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Background: The retrolabyrinthine approach helps clinicians perform complex surgeries such as vestibular neurectomy, resection of petrous apex cholesteatoma, or use this space to complete endoscopic combined with microscope surgical operations in a relatively safe buffer space. Some of our current studies using 3D reconstruction in the clinic have also helped us perform some complex surgical procedures.Objective: This study aims to reveal the relationship between important structures in retrolabyrinthine space through objective parameters. These measurement data help clinicians locate intraoperatively and provide a reference for clinical surgery. Also, we are intended to help improve surgical techniques and expand the operating space to increase reachable anatomic structure.Material and Methods: The inner structures of the temporal bone from HRCT (High-resolution computed tomography) images which were taken at the Eye & ENT Hospital of Fudan University were reconstructed. Precise measurement of the structures was accomplished by using the software 3D-Slicer (3D Slicer, ; version 4.8.0, Massachusetts, USA).Results: 3D model of temporal bone structures, including the cochlea, semicircular canals (SCCs), the internal auditory canal (IAC), facial nerve (FN), jugular bulb(JB), and carotid artery was reconstructed. The combination of HRCT and 3D models is utilized to analyze the Quantitative data of the retrolabyrinthine space and its adjacent structures.Conclusions and Significance: 3D reconstruction of CT images clearly displayed the detailed structures of the temporal bone. Surgical adaptability of the retrolabyrinthine approach can be assessed preoperatively by image and other methods, and anatomical parameters play an important role in the retrolabyrinthine space. Therefore, this study helps to skeleton the bone as much as possible to expand the surgical space, so that the surgeon can contact the anatomical structure more diversified to expand the surgical indications. [ABSTRACT FROM AUTHOR]

Objectives: Descending necrotizing mediastinitis (DNM) is a serious and progressive infection involving the neck and chest and with high mortality if not treated quickly and properly. The aim of this study is to share our practices for managing this condition. Methods: We retrospectively evaluated 9 patients diagnosed with DNM in our hospital between January 2006 and October 2019. Age, gender, origin of infection, length of hospital stay, microorganisms present, type of surgical treatment, and clinical outcomes were reviewed. Results: All patients underwent surgery to drain neck and mediastinal secretions and collections. Three (33.3%) patients were treated with transcervical drainage alone, and 6 (66.7%) patients were treated with combined transcervical and transthoracic drainage. Reoperations were reported in 3 (33.3%) cases. The average length of hospital stay was 22.78 ± 10.05 days (range: 9-40 days). The average length of intensive care unit stay was 6.44 ± 10.10 days (range: 0-25 days). There were no in-hospital deaths, and all patients were discharged home with good outcomes. Conclusions: To improve the prognosis of DNM, we suggest early and adequate debridement of all affected areas along with the proper use of antibiotics. A multidisciplinary approach involving both cardiothoracic and ENT surgeons is also required. [ABSTRACT FROM AUTHOR]