Objective:To analyze the clinical efficacy of tympanoplasty in patients with chronic suppurative otitis media（CSOM） complicated by fungal infection through a prospective randomized controlled study, and to explore the optimal surgical timing for chronic otitis media patients accompanied by fungal infection. Methods:A total of 92 patients diagnosed with chronic otitis media who were admitted to Yinchuan First People's Hospital from December 2024 to December 2025 were enrolled in this study. All subjects underwent preoperative microbiological examinations（including fungal smear counting and culture）, otoendoscopy, Zurich Chronic Middle Ear Inventory-21（ZCMEI-21） assessment, and pure-tone audiometry. According to the results of preoperative electronic otoendoscopy and microbiological tests, the patients were divided into the non-fungal infection group（n=58） and the fungal infection group（n=34）. The 34 patients in the fungal infection-complicated group were randomly assigned to the control group（n=17, receiving systemic antifungal treatment preoperatively） and the experimental group（n=17, without preoperative systemic antifungal treatment） using the double-blind design. All 92 patients underwent electronic otoendoscopy at 2, 4, 8, and 12 weeks postoperatively, and the time to dry ear was recorded during follow-up. ZCMEI-21 assessment and pure-tone audiometry were re-evalutaed at 12 weeks after surgery. Results:①There was no statistically significant difference in the preoperative and postoperative air-bone gap improvement （ΔABG=preoperative ABG-postoperative ABG） among the three groups（P>0.05）. ②No statistically significant difference was observed in the postoperative time to dry ear among the three groups（P>0.05）. ③The tympanic membrane healing rate showed no statistically significant difference among the three groups（P>0.05）. ④The ZCMEI-21 scale scores were not statistically different among the three groups（P>0.05）. However, in terms of medical resource utilization reflected by the scale, statistically significant differences were found between the blank group and the experimental group, as well as between the control group and the experimental group（P<0.05）. Conclusion:Patients with chronic otitis media complicated by external auditory canal fungal infection can undergo otoendoscopy-assisted tympanoplasty without preoperative systemic antifungal treatment, achieving clinical efficacy comparable to those without fungal infection.

Bats host a diverse assemblage of ectoparasites that occupy specific anatomical microhabitats, yet the histological effects of these associations remain poorly documented. Here, we report a case of mite infestation of the external ear in the Neotropical bats species Carollia perspicillata and Carollia brevicauda, with a detailed histological characterisation of the auricle and inner ear of C. perspicillata. Bats were captured during biodiversity monitoring programmes in Antioquia, Colombia, and mites were collected and identified morphologically. Histological and histochemical analyses of ear tissues were conducted using haematoxylin and eosin, periodic acid-Schiff, and Masson's trichrome staining. Mites were identified as Spelaeorhynchus praecursor (Spelaeorhynchidae), occurring exclusively on the external ear with infestation frequencies of 6.6% for C. perspicillata and 5.8% for C. brevicauda. Histological examination of the auricle revealed a thin keratinised stratified squamous epithelium, abundant sebaceous glands, well-developed striated skeletal muscle, elastic cartilage, and prominent white adipose tissue at the auricular base. Only minimal focal leukocytic infiltrates were observed, with no evidence of severe pathological alterations associated with mite attachment. The inner ear displayed preserved cochlear architecture, with eosinophilic fibrillar and granular material in the scala vestibuli and scala tympani, interpreted as perilymphatic content or processing artefacts. This study provides baseline histological data on ear tissues in C. perspicillata and documents a localised mite-host association with limited tissue response, contributing to the understanding of bat ectoparasitism and ear morphology in Neotropical chiropterans.

A woman in her 20s presented with a 3-month history of progressive right-sided otalgia. Otoendoscopic examination revealed a greyish mass occluding more than 75% of the external auditory canal. Biopsy confirmed well-differentiated squamous cell carcinoma. High-resolution CT demonstrated cortical erosions of the anterior and posterior bony external auditory canal with mastoid involvement. The patient underwent two-handed endoscopic lateral temporal bone resection using the Justtach ASM2 endoscope holder, combined with superficial parotidectomy and selective neck dissection. Histopathological examination confirmed complete excision with negative margins. The patient received adjuvant chemoradiation therapy and remains disease-free at follow-up. This case demonstrates the technical feasibility of a two-handed endoscopic approach for temporal bone malignancy resection, though larger studies are needed to establish its efficacy compared with conventional microscopic techniques.

The treatment of skin diseases, including hypertrophic scars and cutaneous melanoma, remains clinically challenging. Conventional radionuclide (e.g., [90]Sr, [32]P) patches for beta-ray external beam radiotherapy suffer from rigid structures, leading to off-target irradiation, uneven radionuclide distribution, inconsistent dosing, and potential leakage risks. To address these limitations, we developed an innovative, flexible radioactive patch ([32]P-RU) by integrating [32]P-loaded resin microspheres with boric acid-modified flexible polydimethylsiloxane (PBDMS) gel (P4U), enabling robust adsorption of H[32]PO4[2-], homogeneous distribution, and precise, repeated reshaping to conform to irregular lesions. As a pure beta emitter, [32]P (Emax = 1.71 MeV, T1/2 = 14.28 d, tissue penetration depth = 4 mm) minimizes damage to adjacent normal tissues. In preclinical models, [32]P-RU demonstrated significant therapeutic efficacy: in rabbit ear hypertrophic scar models, five 4 Gy fractions reduced scar volume and improved collagen organization; in murine subcutaneous melanoma models, five 8 Gy fractions effectively suppressed tumor growth. Notably, combining [32]P-RU with the immune checkpoint inhibitor (anti-PD-L1) synergistically enhanced anti-tumor effect, promoting dendritic cell maturation, increasing CD8[+] T cell infiltration, and suppressing both primary and distant tumors. This conformal, safe, and effective [32]P-RU patch offers a strategy for the precise treatment of superficial skin diseases, including refractory cutaneous malignancies.

Localized infections of the auricle and tragus are uncommon. Recurrent disease should lead clinicians to ask about possible risk factors and contributing factors. A 39-year-old medically and surgically free man presented with a 3-day history of painful right tragal swelling preceded by localized discharge. He denied fever and trauma. He had two earlier similar episodes affecting both ears at different times, both resolving spontaneously. He reported frequent prolonged use of in-ear headphones, with symptoms usually following heavy in-ear headphone use. Incision and drainage were done, and pus culture grew Staphylococcus aureus. Initial clindamycin dosing was incorrect, so treatment was subtherapeutic. He was then switched to trimethoprim-sulfamethoxazole along with topical mupirocin with clear improvement. At follow-up, pain and discharge had resolved and the swelling was smaller. This case suggests that prolonged in-ear headphone use may be a contributing factor in recurrent tragal abscess.

Wideband acoustic immittance (WAI) provides comprehensive frequency-dependent information for diagnosing middle ear pathologies. However, the scarcity of clinical data and complex response patterns significantly hinder automated diagnosis, particularly in data-limited scenarios. To address this issue, this study proposes a simulation-driven computer-aided diagnosis framework for WAI based on finite element (FE) modeling. Latin hypercube sampling was employed to systematically perturb key physiological parameters of the human ear FE models, generating a standardized virtual WAI dataset comprising 12 000 samples across the 0.2-6 kHz frequency range. The dataset includes four middle ear conditions: normal ear, ossicular chain discontinuity, ossicular chain fixation, and otitis media with effusion. Based on this dataset, a lightweight convolutional neural network tailored for multi-channel WAI inputs, termed WAIHybrid, was developed. It was benchmarked against traditional feature-based machine learning models and five representative deep learning architectures on simulated data and subsequently evaluated on an external clinical dataset comprising 206 ear-level WAI records. WAIHybrid achieved a macro-F1 of 96.30% and a balanced accuracy of 96.29% on an independent simulated test set. On the external clinical dataset, the corresponding values were 87.76% and 88.07%, respectively. Response-level comparisons, learned-representation analyses, and Integrated Gradients maps identified partial class-related correspondence between the simulated and clinical data, residual simulation-to-clinical discrepancy, and class-dependent channel-frequency attribution patterns. These findings support a simulation-driven proof of concept for automated WAI analysis in data-limited middle ear assessment. Further evaluation in larger, more balanced, and clinically heterogeneous cohorts is needed.