Auricular Research Articles

Assessment of Outer and Middle Ear Pathologies in Lilongwe, Malawi.

Outer and middle ear pathologies are known to disproportionately affect low-income countries but data is limited. We aim to quantify the prevalence rate of patients presenting with middle/outer ear pathologies at ABC Hearing Clinic and Training Centre in Lilongwe, Malawi. Audiological consultations (adult and paediatric) from 2018-2020 were reviewed for outer and middle ear pathologies. Secondary outcomes included patient type (private vs. community) compared to otoscopy findings, tympanometry findings, need for follow up, and follow up compliance. Out of 1576 patients reviewed, the proportion of abnormal cases' was 98.2%, with 41.4% being unilateral and 57.4% bilateral. Eighty-three percent presented with outer/middle ear pathologies. 68% of those presented with a pathology often associated with some degree of conductive hearing loss (occluding wax, perforation, discharge, Type B/Type C tympanogram). Average age was 29 + 0.527 years; 41.6% private and 58.2% community patients. Cerumen impaction was most common finding (51%). Higher rates of otoscopic abnormalities and type B tympanograms were noted in community vs. private patient (~40% vs. ~30%; ~70% vs. ~30%). Adherence to follow up was higher for community vs. private patients (29% vs. 17%); ~70% reported subjective improvement upon follow up. The majority required multiple interventions on follow up. Secondary follow up was recommended in 64.8%. A significant disease burden of outer and middle ear pathologies was identified. Further research is required to understand the disease burden and promote health policy.

Comprehensive Review of External and Middle Ear Anatomy on Photon-Counting CT.

Photon-counting CT (PCT) allows for improved spatial and contrast resolution compared with traditional energy-integrating detector CT. PCT offers markedly improved visualization of previously described structures, as well as those that were previously beyond the resolution of imaging. Although the anatomic details of the external ear and middle ear structures have been described previously, the rich detail of these structures has not been comprehensively reviewed in the radiology literature. The microarchitecture of the middle ear ossicles and bony protuberances are particularly well visualized on PCT. This review updates the existing literature with a detailed anatomic review of the external ear and the middle ear on temporal bone CT.

Canal cholesteatoma: an alarming sequela of congenital aural atresia

Congenital aural atresia is an external ear malformation that may have diverse clinical presentations ranging from conductive hearing loss to the formation of canal cholesteatoma. Canal cholesteatoma, once developed can aggressively erode the bony boundaries of the middle ear cleft and lead to dangerous complications. Here we present the clinical outlook and surgical management of a child with congenital aural atresia with extensive canal cholesteatoma and complications. A twelve-year-old girl with congenital aural atresia and microtia of the right ear presented with right sided infra-auricular abscess with overlying skin ulceration. She also had right sided grade 4 facial paralysis. Pure tone audiometry revealed severe conductive hearing loss on the right side. In contrast, a high-resolution computed tomography scan showed extensive soft tissue on the right side completely destroying the posterior bony canal wall, with erosion of the sigmoid plate and the mastoid tip. We performed a right sided modified radical mastoidectomy and canal atresia repair along with the removal of the necrotic and infected tissues. The little girl recovered uneventfully with improved facial nerve function and without any sign of cholesteatoma recidivism. In congenital aural atresia, early surgical intervention is the key to prevent the formation of canal cholesteatoma and subsequent complications.

Imaging of the vascular distribution of the outer ear using optical coherence tomography angiography for highly accurate positioning of a hearable sensor.

Novel hearable technology is securely and comfortably positioned within the ear canal minimizing inaccuracies caused by accessory movements during activities. Despite extensive research on hearable technologies within the outer ear, there is a lack of research in the field of vascular imaging and quantitative analysis in the outer ear in vivo, which is one of the crucial factors to select the appropriate sensor position. Therefore, in this paper, we introduced optical coherence tomography angiography (OCTA)-based qualitative and quantitative analyses to visualize the inner vasculature of the outer ear to acquire vascular maps for microvascular assessments in vivo. By generating maximum amplitude projection images from three-dimensional blood vascular volume, we identified variations of blood vessel signal caused by the different biological characteristics and curvature of the ear among individuals. The performance of micro-vascular mapping using the proposed method was validated through the comparison and analysis of individual vascular parameters using extracted 20 vascular-related variables. In addition, we extracted pulsatile blood flow signals, demonstrating its potential to provide photoplethysmographic signals and ear blood maps simultaneously. Therefore, our proposed OCTA-based method for ear vascular mapping successfully provides quantitative information about ear vasculature, which is potentially used for determining the position of system-on-chip sensors for health monitoring in hearable devices.

CURRENT APPROACHES TO MANAGING MICROTIA

Microtia, a developmental anomaly of the external ear resulting in a deformed auricle, affects 1 to 5 individuals per 10,000. Literature suggests a male predominance, with nearly 2.5 times more male patients affected than females. Additionally, there is a notable right-sided predilection, leading to pronounced asymmetry, observed in approximately 83% of cases. Surgical reconstruction is the primary treatment for microtia, albeit a technically demanding procedure with challenges in achieving optimal aesthetic outcomes. Reconstruction typically involves autologous costal cartilage, known for its effectiveness but requiring advanced surgical skills. Complications, including pneumothorax, postoperative pain, chest wall deformity, and pathological scarring, are common with this approach. In recent years, surgeons have increasingly adopted modern techniques utilizing porous high-density polyethylene implants for reconstruction. This approach is gaining popularity due to the challenges associated with achieving satisfactory cosmetic results using autologous costal cartilage reconstruction. Based on the bibliosemantic and analytical methods employed to analyze the literature, we posit that this topic necessitates further investigation and a multidisciplinary approach. The involvement of otolaryngologists and maxillofacial surgeons is imperative for the comprehensive treatment of this pathology.

Hyperbaric oxygen therapy in malignant otitis externa: a retrospective analysis.

Malignant otitis externa (MOE) is a rare form of invasive osteomyelitis of the external ear canal. It is typically caused by Pseudomonas aeruginosa in immunocompromised patients. The diagnosis is clinical, and the initial treatment involves systemic antibiotics or antifungal therapy. Surgery is usually only considered when medical treatment has failed. Although hyperbaric oxygen therapy (HBOT) is recommended for refractory osteomyelitis, there are no specific guidelines for MOE. This is a retrospective study that evaluates clinical data, treatment, and results obtained in patients diagnosed with MOE treated with HBOT at the Pedro Hispano Hospital between 2007 and 2022. During the study period, fifteen patients diagnosed with MOE were admitted for treatment with HBOT. All patients received antibiotic and/or antifungal therapy, and three required surgical intervention before starting HBOT. The pathology was successfully managed on all patients. HBOT may be an effective adjuvant treatment option in patients with MOE but it lacks robust scientific evidence. However, its therapeutic value should not be underestimated due to the good results and few adverse effects reported in recent retrospective studies and case reports.

Low-concentration imiquimod treatment promotes enhanced skin barrier functions through epidermal melanization reaction regulation.

The primary function of the skin is to form a mechanical, permeability, antimicrobial, and ultraviolet radiation barrier, which is essential for maintaining physiological homeostasis. Our previous studies demonstrated that cutaneous pigmentation could promote skin barrier function in addition to providing anti-ultraviolet irradiation defense. The present study aimed to develop a new regimen that enhances skin barrier function by regulating skin pigmentation using low-concentration imiquimod. Results showed that topical application of low-concentration imiquimod effectively induced skin hyperpigmentation in the dorsal skin and external ear of mice without inducing inflammatory cell infiltration. An in vitro study also revealed that low-concentration imiquimod did not induce any cytotoxic effects on melanoma cells but triggered excessive melanin synthesis. In coculture systems, low-concentration imiquimod was noted to increase tyrosinase activity in a broader cellular context, revealing the potential role of neighboring cells in melanin production. The next-generation sequencing result indicated that PKCη and Dnm3 might regulate melanin synthesis and release during imiquimod treatment. Overall, our study presents new insights into the regulation of melanin production by low-concentration imiquimod, both in a mice model and cultured cells. Furthermore, our study highlights the potential benefits of imiquimod in promoting melanin synthesis without causing skin disruptions or inducing inflammation, validating its potential to serve as a method for enhancing skin barrier functions by regulating the epidermal melanization reaction.

Early Non-Surgical Treatment For Microtia Types 1 and 2.

Esthetic concerns and psychosocial distress often accompany auricular deformities and malformations in both children and their parents. Approximately 30% of newborns are affected by auricular anomalies, with 15% to 20% resulting in permanent defects. While surgical intervention is typically considered the gold standard for malformations, a non-surgical approach, such as splinting, molding, or other non-invasive techniques, can effectively address deformations if promptly administered by a specialist. Microtia, classified into 4 types, presents challenges ranging from fundamental structural anomalies in types 1 and 2 to severe defects in type 3 and complete absence of the external ear in type 4 (anotia). This study introduces a novel non-invasive treatment modality for microtia types 1 and 2. The cohort consisted of 5 newborns treated for microtia types 1 or 2 between 2022 and 2023. Utilizing the EarWell system, treatment was initiated before 3 weeks of age (mean age: 2 weeks), with an average treatment duration of 6.6 weeks, supplemented by molding treatment as needed. Minor adverse effects, such as simple dermatitis, were observed in 2 patients. All parents expressed high satisfaction with the esthetic outcomes, with 60% reporting extreme satisfaction. The prompt initiation of the treatment protocol for microtia types 1 and 2 led to outstanding and timely outcomes in infants, enhancing the quality of life for both parents and their children. Early intervention for subsequent treatment may improve the condition and, in certain cases, serve as a satisfactory alternative for parents hesitant about further surgical intervention for their children.

Cytological evaluation, culture and genomics to evaluate the microbiome in healthy rabbit external ear canals.

Lop-eared rabbits may be predisposed to otitis externa (OE) as a consequence of their ear conformation. Although otoscopy, otic cytological evaluation and culture are valuable tools in dogs and cats, published data on rabbits remain lacking. This study aimed to assess the utility of otoscopy and cytological results in evaluating healthy rabbit external ear canals (EECs) and to characterise ear cytological and microbiological findings through culture techniques and metagenomic sequencing. Sixty-three otitis-free client-owned rabbits. All rabbits underwent otoscopy and ear cytological evaluation. In a subset of 12 rabbits, further bacterial and fungal culture, fungal DNA assessment and metagenomic sequencing were performed. Otic cytological results revealed yeast in 73%, cocci in 42.9% and rods in 28.6% of healthy rabbit EECs. Compared to upright-eared rabbits, lop-eared rabbits had more discharge and more bacteria per oil immersion field. Culture isolated eight different species yet metagenomic sequencing identified 36, belonging to the Bacillota (Firmicutes), Pseudomonadota and Actinomycetota phyla. Staphylococcus were the most commonly observed species with both methods. Ten of 12 rabbits were yeast-positive on cytological evaluation with only three yielding fungal growth identified as Yarrowia (Candida) lipolytica, Eurotium echinulatum and Cystofilobasidium infirmominiatum. Healthy rabbit EECs lack inflammatory cells yet can host yeast and bacteria, emphasising the need to evaluate cytological results alongside the clinical signs. Lop-ear anatomy may predispose to bacterial overgrowth and OE. Notably, yeasts may be present despite a negative culture.

A meta-analysis comparing the efficacy and safety of different modes of administration of cream in the treatment of otomycosis.

To assess the efficacy and safety of two different modes of administration, external ear canal filling and smearing, in the treatment of otomycosis. A computerised search of relevant published studies in the China National Knowledge Infrastructure, China Biology Medicine, Web of Science, PubMed, Embase and Cochrane Library databases that include randomised controlled trials or clinically controlled trials on the same drug in different modes of administration for the treatment of otomycosis. Seven studies with 934 patients were included. The filled group had a higher clinical efficacy (relative risk = 1.18, 95 per cent confidence interval (CI) 1.12-1.24, p < 0.0001) and a lower recurrence rate (relative risk = 0.29, 95 per cent CI 0.18-0.47, p < 0.0001) compared with the smear group, and there was no significant difference in the adverse effects (relative risk = 0.61, 95 per cent CI 0.34-1.12, p = 0.11). Current evidence suggests that the efficacy of the delivery modality of the external auditory canal filling treatment is significantly better than external auditory canal smearing.

Recurrent Ear Discharge in Primary Care: Exploring the Possibility of Cholesteatoma - A Case Report

Cholesteatoma is a benign lesion of the keratin-producing squamous epithelium, most commonly arising in the middle ear and mastoid. It is rarely found within the external auditory canal. It presents mainly as unilateral lesions and is often destructive and locally invasive. Hence, early detection and referral to an otorhinolaryngology specialist are warranted due to its grave sequelae. This report is about a rare and atypical case of an external ear canal cholesteatoma (EECC) in a young patient. The diagnosis and referral were delayed due to the nature of the disease that resembles an infection, the rarity and atypical presentation of the case, and a low index of suspicion. Therefore, a high index of suspicion based may lead to a timely diagnosis, management, prevention of serious complications, and optimal preservation of ear function.International Journal of Human and Health Sciences Vol. 08 No. 02 Apr’24 Page: 215-219

Otitis externa in dogs (prevalence, etiology, clinical course, and treatment regimens)

Otitis externa is a reasonably common problem in dogs. The most difficult is the treatment of recurrent chronic otitis media. After all, otitis externa in dogs is a polyetiological disease; therefore, to prescribe effective treatment, the doctor needs to identify the primary cause and take it under control, as well as identify and eliminate secondary infections and develop a prevention plan following predisposing factors. That is why a detailed analysis of the scientific literature on the distribution, etiology, clinical course, and scheme of treatment of dogs with the development of otitis externa was made. To ensure the accuracy and speed of diagnosis of otitis externa, it is promising to develop a diagnostic algorithm that will help the general practitioner clearly understand the etiological factors and eliminate them or take them under control. Many researchers have confirmed that otitis is characterized by seasonality (18.6 % occurs in summer, 30.2 % in autumn, 15.6 % in winter, and 35.6 % in spring). Depending on otitis's etiology in small domestic animals, microorganisms, fungi, and mites are decisive. According to the reports of some authors, otitis externa can be secondary; that is, the etiology of such pathology is already an infection (Staphylococcus and Pseudomonas bacteria, Malassezia yeast). Clinically, otitis externa in dogs, as a rule, is manifested by characteristic symptoms, while the existing peculiarities of the course are, in most cases, determined by etiological factors. In most cases, otitis externa is treated locally with drugs applied directly to the ear. Most of these products contain different ingredients that are active against bacteria, yeast, and inflammation at the same time. There are several remedies for the treatment of otitis externa at the veterinarian's choice, which require different treatment regimens. Recently, the practice of veterinary medicine has increasingly included complex drugs that, on the one hand, are effective in the treatment of otitis and, on the other hand, are safe for the animal body. Such drugs, as a rule, should show, at the same time, anti-inflammatory, anti-parasitic, anti-allergic, analgesic, immunomodulating, and other types of action. Because of this, the search and development of new drugs in the system of comprehensive measures for the prevention and treatment of inflammation of the external ear is relevant and promising.

Validating a New Surgical Gouge for Autogenous Ear Reconstruction During Simulated Microtia Workshops

Autologous ear reconstruction remains a gold standard surgical technique for the treatment of external ear deformities. This highly technical procedure requires experience, an understanding of aesthetic principles, and a surgical approach that can consistently produce optimal results. As an experienced microtia surgeon having trained under Dr Satoru Nagata, the senior author has emphasized the importance of appropriate surgical tools during this procedure. Here, we present results of a novel surgical handle and gouge meant to optimize complex cartilage carving. The senior author regularly holds microtia workshops to help train individuals around the United States. During 2 of such workshops held in 2022, participants were given access to both the standard, commercially available surgical gouge as well as a prototype of a novel surgical gouge developed by the authors. Participants were then given a Likert-scale survey to assess their subjective feedback for both tools. Twenty-seven total participants completed the postworkshop survey. Cumulatively, the results demonstrated that participants rated the custom gouge significantly higher than its counterpart (4.2 versus 3.2, P&lt;0.001). They also had a significantly higher likelihood of using the custom gouge again (4.1 versus 3.2, P=0.023). The custom gouge designed by the senior author demonstrated higher subjective ratings when compared with what is currently available on the market. This serves as a primary validation study that demonstrates feasibility for further assessment in a true operative setting.

Anatomic Study of Vascular Supply of the External Ear Using CT Angiography in Congenital Microtia.

The morphology of the arteries of the external ear on the affected side of congenital microtia differs from normal. The present study aimed to use computed tomography angiography (CTA) to describe the anatomic variations of arteries in microtia and provide theoretical guidance for the first stage of autologous auricular reconstruction by the 2-stage method. Ten patients with unilateral microtia from May 2021 to August 2021 were included. Computed tomography angiography and 3-dimensional reconstruction were used to analyze the supply and branches of the main arteries of the auricle. The number of the superficial temporal artery (STA) and posterior auricular artery (PAA) branches to the auricle, vessel diameter, and the presence or absence of the STA and PAA branches were documented. The skin flap and incision were designed combined with the anatomic of auricular arteries. The blood supply of the auricle mainly came from the STA and PAA. The STA's preauricular branch and PAA's posterior auricular branch were absent to varying degrees, and the middle branch was more prominent. The average diameter of the STA on the healthy auricle was 3.07±0.96mm, and the average diameter of the PAA was 1.72±0.50mm. The average diameter of the STA on the microtia auricle was 2.65±0.42mm, and the average diameter of the PAA was 1.53±0.67mm. There was a statistically significant difference in the diameter of STA between the healthy auricle and the microtia auricle (P=0.006). However, there was no significant difference in the diameter of the PAA between the healthy auricle and the microtia auricle (P=0.112). The skin flap and incision were designed and combined with the preoperative CTA images, and no flap necrosis was observed in all patients. The vascular distribution of arteries in microtia patients was clearly and accurately assessed by CTA. In our experience, the data and detailed imaging were useful in designing skin flaps and incisions during the first stage of autologous auricular reconstruction by the 2-stage method.

Prımary External Audıtory Canal Cholesteatoma

Abstract External auditory canal (EAC) cholesteatoma is characterized by a bony defect in the auditory canal with a cystic structure lined by keratinizing stratified squamous epithelium and retention of keratin debris. Clinically, patients present with chronic dull pain, otorrhea, or conductive hearing loss. Lamellar keratin debris in a bony defect in the case of an intact tympanic membrane is highly suggestive of external ear canal cholesteatoma. It must be differentiated from keratosis obturans. The locally erosive and indolent nature of cholesteatoma in the bony external ear canal may result in complications due to erosion into adjacent structures such as mastoid cells, semicircular canals, fallopian canal, and temporomandibular joint. The treatment options include conservative therapy and surgery. In this case report, we presented a 75-year-old male with a primary left EAC cholesteatoma underlining the diagnostic and therapeutic features of this rare disease.

Antifungal Susceptibility Pattern of Fungi Isolated from Patients with Otomycosis Attending a Tertiary Health Care Institution in Sokoto, Nigeria

Abstract Background: Antifungal therapy is an important component of patient management for acute and chronic mycoses. However, treatment choices are restricted because of the scanty number of antifungal drug classes. Medical treatment of otomycosis is further compromised by the emergence of antifungal drug resistance, and these limits available drug classes as treatment options. Once considered a rare occurrence, antifungal drug resistance is on the rise in many high-risk medical centers. Most concerning is the evolution of multidrug-resistant organisms refractory to several different classes of antifungal agents, especially among common Candida species. Aim: This study seeks to identify the fungal species implicated in otomycosis among patients attending a tertiary health-care institution in Sokoto, Nigeria and determine its susceptibility pattern using commonly used antifungal agents. Methods: A descriptive, cross-sectional, hospital-based study was conducted on 100 patients with otitis externa. The ear discharge specimens were collected and analyzed using the standard microbial techniques. The antibiotic susceptibility profiles were determined for 12 different antifungal by the standard disk diffusion method. Data were analyzed using the SPSS software version 25 and the P &lt; 0.05 was considered as statistically significant. Results: One hundred and twenty-four external ear discharge samples were collected from either right ear, left ear, or both ears (some patients has unilateral while others have bilateral disease and those with bilateral disease, samples were taken from the two ears). Aspergillus niger 30 (40.0%) was the most commonly isolated fungi in this study, followed by Candida spp. 25 (33.3%), Aspergillus fumigatus 5 (6.7%), Mucor 5 (6.7%), Penicillum 4 (5.3%), Aspergillus flavus 3 (4.0%), and Rhizopus 3 (4.0%) %). The isolated fungi were tested for antifungal sensitivity to 6 antifungal discs. A. niger shows good susceptibility to clotrimazole (100%), nystatin (90%), and fluconazole (83.3%) but was resistant to griseofulvin, terbinafine, and ketoconazole. A. flavus and A. fumigatus also show good sensitivity to clotrimazole, nystatin, and fluconazole. Candida albicans was only susceptible to clotrimazole but resistant to other tested antifungal disc. Rhizopus and Penicillum species showed 100.0% sensitivity to clotrimazole but also resistant to other tested antifungal discs. Conclusions: This study revealed that Aspergillus and Candida species were the most common fungal pathogens causing otomycosis. A. niger is the predominant fungal isolate. Molds isolates showed good susceptibility to clotrimazole, while highest resistance was to terbinafine and ketoconazole. Yeasts isolates showed highest susceptibility to clotrimazole and highest resistance to nystatin and fluconazole.

Resistant otorrhea in a diabetic; revealing form of an exceptional carcinoma of the external ear canal

Resistant otorrhea in a diabetic; revealing form of an exceptional carcinoma of the external ear canal

BMP signaling maintains auricular chondrocyte identity and prevents microtia development by inhibiting protein kinase A.

Elastic cartilage constitutes a major component of the external ear, which functions to guide sound to the middle and inner ears. Defects in auricle development cause congenital microtia, which affects hearing and appearance in patients. Mutations in several genes have been implicated in microtia development, yet, the pathogenesis of this disorder remains incompletely understood. Here, we show that Prrx1 genetically marks auricular chondrocytes in adult mice. Interestingly, BMP-Smad1/5/9 signaling in chondrocytes is increasingly activated from the proximal to distal segments of the ear, which is associated with a decrease in chondrocyte regenerative activity. Ablation of Bmpr1a in auricular chondrocytes led to chondrocyte atrophy and microtia development at the distal part. Transcriptome analysis revealed that Bmpr1a deficiency caused a switch from the chondrogenic program to the osteogenic program, accompanied by enhanced protein kinase A activation, likely through increased expression of Adcy5/8. Inhibition of PKA blocked chondrocyte-to-osteoblast transformation and microtia development. Moreover, analysis of single-cell RNA-seq of human microtia samples uncovered enriched gene expression in the PKA pathway and chondrocyte-to-osteoblast transformation process. These findings suggest that auricle cartilage is actively maintained by BMP signaling, which maintains chondrocyte identity by suppressing osteogenic differentiation.

BMP signaling maintains auricular chondrocyte identity and prevents microtia development by inhibiting protein kinase A

Elastic cartilage constitutes a major component of the external ear, which functions to guide sound to the middle and inner ears. Defects in auricle development cause congenital microtia, which affects hearing and appearance in patients. Mutations in several genes have been implicated in microtia development, yet, the pathogenesis of this disorder remains incompletely understood. Here, we show that Prrx1 genetically marks auricular chondrocytes in adult mice. Interestingly, BMP-Smad1/5/9 signaling in chondrocytes is increasingly activated from the proximal to distal segments of the ear, which is associated with a decrease in chondrocyte regenerative activity. Ablation of Bmpr1a in auricular chondrocytes led to chondrocyte atrophy and microtia development at the distal part. Transcriptome analysis revealed that Bmpr1a deficiency caused a switch from the chondrogenic program to the osteogenic program, accompanied by enhanced protein kinase A activation, likely through increased expression of Adcy5/8. Inhibition of PKA blocked chondrocyte-to-osteoblast transformation and microtia development. Moreover, analysis of single-cell RNA-seq of human microtia samples uncovered enriched gene expression in the PKA pathway and chondrocyte-to-osteoblast transformation process. These findings suggest that auricle cartilage is actively maintained by BMP signaling, which maintains chondrocyte identity by suppressing osteogenic differentiation.

Analysis of clinical manifestations and imaging features of facial nerve schwannomas

Objective:To explore the clinical manifestations and imaging characteristics, and to clarify the imaging value in the diagnosis of facial nerve schwannomas. Methods:Retrospectively analyze the data of 23 patients with facial nerve schwannomas confirmed by surgery and pathology in the Department of Otorhinolaryngology of the First Affiliated Hospital of the Air Force Military Medical University from September 2020 to September 2022, including 8 males and 15 females, aged 18-66 years old. Summarize and analyze their clinical symptoms, specialized examinations, and imaging findings. Results:The clinical manifestations were facial nerve paralysis in 15 cases（2 cases of HB Ⅳ, 6 cases of HB Ⅴ, 7 cases of HB Ⅵ）, hearing loss in 14 cases（5 cases of conductive deafness, 2 cases of mixed deafness, and 7 cases of severe sensorineural hearing loss）, 8 cases tinnitus, 7 cases ear pain, 4 cases dizziness, 4 cases headache, 2 cases ear pus, and parotid gland tumors in 6 cases presenting as local masses. Endoscopic examination revealed 8 cases of external ear canal tumors and 3 cases of intratympanic tumors. Combining temporal bone HRCT, MRI enhanced scanning, and CPR imaging techniques, 1 case involved the internal auditory canal segment, 2 cases in the tympanic segment, 6 cases in the parotid gland area. A total of 14 cases involved two or more segments of the internal auditory canal segment, the labyrinthine segment, geniculate ganglion, the tympanic segment, and the mastoid segment. When the tumors were large, adjacent structures were involved. It was found that 8 cases invaded the external auditory canal and tympanic cavity, ossicles were displaced or bony destruction; 3 cases invaded the jugular foramen area, and 1 case grew to the middle cranial fossa region with temporal lobe brain parenchymal compression. Conclusion:The clinical manifestations of facial nerve schwannomas are diverse. The combination of various imaging techniques will be conducive to topical and qualitative diagnosis and provide an important basis for treatment strategies.