OBJECTIVE To clarify the hearing improvement and tympanic membrane healing of tympanoplasty in patients with chronic suppurative otitis media in the stationary phase with soft tissue shadow of mastoid bulla on mastoid CT,and to compare its hearing improvement and tympanic membrane healing with that of canal wall up mastoidectomy+tympanoplasty.METHODS A retrospective analysis was conducted on clinical data of inpatient surgical cases diagnosed with chronic suppurative otitis media in the stationary phase with soft tissue shadow of mastoid bulla by preoperative mastoid CT at the Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Nanchang University between September 2020 and April 2022.Patients were divided into two groups based on the surgical procedure:Group A,tympanoplasty,including 23 cases of type Ⅰ tympanoplasty(A1)and 26 cases of type Ⅱ tympanoplasty with ossicular chain reconstruction(A2);Group B,canal wall up mastoidectomy+tympanoplasty,including 21 cases of canal wall up mastoidectomy with type Ⅰ tympanoplasty(B1)and 20 cases of canal wall up mastoidectomy with type Ⅱ tympanoplasty and ossicular chain reconstruction(B2).Each patient was followed up for one year postoperatively,and at approximately one year after the operation,otoscopy and pure-tone audiometry(PTA)and air-bone gap(ABG)measurements at four frequencies(500,1 000,2 000,and 4 000 Hz)were performed and compared to preoperative values.RESULTS The average PTA at 1 year postoperatively for group A(A1 and A2)and group B(B1 and B2)were(36.35±16.21)dB HL[(31.96±11.78)dB HL,(40.24±18.68)dB HL]and(35.85±12.19)dB HL[(40.24±18.68)dB HL,(39.69±13.69)dB HL],respectively.Compared with preoperative PTA,the difference was statistically significant with P<0.05.The average ABG at 1 year postoperatively for group A and group B were(16.07±6.69)dB HL[(15.16±5.48)dB HL,(16.88±7.63)dB HL]and(15.21±6.40)dB HL[(13.93±5.29)dB HL,(16.56±7.28)dB HL],respectively.Compared with preoperative ABG,the difference was statistically significant with P<0.05.There was no statistically significant difference in postoperative average PTA and ABG between group A and group B.There was no statistically significant difference in effective rate between group A and group B.The results of ear endoscopy at 1 year postoperatively showed that the tympanic membrane healed well in both group A and group B.CONCLUSION There is no significant difference in hearing improvement and tympanic membrane healing between the two surgical procedures of tympanoplasty and canal wall up mastoidectomy+tympanoplasty for patients with CSOM at rest with shadowing of the mastoid sinus on mastoid CT.In clinical work,patients with CSOM at rest who have soft tissue shadow in the mastoid sinus on mastoid CT can opt for simple tympanoplasty.

Objective:To discuss the effect of endoscopic dilatation and plasty for choanal atresia after radiotherapy for nasopharyngeal carcinoma.Methods:Nineteen patients with choanal atresia who were admitted to the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Nanchang University from Jan. 2011 to Dec. 2018 were reviewed, with 12 males and 7 females aging from 33 to 59 years old. All of the patients had a history of radiotherapy for nasopharyngeal carcinoma and were confirmed by electronic nasopharyngoscope and nasopharyngeal imaging. Among 19 patients, there were 3 cases of unilateral occlusion and 16 cases with bilateral atresia, and all of them were membranous atresia. All patients received the transnasal endoscopic surgery of resecting partial vomer bone while trying to keep normal mucosa tissues and using the septonasal mucoperiosteal flap to repair under general anesthesia. One week after operation, the patients were told to do physiological saline nasal irrigation and received regular clean and observation under endoscope. Descriptive statistical method was used to analyze the outcome.Results:The patients were followed up for 1 year postoperatively by electronic nasopharyngoscopic examination. There was no failure case in all the 19 patients including 16 patients with a wide choana and 3 patients had narrowing of the choana (<50%), with adequate and satisfactory airway.Conclusions:Transnasal endoscopic surgery was an effective treatment for choanal atresia after radiotherapy for nasopharyngeal carcinoma. Application of septonasal mucoperiosteal flap for repairing nasal and nasopharyngeal mucosa would avoid recurrence.

This paper mainly reports a case with the foreign body staying in nasal sinus and cranium via orbit. CT manifests the foreign body staying in ethmoid sinus and entering the bottom of cranium. After completing the relevant inspection, the patient unerwent right eye exenteration, endoscopic sinus surgery with general anesthesia in emergency to take out the foreign body in nasal sinus, and Cerebrospinal fluid leak repair surgery . Then the patient recovers well, futhermore, the symptom of cerebrospinal fluid leakage doesn't appear after five months follow-up.
Adult ; Cerebrospinal Fluid Leak ; Foreign Bodies ; surgery ; Humans ; Male ; Orbit ; Paranasal Sinuses

Tympanosclerosis is the middle ear tissue hyalinization and calcification caused by chronic middle ear inflammation, which mainly results in conductive deafness with unobvious clinical symptom. Etiology is unclear. The treatment is given priority to surgical treatment at present, while long-term effect reported mostly poor. This article analyzed etiology and treatment of the tympanic cavity sclerosis.
Calcinosis ; Chronic Disease ; Ear, Middle ; Hearing Loss, Conductive ; etiology ; Humans ; Myringosclerosis ; complications ; etiology ; therapy ; Otitis Media ; Sclerosis

OBJECTIVE: To explore the effect of surgery added with antifungal agents in treatment of fungal rhinosinusitis. METHOD: One hundred and two consecutive patients with fungal rhinosinusitis were randomly divided into two groups: the control group (n=48) were treated with surgery alone, the treatment group (n=54) were treated with surgery plus antifungal therapy during operation and postoperation. The patients were followed up for 6 months and the relapse rates between two groups were compared. RESULT: No relapse was observed in the treatment group. The relapse rate of the control group was 20.8% (P < 0.01). CONCLUSION Surgery plus antifungal therapy can prevent the relapse of fungal rhinosinusitis significantly.
Adult ; Antifungal Agents ; therapeutic use ; Female ; Fluconazole ; therapeutic use ; Humans ; Male ; Sinusitis ; drug therapy ; microbiology ; surgery ; Treatment Outcome

OBJECTIVE: To discuss the clinical features, diagnosis and treatment of traumatic pseudoaneurysm. METHOD: We report 4 unusual cases of traumatic Pseudoaneurysms of the artery of head and neck. The data of the 4 cases was analysed retrospectively. RESULT: Four patients were with history of trauma and traumatic pseudoaneurysm were diagnosed by CT and DSA. Two of them accepted interventional vascular therapy, the others accepted surgical operation. Both methods are safe and effective. CONCLUSION Traumatic pseudoaneurysms of the artery of head and neck are rare but potentially lethal. The diagnosis is not difficult. The interventional treatment should be the first choice if possible, while the surgical approach is another choice. Doctors should try to repair the arterial wall, to keep the artery patency and to decrease the unnecessary complications.
Adult ; Aneurysm, False ; therapy ; Carotid Arteries ; Carotid Artery, Common ; Female ; Humans ; Male ; Retrospective Studies ; Vertebral Artery ; injuries