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Objective: The objective of this study was to evaluate the graft outcomes of endoscopic perichondrium-cartilage myringoplasty with preserving of anterior margins for repairing anterior perforation with 3 year followup. Study design: Prospective case series. Setting: Tertiary university hospital. Materials and Methods: We performed a prospective study in 47 patients with anterior perforation who underwent perichondrium-cartilage myringoplasty with preserving of anterior margins and tuck grafts. The operation time, graft success rate, hearing outcome, and complications were evaluated at 6 months and 3 years after surgery. Results: A total of 47 ears with anterior marginal perforation were included in the study. The perforation size was subtotal in 2 (4.3%) eras, large in 11 (23.4%) ears, medium in 27 (57.4%) ears, and small in 7 (14.9%). The mean operation time was 41.2 ± 5.4 minutes. All patients completed 6 months of follow-up. Residual perforation was observed in 2 patients with medium perforations, the graft success rate was 95.7% (45/47). The mean preoperative and postoperative AC PTAs were 38.1 ± 7.3 dB and 25.4 ± 4.6 dB (P <.05), while the mean preoperative and postoperative BC PTAs were 9.0 ± 4.6 dB and 9.6 ± 1.9 dB (P =.672). The functional success was 91.5% (43/47). None of the patients reported sensorineural hearing loss, altered taste, facial nerve palsy, vertigo, or tinnitus during the follow-up period. In addition, 34 (72.3%) patients completed 3 years followup and performed temporal bone CT examination, the mean followup time was 39.1 ± 2.7 months, CT revealed the well pneumatization of mastoids and middle ear. Conclusions: Endoscopic perichondrium-cartilage myringoplasty with preserving of anterior margins and tuck grafts is a safe, suitable, and reliable method for repair of anterior perforation with few risk of anterior blunting and lateralization. [ABSTRACT FROM AUTHOR]

Aim: The American Academy of Pediatrics and the European Centre for Pediatric and Adolescent Medicine guideline define fever as a temperature >38.0°C for all ages and recommend use of rectal thermometers in children <3 years. Based on new literature, this definition of fever using a fixed threshold of 38.0°C needs to be re‐examined. Design: A multi‐site diagnostic accuracy study was conducted to compare an "age‐based" threshold model with a "fixed" threshold over 38.0°C on a total of 894 patients of which 373 were ill. Methods: The "age‐based" and "fixed" threshold fever determinations were then compared to a clinical categorization ("well" or "ill") conducted by a clinician through a comprehensive examination. Results: The sensitivity and accuracy for the age‐based thresholds were found to be superior to the fixed thresholds in all ages and current ear thermometers were found equivalent to rectal thermometers in infants <6 months. [ABSTRACT FROM AUTHOR]

BACKGROUND: With the development of modern otological microsurgery, for the lesions involving the ossicular chain, surgeons are required to select appropriate surgical methods to reconstruct the ossicular chain on the basis of thorough removal of the lesions. Titanium ossicular prosthesis becomes an appropriate material for reconstruction of the ossicular chain. OBJECTIVE: To analyze the clinical effect of titanium artificial ossicular prosthesis in one-stage open tympanoplasty for middle ear cholesteatoma. METHODS: This study enrolled 75 middle ear cholesteatoma patients admitted to the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from August 2015 to November 2018, including 40 males and 35 females, aged 4-76 years old. All patients underwent mastoidectomy and tympanoplasty. In the first stage of the operation, partial titanium artificial ossicles were implanted in 61 cases and total titanium artificial ossicles were implanted in 14 cases. A thin cartilage perichondrium complex was placed between the tympanic membrane graft and the titanium artificial ossicle. The air, bone conduction threshold, and air bone conduction difference of 75 patients before and 6 months after the operation were compared to evaluate the hearing recovery after the operation. This study was approved by the First Affiliated Hospital of University of Science and Technology of China. RESULTS AND CONCLUSION: (1) The follow-up time of all cases was ≥ 6 months. The outcome of dry ear was achieved about 4-6 weeks. At 6 and 12 months after the operation, the otoscope observation showed that the mastoid cavity was well epithelialized, the tympanic cavity was full of air, and the external auditory meatus was spacious and unobstructed. Totally 71 cases of tympanic membrane transplantation healed at the first stage, 3 cases of artificial ossicles were partially prolapsed, and 3 cases of ossicles were completely lost. (2) At 6 months after operation, the air conduction hearing threshold of 75 patients was lower than before operation (P < 0.05). There was no significant difference between bone conduction threshold and preoperative comparison (P > 0.05). (3) The results showed that the one-stage reconstruction of ossicular chain with titanium artificial ossicles on the basis of debridement of lesions in open tympanoplasty can achieve satisfactory hearing effect, with fewer postoperative complications and lower rejection reaction, which is a better optimal treatment option. [ABSTRACT FROM AUTHOR]

The ossicular chain status is directly associated with the severity of conductive hearing loss (CHL) when the tympanic membrane (TM) is intact. To analyze the relationship between intraoperative findings and audiological data in patients with unilateral CHL and an intact TM. Forty-three patients who underwent surgery at Xinhua hospital from January 1, 2012, to December 31, 2019, were included and categorized based on their intraoperative findings. Demographic data, intraoperative findings, and preoperative and postoperative audiological results of these patients were analyzed. Patients with ossicular chain disruption had significantly better outcomes than those with ossicular chain fixation (air conduction threshold [ACT]: 26.51 ± 8.82 vs. 44.08 ± 14.41 dB, p <.01; air-bone gap [ABG]: 10.66 ± 6.47 vs. 18.91 ± 9.32 dB, p =.04). Patients with ossicular chain deformities had a higher ACT (56.95 ± 13.81 vs. 44.56 ± 15.44 dB, p =.048) and a larger ABG (43.17 ± 9.94 vs. 33.02 ± 13.41 dB, p =.047) preoperatively than those with cholesteatoma; however, the postoperative outcomes between both patient groups were similar. Congenital ossicular chain anomalies had similar surgical outcome regardless of the pathology. In acquired cases, ossicular chain disruption had better audiological outcomes than ossicular chain fixation. Ossicular chain reconstruction can significantly improve the hearing in patients with UCHL with intact TM. [ABSTRACT FROM AUTHOR]

Conclusion:Intra-tympanic dexamethasone injection (ITD) could serve as a first-line intra-tympanic (IT) treatment for Meniere’s disease (MD), regardless of hearing level. Even if the response to initial ITD course was unsatisfactory, a repeated course may be beneficial with some patients. Objectives:This study examined the effect of repeated courses of ITD administered on demand and investigated the possibility of ITD as an initial IT treatment for medically intractable MD patients. Method:Fifty-one patients who had been diagnosed with definite MD and given course(s) of ITD treatment were included. Vertigo control, pure tone average and functional disability scores were evaluated against the American Academy of Otolaryngology-Head and Neck Surgery guidelines for MD. Results:Vertigo disappeared or was substantially controlled in 58.8% and 23.5% of the patients, respectively, after the first ITD course. A repeated course further raised the complete vertigo control rate by 15.7% and intra-tympanic gentamycin injection could be postponed or avoided in 78.6% of the patients who required repeated IT treatment. Hearing was unchanged after the first course of ITD (p > .05). No significant differences were detected in the clinical profiles or laboratory findings between patients receiving single course of ITD and those on multiple courses (p > .05). [ABSTRACT FROM PUBLISHER]

Conclusions:One-shot, low-dose intra-tympanic gentamicin (ITG) treatment was effective and safe for Ménière’s disease (MD) patients. Head thrust test (HTT) and vestibular evoked myogenic potentials (VEMPs) test could be used as endpoint indicators for vertigo control in MD patients. Objectives:The present study is to explore end-point indicators of ITG injection in MD. Methods:Patients with MD were reviewed from June 2012 to March 2014. Single-shot ITG at a concentration of 30 mg/ml was administered to patients. The sensitivity and specificity of HTT and VEMPs for vertigo control were measured. Results:All 37 patients with a median follow-up of 26 months were included. Of those 37 patients, 24 patients (64.9%) obtained class A vertigo control and seven patients (18.9%) obtained class B vertigo control. Only six patients had class C control (16.2%). The sensitivity and specificity of HTT for vertigo control were 74.2% and 50.0%. Meanwhile, the sensitivity and specificity of VEMPs threshold were 83.9% and 33.3%. When combined HTT and VEMPs, sensitivity and specificity were 93.5% and 66.7%. Based on the four-tone average thresholds at 0.5, 1, 2, 3 kHz, 78.4% patients had no significant change in PTA and 16.2% patients experienced significant improvement. [ABSTRACT FROM PUBLISHER]

Objective:To establish a new magnetic resonance imaging scoring system for diagnosing endolymphatic hydrops.Patients and methods:A total of 214 ears of 107 patients were categorised into five groups: no symptoms, Ménière's disease, sudden deafness, delayed endolymphatic hydrops and other ear disorders. Gadolinium distribution within the labyrinth was scored separately and quantitatively by two radiologists. Multiple independent-sample non-parametric tests, Bayesian discriminant analysis, multivariate logistic regression and receiver operating characteristic curve analyses were performed.Results:The derived scoring model was highly accurate for diagnosing Ménière's disease and delayed endolymphatic hydrops. Two magnetic resonance imaging scoring methods for the perilymphatic space were proposed for the diagnosis of endolymphatic hydrops: a pre-1 value (a new variable that predicts individual probability) of more than 0.3982299, or a sum of all labyrinth component scores of less than 14.5.Conclusion:A convenient method is proposed which offers reliable radiological diagnostic criteria for Ménière's disease and delayed endolymphatic hydrops. [ABSTRACT FROM PUBLISHER]

Conclusions: During total ossicular replacement surgery, a better auditory functional recovery is obtained when the stapes footplate is retained. Also, the best hearing restoration is obtained when the total ossicular replacement prosthesis (TORP) is placed onto the center of the stapes footplate during operation. Objectives: The effects of TORPs connecting to different positions of the stapes footplate or oval window membrane on hearing restoration were investigated. Methods: A healthy volunteer's right ear was scanned to obtain the CT data, which were digitalized using a self-compiling program and imported into PATRAN software to establish a 3D finite element model, and a harmonic response analysis was carried out using NASTRAN software. Then the effect of TORPs connecting to different positions on the stapes footplate or oval window membrane was studied. Results: The displacement curve of the stapes footplate was in good agreement with that of the normal ear when the TORP was connected onto the center of the stapes footplate. The best hearing restoration was obtained when the TORP was placed onto the center of the stapes footplate. The displacement curve of the stapes footplate was basically equivalent to that of the normal ear when the TORP was connected onto the anterior site, while the displacement curve of the stapes footplate differed from that of the normal ear when the TORP was connected onto the posterior site. In addition, when the TORP was connected onto the oval window membrane, the displacement curve of the stapes footplate was different from that of the normal ear [ABSTRACT FROM AUTHOR]

Conclusion: Treatment of traumatic tympanic membrane (TM) perforation with everted or involute edge flaps at different time intervals within 1 week after the injury did not affect the perforation closure rate and mean closure time. Objective: To retrospectively analyze the effect of treatment at different time intervals for traumatic tympanic membrane perforation with gelatin sponge patch and edge approximation plus gelfoam patching. Methods: Patients with traumatic TM perforation visited at different days since the injury for medical treatment (1, 2, 3, 4, and 5-7 days post trauma). These patients were treated with the following prominent methods of treatment: gelatin sponge patch treatment and edge approximation plus gelfoam patching. Measurement indicators were perforation closure rate and mean closure time at 3 months. Results: In the group treated with the gelatin sponge patch technique, the patients sought medical treatment at different time intervals since the injury. Accordingly, the outcome of the treatment varied in terms of the perforation closure rates achieved in different patients in this group. The respective perforation closure rates were 100%, 100%, 96%, 94%, and 89% in accordance with the time interval at which the patients were treated since the injury. The results were not significantly different when compared by statistical analysis ( p > 0.05); the mean closure times in each of the different sets of cases in this group were calculated and the following values were reported: 7.1 ± 2.3, 8.2 ± 1.6, 8.7 ± 1.2, 9.2 ± 3.1, and 10.7 ± 3.9 days. On the other hand, in the edge approximation plus gelfoam patching group, the perforation closure rates were 100%, 97%, 96%, 97%, and 94%, respectively. This was in accordance with the time elapsed since the injury for the patients who visited the hospital on different days. Statistical analysis confirmed that the perforation closure rates for the different cases of this group did not have any significant difference ( p > 0.05); the mean closure times were 7.6 ± 1.9, 7.9 ± 2.2, 9.2 ± 2.8, 8.5 ± 3.6, and 11.2 ± 4.1 days, respectively, indicating that differences were not significant even in terms of mean closure rates for the different cases of this group ( p > 0.05). [ABSTRACT FROM AUTHOR]

We present the first data on the vocalizations of large odorous frogs ( Odorrana graminea, previously Odorrana livida), from southern China. The males produce diverse broadband signals most of which contain ultrasonic harmonics. Six basic call-types were identified based on the number of call notes, fundamental frequency, call/note duration, frequency modulation patterns and spectral composition. O. graminea is one of only a few non-mammalian vertebrates able to detect ultrasound, but its tympanic membranes are not recessed. These results should stimulate further studies to provide new insights into the mechanisms underlying high-frequency communication in anurans. [ABSTRACT FROM AUTHOR]

This study aimed to retrospectively evaluate the prognosis and outcome of tympanic membrane perforations with a particular focus on the fate of the perforation edge flaps.Chart records of 329 patients with a single ear traumatic tympanic membrane perforation were retrieved and analyzed. Of these patients, 70 were left to heal spontaneously, 93 received gelatin sponge patching treatment and 114 were subjected to otoendoscopic eardrum repair before gelatin sponge patching. The complete perforation closure rate at 3 months was 94.29% (66/70), 98.92% (92/93) and 98.24% (112/114) in the 3 groups, respectively, with no statistically significant difference (p = 0.608). The mean closure time was 28.2 ± 3.6 days in the spontaneous healing group, which was significantly longer than that in the sponge patching group (11.1 ± 2.1 days, p = 0.0017) and in the eardrum repair + sponge patching group (12.5 ± 1.9 days, p = 0.0032), while there was no significant difference between the 2 gelatin sponge patching groups (p = 1.86). The hearing ability improved in the 3 groups (6.4 ± 0.83, 7.2 ± 1.65 and 9.6 ± 2.37 dB, respectively), with no statistically significant difference (p >0.05). In the gelatin sponge patching group, new tympanic membrane tissue of the eardrum flap edge proliferated, and the contour of the eardrum flap was not obvious. In the eardrum flap repair group, the eardrum flap retracted to the perforation edge. In conclusion, the eardrum flap of the perforation edge does not have any obvious effect on the perforation closure so that it is unnecessary to conduct an intervention procedure on the flap in the clinical treatment. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Conclusion: This study shows that cochlear implantation is relatively safe surgery with few major complications and within acceptable limits. However, close follow-up observation and effective medical and nursing intervention could alleviate further complications and thus become key elements for promoting recovery of patients undergoing such surgery. Objectives: Cochlear implantation has become an effective method for curing patients disabled by profound hearing loss in China. However, full exploration of the associated complications remains to be completed. The objective of this study was thus to analyse the postoperative complications in patients with cochlear implants (CIs) in order to design improved measures for clinical and nursing interventions. Methods: A retrospective study of 262 patients receiving CIs at the Department of Otorhinolaryngology/Head and Neck Surgery, Chinese People's Liberation Army General Hospital, Beijing, China from March 1997 to December 2006 was conducted. Results: Among 262 patients, 4 cases (1.5%) had 1 or more major complications requiring substantial medical or nursing interventions, including 1 case of cerebrospinal fluid (CSF) otorrhoea accompanied by meningitis, 2 cases of facial nerve paresis and 1 case of perforation of tympanic membrane. Forty cases (15.3%) had some form of minor complication that settled spontaneously or easily with conventional treatments and nursing, of which dizziness and vomiting was the most frequent (4.2%), followed by CSF gusher without otorrhoea and/or induced meningitis (2.7%), tinnitus (1.9%) and facial nerve partially exposed without paralysis (1.5%). Eleven cases (4.2%) had some symptoms associated with installation of the cochlear device. Except for one patient who had no response after implantation because his auditory nerves were underdeveloped, all the patients who received appropriate treatment and nursing intervention had a favourable prognosis. [ABSTRACT FROM AUTHOR]

Objective: To explore the efficacy of ossiculoplasty surgery under oto-endoscope in patients of conductive hearing loss with intact tympanic membrane. Methods: A retrospective study was conducted. The clinical data of 45 patients with conductive hearing loss who had undergone simple ossiculoplasty surgery between October 2015 and December 2017 from five hospitals in China (West China Hospital of Sichuan University, General Hospital of the People's Liberation Army, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Xijing Hospital, Fourth Military Medical University and Shenzhen Sixth People's Hospital) were collected. There were 28 males and 17 females, with the age ranging from 12 to 69 years old. The tympanic membranes of those patients were intact before surgery. The lesion only occurred in the ossicular chain from CT and intraoperative exploration. The cases of otosclerosis, tympanosclerosis, cholesteatoma of middle ear, chronic suppurative otitis media, and tumor of middle ear were excluded. The postoperative complications, hearing improvements and operation time were observed. SPSS 23.0 software was used for statistic analysis. Results: There was neither sensorineural hearing loss nor facial paralysis after surgery in this group. Seven patients had transient mild tinnitus after surgery and gradually relieved during the follow-up period. Nine patients developed dysgeusia after surgery. Two patients developed dizziness after surgery, and the symptoms were mild and relieved during 1 week without special intervention. The air-bone gap (ABG) range of pre-operation was 22.5-45.7 dB, and the average ABG was (25.3±8.6) dB. The ABG range in the third month after surgery was 5.7-26.8 dB, and the average ABG was (9.3±8.6) dB. The mean value of ABG was significantly lower in the third month after surgery compared with that of pre-operation ( t= 2.31, P< 0.05). The operation time of the surgeons in each research center was similar. The overall average of operation time was (43.56±18.25) min. There was no significant difference in the duration of operation between the centers ( F= 3.26, P> 0.05). Conclusion: The ossiculoplasty surgery under oto-endoscope has good efficacy.