简介：ObjectivesToreportauthors'experiencesinthediagnosisandtreatmentsofcongenitalfirstbranchialfistula(congenitalauriculocervicalfistula).MaterialsandMethodsTwelvecasesofcongenitalfirstbranchialfistulawerereviewed.Ofthese,8underwentfistulectomywithfacialnervedissectionandpartialparotidectomyand4underwentsimplefistulectomy.ResultsTheinneropenings(upperopening)offistulaelayinthefollowingsites:inferioposteriorwallatthejunctionofcartilaginousandbonysegmentsoftheauricularcanalandinferiorwallofcartilaginousauricularcanal.Theouteropenings(loweropening)layalongtheanteriorborderofuppersternocleidomastoidmuscle,atthemastoidtipandposteriortothemandibularangle.Completefistulaeresectionwasachievedinallbutonecase.Elevencaseswerefollowedfor5yearwithnorecurrence.Recurrenceoccurredin1case6monthsaftertheprimarysurgeryandrevisionsurgerywasperformed.ConclusionsPre-operativeradiographyforthelocationandcourseofthefistulaiscrucialforsuccessfulfistularesection,especiallyincaseswithpastinfections.Facialnervedissectionshouldbedoneroutinelyfordeeplylocatedfistulae.

简介：Metastasisoflungcancertothetemporalboneisaveryrarediseaseandsubjectivetinnitusasthepresent-ingsymptominthesepatientsisevenrarer.Herewereportacaseinwhicha42-year-oldmalepresentedwithsubjectivetinnitusofthreemonths,withnopulmonarydiseasesymptoms.Puretoneaudiometryindi-catedmoderateconductivedeafnessinleftearwithanair-bonegapof21.3dB.HRCTtemporalbonescan-ningindicatedhigh-densityshadowsintheleftepitympaniccavity,sinustympaniandmastoidcavity.Chron-icotitismediawithcholesteatomawassuspectedandsurgicaltreatmentrecommended.However,preopera-tivechestx-rayrevealedhigh-densitymilletlesionsscatteredwidelyinbothlungs.HRCTlungscanningconfirmedthelungslesionsandindicatedlungcancer.Inordertodeterminecorrelationsbetweenthetempo-ralboneandpulmonarylesions,aCT-guidedtrans-mastoidaspirationbiopsyandimmunohistochemicalstudywereconducted,whichconfirmedthatthetemporalbonelesionwasmetastaticfromthelungs.Thepa-tientwasgivenaseriesofchemotherapyimmediatelyandhistinnitussignificantlyimprovedafterthreemonthsoftreatment,withfullrecoveryofhishearingandcompleteresolutionofshadowsinthemastoidcavity.Unfortunately,hesubsequentlydevelopedmultiplebonemetastasesinthe9thmonthandcerebralmetastasisinthe18thmonth.Multipleorganfailureresultedindeathin2.5years.