Objective:To describe the characteristics of the clinical presentation,diagnosis,surgical methods,and outcomes of patients with otogenic cerebrospinal fluid(CSF)leakage secondary to congenital inner ear dysplasia.Meth...Objective:To describe the characteristics of the clinical presentation,diagnosis,surgical methods,and outcomes of patients with otogenic cerebrospinal fluid(CSF)leakage secondary to congenital inner ear dysplasia.Methods:A retrospective review was performed of 18 patients with otogenic CSF leakage secondary to inner ear dysplasia who underwent surgery in our group from 2007 to 2017 and had a follow-up of at least 4 months.The average length of follow-up was three years.The characteristics of the clinical presentations of all patients,such as self-reported symptoms,radiographic findings,surgical approaches and methods of repair,position of the leakage during surgery,and postoperative course,including the success rate of surgery,are presented.Results:The patients presented mostly with typical symptoms of meningitis,severe hearing impairment,and CSF otorrhea or rhinorrhea.All 18 patients had at least one previous episode of meningitis accompanied by a severe hearing impairment.The preoperative audiograms of 17 patients showed profound sensorineural hearing loss,and one patient had conductive hearing loss.Twelve patients presented with an initial onset of otorrhea,and two had accompanying rhinorrhea.Six patients complained of rhinorrhea,two of whom were misdiagnosed with CSF rhinorrhea and underwent transnasal endoscopy at another hospital.High-resolution computed tomography(HRCT)images can reveal developments in the inner ear,such as expansion of a vestibular cyst,unclear structure of the semicircular canal or cochlea,or signs of effusion in the middle ear or mastoid,which strongly suggest the possibility of CSF otorrhea.The children in the study suffered more severe dysplasia than adults.All 18 patients had CSF leakage identified during surgery.The most common defect sites were in the stapes footplates(55.6%),and 38.9%of patients had a leak around the oval window.One patient had a return of CSF otorrhea during the postoperative period,which did not re-occur following a second repair.Conclusions:CSF otorrhea due to 展开更多
Objective: To study the clinical and therapeutic epidemiological profile of chronic purulent otorrhea in the ENT and CCF departments of the Gabriel Touré university hospital. Materials and Method: This was a retr...Objective: To study the clinical and therapeutic epidemiological profile of chronic purulent otorrhea in the ENT and CCF departments of the Gabriel Touré university hospital. Materials and Method: This was a retrospective study from May 2019 to April 2021. We made an exhaustive sampling of all patients who consulted for chronic purulent otorrhea with a complete medical file. All ages were included (except from 0 to - 5 years), and all sexes combined. The data medium was the patient records and the department’s operating report register. The non-inclusion criteria were patients with incomplete files and patients who were less than 5 years old. Results: In total, we collected 135 cases. The average age of our patients was 29.27 years. The most represented age group was 16 to 25 years old. We noted a male predominance in 60.7%. The associated signs found were hearing loss, earache, tinnitus, ear pruritus, vertigo, headache and facial paralysis. The main pathology involved is chronic otitis media (CMO) in 55.5%, the most serious of which is dangerous chronic otitis (8.1%). All of our patients have received medical treatment. The treatment was surgical in 64% of patients after medical treatment. With the mean follow-up of 6 months, tinnitus and reperforation were the most common complications found in 6.2% and 3.1% respectively. Conclusion: Chronic purulent otorrhea is the most common ear discharge in ENT consultation. The main pathology involved is CMO, the most formidable of which is cholesteatoma. Medico-surgical treatment.展开更多
Background: Several patients experience persistent otorrhea after a flawless surgical procedure because of insufficient epithelial healing. Several efforts, such as autologous tissue allograft and xenograft, have been...Background: Several patients experience persistent otorrhea after a flawless surgical procedure because of insufficient epithelial healing. Several efforts, such as autologous tissue allograft and xenograft, have been made to halt otorrhea. However, a stable technology to induce temporal epithelial repair is yet to be established. Therefore, this study aims to investigate whether implantation of seeding adipose-derived mesenchymal stem cell (ADMSC) aggregates on extracellular matrix (ECM;herein, ADMSC aggregate-ECM) into damaged skin wound promotes skin regeneration. Methods: ADMSC aggregate-ECM was prepared using a previously described procedure that isolated ADMSCs from rabbits and applied to the auricle and auditory meatus wound beds of New Zealand white rabbits. Wound healing was assessed by general observation and hematoxylin and eosin (H&E) staining. Secretion of growth factor of the tissue was evaluated by western blotting. Two other groups, namely, ECM and control, were used. Comparisons of three groups were conducted by one-way analysis of variance analysis. Results: ADMSCs adhered tightly to the ECM and quickly formed cell sheets. At 2 weeks, general observation and H&E staining indicated that the wound healing rates in the ADMSC aggregate-ECM (69.02±6.36%) and ECM (59.32 + 4.10%) groups were higher than that in the control group (43.74± 12.15%;P=0.005, P<0.001, respectively) in ear auricle excisional wounds. At 7 weeks, The scar elevation index was evidently reduced in the ADMSC aggregate-ECM (2.08±0.87) and ECM (2.31 ±0.33) groups compared with the control group (4.06 ±0.45;P < 0.001, P < 0.001, respectively). In addition, the scar elevation index of the ADMSC aggregate-ECM group reached the lowest rate 4 weeks in advance. In auditory meatus excisional wounds, the ADMSC aggregate-ECM group had the largest range of normal skin-like structure at 4 weeks. The ADMSC aggregate-ECM and ECM groups secreted increased amounts of growth factors that contributed to skin regeneration at weeks 1 and 2, respec展开更多
Cerebrospinal fluid fistulae occur when defects in dura, pla-arachnold or skull permit the cerebrospinal fluid escape from the subarachnoid space via anterior naris, nasopharynx or external acoustic meastus, Which is ...Cerebrospinal fluid fistulae occur when defects in dura, pla-arachnold or skull permit the cerebrospinal fluid escape from the subarachnoid space via anterior naris, nasopharynx or external acoustic meastus, Which is most commonly manifested as rhinorrhea or otorrhea,complicated by serious recurrent meningitis for months or years.This paper reports 20 cases of rhinorrhea and one of otorrhea, persisting longer than 3 months. All the cases were repaired successfully and there was no recurrence arter being followed up for 1 to 20 years.We compared various diagnostic methods and suggested a simple operative procedure.展开更多
Objective Poreneephalic cyst presenting with otologie involvement is uncommon. Only a few eases have been reported. We report a rare case of cerebrospinal fluid （CSF） otorrhea caused by a massive porencephalic cyst ...Objective Poreneephalic cyst presenting with otologie involvement is uncommon. Only a few eases have been reported. We report a rare case of cerebrospinal fluid （CSF） otorrhea caused by a massive porencephalic cyst encompassing the left temporal and occipital lobes. The CSF leak was repaired successfully using a transmastoid approach with facia, abdomen fat and fibrin glue to seal the osseous defects in the sinodural angle. A review of the literature concerning porencephalic cyst and CSF otorrhea is also presented.展开更多
Cerebrospinal fluid(CSF)fistulae originating from the fallopian canal of the facial nerve is hypothesized to arise due to atypical patterns of subarachnoid space extension into the geniculate ganglion or more distal r...Cerebrospinal fluid(CSF)fistulae originating from the fallopian canal of the facial nerve is hypothesized to arise due to atypical patterns of subarachnoid space extension into the geniculate ganglion or more distal regions along the intratemporal course of the facial nerve,but its pathogenesis remains poorly understood.Although a rare etiology of CSF fistulae of the temporal bone,there are significant clinical ramifications due to the risk of recurrent meningitis,difficulty in identifying the anatomic location of the CSF leak,and technical challenges associated with surgical repair.We present three clinical cases of arachnoid cysts within the geniculate fossa with or without CSF fistulization and provide histopathologic correlates of this rare clinical phenomenon from a human temporal bone collection.The pediatric and adult patients presented suggest differential pathophysiologic mechanisms associated with CSF fistulae.Temporal bone histology reveals atypical patterns of subarachnoid space extension in the fallopian canal that may underlie arachnoid cyst formation and overt CSF leak from the geniculate region.展开更多
目的通过Meta分析系统评价OTO-201在鼓膜置管术后耳漏治疗的有效性,微生物根除数及不良事件发生数。方法计算机检索Pubmed,the Cochrane Library,Web of science,中国生物医学文献数据库,万方,维普,CNKI数据库文献(自建库至2021年2月),...目的通过Meta分析系统评价OTO-201在鼓膜置管术后耳漏治疗的有效性,微生物根除数及不良事件发生数。方法计算机检索Pubmed,the Cochrane Library,Web of science,中国生物医学文献数据库,万方,维普,CNKI数据库文献(自建库至2021年2月),检索OTO-201在鼓膜置管患者术后并发症治疗方面的文献并进行筛选,选取随机对照实验(RCT),对符合纳入标准的文献进行Jadad评分,并用使用 Rev Man 5.3软件对符合质量标准的研究进行Meta分析。结果纳入5篇原始研究,共包括2000例,其中OTO-201组1281例,对照组719例,结果在本文中显示术后4,8,15,29天耳漏发生数OTO-201组低于对照组发生数,其中术后4天:I2=43%(OR=3.67,95%CI:2.75~4.91);术后8天:I2=O%(OR=3.52,95%CI:2.73~4.53);术后15天:I2=0%(OR=3.27,95%CI:2.59~4.14);术后29天:I2=0%(OR=3.03,95%CI:2.43~4.80);术后微生物根除人数:I2=25% (OR=3.03,95%CI:2.43~3.80);而术后不良事件发生数;I2=2%(OR=0.87,95%CI:0.70~1.10)。结论本文结果显示OTO-201组与对照组两者差别无统计学意义,即使用OTO-201并不会增加不良事件的发生数。受纳入研究质量的限制,上述结论尚需展开更多高质量的研究予以验证。展开更多
基金Project supported by the National Natural Science Foundation of China(Nos.81570914 and 81700925)
文摘Objective:To describe the characteristics of the clinical presentation,diagnosis,surgical methods,and outcomes of patients with otogenic cerebrospinal fluid(CSF)leakage secondary to congenital inner ear dysplasia.Methods:A retrospective review was performed of 18 patients with otogenic CSF leakage secondary to inner ear dysplasia who underwent surgery in our group from 2007 to 2017 and had a follow-up of at least 4 months.The average length of follow-up was three years.The characteristics of the clinical presentations of all patients,such as self-reported symptoms,radiographic findings,surgical approaches and methods of repair,position of the leakage during surgery,and postoperative course,including the success rate of surgery,are presented.Results:The patients presented mostly with typical symptoms of meningitis,severe hearing impairment,and CSF otorrhea or rhinorrhea.All 18 patients had at least one previous episode of meningitis accompanied by a severe hearing impairment.The preoperative audiograms of 17 patients showed profound sensorineural hearing loss,and one patient had conductive hearing loss.Twelve patients presented with an initial onset of otorrhea,and two had accompanying rhinorrhea.Six patients complained of rhinorrhea,two of whom were misdiagnosed with CSF rhinorrhea and underwent transnasal endoscopy at another hospital.High-resolution computed tomography(HRCT)images can reveal developments in the inner ear,such as expansion of a vestibular cyst,unclear structure of the semicircular canal or cochlea,or signs of effusion in the middle ear or mastoid,which strongly suggest the possibility of CSF otorrhea.The children in the study suffered more severe dysplasia than adults.All 18 patients had CSF leakage identified during surgery.The most common defect sites were in the stapes footplates(55.6%),and 38.9%of patients had a leak around the oval window.One patient had a return of CSF otorrhea during the postoperative period,which did not re-occur following a second repair.Conclusions:CSF otorrhea due to
文摘Objective: To study the clinical and therapeutic epidemiological profile of chronic purulent otorrhea in the ENT and CCF departments of the Gabriel Touré university hospital. Materials and Method: This was a retrospective study from May 2019 to April 2021. We made an exhaustive sampling of all patients who consulted for chronic purulent otorrhea with a complete medical file. All ages were included (except from 0 to - 5 years), and all sexes combined. The data medium was the patient records and the department’s operating report register. The non-inclusion criteria were patients with incomplete files and patients who were less than 5 years old. Results: In total, we collected 135 cases. The average age of our patients was 29.27 years. The most represented age group was 16 to 25 years old. We noted a male predominance in 60.7%. The associated signs found were hearing loss, earache, tinnitus, ear pruritus, vertigo, headache and facial paralysis. The main pathology involved is chronic otitis media (CMO) in 55.5%, the most serious of which is dangerous chronic otitis (8.1%). All of our patients have received medical treatment. The treatment was surgical in 64% of patients after medical treatment. With the mean follow-up of 6 months, tinnitus and reperforation were the most common complications found in 6.2% and 3.1% respectively. Conclusion: Chronic purulent otorrhea is the most common ear discharge in ENT consultation. The main pathology involved is CMO, the most formidable of which is cholesteatoma. Medico-surgical treatment.
基金a grant from the National Natural Science Foundation of China (No. 81170904).
文摘Background: Several patients experience persistent otorrhea after a flawless surgical procedure because of insufficient epithelial healing. Several efforts, such as autologous tissue allograft and xenograft, have been made to halt otorrhea. However, a stable technology to induce temporal epithelial repair is yet to be established. Therefore, this study aims to investigate whether implantation of seeding adipose-derived mesenchymal stem cell (ADMSC) aggregates on extracellular matrix (ECM;herein, ADMSC aggregate-ECM) into damaged skin wound promotes skin regeneration. Methods: ADMSC aggregate-ECM was prepared using a previously described procedure that isolated ADMSCs from rabbits and applied to the auricle and auditory meatus wound beds of New Zealand white rabbits. Wound healing was assessed by general observation and hematoxylin and eosin (H&E) staining. Secretion of growth factor of the tissue was evaluated by western blotting. Two other groups, namely, ECM and control, were used. Comparisons of three groups were conducted by one-way analysis of variance analysis. Results: ADMSCs adhered tightly to the ECM and quickly formed cell sheets. At 2 weeks, general observation and H&E staining indicated that the wound healing rates in the ADMSC aggregate-ECM (69.02±6.36%) and ECM (59.32 + 4.10%) groups were higher than that in the control group (43.74± 12.15%;P=0.005, P<0.001, respectively) in ear auricle excisional wounds. At 7 weeks, The scar elevation index was evidently reduced in the ADMSC aggregate-ECM (2.08±0.87) and ECM (2.31 ±0.33) groups compared with the control group (4.06 ±0.45;P < 0.001, P < 0.001, respectively). In addition, the scar elevation index of the ADMSC aggregate-ECM group reached the lowest rate 4 weeks in advance. In auditory meatus excisional wounds, the ADMSC aggregate-ECM group had the largest range of normal skin-like structure at 4 weeks. The ADMSC aggregate-ECM and ECM groups secreted increased amounts of growth factors that contributed to skin regeneration at weeks 1 and 2, respec
文摘Cerebrospinal fluid fistulae occur when defects in dura, pla-arachnold or skull permit the cerebrospinal fluid escape from the subarachnoid space via anterior naris, nasopharynx or external acoustic meastus, Which is most commonly manifested as rhinorrhea or otorrhea,complicated by serious recurrent meningitis for months or years.This paper reports 20 cases of rhinorrhea and one of otorrhea, persisting longer than 3 months. All the cases were repaired successfully and there was no recurrence arter being followed up for 1 to 20 years.We compared various diagnostic methods and suggested a simple operative procedure.
基金supported by the National Natural Science Foundation of China(NSFC)Grant No.30600703 and No.81170911
文摘Objective Poreneephalic cyst presenting with otologie involvement is uncommon. Only a few eases have been reported. We report a rare case of cerebrospinal fluid （CSF） otorrhea caused by a massive porencephalic cyst encompassing the left temporal and occipital lobes. The CSF leak was repaired successfully using a transmastoid approach with facia, abdomen fat and fibrin glue to seal the osseous defects in the sinodural angle. A review of the literature concerning porencephalic cyst and CSF otorrhea is also presented.
文摘Cerebrospinal fluid(CSF)fistulae originating from the fallopian canal of the facial nerve is hypothesized to arise due to atypical patterns of subarachnoid space extension into the geniculate ganglion or more distal regions along the intratemporal course of the facial nerve,but its pathogenesis remains poorly understood.Although a rare etiology of CSF fistulae of the temporal bone,there are significant clinical ramifications due to the risk of recurrent meningitis,difficulty in identifying the anatomic location of the CSF leak,and technical challenges associated with surgical repair.We present three clinical cases of arachnoid cysts within the geniculate fossa with or without CSF fistulization and provide histopathologic correlates of this rare clinical phenomenon from a human temporal bone collection.The pediatric and adult patients presented suggest differential pathophysiologic mechanisms associated with CSF fistulae.Temporal bone histology reveals atypical patterns of subarachnoid space extension in the fallopian canal that may underlie arachnoid cyst formation and overt CSF leak from the geniculate region.
文摘目的通过Meta分析系统评价OTO-201在鼓膜置管术后耳漏治疗的有效性,微生物根除数及不良事件发生数。方法计算机检索Pubmed,the Cochrane Library,Web of science,中国生物医学文献数据库,万方,维普,CNKI数据库文献(自建库至2021年2月),检索OTO-201在鼓膜置管患者术后并发症治疗方面的文献并进行筛选,选取随机对照实验(RCT),对符合纳入标准的文献进行Jadad评分,并用使用 Rev Man 5.3软件对符合质量标准的研究进行Meta分析。结果纳入5篇原始研究,共包括2000例,其中OTO-201组1281例,对照组719例,结果在本文中显示术后4,8,15,29天耳漏发生数OTO-201组低于对照组发生数,其中术后4天:I2=43%(OR=3.67,95%CI:2.75~4.91);术后8天:I2=O%(OR=3.52,95%CI:2.73~4.53);术后15天:I2=0%(OR=3.27,95%CI:2.59~4.14);术后29天:I2=0%(OR=3.03,95%CI:2.43~4.80);术后微生物根除人数:I2=25% (OR=3.03,95%CI:2.43~3.80);而术后不良事件发生数;I2=2%(OR=0.87,95%CI:0.70~1.10)。结论本文结果显示OTO-201组与对照组两者差别无统计学意义,即使用OTO-201并不会增加不良事件的发生数。受纳入研究质量的限制,上述结论尚需展开更多高质量的研究予以验证。
