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Table of Content

    20 July 2024 Volume 38 Issue 4
      
    Original Article
    Effect of bilirubin on the viability and proliferation of neural stem cells
    WU Cuiping, ZHU Yidan, LI Chunyan, YIN Shankai
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  1-6.  doi:10.6040/j.issn.1673-3770.0.2023.071
    Abstract ( 27 )   PDF (8416KB) ( 2 )   Save
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    Objective To investigate the effect and mechanism of bilirubin on neural stem cell(NSC)viability and proliferation. Methods Primary mouse NSCs were cultured with different concentrations of bilirubin, and live-dead cell staining was performed after 2 days of culture; neurosphere assay, Ki-67 assay, and transcriptome sequencing were performed after 7 days of culture to investigate the effects of bilirubin on NSC viability and proliferation. Results Approximately 1.71-6.84 μmol/L bilirubin had no effect on NSC viability, while 13.68 μmol/L bilirubin decreased NSC viability. Approximately 0.17-6.84 μmol/L bilirubin promoted NSC proliferation, while this pro-proliferation effect disappeared when the bilirubin concentration reached 13.68 μmol/L. Bilirubin increased Ki-67 expression in NSCs. RNA Seq showed that bilirubin upregulated 184 genes and downregulated 100 genes. Gene Ontology analysis suggested that the differentially expressed genes were mainly related to “regulation of cell population proliferation” and other biological processes. KEGG analysis suggested that the differentially expressed genes were related to several pathways, such as the “PI3K-AKT signaling pathway”. Conclusion High bilirubin concentrations were toxic to NSCs, while low bilirubin concentrations had no effect on NSC viability and promoted NSC proliferation.
    Based on baidu index SARS-CoV-2 infection ear symptoms before and after the outbreak of health network research attention
    LIU Panpan, ZHAO He, WANG Yan, QIU Jingjing, LIU Dawei, SUN Yan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  7-14.  doi:10.6040/j.issn.1673-3770.0.2023.049
    Abstract ( 24 )   PDF (3899KB) ( 3 )   Save
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    Objective This study aimed to understand the trend of online public attention toward ear symptoms before and after the SARS-CoV-2 infection outbreak, use the Baidu Index to explore the correlation between SARS-CoV-2 infection case numbers and public interest in China, and investigate the potential of online data as an early warning for public health events. Methods Keywords associated with ear symptoms(“hearing impairment”“tinnitus” “hearing loss”“vertigo” “ stuffy ears”“deafness”)were extracted from the Baidu index platform. Searched volume data were compared before and after the outbreak. We used a one-way analysis of variance to analyze differences in search volume pre- and post-outbreak. Pearson correlation coefficients were calculated between the Baidu search index and the daily trend of SARS-CoV-2 cases nationwide. Results Compared to the same period in previous years(2017-2020), online searches for “hearing impairment”“tinnitus” “hearing loss” “vertigo”“deafness” significantly increased 2020-2023(all P<0.001). The Baidu search index for “hearing impairment”“hearing loss” “vertigo” “stuffy ears” “deafness” showed significant positive correlations with new SARS-CoV-2 cases(all P<0.001). Conclusion Following the SARS-CoV-2 outbreak, online public attention to ear symptoms intensified. We observed a significant positive correlation between the Baidu search index for ear symptoms and the new number of COVID-19 cases. These findings suggest that monitoring online trends in ear symptoms may hold promise for early prevention and control of SARS-CoV-2.
    Comparative analysis of speech recognition ability before and after treatment of intractable sudden deafness using retroaural injection of ganglioside and intratympanic injection of methylprednisolone
    CAO Ying, QIU Yue, CHEN Zhibin, FEI Bing, LI Dong, ZHANG Xiaofeng,WANG Hui,KANG Xinle, WANG Haixu,HUAI De,LI Xiuting, SHU Mingyang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  15-21.  doi:10.6040/j.issn.1673-3770.0.2023.083
    Abstract ( 20 )   PDF (1098KB) ( 5 )   Save
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    Objective This study aimed to analyze the impact of postauricular injection of ganglioside combined with intratympanic injection of methylprednisolone on word recognition score(WRS)and its influencing factors in patients with unilateral refractory sudden deafness. Methods This study included 58 patients with refractory sudden deafness who were treated with postauricular ganglioside injection combined with intratympanic methylprednisolone injection. Data was collected on the patients' age, sex, disease duration, ear category, concomitant symptoms, and pure tone audiometry(PTA)and speech audiometry results pre- and post-treatment. The PTA results and the maximum speech recognition rate(WRSmax)were statistically analyzed pre- and post-treatment. Logistic regression analysis was applied to identify factors that improve WRS. Results Patients with refractory sudden deafness showed significant improvements in PTA and WRS in the affected ear after treatment(P=0.027,P=0.038). Furthermore, a negative correlation was observed between PTA and WRS(r=-0.682, P<0.05). Univariate analysis revealed that age, sex, precipitating factors, affected ear, concomitant symptoms, and WRS were not significantly correlated(P=0.693, P=0.208,P=0.079, P=0.335, P=0.331)), and the differences were not statistically significant. However, time from onset to the first visit, degree of hearing damage, and type of hearing curve were identified as important factors that influenced improvement in WRS(P=0.010, P=0.033, P=0.026). Conclusion Administration of postauricular ganglioside combined with intratympanic methylprednisolone resulted in a 41.38% improvement in WRS for patients with refractory sudden deafness. Improvement in WRS was also influenced by the time from onset to the first visit, degree of hearing impairment, and type of hearing curve. The improvement in WRS was significantly worse in those with a longer time from onset to first visit than in those with a shorter duration; however, it was significantly better in those with low-frequency hearing loss than in those with flat and high-frequency hearing loss after treatment with the aforementioned methods. The severity of hearing impairment negatively impacted improvement in WRS.
    Clomipramine hydrochloride protects auditory hair cells from neomycin-induced damage
    ZHOU Jing, BI Xiuli, XIAO Yu, HU Jun, FU Xiaolong, YU Yafeng
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  22-27.  doi:10.6040/j.issn.1673-3770.0.2023.200
    Abstract ( 21 )   PDF (5181KB) ( 5 )   Save
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    Objective The aim of this study was to identify small-molecule drugs that inhibit neomycin-induced hair-cell-like cell(HEI-OC1)death, and to verify their effects on hair cells in cochlear explants and the lateral line of zebrafish. Methods Small-molecule drugs that increased the viability of HEI-OC1 cells were identified using Cell Counting Kit-8. The protective effect of the identified small-molecule drugs was verified in hair cells of cochlear explants and zebrafish by Immunofluorescence staining. Results Of the 350 small-molecule drugs screened, clomipramine hydrochloride was found to significantly improve the survival rate of neomycin-treated HEI-OC1 cells. In addition, clomipramine hydrochloride was found to have a protective effect on hair cells of neomycin-treated mouse cochlear explants and the lateral line of zebrafish. Conclusion Clomipramine hydrochloride, which as an FDA-approved clinical drug, has a protective effect against neomycin-induced hair cell damage.
    Surgical treatment of lesions of the upper parapharyngeal space by endoscopic prelacrimal recess-transpterygoid approach
    HOU Jie, LIU Dingding, WANG Handong, QIAN Xiaoyun, GAO Xia, YU Chenjie
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  28-35.  doi:10.6040/j.issn.1673-3770.0.2023.098
    Abstract ( 22 )   PDF (10866KB) ( 5 )   Save
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    Objective In this study, we aimed to evaluate the feasibility of the operative method, indications, and clinical outcomes of the endoscopic prelacrimal recess-transpterygoid approach for treating lesions in the upper parapharyngeal space. Methods We retrospectively analyzed 10 cases of upper parapharyngeal space lesions between February 2016 and August 2021. Enhanced MRI and CT scans were performed before surgery. All the patients underwent endoscopic surgery, during which the pterygoid process was exposed by removing the anterior and medial walls and soft tissues in the pterygopalatine fossa through a prelacrimal-recess approach. Furthermore, using the eustachian tube, musculus palatosalpingeus, medial pterygoid muscle, and lateral pterygoid plate as reference marks, lesions in the upper parapharyngeal space were removed under image-navigation-assisted endoscopic surgery. A week after the surgery, enhanced MRI reinspection was performed to assess the characteristics, complications, and surgical outcomes. Results All patients' lesions were fully exposed by endoscopic prelacrimal-recess - transpterygoid approach. Among the ten cases, three cases of cavernous hemangioma, two cases of lymphoma, four cases of inflammation/inflammatory pseudotumor, and one case of nasopharyngeal carcinoma were confirmed through histopathological and immunohistochemical examination. Among these, all cavernous hemangiomas were totally removed, whereas lymphomas, and inflammation/inflammatory pseudotumors, nasopharyngeal carcinoma were subtotally removed after surgery. During the post-surgery follow-up period of 6-28 months, all the cases of hemangioma exhibited no recurrence, lymphoma cases exhibited complete remission after chemotherapy, inflammation/inflammatory pseudotumor cases exhibited no significant change compared with their post-surgery condition, and nasopharyngeal carcinoma case exhibited complete remission of nasopharyngeal disease after radiotherapy. Additionally, postoperative hard palate numbness on the affected side occurred in all 10 patients, four cases of hard palate numbness exhibited no remission. Conclusion The endoscopic prelacrimal-recess-transpterygoid approach effectively exposed the upper parapharyngeal space. The eustachian tube, musculus palatosalpingeus, medial pterygoid muscle, and medial pterygoid plate can be used as anatomical reference marks in this area to facilitate removal of lesions while protecting vital structures of the skull base. This approach is advantageous for the removal of lesions located in the upper parapharyngeal space.
    Study on the correlation between allergic rhinitis and coronavirus disease-2019 infection and symptoms in children
    ZHANG Jie, CHEN Min, SHEN Zhengzheng, WU Yuhua, LIU Yuanhu, SUN Hao, TAN Xinhua, NI Shuren, YANG Shuxun, SHI Xuezheng, NI Xin
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  36-42.  doi:10.6040/j.issn.1673-3770.0.2023.393
    Abstract ( 29 )   PDF (1089KB) ( 3 )   Save
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    Objective This study examined the potential impact of allergic rhinitis on children's susceptibility to and experience of coronavirus disease-2019(COVID-19)infection. Methods A retrospective analysis was conducted on 205 outpatients. Clinical data were collected through a questionnaire that assessed general information, presence of allergic rhinitis, and COVID-19 infection status. A visual analog scale was used to score the severity of COVID-19 symptoms across body areas. Chi-square and non-parametric tests were used to compare the differences in age, sex, and allergic rhinitis prevalence between the COVID-19 infection and non-infection groups. Linear regression analysis explored factors influencing symptom severity in the infection group. Results No significant association was found between COVID-19 infection and age, sex, allergic rhinitis, or other factors. Among the 152 children infected with COVID-19, age showed a positive correlation between symptom scores between children with and without allergic rhinitis. Conclusion In children, allergic rhinitis appears to have minimal impact on COVID-19 infection susceptibility, symptoms severity, or disease duration. While age demonstrated a positive correlation to the severity of throat symptoms in children with COVID-19, allergic rhinitis status was not a significant factor.
    Analysis of anti-IL-4Rα monoclonal antibody and endoscopic sinus surgery in the treatment of eosinophilic chronic rhinosinusitis with nasal polyps
    CHEN Xingxue, ZHANG Guangling, WU Tianyi, WANG Weiwei, SUN Zhanwei, LI Shichao, WANG Guangke
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  43-54.  doi:10.6040/j.issn.1673-3770.0.2024.093
    Abstract ( 19 )   PDF (4671KB) ( 4 )   Save
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    Objective To observe and analyse the short-term efficacy of anti-IL-4Rα monoclonal antibody and endoscopic sinus surgery(ESS)in the treatment of eosinophilic chronic rhinosinusitis with nasal polyps(ECRSwNP). Methods Twenty-one patients diagnosed with bilateral ECRSwNP were treated with endoscopic sinus surgery(surgery group), anti-IL-4Rα monoclonal antibody(monoclonal antibody group)and intranasal corticosteroids(control group)respectively. To observe the difference in subjective and objective scores after treatment at 1 month, 3 months and 6 months compared with baseline, to evaluate the therapeutic effect of the two interventions, and then the efficacy of each group was compared to analyse whether there were differences. Results Nasal polyp scores(NPS), sino-nasal outcome test-22(SNOT-22)score, SNOT-22 nasal obstruction score and olfactory score, and Lund-Mackay score at 6 months post-treatment in monoclonal antibody group and surgery group were compared with the baseline data before treatment. The differences were statistically significant(P<0.05). There was a statistically significant difference in NPS(P=0.02), and no significant difference in SNOT-22(P=0.57), nasal obstruction score(P=0.94), olfactory score(P=0.11)and Lund-Mackay score(P=0.08)between monoclonal antibody group and surgery group. There were statistically significant differences in FEV1%(P=0.04)and FEV1/FVC%(P=0.01)in monoclonal antibody group and surgery group before and after treatment in patients with comorbid asthma, but there was no significant difference between the two groups(P=0.25, P=0.74).There was no statistically significant difference in changes in eosinophil count(F=1.73, P=0.21)and eosinophil percentage(F=0.03, P=0.87)before and after treatment among the three groups. The differences between the three were not significant(P=0.18, P=0.07). Conclusion Both anti-IL-4Rα monoclonal antibodies and endoscopic sinus surgery can not only significantly improve nasal symptoms, olfactory levels, and lung function in patients with ECRSwNP, but also reduce the extent of sinusitis lesions and improve patients' quality of life. Olfactory improvement in anti-IL-4Rα monoclonal antibody patients was more significant than in ESS patients, while polyp burden and nasal symptoms were significantly improved in ESS patients.
    Correlation analysis of gene expression profile of matrix metalloproteinases and their inhibitors in laryngeal squamous cell carcinoma and clinicopathological features
    NI Rongsheng, SHEN Xiaohui, GAO Xia
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  55-61.  doi:10.6040/j.issn.1673-3770.0.2023.146
    Abstract ( 25 )   PDF (1274KB) ( 4 )   Save
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    Objective The study aimed to discover the gene expression profiles of the matrix metalloproteinases(MMPs)family and tissue inhibitors of matrix metalloproteinases(TIMPs)in laryngeal squamous cell carcinoma(LSCC), to analyze the genes most relevant to LSCC, and finally clarify their relationship with clinicopathological features. Methods Twenty-eight patients with LSCC were studied. In four patients, genes in the MMPs family and TIMPs that are up-regulated or down-regulated simultaneously were detected by a gene chip containing the entire human genome. The gene chip results were verified by reverse transcription-polymerase chain reaction(RT-PCR)and western blot in the other 24 patients. The correlation between the expression of the proteins encoded by the genes and the clinicopathological characteristics of the patients were investigated. Results The gene chip analysis revealed 14 differentially expressed genes of MMPs family between LSCC and adjacent normal cells. Of these, four genes were up-regulated, four were down-regulated, and the remaining six were up-regulated in some patients and down-regulated in others. No genes were consistently up- or down-regulated in the four patients. In contrast, all TIMPs were down-regulated between LSCC and adjacent normal cells. The TIMP4 gene was down-regulated in all four patients. RT-PCR and western blot results showed that the TIMP4 gene and protein was poorly expressed, respectively, in LSCC tissue. Western blot also showed that the expression of TIMP4 protein was correlated with lymph node metastasis. Conclusion To our knowledge, this is the first description of the expression profile of MMPs and TIMPs in LSCC. The expression of TIMP4 protein was associated with the clinicopathological features of LSCC. Future studies may further confirm TIMP4 protein as a predictor of the survival of patients with LSCC and/or a potential therapeutic target of LSCC.
    A clinical study of lymph node metastasis rate, risk factors and dissection strategy in the central and lateral cervical region of stage cN0 papillary thyroid microcarcinoma
    ZHANG Lin, XIN Yunchao, SHANG Xiaoling, XIE Qi, LIU Yachao
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  62-69.  doi:10.6040/j.issn.1673-3770.0.2023.485
    Abstract ( 30 )   PDF (1101KB) ( 4 )   Save
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    Objective To investigate the lymph node metastasis rate, risk factors and dissection strategy in the central and lateral cervical region of lymph node negative(cN0 stage)papillary thyroid microcarcinoma(PTMC). Methods 300 patients with stage cN0 PTMC who underwent surgical treatment were selected as the study objects. General data of all patients were collected and their clinicopathological data were retrospectively analyzed. The related factors that may affect cN0 stage PTMC lymph node metastasis were analyzed by method of univariate and multivariate Logistic regression analysis. Results Among 300 patients with cN0 stage PTMC undergoing surgical treatment, 174 cases(58.00%)had no lymph node metastasis and 126 cases(42.00%)had lymph node metastasis. There were 118 cases(39.33%)of central lymph node metastasis, 42 cases(14.00%)of lateral lymph node metastasis, 34 cases(11.33%)of central with lateral lymph node metastasis, 8 cases(2.67%)with lymph node metastasis in lateral cervical region but not central region, i.e. skipping lymph node metastasis. For male, age <45 years, tumor diameter ≥0.5 cm, capsular invasion was independent risk factor for central lymph node metastasis of PTMC(P<0.05). For male, age <45 years, tumor diameter ≥0.5 cm, upper pole tumor, capsular invasion and central lymph node metastasis were independent risk factors for lymph node metastasis in the lateral cervical region of PTMC(P<0.05). Conclusion For male, age <45 years old, tumor diameter ≥0.5 cm, capsular invasion are all independent risk factors for central and lateral lymph node metastasis of PTMC. The independent risk factors for lateral lymph node metastasis also include upper pole tumor and central lymph node metastasis. In clinical practice, this can be used to determine the area of lymph node metastasis and adopt targeted dissection strategies to improve the prognosis in patients.
    An exploration of PBL combined with CBL and CPTM methods in clinical teaching of otorhinolaryngology head and neck surgery
    JIN Peng, LIANG Xu, WANG Yang, ZI Xiaoxue
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  70-76.  doi:10.6040/j.issn.1673-3770.0.2024.121
    Abstract ( 19 )   PDF (1696KB) ( 7 )   Save
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    Objective To explore the application effect of problem based learning(PBL)+ case based learning(CBL)+ clinical pathway teaching method(CPTM)multimodal fusion teaching in the clinical teaching practice of otolaryngology head and neck surgery. Methods A total of sixty probationary doctors who underwent rotation in the Department of Otolaryngology, Head and Neck Surgery at the Second Hospital of Shandong University from September 2023 to December 2023 were selected as research subjects. They were randomly divided into a research group and a control group. The research group received PBL+CBL+CPTM teaching mode, and the control group received PBL+CBL teaching mode. Then the examination scores and teaching evaluation scores of the two groups of trainees were compared. Results The average evaluation scores of theoretical knowledge, case analysis and clinical operations of the trainees in the research group were significantly higher than those in the control group [(92 vs 90, P=0.007),(92 vs 89, P=0.003), and(92 vs 90, P=0.003), respectively], and the differences were statistically significant. The results of a questionnaire survey of novice doctors showed that in terms of self-learning ability, ability to understand theoretical knowledge, problem-solving ability, clinical logical thinking ability, and doctor-patient communication ability, the satisfaction of the research group of novice doctors with teaching methods was superior to that of the control group, and the differences were statistically significant(P=0.016,P=0.025,P=0.022,P=0.024, P=0.044). Conclusion Compared with traditional teaching methods, the PBL+CBL+CPTM multimodal integration teaching method has higher teaching quality, better student satisfaction, and is conducive to the formation of a systematic knowledge structure for students, improving the scientific and systematic nature of teaching. It is worth promoting and applying in the standard training of otolaryngology head and neck surgery and other specialties.
    Evaluation of three different aspheric intraocular lens tilts and decentrations in capsular bags after cataract surgery based on CASIA2
    MA Jiling, WANG Xiaoming, LI Yan, MU Yanxiao, JIN Lin, KONG Hui, YANG Naifu, DANG Guangfu
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  76-85.  doi:10.6040/j.issn.1673-3770.0.2023.138
    Abstract ( 22 )   PDF (6424KB) ( 4 )   Save
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    Objective Evaluation of tilt and decentration of 3 kinds of aspheric intraocular lens(IOL)after cataract surgery based on a new anterior segment swept-source optical coherence tomography CASIA2. Methods Retrospective case series. Clinical data of patients with cataracts who underwent phacoemulsification and IOL implantation between October 2020 and March 2021 were collected. Moreover, clinical data such as age, sex, best-corrected visual acuity(BCVA)before and on the first day after surgery, axial length(AL), and type and power of the IOL used were collected from all patients. CASIA2 was used to obtain clear images at 1, 7, and 30 days postoperatively. Horizontal and vertical tilt and decentration in two-dimensional(2D)images, and tilt, decentration, and orientation in three-dimensional(3D)images were assessed. SPSS26.0 software was used for statistical analysis. Additionally, P<0.05 was considered statistically significant. Results In total, 134 patients(157 eyes)were enrolled. The patients comprised 52 males and 82 females, with an age range of 45-86 years and an average age of 67.86±8.26 years. The eyes were divided into groups A(HOYA250), B(RS60A), and C(ZCB00). The study included 31, 34, and 15 right eyes, and 25, 29, and 23 left eyes. No significant differences were observed in ocular AL, IOL power, or frequency of BCVA improvement on day 1 after surgery among the three groups. On day 7 postoperatively, the horizontal tilt degree of group A was greater than that of group B in 2D images. On days 1 and 7 postoperatively, the horizontal decentration of group A was smaller than that of group B in 2D images; and on days 1 and 7 postoperatively, the vertical tilt degree of group A was larger than that of group C in 2D images, with a significant difference between the two groups. On days 1 and 7 postoperatively, significant differences in the orientation of the tilt between groups A and C group in 3D images were observed. The vertical decentration of group A 1 day postoperatively was significantly greater than that at 30 days postoperatively. On 1, 7, and 30 days postoperatively, the decentration of group A was significantly smaller than that of group B in the 3D images. No significant differences in the remaining intergroup and intragroup results were observed. Left eye results: on days 7 and 30 postoperatively, the decentration of group A was significantly lower than that of group B in 3D images. The tilt of group C 1 day postoperatively was significantly smaller than that at 30 days postoperatively. No significant differences in the remaining intergroup and intragroup results were identified. On days 1, 7, and 30 postoperatively, the three IOL groups demonstrated temporal and infratemporal trends; however, the tilt trend displayed no bias. Conclusion Different degrees of tilt and decentration of the three types of IOLs in the capsular bags were identified. The three types of IOLs demonstrated a tendency to tilt to the temporal and infratemporal sides, and decentration did not display a biased tendency.
    Amyloidosis of torus tubalis with middle ear effusion: a case report with literature review
    LIN Yunxian, MA Lingguo
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  86-90.  doi:10.6040/j.issn.1673-3770.0.2023.330
    Abstract ( 23 )   PDF (5881KB) ( 4 )   Save
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    Objective The purpose of this study is to investigate the clinical characteristics and treatment of localized amyloidosis of torus tubalis. Methods We retrospectively analyzed the amyloidosis of torus tubalis with middle ear effusion, summarized the characteristics, performed diagnosis of the clinical case, and reviewed relevant literature. Results The patient had repeated hydrops in the left middle ear, and conservative treatment was poor for this case. Electronic nasopharynx examination showed bilateral torus tubalis hypertrophy, and amyloidosis was recommended after biopsy. The examination was completed to exclude systemic amyloidosis. Lesions of bilateral torus tubalis were removed through operation with low-temperature plasma radio-frequency ablation. After one year of follow-up, the patient recovered well, and no recurrence or progression to systemic amyloidosis was observed. Conclusion Amyloidosis is rare in the torus tubalis. Surgical treatment is feasible when the clinical symptoms are not treated conservatively. In particular, it is crucial to exclude systemic amyloidosis, and postoperative follow-up should be closely followed.
    Sudden sensorineural hearing loss combined with hand, foot and mouth disease treated by integrated traditional Chinese and western medicine: a case study and literature review
    LIANG Junjie, ZHANG Jiajia, ZHANG Linjing, MENG Yan, LI Yang, BAI Peng
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  91-95.  doi:10.6040/j.issn.1673-3770.0.2023.405
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    Objective This study to explore the clinical characteristics and therapeutic approaches of integrating traditional Chinese and Western medicine in treating sudden sensorineural hearing loss(SSNHL)combined with hand, foot and mouth disease(HFMD). Methods A restrospective analysis was conducted on the clinical data of one patient with SSNHL complicated by HFMD, supplemented by a review of relevant literature. Results The patient initially presented with symptoms including fever, perioral erythema, maculopapular rash on hand and feet, hearing reduction and tinnitus. Following isolation and integrated traditional Chinese and Western medicine treatment, there was a resolution of HFMD-related perioral erythema, red maculopapules on hands and feet, as well as improvement in hearing loss and tinnitus.No recurrence was observed during a follow-up period of four months. Conclusion The integration of traditional Chinese and Western medicine in treating SSNHL complicated by HFMD demonstrates clear clinical efficacy. However, the underlying mechanisms of the disease require further elucidation.
    Analysis of clinical data form 112 cases of children with congenital single-sided deafness
    ZHANG Xiao, LIU Haihong, LIU Wei, LI Ying, CHEN Min, LIU Bing, BAI Jie, ZHANG Jie, ZHENG Jun, YANG Yang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  96-196.  doi:10.6040/j.issn.1673-3770.0.2024.219
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    Objective To investigate the causes/detection pathways, audiological characteristics, and imaging features of children with congenital single-sided deafness(SSD), and to summarize the clinical characteristics and intervention strategies. Methods We retrospectively analyzed the clinical data of children diagnosed with congenital SSD at the Department of Otorhinolaryngology, Beijing Children's Hospital; from June 2020 to June 2022, including general information of the children, reason for consultation/path of discovery, ABR, pure tone audiometry, CM, OAE, acoustic impedance, temporal bone CT and/or inner auditory canal MRI, summarized the clinical characteristics and followed up the children who received treatment. Results A total of 112 children were enrolled in this study, including 66 males and 46 females; 61 left ears and 51 right ears; 0-13 years old; OAE: none of the deaf ears were elicited; CM: 38 deaf ears could be elicited; the highest proportion of children visited the clinic due to failure of newborn hearing screening(41.1%); 75 cases(66.9%)had structural anomalies shown by imaging, with the proportion the highest percentage was 62 cases(82.7%)with simple cochlear nerve foramen stenosis/cochlear nerve dysplasia; 2 children with SSD underwent surgical interventions, including 1 case of cochlear implantation without cochlear nerve dysplasia and 1 case of bone bridge implantation with cochlear nerve dysplasia. Six months after surgery, both children's RMSE and BIAS improved, and the ability to localize the sound source was improved. Conclusion Children with congenital SSD have a high proportion of structural abnormalies of the inner ear, with stenosis of the cochlear nerve foramen/cochlear nerve hypoplasia being the most common. SSD in children is not easy to detect, and attention should be paid to newborn hearing screening and hearing screening, and vigilance should be exercised to prevent the occurrence of potential traffic accident risks. Given the current situation that the intervention rate of congenital SSD is extremely low, we should improve the understanding of the characteristics of the disease and provide individualised and scientific interventions.
    Clinical characteristics of mucormycotic rhinosinusitis in 25 cases
    YUAN Yue, PANG Wenhui, CHEN Min, FU Shengyao, YU Longgang, SUN Yubo, LI Lingling
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  102-107.  doi:10.6040/j.issn.1673-3770.0.2023.192
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    Objective This study aimed to explore the clinical characteristics of patients with invasive and non-invasive mucormycotic sinusitis. Methods We retrospectively analyzed 25 patients with mucormycotic sinusitis. The clinical characteristics, treatment methods, prognoses, and outcomes of the two groups of patients were analyzed. Results Non-invasive mucormycotic sinusitis mainly occurred unilaterally, with an average course of 6.83 months. The typical clinical manifestations were nasal congestion(13/21), purulent discharge(12/21), headache(11/21), and nasal odor(9/21). Most patients had no underlying diseases(15/21). CT revealed increased soft tissue density with calcification(16/21). All patients underwent endoscopic sinus surgery, during which cheese-like lumps were observed(17/21). No recurrence was observed during a follow-up of 6 months. Invasive mucormycotic sinusitis was primarily unilateral, with an average course of 25.75 days. The typical clinical manifestations included headache(4/4), eye pain(3/4), and vision loss(3/4), and all patients were diabetic(4/4). CT findings revealed changes in the sinus walls and surrounding bones(4/4). The patients underwent endoscopic sinus surgery combined with antifungal medication. Numerous fungal masses with purulent discharge(4/4), and bone destruction of the sinus and orbital walls(3/4)were observed intraoperatively. After a 2-year follow-up, there was no incidence of recurrence in two patients; however, mortality was reported in two patients. Conclusion Non-invasive mucormycotic sinusitis, uncommon in clinical practice, can be treated effectively with endoscopic sinus surgery. Adequate nasal and sinus drainage is the key tosuccessful treatment and a low postoperative recurrence rate. Invasive mucormycotic sinusitis progresses rapidly and has a high mortality rate, for which early surgery and antifungal drugs are critical.
    Rosai-Dorfman disease of the bilateral neck and nasopharynx: a case report and review of related cases
    LI Yaru, XU Zhenju, WANG Xiaojun, FU Tao, YUAN Yue, WU Ce
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  108-114.  doi:10.6040/j.issn.1673-3770.0.2023.214
    Abstract ( 18 )   PDF (8096KB) ( 2 )   Save
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    Objective In order to explore the etiology, clinical manifestations, diagnostic basis, and treatment experience of Rosai-Dorfman disease(RDD). Methods The clinical data of a patient with RDD were retrospectively analyzed, and the hospitalization data of patients diagnosed with RDD in our hospital in the last 10 years were summarized. Results By searching the case system of our hospital, three patients with non-RDD pathological results were excluded, and six patients with RDD pathological results were screened out, plus seven patients in this case. The male-to-female ratio was 4:3, and the patients were aged 16-65 years. There were two cases(2/7)involving the skin, one case(1/7)involving the brain, one case(1/7)involving the trachea, two cases(2/7)involving the cervical lymph nodes, and one case(1/7)involving the nasal sinus, parotid gland, orbit, armpit, and cervical lymph nodes. Conclusion Classical RDD often manifests as bilateral cervical lymph node enlargement, which may be accompanied by fever, night sweats, fatigue, and weight loss. Extranodal RDD and mixed RDD are rare in clinical practice. However, as they affect the function of important organs, cause serious consequences, and have a difficult diagnosis, they need to be differentiated from other diseases. At present, there is no unified standard treatment for RDD. For patients with clinical symptoms, surgical treatment can quickly relieve clinical symptoms. Although RDD is a benign lesion, extranodal RDD may have serious consequences because of its location; therefore, it should be paid attention to in the clinic.
    Practical use of THRIVE to administer general anesthesia for bronchofiberoscopy in 32 cases
    DONG Xude, WANG Qiaobei, WANG Ying, MA Xingwang, LI Chuangang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  115-120.  doi:10.6040/j.issn.1673-3770.0.2023.246
    Abstract ( 18 )   PDF (1077KB) ( 3 )   Save
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    Objective To study the use of transnasal humidified rapid insufflation ventilatory exchange(THRIVE)ventilation technology in bronchofiberoscopy under general anesthesia. Methods A total of 32 patients requiring bronchoscopy under general anesthesia at The Second Hospital of Shandong University between August 2022 and May 2023 were selected for this study. Each received atomizing inhalation of local anesthesia, after which bronchofiberoscopy was initiated under general anesthesia. Arterial blood samples were collected for blood gas analysis before the anesthesia was administered and during the recovery period following each procedure. The total anesthesia time was recorded. The patients were followed up with on the next day after the procedure. Results No intraoperative or postoperative complications were observed in any of the 32 patients. Among them, five patients(four of whom snored)were switched to low-minute volume owing to oxygen desaturation. The average anesthesia time of the remaining 27 patients was 20.75±6.70 minutes. Oxygen partial pressure(SpO2)was maintained above 95% throughout the procedure. The postoperative SpO2 values were slightly higher than the preoperative ones, although the difference was not statistically significant. No significant correlation was identified between SpO2 and total anesthesia time. Carbon dioxide partial pressure(SPCO2)and total CO2 were significantly increased following the administration of the anesthesia. However, PH was significantly reduced. Both the increase in SPCO2 and the decrease in PH were positively correlated with the duration of the anesthesia. No significant differences were observed in terms of BE values. Conclusion THRIVE carries certain advantages for bronchofiberoscopy procedures performed under general anesthesia-particularly in terms of providing sufficient oxygen to the patient. Moreover, THRIVE can also make the procedure convenient and comfortable for the patient, without causing any obvious complications. However, certain limitations to the use of THRIVE exist. Patients with stenosis in their airways, such as those who snore, often cannot achieve a satisfactory apnea time. This technique may lead to CO2 accumulation, which can limit the time available to complete the procedure. With much interest, we await the development of new techniques to adequately remove CO2 from the lungs, which may lead to a wide adoption of THRIVE.
    Three-dimensionally printed titanium prosthesis for repair of large tracheal defect: a case report and literature review
    WANG Yang, HU Yue, LI Xiaoming, QI Wenwen, ZHANG Jie, ZHANG Hao, WANG Qianqian, XU Fenglei, JIA Tao, XIA Ming
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  121-125.  doi:10.6040/j.issn.1673-3770.0.2023.238
    Abstract ( 21 )   PDF (4631KB) ( 3 )   Save
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    Objective This study aimed to explore the pathogenesis, diagnostic criteria, and treatments for tracheal defects. Methods We retrospectively analyzed the clinical data of a patient with a large tracheal defect caused by a mediastinal tumor using a three-dimensionally(3D)printed titanium prosthesis and summarizing relevant literature. Results Repairing large tracheal defects has always been a clinical challenge. Using 3D-printed titanium tracheal prostheses for tracheal defect repair can personalize and restore a patient's normal physiological structure and have stable mechanical properties. Prosthesis use can effectively prevent airway collapse, and its pre-designed customized shape fits the patient better, shortening operation time and reducing postoperative complications. Conclusion In the treatment of large tracheal defects, 3D-printed titanium tracheal prostheses have greater advantages than traditional repair methods, bringing new hope for patients with large tracheal defects.
    Easily misdiagnosed posterior scleritis:a case and literature review
    CHEN Haiyan, WANG Ping
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  126-130.  doi:10.6040/j.issn.1673-3770.0.2023.078
    Abstract ( 23 )   PDF (5800KB) ( 2 )   Save
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    Objective To investigate the etiology, pathogenesis, clinical manifestations, diagnostic approach, differential diagnosis, treatment, and prognosis of posterior scleritis, with a focus on early diagnosis and prevention of misdiagnosis and missed diagnosis. Methods The clinical data of a young patient with posterior scleritis were retrospectively analyzed, and the diagnosis, treatment process, and clinical reasoning of this case were summarized and analyzed. Results Following 2 weeks of treatment, the corrected visual acuity of the left eye was improved from 0.12 to 0.8, with the resolution of symptoms and signs. Conclusion Posterior scleritis presents with diverse clinical manifestations and is easily misdiagnosed as dacryoadenitis or central serous chorioretinopathy. Therefore, detailed inquiry and careful physical examination are crucial in improving the early diagnostic rate of posterior scleritis and avoiding misdiagnosis and mistreatment.
    Bilateral posterior ischemic optic neuropathy following thoracic vertebrae surgery: a case and literature review
    LI Shanshan, GAN Chunlan, ZHU Jun, HUA Xin, CHEN Fang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  131-134.  doi:10.6040/j.issn.1673-3770.0.2023.211
    Abstract ( 21 )   PDF (3916KB) ( 4 )   Save
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    Objective To report a case of binocular posterior ischemic optic neuropathy following thoracic vertebrae surgery, aiming to enhance the knowledge of ophthalmic and spinal surgeons. Methods The clinical data of posterior binocular ischemic optic neuropathy in a patient with thoracic tuberculosis complicated with renal failure after thoracic vertebra operation were retrospectively analyzed and the relevant literature was reviewed. Results Treatment involved medications to enhance circulation, nourish the optic nerve, and promote metabolism for the entire body and eyes. This was supplemented with hyperbaric oxygen therapy and acupuncture. After three months of treatment, the visual acuity of the right eye improved from 0.15 to 0.2, while the visual acuity in the left eye remained at FC/1 m. Conclusion Postoperative vision loss(POVL)is a severe and often permanent visual impairment associated with surgery, with a grim prognosis. Spinal and ophthalmic professionals should increase awareness of POVL and work to minimize its occurrence.
    Review
    Utilization of real-world data from mobile health applications in therapeutic interventions for allergic rhinitis
    ZHU Lang, LIU Zhiqi
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  135-139.  doi:10.6040/j.issn.1673-3770.0.2023.073
    Abstract ( 23 )   PDF (1042KB) ( 6 )   Save
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    With rapid development of internet technologies, mobile health(mHealth)technologies and real-world data provide new opportunities for precision treatment of allergic rhinitis. Real-world data from mHealth suggest that patients often take medication on demand and have low treatment compliance. Mobile health prioritizes patient treatments, continuously monitors patients' allergic rhinitis symptoms, and provides pollen forecast for seasonal allergic rhinitis. It categorizes patients to achieve personalized treatment for allergic rhinitis and improve patient compliance. Currently, pertinent technologies have been implemented for allergic rhinitis internationally. This paper summarizes the concept of mHealth care, real-world data, and its application in the treatment of allergic rhinitis, to provide guidance.
    Research progress on pyroptosis in otorhinolaryngology diseases
    ZHANG Jingyi, DONG Xiangyi, MU Yakui, SONG Xicheng
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  140-148.  doi:10.6040/j.issn.1673-3770.0.2024.181
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    As one of the programmed cell death modes, the process of cell pyroptosis cannot be separated from caspase family and gasdermin family, and accompanied by the occurrence of inflammatory response, the main process is that the caspase family is activated, and then acts on the N-terminal structure of gasdermin family, which causes the cell membrane to be ruptured through translocation insertion on the surface of the cell membrane, oligomerisation, etc. The cell membrane is then activated by the caspase family, and the caspases are activated. The cell membrane is then activated by the caspase family and the caspases are activated. After the formation of lacunae, the volume gradually expands and eventually the cell membrane ruptures and the substances inside the cell are released from the cell, triggering a strong inflammatory response in the organism. In recent years, cell death has become one of the hot spots in ENT research. In this article, we review the discovery process, molecular mechanism of cellular pyroptosis and its research progress in common otolaryngological diseases such as chronic sinusitis, allergic rhinitis, nasopharyngeal carcinoma, hearing loss, head and neck tumours, and so on.
    Advancements in non-surgical management of myopia and choroidal research
    ZHANG Liyuan, ZHONG Dingjuan, WANG Hua
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  149-153.  doi:10.6040/j.issn.1673-3770.0.2023.033
    Abstract ( 29 )   PDF (1048KB) ( 6 )   Save
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    The mechanisms of development of myopia are extremely complex. The “scleral hypoxia theory” proposed in recent years suggests that scleral hypoxia and remodeling may be a key factor in the development of myopia. Choroidal thickness and choroidal blood flow changes may play an important role in the retinal scleral pathway signaling and participate in the regulation of eyeball growth. Studies have shown choroidal thinning to be associated with the onset and development of myopia. Interventions such as orthokeratology, atropine eye drops and exposure to ambient light can increase choroidal thickness, suggesting that choroidal thickening is a protective factor for myopia progression. Therefore, this paper reviews the relationship between myopia and choroid, and the changes induced in the choroid by optical, drug and environmental interventions used for improvement of myopia, aiming to better understand the effects of such non-surgical interventions on choroid.
    Gene therapy for leber hereditary optic neuropathy
    LIU Ruowu, ZHANG Han
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  154-158.  doi:10.6040/j.issn.1673-3770.0.2023.074
    Abstract ( 18 )   PDF (1035KB) ( 4 )   Save
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    Leber hereditary optic neuropathy(LHON)is a maternal hereditary mitochondrial disease which is a common cause of bilateral teenaged blindness. LHON is a complex and multifactorial disease for which more than 50 associated mitochondrial DNA(mtDNA)mutations have been found. Further, about 90% of global Leber hereditary optic neuropathy cases have the mtDNA mutations m.11778G>A, m.3460G>A, or m.14484T>C. As an important method of future medical treatment, gene therapy is becoming a hot spot in current research, and gene therapies targeting mtDNA mutations are among the fastest developing of these therapies. Currently, basic research on gene therapies targeting mtDNA mutations has demonstrated its safety in animal studies. Currently, different teams are initiating clinical phase I/II studies of the safety and efficacy of gene therapy products in patients. Herein, we review the progress of gene therapy for LHON.
    Current status of experimental models and applications of meibomian gland dysfunction
    BI Zhaojing, LI Yuanbin
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  159-165.  doi:10.6040/j.issn.1673-3770.0.2023.077
    Abstract ( 18 )   PDF (1704KB) ( 4 )   Save
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    Meibomian gland dysfunction(MGD)is a common ocular surface disease in clinics that seriously affects the quality of patients' daily life. To date, related research on the pathogenesis and treatment of MGD has gradually become a research hotspot in dry eye. Therefore, the establishment of a stable and effective experimental model is a prerequisite for further exploration of MGD. The experimental models of MGD are divided into two categories: in vivo and in vitro models. The in vivo model is modeled mainly by drug induction, surgical induction, gene knockout, and transgenic methods. The in vitro model is used to simulate the pathophysiology of meibomian glands in vitro. This paper briefly reviews several MGD experimental models reported so far and their evaluation.
    Research progress in the diagnosis and treatment of incontinentia pigmenti-related eye diseases
    AI Zhaohui, ZHANG Jie
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  166-174.  doi:10.6040/j.issn.1673-3770.0.2023.101
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    Incontinentia pigmenti is a rare X-linked genetic disease more commonly observed in women, presenting with characteristic skin lesions. Complications of this disease include ocular and central nervous system abnormalities. Incontinentia pigmenti-associated ophthalmopathy is characterized by abnormal retinal vascular perfusion and ischemic proliferation, as well as non-retinal manifestations such as cataracts and strabismus. Early examination, timely treatment, and regular follow-ups are essential in preventing progressive and permanent vision loss. This article summarizes the pathogenesis, clinical manifestations and stages, and diagnostic criteria of these diseases, as well as methods of auxiliary examination, differential diagnosis, treatment, and long-term follow-up management.
    Computer-aided 3D reconstruction based on CT imaging for guidance in lacrimal duct surgery
    GUO Sirui, MO Ya
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(4):  175-182.  doi:10.6040/j.issn.1673-3770.0.2023.114
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    By means of clinical CT image acquisition and specific software analysis, the structure and anatomical landmarks of the duct can be accurately identified, resulting in an effective preoperative evaluation and the subsequent formulation of a virtual surgical plan, becoming important bases for preoperative diagnosis and formulation of lacrimal duct surgery. Increasing clinical research has definitively demonstrated computer-aided three-dimensional reconstruction technology's important guiding role in lacrimal surgery, presenting prospects for significant future development. This review provides a detailed analysis of the research progress on computer-aided three-dimensional reconstruction technology in lacrimal surgery, granting ophthalmologists a more profound comprehension of said technology's usage in the context of lacrimal surgery. This technology facilitates increasingly accurate and personalized preoperative evaluation for patients, ultimately raising surgical safety and improving surgical outcomes.