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

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

OBJECTIVETo analyze factors relevant to revisional tympanomastoid surgery for chronic otitis media(COM).

METHODSThe clinical data of 159 patients (159 ears), who exhibited either wet ear or relapsed after the initial operation, and were subjected to revisional tympanomastoid surgery, were retrospectively analyzed in this study. Of those 159 consecutive patients, 85 were males and 74 were females, aged 11-64 years, with a median age of 36 years old. The situations in terms of intra-operative findings, surgical procedures, change dressing post-operation, dry ear time, and the improvement of aural ability during the second operation, were recorded and analyzed.

RESULTSThe second surgery found that, of those 159 patients underwent the re-operation, 67 presented with cholesteatoma and 92 had no cholesteatoma. In addition, the inadequate skeletonization and insufficient opening for mastoid cavity accounted for 70.4% (112/159) of all previous operations, the external auditory canal stenosis for 98.7% (157/159), the high facial ridge leading to insufficient drainage for 61.0% (97/159), the lesion in tympanic ostium of Eustachian tube for 34.6% (55/159), the insufficient drainage due to inappropriate post-operating dressing for 5.0% (8/159), the postauricular incision for 30.8% (49/159), and the endaural incision for 69.2% (110/159). As for the re-operation of the canal wall down mastoidectomy, tympanoplasty plus plastic repairing of cavity of concha were performed in 94 cases, the modified Bondy plus plastic repairing of cavity of concha in four cases, the radical mastoidectomy plus plastic repairing of cavity of concha in 59 cases, and the simple cleaning for mastoid cavity in two cases. Since one to two weeks after the revisional operations, the post-operating dressing was performed with aid of microscopy once a week on average. The average dry ear time ranged from 2 to 6 weeks (median=3 weeks). During a period of 6-93 months for the follow-up, all patients presented with dry ears. The epithelialization of the operating cavity was well and the tympanic membranes were integrity. Neither granulation tissue nor cholesteatoma was found to reoccur. Both pure tone hearing thresholds and air-bone gap decreased in 87 cases after the revisional operation, with statistically significant different in comparison to those two parameters before the operation (P<0.05).

CONCLUSIONThe primary causes responsible for the wet ear or reoccurrent cholesteatoma after tympanomastoid surgery may be related to the improper operation procedures and selection of incision, the non-standard operation, inexhaustive removal of pathological tissues, as well as the irregular postoperation change dressing, and other factors.

Adolescent ; Adult ; Child ; Cholesteatoma, Middle Ear ; surgery ; Chronic Disease ; Ear Auricle ; surgery ; Eustachian Tube ; pathology ; Female ; Humans ; Male ; Mastoid ; surgery ; Middle Aged ; Otitis Media ; surgery ; Postoperative Period ; Reconstructive Surgical Procedures ; Reoperation ; Retrospective Studies ; Treatment Outcome ; Tympanic Membrane ; pathology ; surgery ; Tympanoplasty ; Young Adult

OBJECTIVE: To investigate the ultrastructural changes of the mucosa of eustachian tube in mice and to reveals the influence of eustachian tube on middle ear function and its relavence with otitis media. METHOD: 12 wild type and 12 mutant mice were divided into two groups by age to observe the the ultrastructural changes of the mucosa of eustachian tube. RESULT: Wild type mice exhibited a thick lawn of morphologically normal, distributed cilia in the mucosa of the middle ear at both time points. The cilia of mucosa of middle ear in mutant mice were short, impaired and disrupted. The impairment of the cilia progressed to a much great severity at 6 months compared to 3 months. CONCLUSION Otitis media occurs not only the ciliated cells decreased and the goblet cells increased. More importantly, the ciliary structure was damaged, leading to the dysfunction of the mucociliary transport system and causing otitis media.
Animals ; Cilia ; pathology ; ultrastructure ; Disease Models, Animal ; Ear, Middle ; pathology ; Eustachian Tube ; pathology ; ultrastructure ; Goblet Cells ; Mice ; Microscopy, Electron, Scanning ; Mucociliary Clearance ; Mucous Membrane ; pathology ; ultrastructure ; Otitis Media ; pathology

OBJECTIVE: To observe and analyze the function and morphology of pharyngeal ostium of the eustachian tubes in secretory otitis media and chronic rhinosinusitis in children under direct vision,in order to provide an objective basis for clinical treatments. METHOD: Fifty cases of secretory otitis media,50 cases of chronic rhinosinusitis and a control group of 50 cases with hoarseness were examined under video laryngoscope to observe the pharyngeal ostium morphological changes of the eustachian tubes, and their functional statuses were tested by using acoustic impedance instrument. All the data were analyzed by statistical methods. RESULT: (1) In the secretory otitis group, the abnomal rate of the pharyngeal ostium of the eustachian tubes was 94% while the chronic rhinosinusitis group was 80%,and between them there was no significant differences (P > 0.05). But both of them had significant differences with the control group (P < 0.05). (2) In the secretory otitis group, the rate of the eustachian tube dysfunction was 70% while the chronic rhinosinusitis group was 26%, and between them there was significant differences (P < 0.05), and both of them have significant differences when compared with the control group (P < 0.05). CONCLUSION There are some abnormal points exist in the function and the morphology of the eustachian tube in secretory otitis media and chronic rhinosinusitis in children. Eustachian tube dysfunction played a dominant role in the pathogenesis of secretory otitis media in children rather than the morphological change did compared to the chronic rhinosinusitis in children.
Case-Control Studies ; Child ; Chronic Disease ; Eustachian Tube ; pathology ; physiopathology ; Humans ; Otitis Media with Effusion ; pathology ; physiopathology ; Rhinitis ; pathology ; physiopathology ; Sinusitis ; pathology ; physiopathology

The patient, a 52 year old male was admitted to the hospital, because of right hearing loss before three months. Six months ago; the patient had the right former group sinusitis and nasal polyps, and had the right former group sinus open and polypectomy operation outside the hospital. The surgery was uneventful and the postoperative dressing was done. He has no history of tinnitus, earache, ear pus, epistaxis, headache, dizziness. Physical examination on admission shows the right external auditory canal was clean, tympanic membrane integrity, pale yellow, mild depression, and poorly eardrum movement. The electronic nasopharyngoscopy show a black mass in the edge of the anterior lip of the right eustachian tube. The mass has a smooth surface, and only seen partly. Nasopharynx magnetic resonance shows in the right pharyngeal orifice visible there was a round short T2 node, maximum diameter of 13 mm, the border was clear. The parapharyngeal space had been compressed which close to the right eustachian tube torus. After the scan enhanced, the lesions was strengthened. The pure tone audiometry shows right mild conduction deafness, and the acoustic impedance showing right type B tympanogram curve. Eardrum puncture extracted got about 0.2 ml yellow liquid. Otitis media with effusion is considered. A biopsy is taken by means of the nasal endoscopic. The pathology report is the right eustachian orifice malignant melanoma. The immunohistochemical examination (Horton-Magath-Brown 45) showed a positive reaction.
Ear Neoplasms ; Eustachian Tube ; pathology ; Humans ; Male ; Melanoma ; Middle Aged

We report a case of malignant melanoma of Eustachian tube with extension to the middle ear cavity and nasopharynx in a 51-year-old woman who presented with right ear fullness. Computed tomography showed a soft tissue mass in the middle ear cavity and causedthe widening and eroding of the bony eustachian tube. Magnetic resonance imaging showed well enhancing mass in eustachian tube extending nasopharynx to middle ear cavity. A biopsy of the middle ear cavity mass revealed a malignant amelanotic melanoma.
Ear Neoplasms/*diagnosis ; Ear, Middle/pathology ; *Eustachian Tube ; Female ; Humans ; Magnetic Resonance Imaging ; Melanoma/*diagnosis ; Middle Aged ; Nasopharynx/pathology ; Neoplasm Invasiveness ; Tomography, X-Ray Computed

Adult ; Ear Neoplasms ; Eustachian Tube ; pathology ; Humans ; Male ; Teratoma

OBJECTIVE: To compare the effect of two different approaches in curettage of adenoid hypertrophy on eustachian tube function: the endoscopic assisted transoral adenoidectomy, and the traditional transoral curette adenoidectomy. METHOD: Clinical data of adenoid hypertrophy patients who underwent surgery therapy were prospectively analyzed; Eustachian tube function were compared among them. RESULT: Both traditional curettage of adenoids through mouth(group TCA) and endoscopic assisted transoral adenoidectomy (group ETA) significantly improved eustachian tube function (P < 0.01), while group ETA seemed to have a better outcomes (P < 0.01). CONCLUSION Both traditional curettage of adenoids through mouth and the endoscopic assisted transoral adenoidectomy can significantly improve eustachian tube function, and the endoscopic assisted transoral adenoidectomy produces a better outcome.
Adenoidectomy ; methods ; Adenoids ; pathology ; Aged ; Curettage ; methods ; Eustachian Tube ; physiology ; Humans ; Hypertrophy ; surgery

OBJECTIVETo study the significance of supratubal recess and its aeration pathway to epitympanum in the pathogenesis of cholesteatoma otitis media.

METHODSFifty-two ears of cholesteatoma were selected as study group. Sixteen ears of traumatic facial palsy with pneumatic mastoid, which had no history of chronic otitis media were selected as control group. The status of supratubal recesses of all and their aeration pathways to epitympanum were observed in operations.

RESULTSSixteen ears from control group clearly presented supratubal recesses. Membrane closure was founded in four of them. The aeration pathways of fifty-two ears (100%) from study group were all completely closed. Comparing with control group, the difference was obviously significant (chi2 = 41.7144, P = 0.000). Among these cases, bony closure was observed in thirty-four ears (65.4%), while membrane closure in eighteen ears (34.6%). Their epitympanum space was very narrow and mastoid was sclerotic or poorly developed.

CONCLUSIONSBlockage of the aeration pathway between supratubal recess and epitympanum was possible one of the origins of negative-pressure status of epitympanum and mastoid, which might lead to the formation of aural cholesteatoma. Anatomy variation of the aeration pathway from supratubal recess to epitympanum might be a pathogenesis factor of cholesteatoma otitis media. It suggested that opening the aeration pathway in tympanoplasty with intact canal wall up technique might be helpful to prevent recurrence of aural cholesteatoma.

Adolescent ; Adult ; Aged ; Case-Control Studies ; Cholesteatoma, Middle Ear ; pathology ; Eustachian Tube ; pathology ; Facial Paralysis ; pathology ; Female ; Humans ; Male ; Middle Aged ; Young Adult