[The clinical characteristics of pediatric external auditory canal keratosis obturans].

Objective: To analyze the clinical characteristics of pediatric external auditory canalkeratosis obturans(KO). Method: Retrospective analyze the clinical data of twenty-three patients were diagnosed with external auditory canal cholesteatoma(EACC). Their chief complaint, the course of the disease, clinical characteristics,CT manifestations,surgical procedure and prognosis were retrospectively analyzed. The clinical characteristics between EACC and KO were compared.Result: Twenty cases(22 ears) were eventually diagnosed as KO. Among them, 2 cases were bilaterally involved. In the remaining unilateral cases, right ear was involved in 11 cases and left ear in 7 cases. All patients complained otalgia(100%). Purulent otorrhea was found in 17 ears(77.3%), and hearing loss withpurulent otorrhea in 3 ears(13.6%). Otoscopic examination found 17 ear with granulation(77.3%).CT scan found deformation of the osseous ear canal and displacement of the tympanic membrane because of compression in 18 ears(81.8%), and the bony canal was absorpt because of pression in 7 cases(38.9%).All patients underwent otoendoscopic operation,and tympanic membrane perforation was found in 4 cases.Postoperative pathologic examination results were keratin epithelial. Conclusion: EACC is easily confused with KO. KO should be considered in the following circumstances: patient who complained of ear pain, ear granulation with purulent discharge, or circinate deformation of the osseous ear canal and displacement of the tympanic membrane in CT scan.

Loss of Notch3 Signaling Enhances Osteogenesis of Mesenchymal Stem Cells from Mandibular Torus.

Mandibular torus (MT) is a common intraoral osseous outgrowth located on the lingual surface of the mandible. Histologic features include hyperplastic bone consisting of mature cortical and trabecular bone. Some theories on the etiology of MT have been postulated, such as genetic factors, masticatory hyperfunction, trauma, and continued growth, but the underlying mechanism remains largely unknown. In this study, we investigated the potential role of mesenchymal stem cells (MSCs) derived from human MT in the pathogenesis of bone outgrowth. We demonstrated that MT harbored a distinct subpopulation of MSCs, with enhanced osteogenic and decreased adipogenic differentiation capacities, as compared with their counterparts from normal jaw bone. The increased osteogenic differentiation of mandibular torus MSCs was associated with the suppression of Notch3 signaling and its downstream target genes, Jag1 and Hey1, and a reciprocal increase in the transcriptional activation of ATF4 and NFATc1 genes. Targeted knockdown of Notch3 expression by transient siRNA transfection promoted the expression of osteogenic transcription factors in normal jaw bone MSCs. Our data suggest that the loss of Notch3 signaling may contribute partly to bone outgrowth in MT, as mediated by enhanced MSC-driven osteogenic differentiation in the jaw bone.

[Analysis of acute sinusitis or nasal furuncle derived orbitalcellulitis in children: review of 18 cases].

Objective:To analyze the diagnosis and treatment of acute sinusitis or nasal furuncle derived periorbital cellulitis in children.Method:The clinical data of 18 children with acute sinusitis or nasal furuncle derived orbital cellulitis was analyzed retrospectively.Result:Sixteen cases(88.89%) had acute sinusitis and 2(11.11%) had furuncle of nose.All cases were treated with antibiotics and steroids.And 16 cases were cured and the other two received surgery.The median length of hospitalization was 7.33 days(5-13 days).Conclusion:Sufficient antibiotics combined with steroids and local treatment is critical in treating pediatric orbital cellulitis.Timely and decisive surgical intervention can effectively control the progression of disease.