Objective:To evaluate the efficacy of triple semicircular canal occlusion （TSCO） in controlling vertigo, its impact on hearing function, and its safety profile in patients with intractable delayed endolymphatic hydrops （DEH）. Methods:A retrospective analysis was conducted on 16 patients with intractable DEH who underwent TSCO at Beijing Friendship Hospital, Capital Medical University, between June 2020 and June 2025. Vertigo control rate, Dizziness Handicap Inventory （DHI） score, pure-tone average （PTA） threshold, and procedure-related complications were assessed preoperatively and at a minimum follow-up of 6 months postoperatively. Results:The postoperative vertigo control was achieved in all patients, with Class A （complete control） achieved in 81.25% （13/16） of patients and Class B （substantial control） in 18.75% （3/16）. The median postoperative DHI total score decreased significantly from 61.63 to 35.81 postoperatively （P<0.001）. Mean PTA increased from（76.46±12.04）dB preoperatively to（90.51±13.44）dB postoperatively, representing a mean deterioration of 14.05 dB. Preoperatively, 13 patients had an average hearing threshold ≤90 dB, while 3 patients had thresholds >90 dB. Postoperatively, 76.9% （10/13） of patients retained usable hearing （≤90 dB HL）, and no cases exhibited significant hearing loss （>30 dB）. All patients experienced transient dizziness or vertigo following surgery but became ambulatory with or without assistance within 1 to 4 days. No severe complications, such as cerebrospinal fluid leakage, facial paralysis, or infection, were observed. Conclusion:Triple semicircular canal occlusion is an effective and safe function-preserving surgical intervention for intractable DEH. It offers reliable vertigo control and significant improvement in quality of life, with an acceptable risk of hearing deterioration.

Objective:We aimed to investigate the functional alterations caused by pathogenic variants in the FOXL2 gene, a forkhead transcriptional factor. Methods:This study is an experimental research with a duration from January to September 2022. We selected six variants for analysis, including a double missense variant, c.150C>G (p. Asp50Glu) and c.326A>T (p. Asn109Ile); three deletions, c.411_412del (p. Met137Ilefs101), c.533_542del (p. Val178Alafs90), and c.684delA (p. Ala229Leufs43); a nonsense variant, c.214G>T (p. Glu72); and a duplication, c.663_692dup (p. Ala225_Ala234dup). We constructed expression vectors containing these variants and transfected them into HeLa cells. Confocal microscopy was used to observe the subcellular localization of the expressed proteins. We evaluated gene expression using dual luciferase reporter assays and quantitative PCR. Results:Proteins expressed by vectors with deletion variants were predominantly localized to the nucleus, while those with the double missense variant exhibited diffuse expression throughout the cell. Proteins from nonsense and duplication variants localized to the cytoplasm. Luciferase activity assays revealed that proteins encoded by the p. Ala229Leufs43, p. Glu72, and p. Ala225_Ala234dup variants significantly diminished the inhibitory effects on the transcription of the StAR gene. Additionally, all proteins encoded by indel and nonsense variants, except for the double missense variant, demonstrated a marked reduction in their inhibitory effects on CCDN2 and INHBB gene expression. Conclusions:The double missense variant does not exert a superimposed inhibitory effect on gene expression. Despite differences in subcellular localization, all mutant proteins produced by these variants likely interfere with downstream gene expression through a shared pathway. Furthermore, mutant FOXL2 proteins may disrupt ovarian development via multiple pathways, extending beyond their impact on StAR gene expression.

Objective: We aimed to investigate the functional alterations caused by pathogenic variants in the FOXL2 gene, a forkhead transcriptional factor. Methods: This study is an experimental research with a duration from January to September 2022. We selected six variants for analysis, including a double missense variant, c.150C>G (p. Asp50Glu) and c.326A>T (p. Asn109Ile); three deletions, c.411_412del (p. Met137Ilefs101), c.533_542del (p. Val178Alafs90), and c.684delA (p. Ala229Leufs43); a nonsense variant, c.214G>T (p. Glu72); and a duplication, c.663_692dup (p. Ala225_Ala234dup). We constructed expression vectors containing these variants and transfected them into HeLa cells. Confocal microscopy was used to observe the subcellular localization of the expressed proteins. We evaluated gene expression using dual luciferase reporter assays and quantitative PCR. Results: Proteins expressed by vectors with deletion variants were predominantly localized to the nucleus, while those with the double missense variant exhibited diffuse expression throughout the cell. Proteins from nonsense and duplication variants localized to the cytoplasm. Luciferase activity assays revealed that proteins encoded by the p. Ala229Leufs43, p. Glu72, and p. Ala225_Ala234dup variants significantly diminished the inhibitory effects on the transcription of the StAR gene. Additionally, all proteins encoded by indel and nonsense variants, except for the double missense variant, demonstrated a marked reduction in their inhibitory effects on CCDN2 and INHBB gene expression. Conclusions: The double missense variant does not exert a superimposed inhibitory effect on gene expression. Despite differences in subcellular localization, all mutant proteins produced by these variants likely interfere with downstream gene expression through a shared pathway. Furthermore, mutant FOXL2 proteins may disrupt ovarian development via multiple pathways, extending beyond their impact on StAR gene expression.

Abstract Objective To investigate the characteristics of eye movement in children with anisometropic amblyopia, and to compare those characteristics with eye movement in a control group. Methods 31 children in the anisometropic amblyopia group (31 amblyopic eyes in group A, 31 contralateral eyes in group B) and 24 children in the control group (48 eyes in group C). Group A was subdivided into groups Aa (severe amblyopia) and Ab (mild-moderate amblyopia). The overall age range was 6–12 years (mean, 7.83 ± 1.79 years). All children underwent ophthalmic examinations; eye movement parameters including saccade latency and amplitude were evaluated using an Eyelink1000 eye tracker. Data Viewer and MATLAB software were used for data analysis. Results Mean and maximum saccade latencies, as well as mean and maximum saccade amplitudes, were significantly greater in group A than in groups B and C before and after treatment (P < 0.05). Mean and maximum saccade latencies were significantly different among groups Aa, Ab, and C (P < 0.05). Pupil trajectories in two detection modes suggested that binocular fixation was better than monocular fixation. Conclusions Eye movement parameters significantly differed between contralateral normal eyes and control eyes. Clinical evaluation of children with anisometropic amblyopia should not focus only on static visual acuity, but also on the assessment of eye movement.

BACKGROUND Congenital eyelid coloboma in children often faces complications such as keratitis, symblepharon, and amblyopia. Repairing defects involving at least 50% of the eyelid margin can be challenging. Acellular dermal allograft (ADA) has achieved excellent results as a substitute in adult eye plastic surgery, with minimal morbidity. This report describes a case of reconstruction of an eyelid defect in a 7-month-old male infant using an ADA. CASE REPORT A 7-month-old male infant was referred due to congenital eyelid coloboma in the left eye, which affected nearly one-half of the upper and lower eyelids medially, with more than 9 mm of lagophthalmos and lacrimal duct malformation inducing dacryocystitis. Under general anesthesia, A U-shaped silicone drainage tube was inserted in the nasolacrimal duct to ensure an unobstructed lacrimal duct. The symblepharon release, pseudopterygium excision, and medial canthus reconstruction were performed sequentially. Then, the upper eyelid defect was repaired through the advancement of the lateral segment of the eyelid, following lateral cantholysis. A trimmed ADA was placed as a substitute for the tarsal plate in the lower eyelid defect area and sutured with the free edge of the retractor. Finally, the lower and lateral skin orbicular muscle flap was advanced to cover the acellular dermis composite graft. The postoperative eyelid morphology was satisfactory. At 6 months after surgery, lower eyelid retraction gradually appeared. CONCLUSIONS ADA is presented as an effective solution for reconstructing significant eyelid defects of infants. However, the potential of postoperative eyelid retraction still deserves future research and refinement in surgical techniques.

ObjectiveThe relationship between the stapedius muscle and the vertical part of the facial nerve is important for surgery. The study aims to understand the spatial relationship between the stapedius muscle and the vertical part of the facial nerve in ultra-high-resolution computed tomography (U-HRCT) images.MethodsA total of 105 ears from the heads of 54 human cadavers were analyzed using U-HRCT. The location and direction of the stapedius muscle were evaluated with the facial nerve as the reference. The integrity of the bony septum between the two structures and the distance between the transverse sections were examined. Paired Student's t-test and the nonparametric Wilcoxon test were applied.ResultsThe lower end of the stapedius muscle emerged at the upper (45 ears), middle (40 ears), or lower (20 ears) level of the facial nerve and was positioned medial (32 ears), medial posterior (61 ears), posterior (11 ears), or lateral posterior (1 ear) to the facial nerve. The bony septum was not continuous in 99 ears. The distance between the midpoints of the two structures was 1.75 mm (IQR=1.55-2.16 mm).ConclusionThe spatial relationship between the stapedius muscle and the facial nerve was varied. They were close to each other and in most cases the bony septum was not intact. Preoperative familiarity with the relationship between the two structures is helpful for avoiding unwanted injury to the facial nerve in surgery.

Background: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is the most common type of auto -immune encephalitis. Here, we investigated the factors associated with poor prognosis and relapse in patients with anti-NMDAR encephalitis.Methods: In this single-center observational cohort study, we retrospectively analyzed 51 patients with anti-NMDAR encephalitis treated in our hospital from January 2014 to October 2022. The demographic data, clin-ical characteristics, scale scores, results of auxiliary examination, and treatment details were statistically analyzed. Based on modified Rankin Scale (mRS) scores measured before final discharge, patients were divided into groups with good (mRS score 0-2) and poor (mRS score 3-6) prognoses for functional evaluation. The chi -squared test or Fisher's exact test was used to compare categorical data, and the t-test and Mann-Whitney U test were used to compare normally and non-normally distributed continuous data, respectively. Binary logistic regression was used to identify the risk factors for prognosis and relapse.Results: At admission, the main clinical manifestations observed were psychobehavioral disorders (50 cases, 98.0%), consciousness disorders (28 cases, 54.9%), epilepsy (33 cases, 64.7%), motor disorders (28 cases, 54.9%), speech disorders (24 cases, 47.1%), and dysfunction of the autonomic nervous system (15 cases, 29.4%). All 51 patients (100%) had mRS scores of 3-5 at admission, and 50 were treated with intravenous methyl-prednisolone and human immunoglobulin. A total of 22 patients (43.1%) had an mRS score of 3-6 at discharge, which was significantly lower than those at admission. One patient died (mRS score 6) after developing septic shock (fatality rate 1.9%). Binary logistic regression analysis showed that movement disorders/involuntary movement (odds ratios [OR] 3.778, p = 0.029), abnormal brain magnetic resonance imaging (OR 4.817, p = 0.013), electroencephalogram slow wave activity of >50% (OR 8.400, p = 0.001), a white blood cell count of >10 x 106/L in the cerebrospinal fluid (OR 3,210, p = 0.048), and male sex (OR 3.282, p = 0.050) were risk factors for poor prognosis. A duration of disease of >12 months (OR 8.800, p = 0.001) and first-line-immunotherapy for less than 3 months after first onset (OR 3.719, p = 0.048) were identified as risk factors for relapse.Conclusion: Motor disorders or involuntary movement, abnormal brain magnetic resonance imaging, electroen-cephalogram slow wave activity >50%, and elevated white blood cell counts in cerebrospinal fluid were asso-ciated with poor prognosis in patients with NMDAR encephalitis. First-line immunotherapy less than 3 months after first onset may be a risk factor for relapse.

PurposeOverhanging facial nerve (FN) may be challenging in imaging diagnosis. The purpose of the study is to investigate the imaging clues for overhanging FN near the oval window on ultra-high-resolution computed tomography (U-HRCT) images.MethodsBetween October 2020 and August 2021, images of 325 ears (276 patients) were included in the analysis obtained by an experimental U-HRCT scanner. On standard reformatted images, the morphology of FN was evaluated and its position was quantitatively measured using the following indices: protrusion ratio (PR), protruding angle (A), position of FN (P-FN), distance between FN and stapes (D-S), and distance between FN and anterior and posterior crura of stapes (D-AC and D-PC). According to the FN morphology in imaging, images were divided into overhanging FN group and non-overhanging FN group. Binary univariate logistic regression analysis was used to identify the imaging indices independently associated with overhanging FN.ResultsOverhanging FN was found in 66 ears (20.3%), which manifested as downwards protrusion of either local segment (61 ears, 61/66) or the entire course near the oval window (5 ears, 5/66). D-AC [odds ratio: 0.063, 95% CI 0.012-0.334, P = 0.001) and D-PC (odds ratio: 0.008, 95% CI 0.001-0.050, P = 0.000) were identified as independent predictors of FN overhang (area under the curve: 0.828 and 0.865, respectively).ConclusionAbnormal morphology of the lower margin of FN, D-AC and D-PC on U-HRCTimages provide valuable diagnostic clues for FN overhang.

目的 总结归纳并探讨自发性脑脊液耳漏(SCSFO)的临床特点、手术方式及术后疗效.方法 回顾性分析2015-2020年收治的SCSFO患者的临床资料,总结病例的临床特点,分析归纳病例的漏口、手术修补方式、术后反应,并随访手术效果.结果 共收集10例SCSFO病例资料,其中男4例,女6例;儿童患者3例,成人患者7例.病史25 d至20余年,单侧发病9例,双侧发病1例.3例儿童患者均为先天性极重度感音神经性耳聋,均因发现鼻漏或脑膜炎就诊.7例成人患者中,因耳闷伴听力下降就诊5例,其中1例同时合并耳漏;因鼻漏就诊1例;因耳痛合并脑膜炎就诊1例.外院曾行鼓膜穿刺或置管史4例.3例儿童患者中,缺损部位均位于镫骨足板处和镫骨周围,其中2例患者伴镫骨畸形;7例成人患者中,2例漏口位于镫骨足板,3例漏口位于鼓室天盖,2例漏口位于乳突天盖.1例术后出现癫痫及颅内压升高.10例患者随访周期为5个月至6年,均无再发脑脊液耳漏.结论 早期识别脑脊液耳漏的不典型症状,掌握确诊脑脊液耳漏的定位、定性诊断方法非常重要.SCSFO保守治疗效果差,一旦确诊,建议积极手术探查,精准寻找漏点,确切修补漏口是关键.

目的 基于超高分辨率CT(U-HRCT)分析正常砧镫关节(ISJ)影像解剖.方法 回顾性分析2020 年 9月至2021 年8 月行U-HRCT检查的耳鼻喉科患者258 例,正常耳共计304 侧.于U-HRCT图像设置ISJ标准观察层面,描述其解剖特征,并比较不同年龄及性别的 ISJ解剖形态差异.结果 88.2%(268/304)ISJ清晰可见,11.8%(36/304)模糊可见;47.7%(145/304)ISJ表现为低密度,40.8%(124/304)为部分骨性密度,11.5%(35/304)为骨性密度.≤30 岁及>30 岁中ISJ解剖特征未见显著差异(P均>0.05).男性镫骨头-豆状突外侧距离、豆状突长径数值均大于女性,分别为[0.93 mm(0.81 mm,1.02 mm)vs.0.87 mm(0.74 mm,0.96 mm)(Z =-2.870,P =0.004)]、[0.66 mm(0.55 mm,0.77 mm)vs.0.59 mm(0.51 mm,0.69 mm),(Z =-2.825,P =0.005)],关节间隙宽度(即二者差值)则未见显著差异.砧骨豆状突-镫骨头夹角在男性[137.9°(126.3°,155.6°)]显著大于女性[129.8°(119.8°,148.9°)](Z =-2.942,P =0.003).结论 U-HRCT可清晰显示正常ISJ,可为ISJ病变的影像诊断及术前评估提供基础.

Amblyopia is an abnormal visual processing-induced developmental disorder of the central nervous system that affects static and dynamic vision, as well as binocular visual function. Currently, changes in static vision in one eye are the gold standard for amblyopia diagnosis. However, there have been few comprehensive analyses of changes in dynamic vision, especially eye movement, among children with amblyopia. Here, we proposed an optimization scheme involving a video eye tracker combined with an "artificial eye" for comprehensive examination of eye movement in children with amblyopia; we sought to improve the diagnostic criteria for amblyopia and provide theoretical support for practical treatment. The resulting eye movement data were used to construct a deep learning approach for diagnostic and predictive applications. Through efforts to manage the uncooperativeness of children with strabismus who could not complete the eye movement assessment, this study quantitatively and objectively assessed the clinical implications of eye movement characteristics in children with amblyopia. Our results indicated that an amblyopic eye is always in a state of adjustment, and thus is not "lazy." Additionally, we found that the eye movement parameters of amblyopic eyes and eyes with normal vision are significantly different. Finally, we identified eye movement parameters that can be used to supplement and optimize the diagnostic criteria for amblyopia, providing a diagnostic basis for evaluation of binocular visual function.

Purpose:To investigate the molecular pathogenesis of a large group of Han Chinese patients with blepharophimosis-ptosis-epicanthus inversus syndrome (BPES), and to evaluate the correlation between the phenotype and genotype for these patients.Methods:Seventy-six affected individuals, including 45 patients from 17 pedigrees and 31 sporadic patients, were recruited with their family members. All participants underwent complete clinical examinations and were classified as having type I or II based on whether they had premature ovarian failure. The patients' genomic DNA was extracted. A genetic test was performed with direct sequencing of the coding regions of the forkhead transcriptional factor 2 (FOXL2) gene. Variations were analyzed using online databases and programs. Genotype-phenotype correction was investigated.Results:Seventy-six affected and 75 unaffected individuals underwent clinical evaluations and genetic testing. Only one family was diagnosed with type I; the others could not be classified because of a lack of female patients or a definite history of premature ovarian failure. Twenty-seven variations were identified, including 12 novel and 15 previously reported variations. Six variations were detected repeatedly in different nonconsanguineous pedigrees. Four indel variations, located in the alanine/proline-rich region of the FOXL2 gene, presented with a relatively higher frequency. Two rare double variations were detected in two sporadic patients. FOXL2 gene variations were not detected in five sporadic patients. The phenotype varied among different families and patients, although they carried the same variations.Conclusions:We identified 12 novel variations in the FOXL2 gene that would expand the spectrum of the FOXL2 variation database. In addition, we found that the alanine/proline-rich region is a variation hotspot in the FOXL2 gene. The genotype-phenotype correlation is not easy to establish due to clinical and genetic heterogeneity.

临床上儿童外眦部肿物合并眼睑畸形及结膜肿物少见,需在切除眼睑、结膜肿物的同时,灵活处置眼睑整复.本文回顾2例就诊于北京儿童医院的先天性外眦肿物合并眼睑缺损的病例.术后病理示皮赘伴结膜皮样脂肪瘤.患儿眼睑肿物切除彻底,眼睑整复后外观满意.

BACKGROUND:To visualize the course of the tympanic segment of chorda tympani nerve (CTN) using ultra-high-resolution computed tomography.METHODS:A hundred and fourteen ears with no evident otologic pathologies were included. The tympanic segment of CTN was divided into 4 portions as follows: periannular, posteromalleal, malleal, and anteromalleal. The length of the periannular portion running along the tympanic annulus was recorded. Four points of interest (the beginning and end of the posteromalleal and anteromalleal portions) were selected to perform distance measurements relative to the tip of the malleus manubrium. Differences in lengths and distances were compared in terms of ear sides and sexes.RESULTS:The length of the periannular portion was 2.49 ± 1.16 mm. The beginning of the posteromalleal portion was located more laterally on the right side than on the left side (mean: 4.09 mm vs. 3.92 mm;, P = 0.016). The end of the posteromalleal portion was located more inferiorly on the right (mean: 2.11 mm vs. 2.26 mm; P = 0.018). The beginning of the anteromalleal portion on the right was located more laterally than that on the left (mean: 2.60 mm vs. 2.45 mm; P = 0.027). The start and end of the anteromalleal portion were more posteriorly located in women than in men (both Ps < 0.001).CONCLUSIONS:The course of the tympanic segment of normal CTN was comprehensively visualized by ultra-high-resolution computed tomography. Preoperative evaluation of the tympanic segment of CTN might be helpful in avoiding iatrogenic injury during middle ear surgery.

目的 评估以问题为导向学习(PBL)结合显微手术视频系统在诊治儿童眼睑缺损教学中的应用效果.设计回顾性比较性教学研究.研究对象北京儿童医院眼整形专业组内轮转的各类住院医师25人.方法 接受传统教学模式的住院医师12人,接受改革教学模式(即PBL结合显微手术视频系统观摩手术操作的教学模式)的住院医师13人,比较组间教学效果的差异.主要指标疾病诊断准确率、重要手术步骤的正确识别率和基本眼整形显微技术的掌握率.结果 改革教学组的疾病诊断准确率为100％(13/13)、重要手术步骤的正确识别率为92.3％(12/13)、基本眼整形显微技术的掌握率为92.3％(12/13),分别高于传统教学组的58.3％(8/12)(P=0.039)、50.0％(6/12)(P=0.030)和41.7％(5/12)(P=0.011).结论 手术显微镜视频系统联合 PBL 模式可改善眼睑缺损修复手术的教学效果.

目的 探讨儿童眼球突出继发下睑退缩的手术方式和效果.设计回顾性病例系列.研究对象北京儿童医院不同原因所致眼球突出合并下睑退缩、内翻倒睫患儿8例(14眼),年龄1岁3个月～8岁4个月.方法 所有病例采用下睑缩肌后徙联合睑板内固定术.术后随访6～12个月.主要指标术前术后下睑缘中央至瞳孔反光点距离(MRD2)、下睑内翻倒睫及角膜上皮损伤情况的变化.结果 术后所有8例患者羞明流泪症状缓解,眼睑闭合良好,下睑缘弧度良好无明显内外翻及倒睫,角膜上皮基本完整.下睑位置MRD2术前为(6.3±0.5)mm,术后最后随访时为(4.3±0.8)mm(t=7.772,P＜0.01).下睑退缩复发1例.结论 本小样本量的回顾性研究显示,下睑缩肌减弱联合下睑板内固定治疗儿童眼球突出所致下睑退缩,有利于解决眼球突出引起的眼睑紧张度增加、下睑后退、内翻倒睫等问题,手术效果满意,下睑退缩复发率低.

Objective:To evaluate the application of 10 μm otology CT on evaluation of isolated malleus fixation (IMF) in patients with conductive hearing loss.Methods:A total of 19 patients (25 sides) with idiopathic hearing loss, including 8 males and 11 females, aged between 4 to 50 years, who underwent 10 μm otology CT examination in Department of Radiology, Beijing Friendship Hospital, Capital Medical University from October 2020 to July 2021, were retrospectively collected. For those patients with idiopathic hearing loss, there were 5 cases (6 sides), including 2 males and 3 females, with an average age of 18-70 [65(20,68)] years, with bony connection between malleus and tympanum wall. Eighteen sex-and age-matched cases with normal hearing group, including 6 males and 12 females, with an average age of 20-68 (39±14) years, as the ratio of 1∶3, were included as the controls. The distances of the tegmen tympani between malleus head and horizontal semicircular canal, as well the distances between malleus head and horizontal semicircular canal were retrospectively measured and further compared between the two groups.Results:The incidence of IMF in patients with idiopathic conductive hearing loss without other etiologies was 24.0% (6/25). The specificity of 10 μm otology CT in diagnosing IMF was 100%. The distances of tegmen tympani between horizontal semicircular canal and malleus head in IMF patients were significantly smaller compared with the controls [-0.65(-1.21, -0.35) mm vs 1.34(0.04, 1.68) mm;0.92(0.51, 1.49) mm vs 2.82(1.76, 3.53) mm](both P<0.05, respectively). There was no significant difference in distances between malleus head and horizontal semicircular canal [-1.30 (-1.90, -0.46)mm vs -0.42 (-1.15, 0.05), P=0.057]. Conclusions:IMF is not uncommon in conductive hearing loss without other causes, which can be clearly shown by 10 μm otology CT. Its occurrence is related to the local downward shift of tegmen tympani above the malleus, without upwards displacement of the malleus.

Objective: To analysis the anatomical features of normal vestibular nerve canal based on 10 μm otology CT. Methods: Sixty-seven patients (103 ears) underwent 10 μm otology CT examinations in Department of Radiology, Beijing Friendship Hospital, Capital Medical University from September 2020 to March 2021 were retrospectively recruited. There were 24 males and 43 females, aged from 18 to 70 (40±17) years. According to the morphology of the inferior vestibular nerve canal, it can be divided into four types as follows: uniform straight type, curved type, ampullary type and direct connection. The anatomical variables of the superior vestibular nerve canal (external orifice, isthmus and internal orifice widths, canal length, angle with labyrinthine segment of the facial nerve) and inferior vestibular nerve canal (widths of the externaland internal orifice, canal length, angles with long axis of the vestibule and the modiolus) between the different sides, genders and canal morphologies were analyzed and compared, respectively. Results: 100% superior vestibular nerve canals and 75.7% (78/103) inferior vestibular nerve canals are clearly depicted by otology CT. The left-side ear presented with larger internal orifice diameter of the superior vestibular neve canal [(1.46±0.47) mm vs (1.31±0.41) mm], and a smaller angle between the inferior vestibular neve canal and the modiolus [(41.6±16.9)° vs (51.6±21.0)°] than the right-side ear (all P<0.05, respectively), respectively. Compared to females, males demonstrated larger internal orifice of the superior vestibular nerve canal [(1.55±0.37) mm vs (1.28±0.36) mm, P<0.05]. The uniform straight type of the inferior vestibular nerve canal was the most common type (62.1%, 64/103), followed by the direct connection (19.4%, 20/103), and the ampullary type was the least common type (4.9%, 5/103). There were significant differences in external diameter and angles with the long axis of the vestibule and the modiolus between the four morphologies of the superior vestibular nerve canal (all P<0.05, respectively). Conclusion: Ten μm otology CT is capable of depicting normal vestibular nerve canal clearly. Quantitative measurement of the normal vestibular nerve canal can provide references for the imaging diagnosis and preoperative evaluation of lesions in this area.

ABSTRACTImportanceIn cases of epiblepharon with lower eyelid retraction secondary to glaucoma, correcting epiblepharon alone is ineffective. Combined surgery should be performed to obtain satisfactory outcomes.ObjectiveTo investigate outcomes after surgery to correct epiblepharon with lower eyelid retraction secondary to buphthalmos in children.MethodsA retrospective analysis of six eyes in four patients was performed included lower lid retractor recession combined with marginal rotation with tarsal fixation. The margin reflex distance‐2, lagophthalmus, resolution of clinical symptoms, and complications were assessed during 6 to 12 months of follow‐up.ResultsIn all cases, epiblepharon and lagophthalmus were corrected, symptoms of photophobia and epiphora were relieved, and the corneal epithelium was repaired. The margin reflex distance‐2 decreased and remained normal during the follow‐up period, but slightly regressed within 6 months postoperatively.InterpretationEpiblepharon caused by buphthalmos in children is often associated with lower eyelid retraction. Lower lid retractor recession combined with marginal rotation with tarsal fixation fundamentally solves the problems of high eyelid tension, lower eyelid retraction, and epiblepharon and reduces the recurrence rate.

目的 借助水囊法超声生物显微镜检查探讨儿童先天性角膜混浊的影像学特点.方法 回顾性分析先天性角膜混浊患儿142例(181眼),观察先天性角膜混浊的眼前节发育情况,根据发育异常的表型分为A、B、C、D四型.结果 181眼中有A型43眼(23.8％),仅前部角膜混浊不伴有其他结构异常.B型11眼(6.1％)为后部或全层角膜混浊,伴角膜后部局部缺损,而虹膜晶状体正常.C型88眼(48.6％)为虹膜或房角发育异常,但晶状体未见异常,其中房角发育异常范围小于4个方位的C1型共35眼(19.3％);房角发育异常范围大于等于4个方位的C2型共53眼(29.3％).D型39眼(21.5％)为角膜虹膜与晶状体粘连,或存在混浊、膜样、缺如等晶状体异常.双眼混浊患者两眼表现可不对称;同时伴有晶状体和虹膜异常的比例,双眼混浊(32.1％)显著多于单眼(13.6％)(x2=8.947,P=0.003).结论 采用水囊包裹探头的超声生物显微镜是适合于儿童的眼前节检查方法,可用于分析先天性角膜混浊角膜、虹膜、房角和晶状体的影像学特点并分型,对明确其诊断和预后具有指导意义.