[CORNU CUTANEUM-LIKE CANCER OF THE EXTERNAL EAR].
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OBJECTIVE: To present our surgical technique for congenital atresia of the external ear canal with middle ear infection. METHODS: A modified transmastoid approach to congenital atresia of the external ear canal with middle ear infection was applied. Our method is to visualize the landmarks of the mastoid cavity such as the antrum, sinodural angle and digastric ridge by the canal-open method to avoid facial nerve injury and then prepare a relatively large external ear canal with reconstruction of the posterior wall of the external ear canal. RESULTS AND CONCLUSION: This method is suitable not only for treating congenital atresia of the external ear canal with middle ear infection, but also for avoiding facial nerve injury and postoperative complications such as re-stenosis of the new ear canal and postoperative middle ear infection.
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The external-ear transfer function for big brown bats (Eptesicus fuscus) contains two prominent notches that vary from 30 to 55 kHz and from 70 to 100 kHz, respectively, as sound-source elevation moves from -40 to +10 degrees. These notches resemble a higher-frequency version of external-ear cues for vertical localization in humans and other mammals. However, they also resemble interference notches created in echoes when reflected sounds overlap at short time separations of 30-50 micros. Psychophysical experiments have shown that bats actually perceive small time separations from interference notches, and here we used the same technique to test whether external-ear notches are recognized as a corresponding time separation, too. The bats' performance reveals the elevation dependence of a time-separation estimate at 25-45 micros in perceived delay. Convergence of target-shape and external-ear cues onto echo spectra creates ambiguity about whether a particular notch relates to the object or to its location, which the bat could resolve by ignoring the presence of notches at external-ear frequencies. Instead, the bat registers the frequencies of notches caused by the external ear along with notches caused by the target's structure and employs spectrogram correlation and transformation (SCAT) to convert them all into a family of delay estimates that includes elevation.
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Commissural lip pits, pinna dysplasia, pre-auricular sinus and hearing loss constitute a recently described autosomal dominant branchial arch syndrome. In a large family, eight out of the 74 members were also affected by conductive hearing loss. No inner ear abnormalities could be demonstrated on the CT scans. In three patients (four ears) out of four patients (six ears), exploratory tympanotomy revealed serious ossicular chain anomalies. In one ear, round window aplasia was also present. Long-term hearing improvement could only be achieved in one ear.
Eleven patients with known malignant tumours of the outer ear and three patients with otitis externa maligna were examined by high resolution CT. CT provided accurate information concerning soft tissue infiltration into the parotid or subtemporal tissues, and of the bony destruction in the mastoid, meatus and tympanic cavity. Absolute differentiation between a malignant tumour and otitis cisterna maligna is not possible, not even by high resolution CT.
Cerumenal adenocarcinoma is a rare neoplasm arising from the modified sweat glands of the ear. Before the diagnosis of primary tumour is made, a thorough search must be undertaken to exclude the possibility of metastatic disease, which occurs more commonly. Benign adenoma can also occur and this may be identical histologically to the malignant variety. The presence of local invasiveness may be the only differentiating feature. Aggressive local resection followed by postoperative radiotherapy form the cornerstone of management. Individuals treated with radiotherapy alone have a life expectancy of less than 12 months whereas cures have been reported with radical surgery.
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