摘要：Benign paroxysmal positional vertigo (BPPV) is probably the most common diagnosis at vertigo clinics. Seasonal cycles of several human illnesses could be attributed variously to changes in atmospheric or weather conditions. In this retrospective study, patients with BPPV from January 2010 to December 2012 were studied, and their charts were reviewed. Statistical analysis revealed a statistically significant difference in patients' numbers among different months of the year. Also there is a significant statistical correlation between the numbers of patients with climatic variations especially the temperature. The present paper discusses the possible explanations for these results which confirms the seasonal variations in BPPV, together with a review of literature to view the possible associations with other disorders that causes such sea-sonality.

摘要：Objective The study is to identify the carrier rate of common deafness mutation in Chinese pregnant women via detecting deafness gene mutations with gene chip. Methods The pregnant women in obstetric clinic without hearing impairment and hearing disorders family history were selected. The informed consent was signed. Peripheral blood was taken to extract genom-ic DNA. Application of genetic deafness gene chip for detecting 9 mutational hot spot of the most common 4 Chinese deafness genes, namely GJB2 (35delG,176del16bp, 235delC, 299delAT), GJB3 (C538T) ,SLC26A4 ( IVS72A>G, A2168G) and mito-chondrial DNA 12S rRNA (A1555G, C1494T) . Further genetic testing were provided to the spouses and newborns of the screened carriers. Results Peripheral blood of 430 pregnant women were detected,detection of deafness gene mutation carri-ers in 24 cases(4.2%), including 13 cases of the GJB2 heterozygous mutation, 3 cases of SLC26A4 heterozygous mutation, 1 cases of GJB3 heterozygous mutation, and 1 case of mitochondrial 12S rRNA mutation. 18 spouses and 17 newborns took fur-ther genetic tests, and 6 newborns inherited the mutation from their mother. Conclusion The common deafness genes muta-tion has a high carrier rate in pregnant women group,235delC and IVS7-2A>G heterozygous mutations are common.

摘要：Objective:To test the feasibility of measuring fine temporal bone structures using a newly established cone-beam computed tomography (CBCT) system. Materials and methods: Six formalin-fixed human cadaver temporal bones were imaged using a high-resolution CBCT system that has 900 frames and copper+aluminum filtration. Fine temporal bone structures, including those of the facial nerve canal and vestibular structures, were identified and measured. Results:The fine structures of the middle ear, including the tympanic membrane, tendon of the tensor tympani, cochleariform process of the semicanal of the tensor tympani, pyramidal eminence, footplate of the stapes, full path of the facial nerve within the temporal bone, supra-labyrinthine space, semicircular canals, pathway of the subarcuate canal, and full path of the vestibular aqueduct, were clearly demonstrated. The vestibular aqueduct has a midpoint width of 0.4 ± 0.0 mm and opercular width of 0.5 ± 0.1 mm (mean ± SD). The length of the internal acoustic meatus was 10.6 ± 1.2 mm (mean ± SD), and the diameter of the internal acoustic meatus was 3.7 ± 0.3 mm (mean ± SD). Conclusion:This novel high-resolution CBCT system has potentially broad applications in the diagnosis of inner ear disease and in monitoring associated pathological changes, surgical planning, navigation for the ear surgery, and temporal bone training. Copyright ? 2017, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license.

摘要：Objective: Recent studies have shown that chronic inflammation contributes to the development of sudden sensorineural hearing loss (SSNHL). Some hematologic parameters have also been linked to the prognosis of SSNHL. However, the prognostic value of such hematological factors is not conclusive. This study explored the association of routine hematological parameters with SSNHL.Methods: A systematic literature search was conducted in PubMed, Cochrane Library, Web of Science and Embase to identify eligible studies. Standardized mean deviation (SMD) and the 95％confidence interval (CI) were retried from relevant studies for analysis. Heterogeneity, subgroup, and publication bias ana-lyses were performed. Results: A total of 18 studies involving 1505 SSNHL patients and 1466 healthy persons were enrolled in thefinal analysis. The study population included 699 responders and 458 non-responders to treatment. Pooled results revealed that the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) value in the SSNHL patient group were higher than in the healthy group (SMD=1.05, 95％CI:0.86,1.24, p<0.001, SMD=0.52, 95％ CI:0.26,0.78, p<0.001, respectively). However, there was no significant dif-ference in the mean platelet volumes (MPV) between the groups (SMD=0.03, 95％ CI: 0.44, 0.49, p=0.91). Notably, NLR and PLR values were evidently higher in the unrecovered group than in the recovered group (SMD=-0.63, 95％CI:1.02,-0.23, p=0.002, SMD=-0.4, 95％CI:0.76,-0.03, p=0.03, respectively). However, the MPV value was similar in both groups (SMD=-0.35, 95％ CI: 1.14,0.44, p=0.38).

摘要：To study the efficacy and safety of the Jiang Tang Fang Long Jiao Nang (Hypoglycemic Anti-Deafness Capsule) in treating non-insulin dependent diabetes mellitus with hearing loss. Methods Two hundred ninety six patients with non-insulin dependent diabetes mellitus and hearing loss were randomly assigned to a treatment group(n=164, 208 ears) and a control group(n=132,184 ears). Patients in the treatment group were treated with the Jiang Tang Fang Long Jiao Nang and supplement herbal preparations as indicated by traditional Chinese medicine dialectical assessment, while control patients received glibenclamide and conventional treatments for deafness. Hearing, fasting blood glucose (FBG), post-prandial blood glucose(PBG), 24 hour urine sugar, platelet function indices, blood superoxide dismutase (SOD) and lipid peroxides (LPO) levels, and symptom improvement were compared between the two groups. Results The rate of hearing improvement was 56.7% for the treatment group and 26.6% for the control. FBG, PBG and 24 hour urine sugar improved in both groups, but the last two were superior in the treatment group compared to the control. Symptoms improvement was also superior in the treatment group compared to the control. In patients receiving Jiang Tang Fang Long Jiao Nang treatment, platelet function indices, SOD and LPO were all improved, while only LOP improvement was noticed in control patients. No acute or long-term toxicity was demonstrated for the Jiang Tang Fang Long Jiao Nang in animal tests. The Jiang Tang Fang Long Jiao Nang lowered blood glucose and serum triglycerides in a rat model of alloxan-induced diabetes. Conclusion The Jiang Tang Fang Long Jiao Nang is effective in improving hearing and diabetic indices in diabetic patients with deafness, without significant side effects.

摘要：Objective: To report complications related to flap around implants after cochlear implantation, possible causes of such complications and treatments. Methods and material:We performed a retrospective analysis of children in whom complications related to flap around implants occurred after undergoing cochlear implantation in our department from 2005 to 2016. Results:Complications among 1500 cochlear implantation (CI) recipients by the same surgeon included hematoma (n ? 20) and seroma around implants (n ? 15), of which most (n ? 10) recovered in 2 weeks after effective drainage, utility of antibiotics and pressure dressing, but 5 developed flap necrosis and had to undergo contralateral re-implantation. Four patients developed abscess around implants, of whom 2 recovered after 2 weeks of drainage, gentamicin irrigation and use of antibiotics, but 2 patients ended up with flap necrosis and had to receive contralateral reimplantation. Conclusions: Immediate drainage, pressure dressing and antibiotics can be used to effectively control seroma around implants. For seroma lasting for more than two weeks without improvement, surgical drainage may be need.

摘要：Objective: To review the published literature related to the different obliteration and reconstruction techniques in the management of the canal wall down mastoidectomy.Methods: A PubMed (Medline) and LILACS databases as well as crossed references search was performed with the following Mesh terms:"cholesteatoma","cholesteatoma-middle ear","otitis media","otitis media, suppurative","mastoiditis","mastoidectomy","canal wall down mastoidectomy","radical mas-toidectomy","mastoid obliteration"and crossed references. Inclusion criteria were adult patients subject to mastoid cavity obliteration and posterior canal wall reconstruction. The technique and materials used, anatomic and functional results, complications, recurrence rates, and changes in quality of life, were analyzed. A total of 94 articles were screened, 38 were included for full-text detailed review. Results: Twenty-one articles fulfilled the inclusion criteria. Techniques and materials used for canal wall reconstruction, tympanoplasty, and ossiculoplasty were varied and included autologous, biosynthetic, or both. Auditory results were reported in 16 studies and were inconsistent. Three studies reported improvement in the quality of life using the GBI scale. Follow-up time ranged from 1 to 83 months. Eleven articles used imaging studies to evaluate postoperative disease recurrence. The highest recurrence rate reported for cholesteatoma after obliteration was 19％. The most frequently reported complications were retraction pockets and transient otorrhea. Conclusion: Plenty of techniques combining grafts and other materials have been used to overcome mastoidectomy cavity problems. So far, it is still not possible to standardize an ideal procedure. The available level of evidence for this topic is low and limited.

摘要：Objective:To investigate the efficacy of quick repositioning maneuver for horizontal semicircular canal benign paroxysmal positional vertigo (H-BPPV). <br> Methods:Clinical data of 67 patients with H-BPPV who underwent quick repositioning maneuver in our hospital from July 2009 to November 2014 were retrospectively analyzed. The maneuver involved rotating the patient in the axial plane for 180? from the involved side towards contralateral side as quickly as possible. <br> Results:Complete symptom resolution was achieved in 61 patients (91.0%) at one week and in 64 patients (95.5%) at 3 months post-treatment. During the repositioning maneuver process, there were no obvious untoward responses except transient nausea with or without vomiting in a few patients. <br> Conclusion:The results indicate that the quick repositioning maneuver is an easy and effective alternative treatment in the management of H-BPPV. <br> Copyright ? 2015 The Authors. Production & hosting by Elsevier (Singapore) Pte Ltd On behalf of PLA General Hospital Department of Otolaryngology Head and Neck Surgery. This is an open access article under the CC BY-NC-ND license (

摘要：Mutations in GJB2 gene are the most frequently found mutations in patients with nonsyndromic hearing impairment. However, the spectrum and prevalence of mutations in this gene vary among different ethnic groups. In China, 30,000 infants are born with congenital hearing impairment annually. In order to provide appropriate genetic testing and counseling to the families, we investigated the molecular etiology of nonsyndromic deafness in 103 unrelated school children attending Nantong School for the Deaf and Mute in Jiangsu Province, China. The coding exon of the GJB2 gene was PCR amplified and sequenced. Sixty two GJB2 mutant alleles were identified in 35.9% (37/103) of the patients. Twenty five patients carried two pathogenic mutations and 12 patients carried one mutant allele. The 235delC was the most common mutation accounting for 69.4% (43/62) of GJB2 mutant alleles.The GJB2 mutant alleles accounted for 30.1% (62/206) of all chromosomes responsible for nonsyndromic hearing impairment. Testing of the 3 most prevalent deleterious frame shift mutations in this cohort detected 100% of all GJB2 mutant alleles. These results demonstrate that an effective genetic testing of GJB2 gene for patients and families with nonsyndromic hearing impairment is possible.

摘要：Primary hemifacial spasm (HFS) is a disorder that causes frequent involuntary contractions in the muscles on one side of the face, due to a blood vessel compressing the nerve at its root exit zone (REZ) from the brainstem. Numerous prospective and retrospective case series have confirmed the efficacy of microvascular decompression (MVD) of the facial nerve in patients with HFS. However, while MVD is effective, there are still significant postoperative complications. In this paper, recent technological advances related to MVD (such as lateral spread response, brainstem auditory evokes potential, three dimensional time of flight magnetic resonance angiography, intraoperative neuroendoscopy) are reviewed for the purposes of improving MVD treatment efficacy and reducing postoperative complications.

摘要：Subjective tinnitus is the most common type of tinnitus,which is the manifestation of pathological activities in the brain.It happens in a substantial portion of the general population and brings significant burden to the society.Severe subjective tinnitus can lead to depression and insomnia and severely affects patients' quality of life.However,due to poor understanding of its etiology and pathogenesis,treatment of subjective tinnitus remains challenging.In recent decades,a growing number of studies have shown that subjective tinnitus is related to lesion-induced neural plasticity of auditory and non-auditory central systems.This article reviews cellular mechanisms of neural plasticity in subjective tinnitus to provide further understanding of its pathogenesis.

摘要：Benign paroxysmal positional vertigo (BPPV) is the most frequent episodic vestibular disorder. It is due to otolith rests that are free into the canals or attached to the cupulas. Well over 90%of patients can be successfully treated with manoeuvres that move the particles back to the utriculus. Among the great variety of procedures that have been described, the manoeuvres that are supported by evidenced-based studies or extensive series are commented in this review. Some topics regarding BPPV treatment, such as controlling the accuracy of the procedures or the utility of post-manoeuvre restrictions are also discussed.

摘要：Objective To retrospectively study clinical features and diagnostic imaging of vasculogeneic pulsatile tin-nitus, and the feasibility and efficacy of transvascular interventional treatment for this condition. Methods Data from 82 cases of arterial or venous pulsatile tinnitus were reviewed. DSA characteristics and possible pathophysiological mechanisms of pulsatile tinnitus in these cases were studied. Diagnoses in this group in-cluded intracranial arterovenous fistula (AVF) (n=3), spontaneous skull base dural AVF (n=16), traumatic ca-rotid-cavernous sinus fistula (n=5), subclavian artery stenosis (n=2), internal carotid artery stenosis (n=3), in-tracranial arterial stenosis (n=1), kinked and/or elongated vertebrobasilar artery (n=2), venous sinus divertic-ulum (n=2), venous sinus stenosis on the dominant drainage side (n=46) and occipital sinus stenosis (n=2). Treatments included embolization and stenting using coils, NBCA glue, Balt balloons, self-expansion stents and intracranial micro-stents via either the femoral artery or femoral vein. Results Procedures were suc-cessful in all cases with no surgery-related complications. Tinnitus disappeared within 2 days after the pro-cedure in all cases. Follow up duration was 5-36 months. Recurrence occurred in 4 cases of arterial tinnitus within 3 months following the initial procedure, which improved after revision embolization or symptom management. There was no recurrence in venous tinnitus cases following stent plastic or stent-coiling embo-lization treatments. Conclusions Endovascular intervention provides a new approach to the diagnosis and treatment of intractable pulsatile tinnitus. It is also effective in differentiating and studying other types of tinnitus.

摘要：Objectives: To evaluate hearing outcome of salvage treatment with intratympanic steroids (ITS) in idiopathic sudden sensorineural hearing loss (ISSNHL) refractory to initial systemic steroid (SS) therapy. Material and methods: A retrospective medical chart review was conducted on 54 consecutive patients with ISSNHL refractory to SS. Salvage treatment with a low dose intratympanic dexamethasone (4 mg/ml) was offered after one week of primary treatment. Patients were divided into two groups:25 patients accepted ITS (treatment group) and 29 patients did not undergo additional treatment (control group). A pure tone average (PTA) gain of at least 10 dB was considered hearing improvement. Results: Hearing improvement rate was higher in ITS group compared to control group (40％ vs. 13.8％, p = 0.035). A mean PTA improvement of 8.6 ± 9.8 dB was observed in the ITS group and, whereas the control group had an average hearing gain of 0.7 ± 2 dB (p < 0.001). Audiometric analysis revealed a significant hearing gain in ITS group at all tested frequencies compared to control group (p < 0.05). Analysis of the selected variables, identified intratympanic steroid treatment as the only independent prognostic factor for hearing improvement (OR= 4.2, 95％CI:1.1-15.7; p=0.04). Conclusion: Intratympanic low dose dexamethasone is effective in patients with incomplete hearing recovery after primary systemic steroid treatment.

摘要：Middle ear surgery is usually performed using a surgical microscope. Initially, in otorhinolaryngology practice, endoscopes were used for paranasal sinus surgeries. It was only later that they were applied in the area of otology. In otologic surgeries, endoscopes were first used to visualize the middle ear, before being used to assist with visualization of instruments during cholesteatoma surgeries, although they are still not used alone in various otologic surgeries. As in other surgical fields, there is also a trend towards minimally invasive intervention in the field of otorhinolaryngology. Smaller incisions performed under the guidance of endoscopes are preferred over conventional large incisions. Using this approach, improved outcomes can be achieved and postoperative morbidities can be reduced. In addition, the outcomes of grafts performed using the endoscopic approach are similar to that achieved by the microscopic approach. Therefore, endoscopic ear surgery implementations are becoming increasingly popular.