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Superior semicircular canal dehiscence syndrome (SSCDS) is a set of symptoms, related to vestibular and/or auditory, which dues to a dehiscence of bone at the superior semicircular canal. We reported an extremely rare case with idiopathic bony dehiscence at the lateral semicircular canal, which presents the similar symptoms with SSCDS, and performed a pertinent literature review. A 76-year-old male patient complained experiencing vertigo and autophony caused by loud noises, with a sign of horizontal eye movements for the stimuli of loud noise to his right ear. HRCT scanning presented a solitary 2.0 mm bony defect at the right lateral semicircular canal. For a chief complaint of sound-/pressure-induced vertigo and/or oscillopsia and/or auditory symptoms, semicircular canal dehiscence syndrome should be considered. Then the doctor could presume the location of the dehiscence via the way of the oscillopsia. If the dehiscence lying the lateral semicircular canal, in clinical radiology, both axial and coronal images to be produced though the lateral semicircular canal plane in a parallel and perpendicular way should be carefully assessed for making diagnosis.

Solitary or isolated involvement of the sphenoid sinus (Isolated sphenoid sinus disease; ISSD ) is a relatively uncommon disease. The present study reviews retrospectively 125 patients with ISSD treated at the Departments of Otolaryngology, Eye Ear Nose and Throat Hospital, Shanghai Medical University (109), and Hyogo College of Medicine (16) over a period of 25 years. Diagnosis was made on the basis of history, signs, nasal endoscopy, imaging techniques with CT/MRI. The final diagnosis of ISSD was established after histopathological and microbiological examinations of the excisional specimen. The pathology was sphenoid sinusitis (40), sphenoid cysts (35), fungal diseases (19), malignant tumors (9), and others (20). The most common initial symptom was headache, followed by visual changes and cranial nerve palsies due to the nearby involvements. Increasing use of routine imaging techniques with CT/MRI and diagnostic nasal endoscopy resulted in the increased numbers of early ISSD. Recent nasal endoscopic ostial sphenoidotomy warrants for the precise pathological diagnosis, and at the same time for the safe and immediate treatment, prior to the sequential extension to adjacent vital structures even to the serious or fatal stage.

To evaluate surgical outcomes for adenoid cystic carcinoma (ACC) of the external auditory canal (EAC).Forty-three patients with ACC of the EAC in Eye and ENT Hospital of Fudan University were analyzed retrospectively for survival. The patients were staged according to the modified Pittsburgh staging system. Thirteen patients with T1 stage underwent local resection (LR), 6 patients with T1 stage underwent lateral temporal bone resection (LTBR), and 8 patients with T1 stage underwent LTBR including superficial parotidectomy (SP). Two patients with T2 stage underwent LTBR, and 1 patient with T2 stage underwent LTBR+SP. Three patients with T3 stage underwent LTBR. One patient with T4 stage underwent LTBR, two patients with T4 stage underwent subtotal temporal bone resection (STBR), and 7 patients with T4 stage underwent LTBR+SP.Of all patients that underwent surgery, 13 died of their primary cancers during the follow-up time. The 5-year survival rates of patients with T stages 1 through 4 were 85%, 67%, 67%, and 30%, respectively. There was statistically significant difference in 5-year survival rate between T1 and other stages (T2, T3, T4) using the log-rank test (p0.05). There was significant difference in 5-year survival rate between T4 and other stages using the log-rank test (p0.05). The 5-year survival rates after LR, LTBR or LTBR plus SP for T1 were 77%, 87% and 100%, respectively. The 5-year survival rates after LTBR, STBR or LTBR plus SP for T4 were 0%, 50% and 29%, respectively. The 5-year survival rates for 19 patients with clear surgical margins and 24 patients with positive margins were 89% and 54%, respectively. The 5-year survival rates of patients with radiotherapy and without radiotherapy were 62% and 86%, respectively.An en bloc resection including superficial parotidectomy is favored in an effort to produce negative surgical margins for ACC of the EAC. Adjunctive radiotherapy is used for patients with positive margins and in advanced lesions.

Labyrinthine sequestrum, a rare form of labyrinthitis, is highly distinct from the more commonly encountered labyrinthitis ossificans based on its unique clinical, radiologic, and histologic characteristics. The study included 4 such patients who had undergone clinical and laboratory investigations, computed tomography (CT), and magnetic resonance imaging (MRI) assessments followed by surgical procedures and pathological evaluation. Their major symptoms were otorrhea, otalgia, tinnitus, and profound hearing loss. Imaging studies showed an osteolytic soft mass with calcified debris in the inner ear, and the bony labyrinth was eroded partly or completely by granulation mass, with loss of bony morphology. Further pathological examination was coincident with inflammatory granulation tissue with some calcification or osseous tissue. The disease process is attributed to chronic osteomyelitis due to the presence of osteonecrosis. Prompt CT and MRI examinations and optimal therapeutic management facilitate definitive diagnosis and protect against fatal complications.

The objective of this study is to explore whether olfactory ensheathing cells (OECs) can promote the survival of newborn rat spiral ganglion cells (SGCs) and the underlying possible mechanisms. Co-culture of OECs from adult rats with SGCs from newborn rat cochlea was established and single culture of SGCs acted as control. OECs were obtained and purified based on their special rate of attachment which was different from the other harvested cell types during culture. OECs and SGCs were immunocytochemically characterized and confirmed by expression of low-affinity nerve growth factor receptor p75 or positive label of neuron-specific betaIII-tubulin. To investigate the mechanisms of the role of OECs in survival of SGCs, brain derived neurotrophic factor (BDNF) and anti-BDNF antibody (IgY) were added into the media of the co-cultures respectively, and the surviving SGCs were examined after treatment. Single layer of OECs (92% pure) was seen seven days after plating. Surviving SGCs, which extended their primary neurites, were found on the surface of the layer in the co-cultures. When OECs and SGCs were co-cultured, the number of surviving SGCs was significantly greater than that in the single culture (P0.01). Nine days after culture, there was even no change in the number of surviving SGCs in the co-culture while the number reduced to almost zero in the single culture. In comparison with co-culture without treatment, addition of BDNF (500 pg/mL) into the media had no obvious promoting effect on the survival of SGCs. The number of surviving SGCs reduced significantly when anti-BDNF antibody was applied into the media of co-cultures (P0.01). These results suggest that OECs can promote the survival of SGCs when they are co-cultured in vitro. BDNF released from OECs, as one of the survival factors, plays an important role in the survival of SGCs.

To evaluate the clinical application of multi-planar reformation (MPR) for the diagnosis of superior semicircular canal dehiscence syndrome.A retrospective study was conducted on 9 patients who were diagnosed with SSCD syndrome in the Otology and Skull Base Surgery group of Fudan University. Three radiologists analyzed all the patients' 0.75 mm-collimated axial and coronal images and 0.75 mm-collimated MPR images, and they came up with the same results.There were 18 superior semicircular canal in the 9 patients, of whom 9 were intact and 9 were defective. All the defective superior semicircular displayed a definite dehiscence in all the MPR images, which indicated the sensitivity was 100%; however, 7 of the 9 defective superior semicircular canal were diagnosed as dehiscence in axial images, while 8 of the 9 were diagnosed in coronal images, but the sensitivities were 77.8% and 88.9% respectively. The results of the other 9 with intact superior semicircular canal displayed in the MPR, axial, and coronal images were also different. In the MPR images, they all displayed definite intact roof over the superior semicircular canal. There were 2 dehiscence in all axial and coronal images, and the specificities were 77.8%.The MPR image is more useful in diagnosis of superior semicircular canal dehiscence syndrome than that of the routine axial and coronal images.

To investigate the upstaging and accumulation of gentamicin by mouse hair cells in vitro.Cochlear explants were prepared from the microdissected neonatal mouse cochlea. Cochlear explants were cultured with gentamicin-Texas-red conjunction (GTTR) for different time. Laser confocal microscopy was used to observe the distribution of GTTR in the cochlear sensory cells after labeling with phalloidin-alexa-488.Soon after culture, there was diffuse red staining all tissue cells in the explants. At later time the hair cells were more staining than other cells in the explants. There was no obviously accumulation of GTTR in the supporting cells. The peak level of fluorescent density was reached at 24 hours culture. The GTTR was seen in the infracuticular zone of the hair cells. There was still accumulation of GTTR in the hair cells of the explants after 7 days culturing.GTTR and cochlea explants were useful methods to investigate the pharmacokinetics and mechanisms of gentamicin accumulation over time.

To better understand superior semicircular canal dehiscence (SSCD) syndrome.A retrospective study was conducted on 6 patients who were diagnosed with SSCD syndrome in the Otology and Skull Base Surgery group of Fudan University. The clinical presentations including symptoms, signs, auditory tests and high resolution temporal bone computed tomography were reviewed.Four patients presented with low frequency hearing loss while acoustic reflex responses were intact. Another patient was concomitance with chronic otitis media demonstrated profound sensorineural hearing loss. The sixth patient demonstrated normal hearing. Two patients also complained of autophony, but they were unable to tolerate their own voice. Five patients presented with vertigo while 2 patients were unable to tolerate the environmental noise. All patients showed slow component vertical torsional eye movement away from the effected eye which was induced by the presence of loud sound or pressure in the middle ear or valsalva maneuver. Four patients also demonstrated vertigo induced by the loud sound, 1 patient was induced head movement by 110 dB tone. All patients were revealed variable bone defect overlying on the SSC using high resolution temporal bone CT scan with SSC reformation.The diagnosis of SSCD syndrome was established on both the presence of bone defect overlying superior semicircular canal which was demonstrated using high resolution temporal bone CT scan, and the presence of associated vestibular and auditory symptoms and signs.

To discuss the etiological factors of facial nerve paralysis due to chronic inflammation of middle ear.This retrospective research included 41 patients operated for facial nerve paralysis due to chronic inflammation of middle ear. Careful exploration was made in facial canal in order to identify pathological tissue involvement. Pathological examination was performed in all operative specimens.Four intact fallopian canals were observed. There was a defect on the fallopian canal in 37 patients (90%) and it was most commonly located on the tympanic segment of the canal (89%). Pathological report was cholesteatoma, granulation and tuberculosis, which was found in 24 cases (59%) 14 cases (34%) and 3 cases (7%), respectively.Facial nerve paralysis due to chronic inflammation of middle ear was frequently relevant with cholesteatoma,the tympanic segment of the fallopian canal was most location to be involved in. Its major factor was the infection spreading along the nerve tissue, but not atrophy due to compression. The defect on the fallopian canal was not necessary for infection diffusion.

To investigate uptake and accumulation of gentamicin by cells in the guinea pig inner ear after intratympanic injection using a fluorescent probe--gentamicin-Texas-red conjunction (GTTR).Adult guinea pigs (n = 80) were administered a single dose of GTrR to the middle ear cavity through the intact membrane and survived for 12 h, 24 h, 48 h, 3 d, 4 d, 7 d, 14 d and 28 d. The distribution of GTTR in the cochlear and vestibular cells was observed after staining with phalloidin-alexa-488. Texas Red and DMSO were injected into the tympanum as control.Diffuse staining of gentamicin in the labyrinth was observed initially after local drug administration. At later time point the outer hair cells and sensory cells of vestibular organ were staining more densely than the support cells in the inner ear. The peak level of fluorescent density was reached 3 days after local injection. The GTTR was observed in the infracuticular zone.GTTR was a potential fluorescent probe to investigate the pharmacokinetics and mechanisms of gentamicin accumulation in local application.

To determine the effects of electrical stimulation on denervated cat posterior cricoarytenoid (PCA) muscle.This study was conducted on six cats with PCA muscle denervation. All animals were sacrificed 12 weeks after surgery and the glottal area in the live animals and the fiber diameters of PCA muscle were obtained.Signals synchronized with inspiration were recorded and transmitted to stimulate PCA muscle. The abduction of the paralyzed vocal cord during inspiration was observed; this allows enough flow of air through the larynx to maintain the respiration. The stimulated fiber diameters of PCA muscle were different from that of nonstimulated (P0.01). Although all denervated muscles were degenerated, electrical stimulation was used to prevent muscular atrophy.This study indicates that electrical stimulation of the PCA muscle synchronized with inspiration could restore the abduction of a paralyzed vocal cord and prevent the denervated muscles from atrophying.Electrical stimulation synchronized with inspiration may lead to reanimation of paralyzed laryngeal muscles.

Objective To investigate the anatomic relationship between utricle, saccule, and stapes footplate, and adapt the stapes prosthesis tip to reduce postoperative vertigo. Study design Five temporal bones were serially sectioned and stained, and the distance from the inner lining of stapes footplate to saccule and utricle, respectively, were measured. The Fisch prosthesis was modified with a slope of 45 degrees at its tip to adapt to the anatomic configuration of the vestibule. Fisch’s original piston or the modified piston was used in 174 ears (Group I) and 108 ears (Group II), randomly. Results There was no statistically significant difference in hearing improvement between the 2 groups (P > 0.5). However, postoperative vertigo was significantly reduced when the modified prosthesis was inserted (P Conclusions The modified piston improved the hearing to the level of the original piston, and the incidence of postoperative vertigo was significantly decreased. Significance A modified prosthesis is presented for a patient undergoing stapedotomy.

To investigate the clinical effect and therapeutic mechanism of Nanmiqing capsule made of rheum palmatum, leech, astragalus memberanaceus on patients with chronic prostatitis(CP).Seventy-six CP cases were treated with Nanmiqing, while 32 CP cases were treated with Qianliekang as a control. The changes of EPS were observed pre- and post-treatment. The rat model of CP got by Xiaozhiling inducing were treated with Nanmiqing and Qianliekang respectively. The concentration of endothelin, TXB2, 6-keto-PGF1 alpha and SOD, IgG, IgA in plasma were measured pre- and post-treatment, meanwhile, pathological changes of prostate tissues were observed.The total effective rate was 89.47% in treatment group, which was significantly higher than 71.88% in the control group (P0.01). Experimental study for CP rats showed that the Nanmiqing was more effective medicine than Qianliekang (P0.01).Nanmiqing was an effective medicine for CP. The mechanism of clearing heat and resolving toxin, activating blood and removing stasis and reinforcing Qi in chinese medicine could be the explanation of the useful treatment including three therapentic ways.

The parotid gland of the cat underwent traction for 2 hours (group A) or until the facial nerve was broken (group B). The cats survived postoperatively for 1 day, 2 weeks, 1 month, and 3 months, respectively. Each cat underwent an electroneurography session before they were killed. The facial nerve was harvested and underwent histologic examination. The present study demonstrated that, in group A, the degree of facial nerve degeneration indicated with evoked electroneurography was 100% at 1 day and 2 weeks and 85% and 35%, respectively, at 1 and 3 months after damage. In group B, no electric response was recorded, epineurium of extratemporal segment was broken. This study also showed that the pronounced alteration of the facial nerve following acute traction on the parotid gland was retrograde degeneration; it involved up to its internal acoustic meatus segment. Furthermore, pronounced damage was noted in its stylomastoid foramen and extratemporal segment.

Isolated sphenoid sinus disease (ISSD) is a relatively uncommon disease. The present study is a retrospective review of 122 patients with ISSD who were treated at the Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital at Shanghai Medical University over a 25-year period. The diagnosis of ISSD was made on the basis of history and physical examination, signs and symptoms, nasal endoscopy, and computed tomography (CT) and magnetic resonance imaging (MRI). The final diagnosis of ISSD was confirmed by histopathologic and microbiological examinations of the surgical specimens. The pathological findings in this study included sphenoid cyst (47 cases), sphenoid sinusitis (31 cases), fungal disease (19 cases), inverted papilloma (4 cases), sphenochoanal polyp (1 case), foreign body (8 cases), malignant tumors (8 cases), and others (4 cases). The most common initial symptom was headache, followed in decreasing order by visual changes, cranial nerve palsies, and nasal symptoms. The more frequent use of routine CT and MRI scanning, as well as endoscopy, in the diagnosis of sinus disease has led to an increase in the early diagnosis of ISSD. The recent advances in endoscopic sphenoidotomy has allowed for relatively safe and immediate treatment of ISSD, preventing late extension into adjacent vital structures, which is commonly fatal. Endoscopic surgery also enables the surgeon to make a precise pathological diagnosis.

Glycosylation-dependent cell adhesion molecule-1 (GlyCAM-1) is a mucin-like glycoprotein previously identified on high endothelial venules (HEV) of lymph nodes and also in lactating mammary glands. A specifically glycosilated form of GlyCAM-1 on HEV has been shown to be a ligand for a leukocyte L-selectin, which plays an important role in leukocyte rolling along the inflamed endothelium. Here we report that GlyCAM-1 is also expressed in the cochlea. Immunohistochemistry revealed the lateral wall of the cochlea, tectorial membrane, modiolus, organ of corti, and spiral modiolar vein (SMV) to be strongly stained with polyclonal anti-GlyCAM-1 antibody. Moreover, RT-PCR of the cochlear tissue by the use of specific oligonucleotide primers for rat GlyCAM-1 generated a 378 bp product which was then verified by nucleotide sequencing to represent GlyCAM-1. Electron microscopic investigation revealed the presence of GlyCAM-1 over the entire lumenal surface of the vessels, and the basolateral infoldings in stria vascularis. However, soluble L-selectin or mAb MECA-79 which recognizes a carbohydrate epitope on functional L-selectin ligands bound only to the spiral ligament, tectorial membrane and modiolus. These observations suggest that GlyCAM-1 expressed in the cochlear region is heterogenous in terms of its glycosylation.

High doses of reserpine induce depletion of biogenic amines. The K-NPPase activity of choroid plexus was determined after one-shot reserpine administration using cerium-based cytochemistry. In normal untreated animals, reaction product was found on the microvilli of the choroidal epithelium but was almost undetectable 3 and 7 days after reserpinization. At 20 days after reserpinization, however, it was detectable. These findings suggested that reserpine decreased the choroidal Na,K-ATPase activity, and that catecholamines might be essential to maintain normal choroidal Na,K-ATPase activity. (J Histochem Cytochem 46: 975-976, 1998)