Canaloplasty is a minimally invasive glaucoma procedure that aims to restore aqueous outflow through the Schlemm canal. Despite its excellent safety profile, complications can occur, including hyphema, creation of a cyclodialysis cleft, and incorrect passage of the catheter into the suprachoroidal space. Descemet membrane detachment (DMD) is an infrequent complication of canaloplasty and can be associated with significant visual decompensation, particularly when involving the central visual axis. Herein, we describe a case of a patient who underwent canaloplasty through an iTrack microcatheter and whose course was complicated by a hemorrhagic DMD with viscoelastic trapped in the interface between the Descemet membrane and posterior corneal stroma. This case helps to highlight the importance of considering factors such as location, relationship to pupil, size, and contents when determining the management of DMDs.

Osteosarcoma of the head and neck is an uncommon malignancy with heterogeneous clinical and radiological presentations, often leading to diagnostic challenges. Its occurrence during pregnancy further complicates management due to the need to balance maternal and fetal outcomes. We report the case of a 23-year-old pregnant woman who initially presented with right-sided otalgia, managed as otitis externa. She subsequently developed a rapidly progressive, highly vascular mass protruding through the external auditory canal, associated with conductive hearing loss and vestibular symptoms. Magnetic resonance imaging revealed an aggressive lesion involving the external auditory canal, middle ear, and mastoid air cells and extending to the dura of the middle and posterior cranial fossae. An initial biopsy performed at 17.5 weeks of gestation was suggestive of cholesteatoma. However, due to clinical progression, surgical resection via mastoidectomy was performed. Definitive histopathological analysis revealed a high-grade spindle cell and epithelioid sarcoma with osteoid formation, consistent with osteosarcoma. The patient developed early recurrence with intracranial progression, requiring multidisciplinary management. Radiotherapy was initiated at 28 weeks of gestation, followed by termination of pregnancy at 29 weeks due to maternal oncologic progression and oligohydramnios. Systemic chemotherapy was subsequently administered, achieving a partial response. In our case, the lesion was initially approached as a benign otologic condition, which delayed definitive diagnosis despite imaging findings suggestive of aggressive disease. Both clinical evaluation and initial histopathological assessment failed to establish the correct diagnosis. This case also underscores the complexity of oncologic decision-making during pregnancy and the critical importance of a multidisciplinary approach.

Diabetic populations are predisposed to atypical, or sometimes silent, responses to myocardial ischemia. This is often the result of chronic neuropathy involving the nociceptive sympathetic pathways of the heart that converge at the T1-T4/5 spinal columns. When these signals are blunted, ischemic pain signals may be delivered via the "Arnold's nerve," the auricular branch of the vagus that innervates the external auditory canal. A 70-year-old woman with a history of type 2 diabetes (diagnosed 14 years before presentation), hypertension, hyperlipidemia, and chronic obstructive pulmonary disease presented to the urgent care for a 24-hour history of left ear pain. Following a negative otoscopic exam, she was advised to apply warm compresses and use Tylenol. The subsequent day, she developed intractable nausea, vomiting, and generalized weakness. Emergency medical services were notified and en route identified an acute inferior ST-elevation myocardial infarction (STEMI) via 12-lead electrocardiogram. Emergent left heart catheterization revealed total right coronary artery occlusion, which resolved after deployment of two drug-eluting stents. Her symptoms of left ear pain and nausea resolved postintervention, and she was discharged the following day. This case thus underscores an exceedingly rare but critical anginal equivalent in diabetics, left otalgia.

Skin diseases of the external ear (auricle and external auditory canal) are not uncommon. The major findings include erythema, pain, edema, discharge, pruritus, and changes in the shape of the ears. Infectious diseases are quite common in infants and children, inflammatory diseases are more prevalent in adolescents and adults, while keratinocytic malignancies increase by age. The dermatologist can serve as a pilot for patients with dermatoses of the outer ear. When there are discharge and pain, collaboration with specialists for ear, nose, and throat is recommended. In case of infants and children, collaboration with pediatrics is recommended. Whenever a malignancy is suspected, a skin biopsy for histopathologic study is crucial. In any patient with discharge, microbiologic and mycologic investigations should be performed. For the best outcome, a multidisciplinary approach is the optimum. Early diagnosis and efficient treatment are the cornerstones of a good prognosis and the best way to limit complications.

Several benign and malignant tumors may be observed on the skin of the external ear at various ages, and some are specifically located in this area. Large lesions may be disfiguring and impair hearing by obstructing the external auditory canal. They may also cause chronic ulcerations and, in some cases, secondary destruction of underlying cartilage. The management of some external ear tumors requires a multidisciplinary approach. Being aware of the rich clinical spectrum of auricular tumors may enable early diagnosis, preventing more aggressive surgery with accompanying undesirable cosmetic results and decreasing the risk of metastasis in malignant tumors. The diagnosis of associated systemic diseases and genodermatoses may also be possible.

Objective:To evaluate the anatomical variations of the inner ear in patients with Meniere's disease using magnetic resonance imaging（MRI） and to explore the role of these variations in different types of endolymphatic hydrops. Methods:Twenty-eight patients clinically diagnosed with Meniere's disease underwent 5.0T inner ear MRI with gadolinium contrast. All patients received conventional non-contrast inner ear MRI, internal auditory canal hydrography, and 3D-FLAIR sequences. Four hours after intravenous administration of a double dose of gadolinium contrast agent, enhanced 3D-FLAIR and thin-slice T1-weighted fat-suppressed sequences were performed. The distance between the vertical portion of the posterior semicircular canal and the posterior cranial fossa（MRI-PP distance） was measured bilaterally on inner ear hydrography sequences. Two radiologists, each with 10 years of experience in head and neck imaging, independently interpreted the degree of endolymphatic hydrops on the gadolinium-enhanced inner ear images according to Bernaets' visual grading method. Any discrepancies were resolved through discussion. Vestibular hydrops was scored from 0 to 3, and cochlear hydrops was scored from 0 to 2. A total hydrops score for each side（left/right） was calculated as the sum of the vestibular and cochlear scores. SPSS 26.0 statistical software was used for Pearson correlation analysis between these scores and the MRI-PP values. Furthermore, the presence or absence of cochlear and vestibular hydrops was defined as 1 and 0, respectively, and independent samples t-tests were performed between these dichotomized groups and the MRI-PP values. Results:A total of 56 ears from 28 patients were analyzed. The mean total hydrops score was（1.25±0.89） for the left ears and（0.89±0.74） for the right ears. The mean MRI-PP distance was（2.36±1.09） mm for the left side and（2.74±1.41） mm for the right side. Pearson correlation analysis results: For the left side, correlation between the total hydrops score and the MRI-PP distance was not significant（P=0.662）, while correlations between the cochlear hydrops score and the MRI-PP distance（P=0.003）, and between the vestibular hydrops score and the MRI-PP distance（P<0.001） were statistically significant. For the right side, correlations between the total hydrops score and the MRI-PP distance（P=0.402）, between the cochlear hydrops score and the MRI-PP distance（P=0.716）, and between the vestibular hydrops score and the MRI-PP distance（P=0.541） were not statistically significant. Conclusion:The MRI-PP distance has the potential to serve as an imaging anatomical indicator for assessing the risk of developing Meniere's disease, especially for left-sided involvement. 5.0T MRI can effectively advance the imaging diagnosis of Meniere's disease from traditional qualitative assessment toward quantitative evaluation, providing a new technical platform and imaging basis for uncovering the disease's pathogenesis and guiding individualized precision treatment.

Accurate sleep assessment relies on the high-quality, long-term acquisition of physiological signals. However, traditional polysomnography (PSG) relies on cumbersome equipment with poor user comfort and often interferes with the user's sleep quality. Herein, a wearable in-ear EEG sleep monitoring and intervention platform is developed based on a poly(3,4-ethylenedioxythiophene) (PEDOT)/leather composite electrode. By leveraging the relatively enclosed and stable environment of the ear canal, this platform achieves an optimal balance between long-term comfort and signal accuracy. The PEDOT/leather electrode demonstrates robust electrical stability, low interfacial impedance, and high mechanical durability. Benefiting from the anatomical proximity to the central nervous system, the platform enables precise EEG acquisition and sleep stage classification (Wake, NREM, REM). Moreover, active sleep modulation is realized through integrated closed-loop acoustic stimulation. This integrated sensing-and-intervention platform offers a highly promising solution for next-generation personalized sleep medicine and neurological disease management.