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Objective To determine whether exposure to monopolar electrosurgery during subsequent surgeries following Bonebridge implantation has negative impact on the implant. Study Design Retrospective study. Setting Tertiary medical center. Methods Fifty‐six patients who received Bonebridge implantation between December 2014 and June 2024 were reviewed. Twelve patients with exposure to monopolar electrosurgery during subsequent operation were included. Bonebridge‐aided sound field thresholds, as well as subjective outcomes based on patient experience were analyzed to determine if there are any adverse effects on the implant after monopolar electrosurgery exposure. Results The mean age at receiving Bonebridge implantation and subsequent operation were 15.1 ± 6.8 (range, 7.7‐29.9) years and 16.5 ± 6.5 (range, 10.2‐30.1) years, respectively. Each of the included patients experienced one episode of monopolar electrosurgery exposure after Bonebridge implantation. All monopolar electrosurgery exposures were in the head‐and‐neck region, but none of them involved the ipsilateral temporoparietal area. The mean pre‐monopolar electrosurgery and post‐monopolar electrosurgery Bonebridge aided sound field thresholds pure tone average were 31.8 ± 3.3 decibel hearing level and 29.5 ± 3.9 decibel hearing level, respectively (Wilcoxon signed‐rank test, P = .203). No adverse events associated with implant malfunction occurred after monopolar electrosurgery exposure. Conclusion No adverse events or hearing impairment were observed in this series of Bonebridge‐implanted patients who underwent operations involving monopolar electrosurgery. Notably, the exposures were of relatively brief duration and limited to areas outside the ipsilateral temporoparietal region. Further multicenter, prospective studies with larger cohorts and comprehensive adverse event analysis are warranted to better corroborate these findings.

This study reviewed the clinical manifestations, pathological findings, and treatment outcomes of adenoid cystic carcinoma (ACC) in the external auditory canal (EAC). This was a retrospective review of 12 patients with a diagnosis of ACC in the EAC seen in a single institution over a 30-year period. Data on the demographics, clinical presentation, treatment strategy, and outcome, as well as the pathological features of ACC, were reviewed and analyzed. The male-to-female ratio was 1:3 and the mean patient age was 55.9 years. The most common clinical presentation was otalgia (75%). Ten patients underwent surgical interventions, including radical mastoidectomy in five patients, wide excision in three, and lateral temporal bone resection in two. Adjuvant radiotherapy or concurrent chemoradiotherapy (CCRT) was performed in case of incomplete resection. Two patients underwent non-surgical treatments: radiotherapy in one and CCRT in the other. Microscopic perineural invasion was not associated with otalgia or histological subtype. The mean follow-up period was 84.6 months. Local recurrence occurred in 33% of patients. One-quarter of patients had distant metastasis, and all had lung metastasis. The 5-year overall survival rate for these patients was 82.5%. EAC ACC should be included in the differential diagnosis when a patient presents with otalgia and a mass in EAC for more than 6 months, particularly if the patient is a middle-aged female. Otalgia might not be associated with perineural invasion or histological subtype. The lung is the most common site of distant metastasis in patients with EAC ACC. Further studies should determine the optimal treatment protocol for this rare malignancy.

Diabetic foot ulcer is closely associated with peripheral vascular disease. Enhancement of tissue oxidative stress, reduction of nitric oxide (NO) and angiogenic growth factors, and abnormal matrix metalloproteinase (MMP) activity are pathophysiological factors in post-ischemic neovascularization and diabetic wound healing. Our previous study demonstrated that the Chinese 2-herb formula, NF3, showed significant wound healing effects on diabetic foot ulcer rats. A novel rat diabetic foot ulcer with hindlimb ischemia model was established in order to strengthen our claims on the diabetic wound healing and post-ischemic neovascularization effects of NF3. Our results demonstrate that NF3 can significantly reduce the wound area of the diabetic foot ulcer rat with hindlimb ischemia by 21.6% (p<0.05) compared with the control group. In addition, flow cytometric analysis revealed that NF3 could boost circulating EPC levels for local wound vessel incorporation. Immunohistochemical analysis showed that NF3 could significantly augment blood vessel density, VEGF and eNOS expression, and attenuate tissue oxidative stress of ischemic muscles (p<0.001). NF3 significantly stimulated MMP activity involved in angiogenesis. Our study shows, for the first time, the beneficial effects of NF3 in wound healing and post-ischemic neovascularization in diabetes.