Selection of a Surgical Approach for Middle Ear Cholesteatoma Based on the Fusion Images of Non-Echo Planar Diffusion-Weighted MRI and CT.

PURPOSE: This study aimed to explore the ability of fusion images of non-echo planar diffusion-weighted magnetic resonance imaging (non-EPI-DWI MRI) and computed tomography (CT) to accurately locate cholesteatoma and plan the surgical approach. METHODS: In the first part, 41 patients were included. Their CT images and non-EPI DWMRI images were fused. The scope of cholesteatoma in the fusion image was compared with that in the surgical video to evaluate the capability to locate cholesteatoma. A total of 229 patients were included in the second part, and they were divided into 2 groups. We chose the surgical approach for the CT group and the fusion group, and compared the accuracy of surgical approaches in the CT group and the fusion group using the surgical records. RESULTS: The location of cholesteatoma shown in the fusion images was almost identical to that observed during the operation (kappa = .862). The overall specificity and sensitivity of the fusion images in locating cholesteatoma were 94.12% and 93.06%, respectively. The accuracy of surgical approach selection based on the fusion images (99.02%) was higher than that of surgical approach selection based on the CT images (85.83%). CONCLUSION: It is recommended that the fusion images be used to locate the range of the cholesteatoma before operation.

Notch signaling pathway plays a critical role in chemotherapeutic drug-induced vestibular injury.

The vestibule of the inner ear is susceptible to certain chemotherapeutic agents in clinical practice. Therefore, it is of great significance to discover molecular pathways and targets that can protect the vestibule from chemotherapeutic drugs. The Notch signaling pathway is closely related to hair cell regeneration in the inner ear. However, the role of Notch signaling in chemotherapeutic drug-induced vestibular injury still remains unclear. The aim of this study was first to evaluate the role of Notch signaling in chemotherapy-induced vestibular injury. Cisplatin-induced vestibular injury of mice was evaluated by the swimming test. Changes of vestibular hair cells and the expression levels of Notch1, Jagged1, and Hes1 in Notch signaling were observed by immunofluorescence. The results showed that Notch signaling was found activated in cisplatin-induced injured vestibular cells, while, DAPT (Notch signaling inhibitor) could reversed this effect. In conclusion, the Notch signaling pathway may play a critical role in chemotherapeutic drug-induced vestibular injury and, therefore, serves as a promising therapeutic target for vestibular injury.