Peristapedial bulb: an indicator of spontaneous CSF leak in cochlear candidates with Mondini dysplasia.

Background: Mondini dysplasia with spontaneous cerebrospinal fluid (CSF) leak is rare in cochlear implantation (CI) candidates but lethal. Detailed evaluation and surgical intervention are needed for these patients.

Aim/objective: To report our findings of the peristapedial bulb in computer tomography (CT) as diagnostic evidence of spontaneous CSF leak and discuss its clinical value to direct the surgical plan for patients with profound sensorineural hearing loss (SNHL) and meningitis.

[The diagnostic value of labyrinthine fistula with multi-planar reconstruction in chronic otitis media by HRCT].

Objective: To study the ability of HRCT to delineate the semicircular canals and the diagnostic value of HRCT in identifying labyrinthine fistula in chronic otitis media (COM) by means of multiplanar reconstruction.

Method: Eighty-six patients (79 healthy ear and 93 failed ears) with chronic otitis media were scanned with HRCT, and the original data was processed with MPR. In the normal ears the semicircular canals form were individually observed and the canal geometry were compared in axial and coronal and s-MPR.

[Efficacy of high-resolution CT in differential diagnosis of chronic suppurative otitis media and cholesteatoma otitis media by soft-tissue shadows].

Objective: To evalute the efficacy of high-resolution CT(HRCT) in differential diagnosis and treatment of chronic suppurative otitis media and cholesteatoma otitis media by soft-tissue shadows.

Methods: HRCT scanning was performed in 120 cases, 153 ears, with chronic otitis suppurative media and cholesteatoma otitis media, of which original data were processed with multi-planar reconstruction (MPR) and maximum intensity projection (MIP), the characteristics of the soft-tissue shadows' growth, window width or window leveling and bony destruction were respectively observed, as well as compared with the surgery findings.

Results: In 120 patients (153 ears), 109 ears were diagnosed as cholesteatoma otitis media, and 44 ears were diagnosed as chronic suppurative otitis media, among which 33 ears had granulation tissue and 11 ears had secretion.

[The diagnostic value of multi-planar reconstruction in semicircular canals disease by HRCT].

Objective: To study the diagnostic value of high-resolution computed tomography (HRCT) and multiplanar reconstruction (MPR) in assessment of semicircular canals disease.

Method: Eighty-three patients were scanned with HRCT and the original data were processed with MPR. The semicircular canals full length was respectively observed in one image of MPR in the normal ears.

[Diagnostic value of high-resolution computed tomography imaging in congenital inner ear malformations].

Objective: To observe the inner ear structure with volume rendering (VR) reconstruction and to evaluate the role of high-resolution computed tomography (HRCT) in congenital inner ear malformations.

Method: HRCT scanning was performed in 10 patients (20 ears) without ear disease (control group) and 7 patients (11 ears) with inner ear malformations (IEM group) and the original data was processed with VR reconstruction. The inner ear osseous labyrinth structure in the images generated by these techniques was observed respectively in the normal ears and malformation ears.

[Evaluation of maximum intensity projection in HRCT in the diagnosis of the destruction of ossicular chain in chronic otitis media].

Objective: To observe the ossicular chain structure with maximum intensity projection (MIP) and to evaluate the diagnostic value of it in the destruction of ossicular chain in chronic otitis media (COM).

Method: Sixty-eight patients (136 ears) were scanned with HRCT. The original data was processed with MIP reconstruction technique.

[The diagnosis and therapy for cholesterol granuloma of middle ear].

Objective: To explore the diagnosis for cholesterol granuloma of middle ear, and discuss the effect of middle ear surgery for this disease.

Method: The files of 18 patients (19 ears) with cholesterol granuloma of middle ear were reviewed in a retrospective study. All patients received middle ear and mastoid surgery, and all involved tissues were verified as cholesterol granuloma by pathologic examination.

[Long-term results analysis of mastoidectomy for chronic otitis media].

Objective: To study the operative indications of chronic otitis media and their long-term results.

Method: One hundred and forty-five cases of mastoidectomy were followed for 5 years between 1995-1998. We discussed the results of recurrence and hearing level of radical mastoidectomy, canal wall up mastoidectomy (CWUM) and canal wall down mastoidectomy with mastoid obliteration (CWDM).

[Clinical study of combined approach of tympanoplasty and mastoidectomy with close technique].

Objective: To improve the surgery results and living quality of patients following the operation of the combined approach of tympanoplasty and mastoidectomy with close technique.

Methods: The clinical data and following-up results of 49 patients treated with combined approach of tympanoplasty and mastoidectomy with close technique and 82 patients treated with open mastoidectomy with tympanoplasty were retrospective analyzed.

Results: In the group treated with combined approach tympanoplasty, all patients got dry ear in 20 days and 31 patients' hearing level enhanced over 15 dB after the operation; but in the group treated with open mastoidectomy with tympanoplasty, only 13 patients got dry ear in 20 days and no patients' hearing level enhance over 15 dB after the operation.

[Surgical approaches to the skull base neoplasms].

Objective: To discuss the best surgical approach to the skull base neoplasms.

Methods: Retrospective analysis the 79 skull base neoplasms cases treated with surgical resection in Qilu hospital of Shandong university from 1992 to 2002. Eleven surgical approaches including midfacial degloving, frontal coronal discission, nasal eversion, maxillary swing, partial maxillary resection, total resection of orbit, mandibular swing, combination of front, temple, preauricular, post aureum, neck, and transoral approaches were used to resect the tumor which involved fossae pterygopalatine, paranasal sinuses, nasopharynx, antero, meso and posterobasilar region, lobi frontalis and lobi temporalis of cerebrum.

[Analysis of preoperative findings and ossicular condition in chronic suppurative otitis media].

Objective: To discussion the relationship of preoperative findings and ossicular condition in chronic suppurative otitis media.

Method: The correlation between the ossicular conditions and classification of tympanic membrane perforation, ear discharge, air conduction pure tone average, air-bone gap, pneumatization, complication, and cholesteatoma in 251 patients(288 ears) with chronic suppurative otitis media was analysed.

Result: The air-conduction threshold and air-bone gap in patients with ossicular discontinuity are higher than that in patients with ossicular continuity.

[Clinical application of the combined presigmoid supra-infratentorial approach].

Objective: To explore the surgical approach to the lesions of the cerebellopontine angle and the petroclival region.

Method: Nine cases of the cerebellopontine angle or petroclival large tumors and one case of the posterior cerebral thrombotic aneurysm were treated by the combined presigmoid supra-infratentorial approach. The tumors including 3 cases of schwannomas and 6 cases of meningiomas spaned supra-infratentorium in our study.

[The developmental expression of embryonic-neural cell adhesive molecule in human olfactory mucosa].

Objective: To discuss the expressional features and physical function of E-NCAM (embryonic- neural cell adhesive molecule) in human fetal olfactory mucosa.

Method: The immune expressions of E-NCAM in human olfactory mucosa at different gestational stages was detected with the technique of immunohistochemistry.

Result: The positive expression of E-NCAM began at gestational week 14 (14W), and was localized in the cell bodied, dendrites, axis of olfactory neurons and olfactory nerve fiber bundles in lamina propria.

[Expression of neuron-specific enolase and olfactory marker protein in the developing olfactory mucosa of human fetuses].

Objective: To study the expression of neuron-specific enolase (NSE) and olfactory marker protein (OMP) in the developing olfactory mucosa of human fetuses.

Method: The expression of NSE and OMP in the olfactory mucosa of 6 human fetuses (12, 16, 20, 24, 28 and 34 weeks) was studied using the technique of immunohistochemistry.

Results: NSE immunological positive reactions were seen in all 6 fetal mucosa from gestational 12 (G12) to G34, with plenty of positive-stained dual-pole neuron cells.

[Combined frontal-preauricular-cervical approach for resection of huge transcranial lateral skull base tumors].

Objective: To search into the appropriate approach for surgical treatment of the huge lateral skull base tumors.

Methods: The combined frontal-preauricular-cervical approach was used in two cases with huge transcranial lateral skull base tumors occupying the parapharngeal space, infratemporal fossa and middle cranial fossa. To acquire a wide surgical exposure, the flaps of orbital-zygomatic bone and the skull bone were removed, and then the mandibula was dislocated inferiorly.

[Cholesteatoma in petrous part of temporal bone].

Objective: To explore the clinic characteristic of petrous bone cholesteatoma.

Method: One case was treated by supra-labyrinth approach. 8 cases did by labyrinth-cochlea approach.