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The wave glider is a new type of unmanned observation platform on water surface, which can generate forward thrust by obtaining wave energy through the swing of submerged glider's hydrofoils. By analyzing the wave energy loss caused by the umbilical cable inclination angle of the submerged glider of the conventional wave glider, a hydrofoil swing mechanism that can change the lower limit of hydrofoil swing with the change of the umbilical cable inclination angle is designed. Firstly, the adjustment ability of the lower limit follow-up mechanism to the hydrofoil swing angle is simulated and analyzed by the computational fluid dynamics software Fluent; secondly, the prototype of the lower limit follow-up mechanism is designed by adding a set of parallelogram transmission mechanism in the conventional submerged glider. A large wave simulation test platform is setup and the propulsion performance of the prototype is verified by pool tests. The research shows that the new hydrofoil swing mechanism can improve the propulsion performance of the submerged glider.

Objective: To investigate the characteristics and prognosis of two anastomosis techniques in repairing facial nerve defects. Methods: A retrospective analysis was conducted on 30 patients who underwent facial nerve anastomosis（direct or rerouting） for facial nerve defects in our department from January 2012 to December 2021. Among them, 21 were male and 9 were female, with an average age of（37.53±11.33） years, all with unilateral onset. Preoperative House-Brackmann（H-B） facial nerve function grades were Ⅳ in 2 cases, Ⅴ in 9 cases, and Ⅵin 19 cases. The duration of facial paralysis before surgery was within 6 months in 21 cases, 6-12 months in 6 cases, and over 1 year in 3 cases. The causes of facial paralysis included 14 cases of cholesteatoma, 6 cases of facial neurioma, 6 cases of trauma, and 4 cases of middle ear surgery injury. Surgical approaches included 9 cases of the middle cranial fossa approach, 8 cases of labyrinthine-otic approach, 7 cases of mastoid-epitympanum approach, and 6 cases of retroauricular lateral neck approach. Results: All patients were followed up for more than 2 years. The direct anastomosis was performed in 10 cases: 6 cases with defects located in the extratemporal segment and 4 cases in the tympanic segment. Rerouting anastomosis was performed in 20 cases: 11 cases with defects located in the labyrinthine-geniculate ganglion, 4 cases from the internal auditory canal to the geniculate ganglion, 3 cases in the internal auditory canal, and 2 cases in the horizontal-pyramid segment. Postoperative H-B facial nerve grades were Ⅱ in 2 cases, Ⅲ in 20 cases, and Ⅳ in 8 cases, with 73.3%（22/30） of patients achieving H-B grade Ⅲ or better. Conclusion: Both direct and rerouting anastomosis techniques can effectively repair facial nerve defects, with no significant difference in efficacy between the two techniques. Most patients can achieve H-B grade Ⅲ or better facial nerve function recovery. Preoperative facial nerve function and duration of facial paralysis are the main prognostic factors affecting the outcome of facial nerve anastomosis., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To analyze the clinical feature, diagnosis and treatment of Anca-associated vasculitis with ear symptoms. Methods: In this retrospective study, we summarized the clinical and laboratory examination, pure tone audiometry, aural immittance measurement, CT scan of temporal bone and treatment of 40 patients in the First Medical Center of the PLA General Hospital. Results: A total of 11 cases（27.5%） had the initial symptom in the ear. The most common symptoms were hearing loss, and the other symptoms included a sense of ear fullness, otorrhea and tinnitus. There were 35 cases with hearing loss: 19 cases with conductive hearing loss（47.5%）, 9 cases with sensorineural hearing loss（22.5%）, and 7 cases with mixed hearing loss（17.5%）. 5 cases had a sense of ear fullness or tinnitus, and the results of the hearing test were normal（12.5%）. All of the 40 patients had multi-system involvement, and respiratory system accounted for the most. All patients had a positive result of Anti-neutrophil cytoplasmic antibody（ANCA）. Treatment included systemic hormonal, immunosuppressive, or biologic therapy. There were 3 cases recovered（7.5%）, 22 cases with alleviated ear symptoms（55.0%）, 6 cases with recurrent hearing loss（15%） and 9 cases had no significant improvement（22.5%）. Conclusion: Conductive deafness（secretory otitis media） can be the first manifestation in the early stage of otitis media with AAV（OMAAV）, later it may turn to binaural mixed deafness. Otolaryngologists need to consider OMAAV diagnosis when diagnosing and treating patients with recurrent secretory otitis media. Multi-system symptom consultation and ANCA examination can help identify. Early systemic medication and the application of immunosuppressants or biological agents can help relieve the ear symptoms., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

The application of microscope is a milestone in the history of otosurgery, which makes otologists deal with middle ear lesions more clearly and finely, and helps otologists expand the scope of treatment to the lateral skull base area, which greatly promotes the development of otosurgery. In the past 20 years, with the continuous improvement of endoscopic equipment research and development and the gradual improvement of endoscopic technology, the application of endoscopic technology in China has shown an explosive development, and Chinese otolaryngologists have experienced from the initial attempts of endoscopic technology, to the widespread popularization of innovative and applicable technology, and then to the feasibility of exploring the future innovative concepts. Endoscopic technology is another revolutionary push for the development of otosurgery after the microscope., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.

Objective: To summarize the experience of establishing middle ear ventilation in endoscopic middle ear surgery. Method: A retrospective analysis was performed on the patients who have received a middle ear endoscopic surgery in our department from 2016 to 2018. The method of reconstructing middle ear ventilation was summarized. Result: A total of 300 ears from 296 paitents were collected. Fourty six of the 300 patients had eustachian tube problems, 241 had problems of ventilation between epitympanum and mesotympanum, and 185 had need of ventilation cavity reconstruction. Conclusion: With the continuous expansile application of endoscopic technology in the ear surgery and the deepening understanding of otologists on both the surgical concept and the physiological function of the middle ear, the use of endoscopy can achieve the goal of removing lesions accurately and preserving or reconstructing the function on the premise of minimally invasion., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To explore the application of simultaneous balloon Eustachian tuboplasty（BET） in hearing reconstruction in patients with chronic suppurative otitis media. Method: Twenty-three patients（23ears） who diagnosesd as chronic suppurative otitis media and Eustachian tube dysfunction and underwent hearing reconstruction surgery were retrospectively enrolled, including 12 patients（12 ears） received BET + hearing reconstruction surgery as the case group, 11 patients（11 ears） received hearing reconstruction surgery as the control group. All patients underwent Eustachian tube function score（ETS） and pure tone audiometry before the surgery and one year after the surgery. The subjective improvement degree of symptoms such as ear fullness, muffled hearing, tinnitus and hearing loss were investigated. The differences in test results between the two groups were analyzed. Result: There was no statistically significant difference in ETS and pure tone audiometry between the two groups before the surgery（ P >0.05）. The preoperative ETS and postoperative ETS of the case group were 3.75±2.42 and 6.58±2.19, compared to 3.18±1.99 and 4.27±1.79 of the control group. ETS of two groups were improved after surgery（ P <0.01）, and the improvement degree of the case group was better than that of the control group（ P <0.05）. The preoperative air conduction hearing threshold, bone conduction hearing threshold and air bone gap of the case group were（65.17±11.56） dB, （24.25±12.96） dB, （40.92±12.17） dB, and decreased to（30.58±6.40） dB, （23.67±9.74） dB, and（6.92±12.00） dB after surgery. The preoperative air conduction hearing threshold, bone conduction hearing threshold and air bone gap of the control group were（63.55±9.74） dB, （22.64±8.61） dB, （40.91±9.83） dB, and decreased to （41.45±15.50） dB, （25.73±8.52） dB, （15.73±11.20） dB after surgery. The air conduction hearing threshold and air bone gap of the two groups were improved after surgery（ P <0.01）, and the postoperative air conduction threshold of the case group was significantly lower than that of the control group（ P <0.05）. In the follow-up questionnaire results, the subjective improvement degree of ear fullness, muffled hearing and hearing loss in the case group was higher than that of the control group（ P <0.05）. Conclusion: In patients with chronic suppurative otitis media and Eustachian tube dysfunction, simultaneous BET and hearing reconstruction surgery can effectively increase the patients' hearing improvement degree, and can improve the Eustachian tube function and subjective symptoms., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To analyze the clinical characteristics of unilateral conductive hearing loss with intact tympanic membrane, and summarize the key diagnostic points, differential diagnosis and observe the effects of surgical treatment., Methods: We reviewed data from 82 patients with unilateral conductive hearing loss with intact tympanic membranes who accepted the exploratory tympanotomy from April 2011 to September 2013. There were 41 males and 41 females, aged from 7 to 66( averaged 26.5±13.7)years, with a history of one month to 50 years. The history, clinical symptoms, audiological evaluation, high resolution temporal bone CT, the results of surgical exploration and hearing reconstruction were analyzed., Results: The exploratory tympanotomy revealed 43 cases of congenital middle ear malformations (52.4%), 22 cases of otosclerosis (26.8%), eight cases of congenital cholesteatoma (9.8%), six cases of trauma induced conductive hearing loss (7.3%), three cases of congenital ossicular malformations with congenital cholesteatoma (3.7%). Progressive hearing loss was common in patients with otosclerosis and congenital cholesteatoma, and patients with congenital middle ear malformations described their hearing loss since childhood. High resolution temporal bone CT of congenital middle ear malformation, trauma induced conductive hearing loss, congenital cholesteatoma diagnosis rate was 40.0%, 50.0%, and 83.3% respectively. The preoperative air-conductive threshold of patients with absence of the oval window were increased to (66.9±1.1)dBHL, the preoperative bone-conductive threshold achieved (28.3±10.4)dBHL at 2 000 Hz. While patients with stapes fixation and that with ossicular chain discontinuity were (27.2±9.7)dBHL and (17.8±8.8)dBHL(P=0.000)respectively. Through the tympanic exploration with endaural incision under the microscope, different hearing reconstruction were applied according to different lesions. After the operation, the hearing level of 52 patients with return visit were improved, the mean air-conductive threshold were decreased from (60.0±11.4)dBHL to (32.2±12.1)dBHL(P=0.000); and the mean ABG were decreased from (43.2±12.0)dB to (16.3±9.4)dB(P=0.000)., Conclusions: Congenital middle ear malformations, otosclerosis, congenital cholesteatoma are the most common causes in unilateral conductive hearing loss with an intact tympanic membrane. The diagnosis rate can be improved by analyzing the clinical features. Through exploratory tympanotomy and hearing reconstruction, we can clarify the diagnosis and achieve a satisfying hearing recover.

With the expansion of human practical activities, more and more areas have suffered from big data problems. The emergence of big data requires people to update the research paradigm and develop new technical methods. This review discussed that big data might bring opportunities and challenges in the area of auditory implantation, the deafness genome, and auditory pathophysiology, and pointed out that we needed to find appropriate theories and methods to make this kind of expectation into reality.

Objective: To investigate the applicability of EuroQol 5-Dimension 3-Level questionnaire (Chinese Version 1.0) (EQ-5D-3L) in the assessment of life quality of patients with idopathic sudden hearing loss., Method: In this retrospect study, the EQ-5D-3L was assigned to 60 patients with idopathic sudden hearing loss before and after drug therapy. Audiometry examinations were undertaken and concomitant symptoms were recorded. A Wilcoxon rank sum test was applicated to the comparisons of results of EQ-5D-3L before and after the treatment, a t-test for results of EQ-VAS and a Kappa measurement for the consistency of certain dimension correlated with the symptoms., Result: Sixty patients completed the five questions and visual analog scale of the EQ-5D. A statistically significant changes of pain/discomfort, anxiety/depression before and after the treatment were observed (P < 0.05). The domains of mobility, self-care and usual activities did not show statistically significant different (P > 0.05). The dimension of pain/discomfort was in agreement with the concomitant symptoms. And the result of EQ-VAS was in agreement with the therapeutic outcome., Conclusion: It is suitable for the EQ-5D to be a general health measure with sensitivity to clinical change in idiopathic sudden sensorineural hearing loss, which monitors the patients' outcomes.

Objective: To analyze the diagnosis, therapy and prognosis of the rare cases of malignant tumors in external auditory canal., Method: Eight cases of rare malignant tumors in external auditory canal were collected except squamous cell carcinoma and adenoid cystic carcinoma. The clinical manifestation, staging, surgical method, secondary treatment and prognosis were analysed., Result: There were 5 cases of basal cell carcinoma and 2 cases of mucoepidermoid carcinoma and 1 case of myoepithelial carcinoma. Three cases of the 5 basal cell carcinoma in external auditory canal have been misdiagnosed for a long time. After admission, 4 of the 5 basal cell carcinoma were T1 stage and cured only by a complete resection of tumor. One case of T2 stage basal cell carcinoma was found recurrence 2 years later after the first excision of tumor, and was treated with radiotherapy. Tumor was controlled. Two cases of mucoepidermoid carcinoma had been misdiagnosed as a benign tumor and received a resection. One case was found metastasis to the parapharyngeal space and nasopharynx and was treated with concurrent chemotherapy. Tumor was also controlled after 5-years follow-up. Another case was found metastasis to parotid gland and received an expanding tumor resection. No recurrence was detected after a 1-year followed up. One case of T4 stage myoepithelial carcinoma in external auditory canal was a metastasis of parotid and received a partial temporal bone resection. No-recurrence was found 1 year later., Conclusion: Because the tumors above have a very low incidence in external ear canal and the location of tumors are hidden, they are often misdiagnosed and delayed in treatment. Therefore, otologists should pay more attention to avoid the misdiagnosis. To the treatment, complete surgical resection of early-stage tumor is important and for late-stage tumor, a supplemented by chemoradiotherapy may be needed.

Objective: To observe the long-term safety and performance of Nurotron cochlear implant system. To analyze the auditory and speech rehabilitation characteristic of pediatric deafened patients after cochlear implantation., Methods: To analyze 3 years results of pediatric deafened patients with Nurotron® Venus™ cochlear implants. From April to June 2011, sixty deaf children received domestic cochlear implant. All subjects were switched on after 3 to 4 weeks of surgery, and were assessed the auditory rehabilitation on 3 months, 12 months, 24 months and 36 months after switching on. To evaluate the rehabilitation results by Aided Hearing Thresholds, Auditory & Verbal Ability Test and IT-MAIS Questionnaire. Meanwhile, the safety and performance of cochlear implant system were followed-up. Before surgery, all the recipients in this study were 12 to 71 months of age with the average hearing threshold higher than 90 dBHL., Results: Sixty cases of deaf children were implanted successfully. All the recipients used their devices every day, and all of their devices worked well. No complication or side effect related to implantation were found. The sound field aided hearing thresholds, vowels, consonants, monosyllabic words and two-syllable words test, as well as Ling's test, and IT-MAIS Questionnaire of all recipients were improved significantly with prolonged use of CI device. The results of grammatical competence, understanding, communication and presentation skills tests also get significantly promotion in 3 years follow up., Conclusions: With prolonged use of CI device, the hearing and language tests of children recipients could obtain significantly improvement. The Nurotron® Venus™ CI system works safely and effectively.

Objective: To investigate the clinical features of labyrinthine fistula and obtain the diagnosis, treatment and prognosis of different types of fistula., Method: A retrospective analysis of 42 cases (43 ears) with labyrinthine fistula in our hospital from January 2007 to November 2014 was conducted. Data of preoperative clinical manifestation, auditory function, CT image, operative findings, treatment and postoperative recovery were collected and statistically analysed., Result: Thirty-nine cases (40 ears) of the 42 cases (43 ears) which were diagnosed as labyrinthine fistula according to operative findings occurred in the lateral semicircular canal, 1 case occurred in the posterior semicircular canal, 1 case occurred in the superior semicircular canal, and 1 case occurred both in lateral and posterior semicircular canal. Before operation, 24 ears (55.8% ) experienced vertigo and 14 ears (32.6%) showed impaired bone conduction hearing threshold. According to Dornhoffer classification standard, 22 cases (23 ears) were diagnosed as type I fistula, 9 cases as type II fistula and 11 cases as type III fistula. There was no statistical difference among the 3 groups on type of hearing loss, vertigo, CT, facial nerve canal damage before operation and bone conduction hearing threshold, vertigo after operation., Conclusion: An accurate diagnosis of labyrinthine fistula relies on the operative findings rather than preoperative clinical manifestation, auditory function or CT The surgical intervention should be individualized. There is no significant difference on postoperative recovery among different types of labyrinthine fistula.

Objective: This study conduct a qualitative synthesis and quantitative meta-analysis of VFAFI, aimed to study whether it is a useful treatment for UVCP., Method: Electronic databases PubMed, YZ365. COM, WANFANG DATA, CMJD, CHKD,CNKI were searched using relevant keywords. Reported treatment outcomes were clustered into three categories,i. e. subjective, perceptual,acoustic,aerodynamic,and stroboscopic. Meta-analyses were performed on studies with numerical results using random effects model., Result: Five articles were identified with a total of 404 patients. All the studies reported significant improvements or decrease after VFAFI in each category of outcome measurements. Meta-analysis demonstrated a significant increase or decrease in all categories. Adverse effects include slight inflammatory reponse can resolve spontaneously within 1 month. The recurrence rate after VFAFI was high due to the self absorption. NNE and Jitter of post-operation is lower than pre-operation,there is no significantly change between the control group and experimental group; F0, Shimmer and MPT of post-operation is higher than pre-operation, there is no significantly change between the control group and experimental group., Conclusion: The invasiveness and morbidity of VFAFI are low and the side effects are self-limited. Meta-analyses demonstrated significant improvements or decreased from both objective and subjective measurements. Further controlled studies with longer follow-up periods and more person were included may evaluate the effectiveness of VFAFI more reliably.

Objective: The aim of the study was to evaluate the effects of cochlear implantation on bilateral perceived tinnitus of postlingually deafened patients., Method: Total of 32 postlingually deafened cochlear implant recipients (13 males, 19 females; 31 unilateral,1 bilateral cochlear implantation) with bilateral tinnitus were assessed by Tinnitus Handicap Inventory (THI) before and after implantation. Furthermore, characteristics information of tinnitus were recorded to analyze the variety of tinnitus. Intensity of tinnitus in ispilateral and contralateral ears was investigated when cochlear implant was switched on and off. Statistical analysis was performed by SPSS 18.0., Results: Twenty-two patients (71.0%) got a decreased THI score of more than 20 points after the operation. The average THI score of pre-operation was 56.4±18.1, and post-operation score was 24.7±22.7. A paired-samples t test analysis showed a significant difference of the THI total scores (t=8.037, P<0.05). Tinnitus in the ipsilateral ear improved in 81.9% (27/33) patients and 18.2% (6/33) unchanged. Tinnitus in the contralateral ear improved in 71.0% (22/31) patients, 16.1% (5/31) unchanged and 12.9% (4/31) worsen. Tinnitus of ipsilateral ears improved or abolished in 97.0% (32/33) patients, while 83.9% (26/31) of contralateral ear got reduction or absence of loudness when cochlear implant was switched on., Conclusions: As an electrical stimulation treatment method, cochlear implant has the inhibitory effect on tinnitus. However, cases of tinnitus aggravation were found, further data is still necessary before considering CI as a treatment of tinnitus.

Objective: To assess the clinical effeetiveness of prelingually deaf children after cochlear implantation at different ages so as to provide reasonable expectations for the patients and guidance for the clinical treatment., Method: Electronic databases PubMed, YZ365. COM, WANFANG DATA, CMJD, CHKD, CNKI were searched using relevant keywords. Extracted data included author, year of publication, diagnosis, et al. Reported treatment outcomes were clustered into speech discrimination and hearing abilities. Meta-analyses were performed on studies with numerical results using random or fixed effects model., Result: There were eight randomized control studies including 442 patients. Comparing speech perception of prelingually deaf children after cochlear implantation younger than three years old (experimental group) and 3-6 years old (control group), three and six months after operation showed that experimental group performed significantly worse than control group; 12 months after operation showed that experimental group performed significantly better than control group. Comparing hearing abilities, three and six months after operation showed that experimental group performed significantly worse than control group; 12 months after operation showed showed that experimental group performed significantly better than control group. Comparing speech perception of younger or older than 4. 5 years old children showed that after 1.5-2 years of operation children implanted younger than 4.5 years of age performed significantly better than children implanted older than 4.5 years old. Comparing speech perception of 7-12 years old children showed that after 3, 6, 12 months of operation patients of 7-12 years old performed significantly better than those children older than 12 years old. Comparing speech perception of implantation younger or older than 18 years old (7-14 yeas old was group A, > 14-18 yeas old was group B, older than 18 yeas old was group C) showed that after one and four years of operation A > B > C, and there were significant differences among them. Comparing warble tone threshold average (WTA) showed that after one year of operation A < B < C, and there were significant differences among them. However, after four years of operation, there was no significant difference among them., Conclusion: Prelinguistically deafened patients younger than three years old with cochlear implantation, insisting on scienctific rehabilitation training for a long period of time can receive the optimal recovery effect. The older patients are suggested as early as possible receiving cochlear implantation. The longer they are implanted, the better results they will receive. Moreover, the younger age they are implanted, the faster postoperative language progress they will receive. Further controlled studies with longer follow-up periods and more person included may make the effectiveness of cochlear implantaion more reliable.

Objective: To construct and obtain ideal protein delivery vectors by researching the delivery efficiency and cytotoxicity to Hela cells using mPEG-PLGA-BSA-FITC-NPs., Method: The mPEG-PLGA nanoparticle was obtained through surface modification of PLGA with PEG, and deliver BSA-FITC into Hela cells in vitro. The positive cells were counted by Laser scanning confocal microscopy and the survival rate of Hela cells was calculated by MTT assay at different time points., Result: mPEG-PLGA-BSA-FITC-NPs shows the classic nanometer size, and the encapsulation efficiency reached 51. 2%. At the same time, the nanoparticles possess characteristics of slow release. By optimizing the delivery conditions, the highest efficiency of mPEG-PLGA-BSA-FITC-NPs was above 65.2%, and the cellular viability was about 85.7%., Conclusion: mPEG-PLGA-BSA-FITC-NPs nanoparticles can successfully carry the target protein into cells as safe and effective as novel delivery materials of protein in vitro, and has shown slow release characteristics. The mPEG-PLGA-BSA-FITC-NPs provide ideal delivery vector for future application in clinical treatment of disease using nano-materials.

Objective: To explore the clinical characteristics, diagnosis method and treatment of petrous apex cholesteatoma., Method: A retrospective analysis was taken with respects to the clinical characteristics, diagnosis and surgical management of 38 patients who underwent surgery for petrous apex cholesteatoma in our department., Result: (1)31 patients had unilateral hearing loss and facial paralysis of different degree, 27 patients were firstly characterized with hearing loss, and followed by facial paralysis. 6 cases had facial paralysis as the main performance. (2)17 patients had syndrome of tinnitus, and 15 patients had syndrome of vertigo and 4 cases of severe pain of ear. (3)All patients had petrous bone destroy with high resolution CT scan, while MRI suggests the presence of pathological changes in petrous apex. (4)All patients were taken surgeries to remove the lesion, and translabyrinth approach was chosen for 23 patients, middle cranial fossa approach is 12, while 3 case has choose endoscopic approach. 8 cases were operated with facial nerve decompression. 7 cases was taken end to end anastomosis. 3 cases of great auricular nerve transplantation. There is no recurrence in follow-up of 1 years to 2 years., Conclusion: The clinical manifestations of petrous apex cholesteatoma lack specificity, and high resolution CT and MRI has important value in the diagnosis of petrous apex cholesteatoma. The strategy of surgical operation should be taken according to the classification, location of petrous apex cholesteatoma as well as hearing level and facial nerve function with patients.

Objective: Assess and compare the clinical efficacy and safety of cochlear implantation in deaf patients with inner ear malformation and in the ones with normal inner ear structure, so that to clarify whether it is effective to restore hearing for the deaf patients with inner ear malformation., Method: The literature with relevant key words were retrieved in the databases including PubMed, YZ365. com, WANFANG data, CMJD, CHKD and CNKI with language limited to Chinese and English. Extracted data included author, year of publication, diagnosis, treatment, et al. The clinical efficacy of cochlear implantation was assessed by the complications, electrode impedance, behavior T-level, hearing abilities and speech discrimination. Meta-analysis was performed using random or fixed effects model according to the heterogeneity of data., Result: There were 11 randomized control studies involving 655 patients included in this study. There was no statistically significant difference among the deaf patients in mixed inner ear-malformation group, Mondini group and large vestibular aqueduct syndrome group in the aspects of postoperative complications, electrode impedance, behavior T-level, hearing abilities and speech discrimination., Conclusion: Cochlear implantation could be the way of treatment and rehabilitation for deaf patients with inner ear malformation. Further controlled studies with longer follow-up periods and more multiracial cases included may help to evaluate the efficacy of cochlear implantation for deaf patients with inner ear malformation more reliably.

Objective: The purpose of the report was to investigate the causes of CSF leakage and discuss the methods for prevention and management of CSF leakage following translabyrinthine resection of acoustic neuromas., Methods: A retrospective review of cerebrospinal fluid leakage following translabyrinthine approach for 152 acoustic neuromas patients, from January 1983 to December 2013, was performed. The cases were divided into two groups, traditional and modified closure techniques. The incidence of CSF leakage was compared between the two groups., Results: The incidence of postoperative CSF leakage by translabyrinthine approach was 5.9% (9/152), with four cases of rhinorrhea, two case of wound leakage, one case of rhinorrhea and otorrhea, one case of otorrhea, and one case of rhinorrhea and wound leakage. The CSF leakage incidence of traditional closure technique was 14.3% (5/35); the incidence of modified closure technique was 3.4% (4/117). After introducing a modified closure technique, the incidence of the CSF leakage significantly decreased., Conclusions: As a common complication of translabyrinthine approach, the incidence of CSF leakage is closely related to the closure technique. The incidence of the CSF leakage should decrease dramatically when adopting the modified closure technique.

Objective: To assess the accuracy of a wrist worn Watch PAT 200 in diagnosing obstructive sleep apnea hypopnea syndrome (OSAHS) by comparing with the standard polysomnography (PSG)., Method: Twenty-eight adults with suspected OSAHS underwent a standard in-lab PSG while wearing a Watch PAT 200. PSG events were manually scored according to standard criteria (AASM). Watch PAT data were collected including changes of apnea hypopnea, sleep stages, peripheral arterial volume, signal oxygen saturation and heart rate, and then apnea hypopnea index (AHI) was analyzed by an automatic algorithm., Result: For PSG, the mean score of AHI was (23.00 +/- 21.55)/h, and for Watch PAT, a mean score of AHI was (25.99 +/- 19.09)/h. There is a statistically positive correlation between PSG-AHI and PAT-AHI (r = 0.92, P < 0.01). The Coincidence rate of the sleep-wake assessment based on 30-second bins between the PSG and Watch PAT 200 was (89 +/- 6)%., Conclusion: Watch PAT 200 could detected OSAHS based on AHI with comparable accuracy with standard PSG. And it would provide a reasonably accurate estimation of sleep and wakefulness stages in patients with OSAHS.

Objective: To assess the performance of the new fine structure processing strategy(FS4) compared to the previous generation coding strategy HDCIS., Method: Twelve post-lingual hearing-impaired cochlear implant users were included. FS4 and HDCIS were compared in music pitch perception and speech perception test., Result: Acute comparison between FS4 and HDCIS showed that FS4 performed as well as HDCIS in speech perception tests, and outperformed HDCIS in music pitch perception., Conclusion: Results indicate that FS4 performs better than HDCIS in music perception. Differences between the two strategies were not significant for speech test.

Objective: To provide clinical reference by summarizing and analyzing characteristics, therapeutic principles and methods for special cases of esophageal foreign bodies., Method: Statistical analysis 182 cases with esophageal foreign bodies, including 41 special cases. Surgery 165 cases, 17 cases without surgery., Result: One hundred and seventy-five cases were cured, 7 cases improved. Hospitalization time 0.5-50 d (average 4.5 d)., Conclusion: It is important to learn about characteristics of esophageal foreign bodies, therapeutic principles and methods for special cases, and it's a key point to diagnosis early and remove the foreign bodies as soon as possible, and comprehensive treatment measures are really effective to process special cases.

Objective: Summarize the treatment skills of esophagus perforation caused by esophageal foreign bodies., Method: Retrospectively analyze the seven cases of esophagus foreign body perforation with various complications in our department., Result: Six cases recovered in 3 to 18 days after operation, on average 14.2 day, while one case recovered in 49 days by conservative method., Conclusion: Foreign bodies removing, fistulae repairing, abscess incising, effusion rinsing, effective antibiotics administrating and support treatment are effective to treat esophagus perforation caused by esophageal foreign bodies. It will take a relative long time to be treated only by conservative way.

Objective: To investigate the surgical technique of the pericanal electrode insertion technique for ies cochlear implantation., Method: Forty cases of sensorineural deafness were subjected to the ies cochlear implants. Cochleostomy was performed through the external auditory canal with a microdrill anterior to the round window. The electrode impedance and electrically auditory brainstem responses(EABR) were tested during the operation. The X-ray photographs were taken after the operation. The cochlear implant was activated in all 40 cases 4 weeks following surgery., Result: All of the electrodes were inserted and all of the implants worked well. No electrode extrusions or serious surgical complications happened during postoperative observation for 6 months., Conclusion: The pericanal electrode insertion technique is a safe approach for ies cochlear implantation.

Objective: To seek a convenient and effective method through subjective psychophysical measurements and CAP/SIR assessment. To compare the discrimination of rehabilitation between post-lingual and pre-lingual deafened patients., Method: Thirty-one post-lingual cochlear implantees and 59 pre-lingual cochlear implantees, the warble tone and CAP/SIR were assessed. The discrimination of threshold levels, comfortable levels and dynamic range between post-lingual and pre-lingual deafened patients in same electrodes were compared., Result: There was no statistic difference in warble tone, T-levels, C-levels and dynamic range in same electrodes implant after 6 months implant (P>0.05). The score of CAP and SIR in post-lingual deafened patients were more prominent., Conclusion: CAP and SIR is a kind of convenient and effective method to assess the ability of aural and oral. There was no discrimination in warble tone, T-levels, C-levels and dynamic range in same electrodes implant, but the ability of aural and oral in post-lingual deafened patients were more prominent.

Objective: To set up an effective technique for isolating the single inner hair cells (IHCs) and observe morphological features to distinguish IHCs from other hair cells (OHCs) in vitro., Methods: Surface preparations contained rows of OHCs and IHCs were prepared from guinea pigs. The cluster and single IHCs were separated microsurgically combination with an enzymatic digestion. The clusters of IHCs were separated using two fine electrodes and transferred by a gentle suction using a glass micropipette., Results: On the average, one guinea pig cochlear yielded approximately 30 to 50 viable solitary IHCs. The cell body of the IHCs was pear or flask shape. The nucleus was located in the central of the cell body, and the cytoplasm was filled with the structured and scattered rough granules. The stereocilia were seen in the most of IHCs (93 out of 98). The stereocilia were aligned, almost lineally or in a "C" shape, in one side on the surface of the cuticular plate. The tight neck and the angle between the cuticular plate and the axis of the cell were observed in some IHCs but not obvious in most cases, which might be due to the orientation of the cells. The length of isolated IHCs was ranged from 13 to 31 microns and with an average of (22.45 +/- 4.14) micron (mean +/- s, n = 98). The diameter of IHCs was ranged from 7 to 15 microns and with an average of (11.95 +/- 1.59) micron. The length of stereocilia was ranged from 2 to 7.5 microns and with an average of (5.21 +/- 1.00) micron., Conclusion: Unambiguous solitary IHCs were successfully harvested from guinea pig cochlea using a microsurgical technique. The tight neck and the angle between the cuticular plate and the axis of the IHCs have been considered as an important landmark to distinguish the IHCs from OHCs.

Objective: To summarize the clinic characteristics of the tumors of facial nerve and discuss the diagnosis and treatment., Methods: Fourteen cases of primary facial nerve tumors confirmed pathologically and treated in the Chinese PLA General Hospital from 1986-2000 were reviewed. The clinic manifestation, diagnosis and treatment in this series were analyzed., Results: Among the 14 cases, there were 9 of facial neurilemmoma, 3 of facial neurofibroma and 2 of facial nerve hemangioma. The commonest first symptom was facial paralysis (10/14), the next was hearing loss(6/10). The commonest sign was the facial paralysis. The following was tumor in tympanic cavity (5/14) and the next was tumor in external auditory canal(4/14). The tumors in all 14 cases were totally resected surgically. The function of the facial nerve was normal in one case with nerve being preserved intact during operation, and in grade II in one case and grade III in other one case with nerves being preserved partly continuous. Facial--great auricular-facial nerve cable grafting were done in 6 cases, as result their facial nerve were in grade II in 2 cases, grade III in 3 case and grade IV in 1 case. The facial-lateral femoral cutaneous-facial nerve cable grafting was done in one case, and the facial nerve function was in grade III with 6 years of following-up. The second-stage facial-hypoglossal nerve anastomosis was done in one case, and the facial function consequently recover to grade II with 3 years of following-up. Three cases of facial nerve remained discontinuity and their facial nerve function showed no recovery (in grade VI)., Conclusions: Once the facial nerve tumors were diagnosed, the surgical treatment should be done as early as possible. At the same time of tumor resection, the continuity of facial nerve should be kept and reconstructed in one stage as possible as we can, otherwise the second-stage surgery have be conducted soon after.

Objective: To investigate the change in the expression of E-Cadherin of human hepatocarcinoma cell line SMMC-7721 after transfection by antisense human DNA MTase gene., Methods: DNA MTase gene eukaryotic expression vectors, including sense and antisense fragments, were constructed with recombinant technology and transfected into the hepatocarcinoma cell line SMMC-7721 with liposome DOTAP. The expression of DNA MTase gene mRNA and E-Cadherin gene mRNA was examined with RT-PCR and the expression of E-Cadherin with immunohistochemical and flow cytometry. The status of methylation in E-Cadherin gene promoter area was examined with methylation specific PCR (MSP)., Results: The sense and antisense eukaryotic expression vectors were successfully constructed and then the constructed recombinant plasmids were successfully transfected into SMMC-7721 cell with liposome DOTAP. The expression of endogenous DNA MTase mRNA was obviously decreased with E-Cadherin gene mRNA and its activity increased in the SMMC-7721 cell, which was tranfected with antisense DNA MTase gene fragment. Moreover, demethylation in the promoter area of E-Cadherin gene was observed with MSP., Conclusion: Demethylation in the promoter area and increasing mRNA level of E-Cadherin gene can be induced by expression inhibition of DNA MTase gene of SMMC-7721 cell line.

Objective: To explore the effect of antisense gene to human telomerase reverse transcriptase (hTRT) on reversing malignant phenotypes of liver cancer cell lines., Methods: Sense and antisense eukaryotic expressing vector of hTRT gene was transfected into human liver cancer line HepG(2) with the DOTAP liposomal transfection method. Changes of cellular malignant phenotypes through proliferation capacity, telomerase activity, cloning formation in soft agar, invasive capacity in Borden's chamber model and tumorigenicity in nude mice were examined., Results: Sense and antisense eukaryotic expressing vector was successfully transfected into HepG(2). The obtained transfectants termed HepG(2)-sense (HepG(2)-S) and HepG(2)-antisense (HepG(2)-AS) stably produced sense and antisense hTRT, respectively. HepG(2)-AS showed an obvious decrease in growth and telomerase activity. HepG(2)-AS penetrated cells through Matrigel were decreased significantly compared with HepG(2) and HepG(2)-S. Cloning efficiency in soft agar and tumorigenicity in nude mice was also markedly inhibited in HepG(2)-AS., Conclusions: Antisense gene to hTRT can significantly suppress cancer cell growth, partially reverse malignant phenotypes of HepG(2), which indicates that hTRT may be a new target gene for antisense gene therapy of liver cancer.