavity and attic.The tympanic membrane was repaired by tragus perichondrium built-in method or tragus cartilage-perichondrium dissection method.Finally,the external auditory canal flap was paved and the surgical cavity was filled.Results The median threshold of airway hearing was 52.0 dB HL (range,33.8-67.5 dB HL) before surgery,which was significantly higher than that at 6 months after surgery[25.0 dB HL (range,15.0-50.0 dB HL),Z=-6.454,P=0.000].The median threshold of airway bone conduction hearing before the operation was 35.0 dB HL (range,21.2-52.5 dB HL),which was significantly higher than that at 6 months after surgery[15.0 dB HL (range,3.8-27.5 dB HL),Z=-6.453,P=0.000].All the patients were followed up at 2 weeks,and 1,3,and 6 months after surgery.Afterwards,follow-ups were performed every 3 months until 24 months after surgery.All the patients had good tympanum healing,and 2 patients had recurrence at 1 year after surgery.All the patients had no complications such as facial paralysis or sensorineural deafness.Conclusions Combining continuous and non-continuous perfusion,otoendoscopic surgery for cholesteatoma of middle ear mastoid process through external auditory canal has a high healing rate of eardrum,few complications,and significant postoperative hearing improvement.It is a minimally invasive,safe,and effective surgical method.

Objective To investigate the expression of IFN-γ, IL-5, IL-17 and TGF-βby Th cells and Th17 cells in rats with allergic rhinitis upon the intervention of IL-10.Methods SD rats were ran-domly divided into three groups including allergic rhinitis ( AR ) group, IL-10 treated group and control group (n=10).Rats in AR group and IL-10 treated group were sensitized by injection of ovalbumin (OVA) and aluminum hydroxide on the 1st, the 7th and the 14th days.The rats treated with equal volume of saline were set up as the control.The corresponding interventions ( OVA, OVA and IL-10, saline) were respec-tively given to rats in each group on the 21th day for 7 consecutive days.The clinical manifestations in rats were observed within 30 minutes after each administration.Serum samples were collected at 48 hours after the last challenge for the detection of IgE and OVA-sIgE.ELISA and Western blot assay were performed to detect IFN-γ, IL-5, IL-17 and TGF-βin nasal mucosa samples.Results Some characteristic symptoms of AR were observed in rats from AR group and IL-10 treated group.Compared with IL-10 treated rats, rats in AR group showed severe clinical symptoms such as constant rubbing and tearing of the eyes (P<0.05).The levels of IgE and OVA-sIgE in serum samples and the levels of IFN-γ, IL-5, IL-17 and TGF-βin nasal tis-sues were significantly increased in rats with RA (P<0.05), but were reduced with IL-10 intervention (P<0.05).Conclusion Exogenous IL-10 could be used to treat AR by reducing the expression of IFN-γ, IL-5, IL-17 and TGF-βin nasal tissues.