Characterization of Malassezia microbiota in the human external auditory canal and on the sole of the foot

Of the fungal skin microbiota, the lipophilic yeast genus Malassezia predominates at all body sites. Of the members of this genus, M. globosa, M. restricta, and M. sympodialis are the most common on the face, limbs, and trunk. In the present study, the Malassezia microbiotas in the external auditory canal and on the sole of the foot were characterized. M. slooffiae was the most common species in both the external auditory canal and on the sole of the foot, followed by M. restricta. Principal component analysis further revealed that the Malassezia microbiota in the external auditory canal and on the sole of the foot constitute a different cluster from those on the scalp and cheek and in the nasal cavity. Additionally, five new Malassezia phylotypes were detected on the sole of the foot and in the external auditory canal. Our results suggest that a distinctive Malassezia microbiota is present in the external auditory canal and on the sole of the foot, although the clinical significance of this finding remains unknown.     

Adenoid cystic carcinoma of the external auditory canal. A case report with diagnosis by fine needle aspiration

BACKGROUND: Although the cytologic findings of adenoid cystic carcinoma have been reported frequently, fine needle aspiration diagnosis of adenoid cystic carcinoma of the external auditory canal has not been reported before in the English-language literature. CASE: A 70-year-old female presented with a mass occluding the external auditory canal. Fine needle aspiration cytology was performed. The smears showed hyaline globules surrounded by tumor cells. The tumor cells had uniform, round, hyperchromatic nuclei, visible nucleoli and little cytoplasm. Based on these cytomorphologic features, diagnosis of adenoid cystic carcinoma was rendered and then confirmed by histopathologic examination. CONCLUSION: This is the first cytologic report of adenoid cystic carcinoma of the external auditory canal, a rare site for this tumor.     

外耳道胆脂瘤30例临床分析

目的:探讨外耳道胆脂瘤的临床特征和最佳治疗方法,提高临床诊治水平。方法:回顾性分析30例(32耳)外耳道胆脂瘤患者的临床资料。12耳病变局限于外耳道无明显骨质破坏,经耳内窥镜下行胆脂瘤清除病术;10耳病变局限于外耳道,但有较广泛的骨质破坏或有外耳道口狭窄者,经耳内切口显微镜下清除病变并加行外耳道成形术;10耳病变侵及鼓室或乳突,在显微镜下经耳后切口行乳突根治术。有条件者行乳突根治术加鼓室成形术。结果:本组病例所有患者术后病理均为胆脂瘤。术后外耳道口保持宽大,外耳道皮肤恢复正常,不产生上皮堆积。随访1年以上胆脂瘤无复发。结论:耳内镜与显微镜配合应用可彻底清除胆脂瘤,防止胆脂瘤残留和复发,并能提高听力.     

应用肱骨近端内锁定系统治疗高龄肱骨近端骨折

目的:探讨应用肱骨近端内锁定系统(PHILOS)治疗高龄肱骨近端骨折的方法及疗效。方法:2007年10月至2010年02月间,我院使用PHILOS内固定钢板治疗高龄肱骨近端骨折45例,男19例,女26例,年龄54～75岁,平均66岁。根据Neer分型,一部分骨折4例,二部分骨折6例,三部分骨折17例,四部分骨折18例。手术采用三角肌钝性劈开入路,保护附着于大骨折块和大、小结节上的软组织,骨折复位后均行PHILOS固定。患肩功能按Neer肩关节评分系统进行评价。结果:本组随访时间10～24个月,平均16个月。骨折均愈合,平均愈合时间3个月。患侧肩关节评分优28例,良12例,可3例,差2例,优良率为88.9%。结论:PHILOS钢板可牢固固定高龄患者骨折,使骨折愈合与功能恢复相同步,适于粉碎性骨折和肱骨近端骨质疏松骨折的治疗。     

外耳道胆脂瘤30例临床分析（英文）

目的：探讨外耳道胆脂瘤的临床特征和最佳治疗方法,提高临床诊治水平。方法：回顾性分析30例（32耳）外耳道胆脂瘤患者的临床资料。12耳病变局限于外耳道无明显骨质破坏,经耳内窥镜下行胆脂瘤清除病术;10耳病变局限于外耳道,但有较广泛的骨质破坏或有外耳道口狭窄者,经耳内切口显微镜下清除病变并加行外耳道成形术;10耳病变侵及鼓室或乳突,在显微镜下经耳后切口行乳突根治术。有条件者行乳突根治术加鼓室成形术。结果：本组病例所有患者术后病理均为胆脂瘤。术后外耳道口保持宽大,外耳道皮肤恢复正常,不产生上皮堆积。随访1年以上胆脂瘤无复发。结论：耳内镜与显微镜配合应用可彻底清除胆脂瘤,防止胆脂瘤残留和复发,并能提高听力.     

A method for repositioning the external ear

The malposition of an otherwise normal-appearing external ear is not uncommon in certain craniofacial syndromes. This paper presents a 10-year experience of 14 patients who underwent external ear repositioning. In this technique, a posterior incision is used to mobilize surrounding soft tissues circumferentially around the external auditory canal, which then serves as an axis for anterior rotation and elevation. Elevation of up to 8 mm and rotation up to 30 degrees can be achieved. Further elevation is limited by the ensuing constriction and resistance of the external auditory canal. More rotation can be achieved with a Z-plasty transposition of an inferiorly based postauricular skin flap.     

真菌性外耳道炎患者耳道环境菌群结构及多样性

本研究针对广东地区真菌性外耳道炎患者,采集健康对照组以及患病组外耳道分泌物,提取其总DNA,分析其微生物群落结构、多样性变化以及真菌与细菌之间的相关关系。结果显示,对于细菌而言,致病细菌不仅存在于患病组耳道,也存在于健康人群的耳道当中;对于真菌而言,虽然健康组也检出了真菌,但与细菌不同的是,患病组与健康组的真菌群落差异显著。健康组耳道真菌以担子菌门Basidiomycota为主,该类真菌并不是真菌性外耳道炎的致病菌,而在患病组中,子囊菌门Ascomycota的曲霉属Aspergillus占据绝对优势地位。曲霉是重要的致病菌,在10个患病组样本中,8个样本的曲霉属占比超过90%。此外,真菌与细菌之间,仅有极少数菌种的丰度变化存在正相关关系,多数细菌与真菌的丰度变化并不相关,这意味着在耳道环境中,真菌与细菌群落变化的依存关系不明显。总的来说,健康人群与患病人群的耳道环境均存在致病菌,致病菌的存在并不必然导致耳道炎症的发生,菌群变化只是炎症产生的前提。而曲霉在耳道的大量繁殖是真菌性外耳道炎发病的重要原因,维持一种不利于该菌繁殖的耳道环境,可能是预防真菌性外耳道炎发病的有效措施。     

Novel Classification of the Posterior Auricular Artery Based on Angiographical Appearance

Purpose

To investigate the length variation of the posterior auricular artery and propose a novel classification of the posterior auricular artery based on angiographical appearance.

Patients and Methods

A series of 234 consecutive patients who had undergone conventional cerebral angiography was analyzed. The posterior auricular artery was examined on the lateral projection of the external carotid or common carotid arteriography. The posterior auricular artery was classified into four groups by length, using the external auditory canal and the top of the helix as radiographical landmarks. Our proposed classification is as follows: Type A, posterior auricular artery terminates between its origin and the center of the external auditory canal; Type B, posterior auricular artery terminates between the center of the external auditory canal and the top of the helix; Type C, posterior auricular artery terminates between the top of the helix and the vertex; and Type D, posterior auricular artery reaches up to the vertex.

Results

A total of 424 (right, 214; left, 210) posterior auricular arteries were analyzed in 111 men and 123 women aged 11 to 91 years (mean, 61.0 years) examined for aneurysms in 78 cases, occlusive vascular diseases in 56, intracranial hemorrhages in 41, tumors in 35, and others in 24. Types A, B, C, and D were found in 15.1%, 34.9%, 48.8%, and 1.2% of the patients, respectively.

Conclusion

A novel classification of the posterior auricular artery identifies four types based on its length on cerebral angiography.     

A method for external auditory canal stent fabrication

An external auditory canal stent made of Dow Corning elastomer and a silicone catheter has proved useful in maintaining the patency of a newly reconstructed external canal. This paper describes the method of stent construction and presents a case report illustrating its use.     

Molecular Identification and Antifungal Susceptibility of Yeasts and Molds Isolated from Patients with Otomycosis

Mycopathologia - Fungal otitis externa, an infection of the external auditory canal caused by molds and yeasts, accounts for approximately 10–20% of ear canal infections accompanying high...     

A new method utilizing the bipedicle flap for reconstruction of the external auditory canal in microtia

A new technique using the bipedicle flap for reconstruction of microtia is described. This technique makes possible construction of a well-shaped new auricle in the presence of scar formation because of tympanoplasty in which the external auditory canal has been created posteriorly.     

Mechanisms of sound reception and conduction in the dolphin

Morphology of the dolphin’s lower jaw, model and behavioral experiments are discussed with the aim of exploring the mechanisms of sound reception and conduction to the lower jaw canals, taking into account the known concepts of acoustics and the theory of grouped antennas. It is shown that the left and right rows of mental foramens with the respective mandibular canal and tissues of the canals are forming the new external ear and the new external auditory duct whereby sound (in the frequency band of 0.1–160 kHz) is transmitted into the middle ear, in contrast to the dolphin’s nonfunctional outer ear. This new external ear is created by nature as a receiving array of traveling-wave antennas located in the throat of an acoustic horn (the respective mandibular canal). The results give reason to assume the existence of a similar new external ear in Odontoceti.     

Auditory epithelial migration. III. Development of the stratified squamous epithelium of the tympanic membrane and external canal in the mouse

The development of the stratified squamous epithelium of the tympanic membrane and external auditory canal was studied in serial sections of 124 mouse ears aged from 11 gestational days to 100 days. A fold developed from the edge of the fundus of the primary canal. It possessed two regions: firstly the meatal plate, which produced the pars tensa-covering epithelium (zone 2) and most of the deep ear canal epithelium (zone 3), and secondly the fundal extension plate, which grew from that part of the fundus not forming the meatal plate. The fundal extension plate gave rise to the pars flaccida-covering epithelium (zone 1) and also to the adjacent deep canal epithelium (zone 3). A difference from human development was that zone 3 in the mouse, in both the meatal plate- and the fundal extension plate-derived areas, formed adnexal structures. In the early development of the meatal plate, zone 3, at its tip, was swollen and actively mitotic and extended always for a short distance on to the zone 2 side. Zone 2, first perceived two days after zone 3, became progressively attenuated, and by the fourth day after its formation was a single thin layer. It is suggested that the proximal part of zone 3, situated in the mature ear around the periphery of the tympanic membrane, is a generation center for unidirectional outward flux of epithelium which terminates in the mouse at the first adnexal structure. It may cause the whole of zone 2 to move in the same direction by negative contact inhibition.     

Correction of low-set ear: superoposterior mobilization of the ear as a transposition flap pivoted on the ear canal with burring of the superoposterior canal wall

In a number of congenital, developmental, and postoperative conditions, many patients have a difference in the vertical and anteroposterior position of the ears. On correction of this deformity, the most difficult problem is the low and anterior location of the external auditory canal. To overcome this unyielding limitation, the authors perform superoposterior transposition of the low-set ear pivoted on the ear canal after making a new path for the canal by burring of the thick superoposterior canal wall. A mastoid hairline incision is followed by three-quarters circumferential subpericranial dissection around the bony ear canal posteriorly. A preauricular incision is followed by subcutaneous dissection anteriorly. By using the natural deformability of the cartilaginous ear canal, the S-shaped canal can be straightened through a new path made by burring of the thick superoposterior wall. Then the low-set ear can be mobilized superoposteriorly as a transposition flap pivoted on the ear canal with minimal tension by straightening of the canal. The corrected auricular position can be maintained by (1) several permanent sutures between the cavum conchae and the mastoid and deep temporal fascia, (2) a suspensory temporoparietal fascial loop, and (3) a skin support provided by the repair in an elevated position and V-Y-plasty or Z-plasty on the lower pole of the ear. From December of 1997 to October of 1998, three cases with a maximum follow-up of 15 months were examined. Symmetric ear position was achieved and maintained on both frontal and lateral views after the operation in all cases. This new technique for correction of low-set ear produces symmetric ear position in both vertical and anteroposterior dimensions for a long time. In addition, it can be performed with various other surgical procedures safely and simultaneously in a variety of pathologic conditions.     

Development of the stratified squamous epithelium of the human tympanic membrane and external canal: the origin of auditory epithelial migration

The development of the stratified squamous epithelium of the tympanic membrane and external canal was studied in 167 embryonic, fetal, and postnatal human ears. It originates as a tube derived from the epithelium of the fundus of the primary external canal (zone 1). The tube is composed of a thin, flat epithelium on the medial side (zone 2), continuous with a thicker one (zone 3) on the lateral side; zone 3 thereafter merges with the external epithelium of the primary external canal (zone 4). Proliferative activity, as indicated by a thickened epithelium, with rete ridges in later fetal life, is present mainly in zones 1 and 3. Cornification at 18 weeks gestation is followed by clearing of keratinous debris to the exterior. Subsequently the canal widens, zone 1 now covering the pars flaccida region, a tongue-shaped area passing inferiorly from it and a part of the postero-superior deep canal adjacent to it; zone 2 covers the pars tensa and zone 3 most of the deep external canal. On the basis of the original embryonic growth, migratory epithelial movement throughout life is postulated to be generated in zone 1 by mitotic interposition and then to pass to zone 2. It then moves en masse through to zone 3, where unilateral progression by mitotic means takes the epithelium up to the cartilaginous canal. Such a pathway is approximately that seen in the marked, living eardrum and canal.     

Further observations on the ear in fossorial mammals with special considerations of Chlamyphorus truncatus (Harlan).

The morphology of the external and the middle ear (auditory ossicles) in Chlamyphorus truncatus is influenced by its fossorial life. The external auditory canal consists of three parts. The most distal part is a short (cartilaginous) auricle which reaches anteriorly close behing the eye. Posteriorly to the auricle is a long, thin bony duct which consists of two segments, movable against each other. This tube leads through a narrow porus into the third part of the canal, the recessus meatus, which is enclosed in the bulla. The recessus with the narrow porus is characteristic for many fossorials and has a morphology with physical chracteristics of a resonator (HELMOHOLTZ). The malleus and the stapes in Ch. truncatus are also influenced by fossorial life. Based on the dorsal view of the malleus head, the Xenarthra can be divided into two groups. To the first division belong the Dasypodidae with Chlamyphorinae and Dasypodinae, to the second the Myrmecophagidae and Bradypodidae. The malleus of Cyclopes, a myrmecophagid, differs from that in the other Mymecophaginae and is similar to the malleus in the Dasypodinae. Two kinds of experiments should be undertaken: (a) physiologic-acoustic experiments in a fossorial to determine the effect of the recesses and (b) acoustic experiments varying the dimensions and positions of a tube and a porus leading into a resonator.     

胶原生物膜在耳内镜下中耳胆脂瘤乳突根治术中的应用效果分析

摘要 目的：探讨胶原生物膜在耳内镜下乳突根治术中的应用效果。方法：选取徐州医科大学附属医院2021年4月至2022年 2月收治的51例中耳胆脂瘤患者进行回顾性分析,其中研究组27例患者予以胶原生物膜修复皮肤缺损,对照组予以颞肌筋膜修复术腔皮肤缺损,观察两组患者术后临床症状,手术时长,术腔完全上皮化时间、干耳时间及术前术后听力改变。结果：研究组术后患者因外耳道进水,存在感染及肉芽生长者1例,予以清理后未再次生长;对照组术后发生1例外耳道口狭窄的情况,予以橡胶扩张管进行扩张并后并定期清理术腔肉芽、脱落痂皮,患者外耳道恢复良好。两组术前耳闷、耳痛、耳鸣及术后耳痛VAS评分无明显差异（P>0.05）;研究组术后耳闷及耳鸣VAS评分较对照组降低（P<0.05）。研究组平均手术时长、术后术腔完全上皮化时间及平均干耳时间短于对照组（P<0.05）。两组术前术后气骨导差（ABG）、平均气导听阈（AC）比较差异均无统计学意义（P＞0.05）。结论：作为术区移植物,胶原生物膜应用于耳内镜下中耳胆脂瘤乳突根治术可加快创面术腔的修复,减少局部创伤与操作步骤,改善临床症状,缩短手术时间、术后术腔完全上皮化时间及获得干耳时间,可作为临床上有效的修复材料。     

The quantitative analysis of the vascularization following two basic auditory canal skin incisions

Three groups of nine patients each were analyzed. The first two groups consisted of those that underwent tympanoplastic due to chronic inflammation of middle ear. Two different standard auditory canal skin incisions were applied, i.e. tympanomeatal flap (TMF) or vascular strip (VS). The third control group consisted of non-operated patients. All the operated patients were subjected to a quantitative analysis of the auditory canal revascularization by means of the Weibel stereological test method, i.e. the B 100 double network system. The density of capillaries, arterioles, venulolymphatic spaces and a total volume density of all vascular elements of the auditory canal skin were measured. The obtained results of vascularization were compared with those of the target control group. It was found out that there were no significant differences in vascularization of auditory canal skin between TMF and VS patients from one side and the control group on the other side.     

Ultrastructure of the black currant gall mite, Cecidophyopsis ribis (Acari: Eriophyidae), the vector of the agent of reversion disease

Electron microscopy of ultrathin serial sections was used to determine the structure and anatomy of the eriophyid gall mite, Cecidophyopsis ribis, the vector of the agent of black currant reversion disease. The composite picture derived from these studies has determined the location of the food canal, and major internal organs of the mite. Detailed ultrastructural studies on the anterior of suitably orientated mites has also provided detailed information on the geometry and complex structure of three sets of stylets in the feeding apparatus. No evidence was found of structures resembling virus-like particles or of other described plant pathogens in the feeding apparatus and food canal of mites obtained from black currant plants affected with reversion disease. However, little or no food was apparently present in the food canal of most mites examined. This is the first detailed report of the anatomy and the ultrastructure of the mouthparts of this important plant pest and vector.     

The relationship between auditory exostoses and cold water: a latitudinal analysis

The frequency of auditory exostoses was examined by latitude. It was found that discrete bony lesions of the external auditory canal were, with very few exceptions, either absent or in very low frequency (less than 3.0%) in 0-30 degrees N and S latitudes and above 45 degrees N. The highest frequencies of auditory exostoses were found in the middle latitudes (30-45 degrees N and S) among populations who exploit either marine or fresh water resources. Clinical and experimental data are discussed, and these data are found to support strongly the hypothesis that there is a causative relationship between the formation of auditory exostoses and exploitation of resources in cold water, particularly through diving. It is therefore suggested that since auditory exostoses are behavioral rather than genetic in etiology, they should not be included in estimates of population distance based on nonmetric variables.