A 49-year-old man presented with a 1-year history of red facial nodules and a 3-month history of left-sided hearing decline. A biopsy revealed mixed inflammation and emperipolesis of histiocyte-like cells. An immunohistochemical analysis demonstrated that the histiocyte-like cells were positive for S100 and CD68PGM1 and negative for CD1a and CD207, confirming the diagnosis of cutaneous Rosai-Dorfman disease (CRDD). The initial treatment consisted of oral prednisone acetate combined with methotrexate. Due to limited efficacy and adverse effects, methotrexate was discontinued, and prednisone acetate monotherapy was used. After 2 months, the patient's skin lesions gradually resolved, and hearing improved. This case demonstrates that CRDD involving the ear can lead to hearing recovery following systemic corticosteroid therapy.

A 34-year-old woman with concurrent Meniere's disease (MD) and superior semicircular canal dehiscence (SSCD) presented with third-window-mediated drop attacks and episodic vertigo refractory to conservative medical management. The coexistence of these conditions and the pattern of presentation suggested overlapping inner-ear pathophysiology in which abnormal third-window mechanics potentiated MD symptoms. The patient underwent a single-stage transmastoid superior semicircular canal plugging and endolymphatic sac decompression to address both aberrant labyrinthine pressure transmission and impaired endolymphatic regulation. Postoperatively, the patient experienced complete resolution of vertiginous episodes and third-window symptoms without significant impact on hearing. Review of the literature revealed no prior reports of single-stage surgical management of concurrent MD and SSCD. This case describes the complex decision-making and considerations involved in treating a patient with multiple vestibular disorders and highlights the potential role of addressing abnormal intracranial and inner ear pressure dynamics when multiple conditions coexist.

Background/Objectives: Antimicrobial resistance (AMR) in companion animals is an emerging public health threat due to zoonotic potential and limited therapeutic options. Dogs with otitis externa may harbor multidrug-resistant (MDR) bacteria, including Escherichia coli (E. coli), Proteus mirabilis (P. mirabilis), and Enterobacter cloacae complex (E. cloacae complex), some producing extended-spectrum beta-lactamase (ESBL) or AmpC β-lactamases. This study aimed to assess the prevalence, AMR patterns, MDR occurrence, β-lactamase production, and co-infection profiles of these pathogens in canine otitis externa. Methods: Ear canal samples were collected from 592 dogs presenting clinical signs of otitis externa, with one sample per dog included in the analysis. Samples were collected from veterinary clinics in Timiș County, Romania, from 2022 to 2025. Samples were cultured on blood agar and MacConkey agar, followed by biochemical testing and MALDI-TOF mass spectrometry for bacterial identification. Antimicrobial susceptibility testing against 15 agents across six classes was performed using the VITEK[®] 2 system. MDR and β-lactamase production (ESBL, AmpC) were determined according to CLSI 2018 veterinary guidelines. Co-isolation with bacterial and fungal species were recorded. Results:E. coli, P. mirabilis, and E. cloacae complex were isolated in 9.12%, 6.25%, and 1.2% of cases, respectively. E. coli exhibited the highest resistance to aminoglycosides (tobramycin 72.2%, gentamicin 61.1%) and full susceptibility to carbapenems. P. mirabilis showed the highest resistance to ampicillin (54%) and trimethoprim + sulfamethoxazole (46%), with complete susceptibility to carbapenems and fluoroquinolones. E. cloacae complex displayed universal resistance to cephalosporins but remained susceptible to non-cephalosporin β-lactams (piperacillin-tazobactam), carbapenems and aminoglycosides. MDR prevalence was 35.2% for E. coli, 18.9% for P. mirabilis, and 14.3% for the E. cloacae complex. ESBL production was detected in 13% of E. coli and 8.1% of P. mirabilis isolates, while all E. cloacae complex isolates were AmpC-positive. Co-isolations were common, primarily involving Staphylococcus pseudintermedius (S. pseudintermedius) and Malassezia pachydermatis (M. pachydermatis). Conclusions: MDR and β-lactamase-producing bacteria were identified in dogs with otitis externa, emphasizing the importance of routine antimicrobial susceptibility testing, targeted therapy based on local resistance profiles, and continuous AMR surveillance to prevent treatment failure and mitigate zoonotic risk.

The objective of this study was to evaluate the mid- to long-term outcomes of surgical treatment for middle ear cholesteatoma in French bulldogs. A retrospective case series was conducted, reviewing medical records of 18 French bulldogs (20 ears) diagnosed with cholesteatoma and treated surgically from 2018 to 2023. Clinical presentation, imaging findings, surgical approach, histopathological and microbiological results, postoperative complications, and long-term outcomes, assessed through telephone follow-ups, were analyzed. The most common clinical signs were head tilt (80%) and facial nerve deficits (70%). Otitis media was present in all cases and magnetic resonance imaging (MRI) was the primary imaging modality for initial diagnosis (90%). All dogs underwent either subtotal or standard ear canal ablation-lateral bulla osteotomy (TECA-LBO). Staphylococcus pseudintermedius was the most frequently isolated pathogen in positive cultures (85%). Long-term follow-ups showed clinical improvement in all cases, with complete recovery in 40% and a recurrence in 10% of treated ears. These findings suggest that dogs undergoing surgical treatment for aural cholesteatoma experience long-term clinical improvement, although recurrence and persistent clinical signs remain possible.

Mineralization of the para-aural soft-tissue region between the tympanic bulla, hyoid apparatus and nasopharynx in dogs has not been described in veterinary literature. The objective of the study was to determine the prevalence of para-aural mineralization on head computed tomography (CT), describe its morphological features, and assess associations with middle-ear disease, body weight, age, and breed. This retrospective case-control study of 1,833 canine head CTs (January 2012 - December 2024) identified para-aural mineralization in 15 dogs (0.8%) and affected cases were compared with 30 breed-matched controls. Affected dogs were predominantly male, median age 9.4 years and weight 27.3 kg, with lesions frequently bilateral, ventrolateral to the tympanic bulla, and having a median area 12.4 mm2 (median Hounsfield Units 424). All affected cases also showed external ear canal wall mineralization and 87% cf. 43% in the control cases had concurrent tympanic bulla disease (wsall thickening, lysis, and luminal soft tissue/fluid, or hyperostotic tympanic bone spicules) (p = 0.009), whereas age (p = 0.065) and weight (p = 0.709) did not differ significantly between the two groups. Dogs with para-aural mineral formations were more likely to have other soft tissue mineralization noted in the head CT. Cases with serial scans revealed coalescence of fragments, suggesting a dynamic calcification process. These CT findings indicate that para-aural mineralization is uncommon, but imaging findings could serve as a marker of occult chronic middle ear disease, rather than being associated with age or body weight.

A 15-month-old intact female rat was presented with worsening lethargy and dysorexia present for 1 wk and bruxism present for 3 d. The diet was fruits, vegetables, and granola. On presentation, the rat was mildly dehydrated and had marked incisor malocclusion with enamel hypoplasia. On oral examination, the left mandibular molars were not visible and the gum line was prominent. Black punctate enamel discoloration was observed multifocally on molars, but no mucosal lesions were observed. The incisors were trimmed and the rat was discharged with analgesics, supportive care, and dietary recommendations. The rat's condition continued to deteriorate and, 1 wk later, a left mandibular mass appeared that the owner perceived as painful. Computed tomography of the head showed lysis of the body of the left mandible, absence of left mandibular molar teeth, and abnormal soft-tissue attenuation in the left tympanic bulla. On the last visit (Day 31), purulent discharge was visible in the left external ear canal and along the left mandibular gingiva. Fine-needle aspiration and cytology of the mandibular mass suggested a keratinizing epithelial tumor of benign appearance. Euthanasia was elected, based on the poor prognosis. Histopathological examination revealed a well-differentiated oral squamous cell carcinoma of the left mandibular region with ipsilateral subacute purulent otitis media. Key clinical message: Squamous cell carcinoma should be included in the differential diagnosis of an infected, non-ulcerated oral mass in a rat.

Objective:To analyze the application experience and operation result of continuous irrigating mode of otoendoscopic surgery in patients with lateral semicircular canal fistula as a complication of cholesteatoma, so as to provide a basis for the feasibility and safety of the operation. Methods:A total of 45 patients diagnosed with middle ear cholesteatoma who underwent transcanal endoscopic surgery in our department between November 2022 and March 2025 were enrolled, among whom 13 presented with labyrinthine fistula. Mastoid opening and lesion removal were performed in continuous irrigating mode, patients with labyrinthine fistula underwent external semicircular canal fistula repair and tympanoplasty were completed at the same time, and outpatient re-examination was performed at 1 week, 3 weeks, 8 weeks and 12 weeks after surgery, of which endoscopic examination was performed at 3 weeks, 8 weeks and 12 weeks after surgery, and pure tone hearing threshold test was performed 6 months after surgery. Thereafter, regular re-examinations will be conducted every 3 to 6 months. The operation time, preoperative and postoperative vertigo symptoms, changes in bone conduction threshold of pure tone auditory threshold, the time of postoperative dry ear and surgical cavity epithelialization were analyzed. Results:A total of 13 patients were collected, all of whom had external semicircular canal fistulas, including 5 males and 8 females, aged 21 to 77 years, with a mean age of （47.62±15.40） years, with lesions located on the left side in 7 cases, 6 cases on the right side, 6 cases of type Ⅰ fistula and 7 cases of type Ⅱ fistula.The average operation time was（164.77±12.77） min, There was no statistically significant difference in the operation time compared with patients without labyrinth fistula（155.13±9.15） minutes（P=0.563）. 11 cases（84.62%） had dry ears 3 weeks after surgery, 9 cases（69.23%） reached cavity epithelialization at 8 weeks after surgery, and all cases reached epithelialization at 12 weeks after surgery. There was no statistically significant difference in the average bone conduction threshold before and after the operation（P=0.064）, and the average air-bone conduction difference was statistically significant（P=0.012）. One patient had vertigo symptoms after surgery, which was relieved 1 week after surgery, and the bone conduction hearing threshold of this patient did not change compared with that before surgery. Conclusion:①Continuous irrigating mode in otoendoscopic surgery provides a clear surgical field and allows for safe lesion removal, with operation times comparable to those in patients without labyrinthine fistula. ②No significant postoperative decline in bone conduction hearing thresholds was observed, while the air-bone gap was significantly improved. ③The low incidence of postoperative vertigo, along with shorter time to dry ear and cavity epithelialization, suggests that transcanal endoscopic surgery with continuous irrigation is a safe and effective approach for managing labyrinthine fistula.

Objective:To explore the characteristics of the video head impulse test（vHIT） in different peripheral vestibular diseases and the diagnostic value of vHIT for vertigo. Methods:A retrospective analysis was conducted on the medical records of patients with positive vHIT results from the vestibular function testing room of Fudan University Eye, Ear, Nose and Throat Hospital from January to December 2024. The vHIT parameters were comprehensively analyzed in patients diagnosed with different vertigo etiologies, including Acute Unilateral Vestibulopathy, Menière's disease, sudden sensorineural hearing loss with vertigo, vestibular schwannoma （VS） and Ramsay-Hunt syndrome. Diagnoses were confirmed by integrating medical history, physical examination, and imaging findings. Results:A total of 169 patients with unilateral positive vHIT results were included in the study. There were significant differences in the proportion of semicircular canal injury among different vestibular lesions （χ²=23.928, P=0.002）. Significant differences in the types of saccades were also observed in patients with unilateral vestibular disease at different compensation stages （χ²=27.623, P<0.001）. However, no significant differences were found regarding the specific semicircular canals affected, the characteristics of vHIT saccades, the gain values of the affected canals, or the asymmetry ratio of canal gain among patients with different sizes of VS（P>0.05）. Conclusion:The characteristics of positive vHIT results are closely associated with the specific type of peripheral vestibular disorder and the patient's stage of compensation. Detailed analysis of vHIT results across different vestibular diseases can enhance our understanding of the underlying pathological mechanisms of vestibular injury and provide a valuable reference for clinical diagnosis.

Objective:To investigate the correlation between the degree of endolymphatic hydrops（EH） and high jugular bulb（HJB）, as well as the relationship between vestibular EH and vestibular function, and between cochlear EH and vestibular function, in patients with refractory Ménière's disease（MD）. Methods:A retrospective analysis was conducted on patients with refractory Ménière's disease admitted to the department of Otorhinolaryngology of the Second Xiangya Hospital of Central South University from 2018 to 2022. All patients underwent video-head impulse test（vHIT） for vestibular function assessment, temporal bone CT to evaluate the the presence of HJB, and gadolinium enhanced inner ear MRI to assess cochlear and vestibular EH. Spearman's correlation analysis, Fisher's exact test, and McNemar's test were used to analyze the concordance between vHIT and caloric test results, the correlation between EH positivity and HJB, the relationship between cochlear and vestibular EH on the affected side, and the associations between cochlear EH grade and vestibular function. Results:The overall abnormality rate for vHIT was 51.1% （48/94）, while the abnormality rate specifically for the horizontal semicircular canal on vHIT was 10.6% （10/94）. The caloric test abnormality rate was 56.4% （53/94）, which was significantly higher than that of the horizontal semicircular canal vHIT （P<0.01）. No significant correlation was found between the presence of HJB and EH positivity （P >0.999）. On the affected side, the detection rates for cochlear EH and vestibular EH were 79.8% （75/94） and 88.3% （83/94）, respectively. A significant correlation was observed between cochlear and vestibular EH （r= 0.504, P<0.01）. Furthermore, the grade of vestibular EH was significantly correlated with the proportion of abnormal caloric test results （P=0.027）. In contrast, the grade of cochlear EH showed no significant correlation with abnormality rates on either the caloric test or vHIT （P>0.05）. Conclusion:This study reveals that caloric test and vHIT provide complementary information, and dissociation between caloric test and horizontal semicircular canal vHIT results may be suggestive of MD. The correlation between the detection rate of the affected cochlea and vestibular EH in patients with MD, and the degree of vestibular EH correlated with the rate of abnormality of caloric test, may provide a basis for the clinical diagnosis of MD and the assessment of its degree of EH.

Objective:External auditory canal cholesteatoma（EACC） is a common otological disease. Failure to provide timely and standardized treatment often leads to persistent inflammatory reactions and localized bone destruction, with potential involvement of adjacent structures such as the middle ear. To advance the standardization of EACC diagnosis and treatment, the Editorial Board of the Journal of Clinical Otorhinolaryngology Head and Neck Surgery in collaboration with the Otology Group of the Otorhinolaryngology Head and Neck Surgery Branch, Chinese Medical Doctor Association, developed this expert consensus. The consensus systematically elaborates on the definition, classification, etiology, clinical manifestations, and imaging evaluation strategies for EACC. It proposes a clinical staging system based on the extent of lesion involvement and clarifies the principles of treatment, which include complete lesion removal, repair or reconstruction of the external auditory canal structure, restoration of patency and drainage, and recovery of its self-cleaning function. In addition, a staged treatment approach-ranging from outpatient debridement to individualized surgery-is recommended. The goal of this consensus is to offer practical guidance for the standardized diagnosis, staging, and treatment of EACC.