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    COVID-19 prevention and control scheme in an ENT endoscopy unit in China
    Huimin LIANG,Liqin WANG,Wenjin WAN,Sailei SHI,Jing YUAN,Yujie SHEN,Jiacheng ZHANG,Zefan MAO,Jingzi NI,Yiwen PAN,Zhibin CHEN,Lei CHENG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 88-92.   DOI: 10.6040/j.issn.1673-3770.0.2020.078
    Accepted: 13 March 2020

    Abstract480)   HTML3)    PDF(pc) (919KB)(237)       Save

    Due to the increasing spread of the novel coronavirus disease (COVID-19), prevention and control measures have become increasingly important. As a key location for diagnosing and treating upper airway diseases, strict precautions are required in ear nose and throat (ENT) endoscopy units. Endoscopy workers have a high risk of occupational exposure. Therefore, procedures must be strictly performed according to the prevention and control plan. The prevention and control requirements for COVID-19, as directed by the National Health Commission of China, have been universally deployed in our hospital. We have carefully analyzed the risk factors of infection during the epidemic period and subsequently formulated a prevention and control scheme for COVID-19 based on the infection control measures in the ENT endoscopy unit. These have helped to avoid cross-infection in the hospital and ensure the safety of patients and medical staff during the COVID-19 epidemic.

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    The difficulties, challenges, and strategy for diagnosing and treating pediatric sinusitis
    LI Yong
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (6): 1-7.   DOI: 10.6040/j.issn.1673-3770.1.2019.055
    Abstract375)      PDF(pc) (676KB)(323)       Save
    Sinusitis in children is a common disease in pediatric otorhinolaryngology. The incidence of sinusitis has gradually increased over the last 10 years. However, there is a lack of epidemiological research that focusses on pediatric sinusitis in China. Pediatric sinusitis is often accompanied by an acute viral upper respiratory tract infection, adenoid hypertrophy, and allergic rhinitis. As symptoms overlap it can be challenging to diagnose pediatric sinusitis. Nasal endoscopy is an important diagnostic method that can be used. A computed tomography(CT)scan of the sinus can often be inconsistent. Additionally, as the radiation dose is high, it should be carefully used in children. Treatment of pediatric sinusitis is different from sinusitis in adults. Also, there is less high-quality evidence available. An intranasal steroid and nasal spray are the first-line treatment used for children with sinusitis. The role of antibiotics has become increasingly controversial over the last few years. The difficulties and challenges in diagnosing and treating pediatric sinusitis need to be addressed so that clinical consensus can be reached and countermeasures can be used.
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    Relationship between sinusitis and adenoid hypertrophy in children
    ZHANG Liqiang
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (6): 25-28.   DOI: 10.6040/j.issn.1673-3770.1.2019.058
    Abstract349)      PDF(pc) (529KB)(83)       Save
    There is a high incidence rate of sinusitis in children. Adenoid hypertrophy is a common cause of sinusitis in children. Adenoid hypertrophy can affect the occurrence and development of sinusitis by hindering nasal cavity development and nasal drainage, as well as releasing pathogenic bacteria. Sinusitis can cause adenoid hypertrophy through inflammatory stimulation. Allergies can affect both sinusitis and adenoid hypertrophy and might be an important therapeutic target to be considered during treatment.There is a closed relationship between adenoid hypertrophy and pediatric sinusitis. An adenoidectomy can be used to treatrefractory sinusitis in children.
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    Physiology and pathology review of the middle ear muscles
    Zhao HAN, Juan DING
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 6-10.   DOI: 10.6040/j.issn.1673-3770.1.2019.038
    Abstract345)   HTML8)    PDF(pc) (1036KB)(78)       Save

    With the complex anatomy of the human ear, we need to better understand the physiological and pathological characteristics of the “noise reduction system” of the ear, the most critical part being the middle ear muscle (MEM). MEMs play an important protective role by constantly monitoring acoustic input and dynamically adjusting hearing sensitivity, to enhance external sounds and to reduce transmission of loud sound through the middle ear. If the MEMs lose the ability to regulate cramps, spasms, or dystonia in the ear, the resulting abnormal pressure can have a significant impact on internal cellular pressure, which can cause some otologic disorders including tinnitus, Meniere’s disease, and sensorineural hearing loss. This literature review aims to explain the physiological structure and function of MEMs and discuss several otological disorders associated with MEM dysfunction.

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    Understanding vertigo from a Chinese medicine perspective
    Hui XIE
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 11-17.   DOI: 10.6040/j.issn.1673-3770.1.2019.044
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    Abstract: Vertigo is a common symptom seen in a range of conditions. It can be treated with a multi-disciplinary approach. Contemporary Chinese medicine practitioners who have a deep understanding of vertigo have previously proposed the concept of “ear vertigo”. In this paper, we cover the process of recognizing this condition in traditional Chinese medicine. We examine the name, “ear vertigo”, and its connotations, as well as discuss the etiology, pathological mechanism, and internal and external combination therapy for this condition.

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    CT scans should not be routinely used for diagnosing chronic sinusitis in children
    XU Geng
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (6): 8-9.   DOI: 10.6040/j.issn.1673-3770.1.2019.059
    Abstract330)      PDF(pc) (582KB)(86)       Save
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    Effect of combined acoustic therapy with background sound on decompensated tinnitus with different frequencies
    Xing ZHOU,Xiangrong QIAN,Li’an GU,Yafeng YU
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 37-39.   DOI: 10.6040/j.issn.1673-3770.1.2019.047
    Abstract311)   HTML9)    PDF(pc) (422KB)(59)       Save
    Objective

    To explore the therapeutic effect of complex sound therapy on decompensated tinnitus with different frequencies.

    Methods

    One hundred and twenty-four patients with decompensated tinnitus for more than 6 months were admitted to the otolaryngology clinic. Following ear and audiology examinations, patients were randomly divided into an experimental group and a control group. The experimental group received combined acoustic therapy with background sound, while the control group received combined acoustic therapy alone for 30 days. According to the patient′s tinnitus frequency, the experimental group was further divided into low-, medium-, and high-frequency subgroups. All the patients were evaluated before and after treatment using the Tinnitus Handicap Inventory (THI) and the Self-Rating Anxiety Scale (SAS).

    Results

    THI and SAS scores significantly decreased after treatment in both the groups. There was no significant difference in THI scores between the groups. However, SAS scores were significantly lower in the experimental group than in the control group. Post-treatment THI scores were significantly lower in the low-frequency subgroup than in the high-frequency subgroup.

    Conclusion

    Combined acoustic therapy with or without background sound can improve decompensated tinnitus symptoms. Combined acoustic therapy with background sound can improve decompensated tinnitus-associated anxiety symptoms and is, particularly, helpful for symptomatic relief in patients with low-frequency tinnitus.

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    Simultaneous Dx-pH monitoring of the oropharynx and esophagus for laryngopharyngeal reflux disease research
    Lei WANG,Gang WANG,Wei WU,Hongdan LIU,Bingxin XU,Xin LI,Haolun HAN,Baowei LI,Ruiying DING,Lianyong LI
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 101-106.   DOI: 10.6040/j.issn.1673-3770.0.2019.114
    Abstract301)   HTML0)    PDF(pc) (507KB)(38)       Save
    Objective

    To investigate the relationship between laryngopharyngeal reflux disease(LPRD)and gastroesophageal reflux disease (GERD) by simultaneous Dx-pH monitoring of the oropharynx and esophagus.

    Methods

    This was a retrospective study of 56 patients, who had presented with suspected laryngopharyngeal reflux at the Department of Otolaryngology Head and Neck Surgery, Chinese PLA 306th Hospital, from June to December 2017. All patients were evaluated using the reflux symptom index (RSI), reflux finding score (RFS), gastroesophageal reflux disease questionnaire (GerdQ), simultaneous 24 hour Dx-pH monitoring of the oropharynx and esophagus, and gastroscopy.

    Results

    Synchronous pH monitoring revealed 17 cases had a positive Ryan score, implying LRPD, of which, 12 cases (70.6%, 12/17) were diagnosed with LPRD alone. Further, 20 cases were diagnosed with GERD, of which, 15 cases (75%, 15/20) were GERD alone. The number of patients with only LPRD was higher than the number diagnosed with both LPRD and GERD (29.4%, 5/17). There were no statistical differences in total percent acid exposure time or the total number of oropharyngeal pH events between the “LPRD only” and the “LPRD+GERD” groups. Additionally, there were no statistical differences in the esophageal reflux indices between the “GERD only” group and the “LPRD+GERD” group. Eleven cases (64.7%, 11/17) of LPRD were negative for GERD, determined by the GerdQ, Dx-pH esophageal probe tests, and gastroscopy.

    Conclusion

    LPRD and GERD can exist independently. Most LPRD cases are not accompanied by GERD and LPRD is not secondary to severe GERD.

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    Changes in the ocular biometric parameters before and after cycloplegia in juveniles with different degrees of myopia
    Danfeng ZHANG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 121-124.   DOI: 10.6040/j.issn.1673-3770.0.2018.529
    Abstract293)   HTML0)    PDF(pc) (493KB)(50)       Save
    Objective

    To analyze the changes in refraction and the ocular biometric parameters with cycloplegia in juveniles with different degrees of myopia.

    Methods

    Fifty-six juveniles with myopia, aged from 7 to 17 years, were enrolled from our optometry outpatient center. Before inducing cycloplegia, refraction, accommodation response, and ocular biometric parameters were measured in all subjects by optical biometry (Lenstar900). Refraction and the ocular biometric parameters were measured again after cycloplegia. The subjects were divided into two groups according to the degree of myopia: low myopia group and moderate-to-high myopia group. We analyzed the differences in the ocular biometric parameters between the two groups and the relationship of these parameters with the age. We also compared the differences in refraction and the ocular biometric parameters between before and after cycloplegia, and analyzed the relationship between those differences and the age and accommodation response.

    Results

    Before cycloplegia, there was a statistically significant difference in the axial length (AL) between the two groups, and AL showed a significant positive correlation with the age. There was no statistical difference in the aqueous depth (AD), lens thickness (LT), and pupil diameter (PD) between the two groups, and none of these parameters correlated with the age. The differences in the changes in refraction, LT, AL, and PD before and after cycloplegia between the two groups were not statistically significant; however, the difference in the changes in AD was statistically significant.

    Conclusion

    The differences in the changes in refraction before and after cycloplegia between the two groups were not statistically significant; however, the changes in the AD were significant. Therefore, it is not necessary to measure refraction with cycloplegia in juveniles with myopia; accommodation should be measured instead.

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    Thoughts on benign paroxysmal positional vertigo and its diagnosis and treatment
    Taisheng CHEN, Wei WANG, Kaixu XU, Peng LIN
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 1-5.   DOI: 10.6040/j.issn.1673-3770.1.2019.053
    Abstract285)   HTML49)    PDF(pc) (474KB)(150)       Save
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    Rhinosinusitis and asthma in children: united airway disease
    YANG Yifan, CHENG Lei
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (6): 10-15.   DOI: 10.6040/j.issn.1673-3770.1.2019.061
    Abstract274)      PDF(pc) (744KB)(88)       Save
    Rhinosinusitis and asthma are common heterogeneous diseases in children and have a number of complex risk factors. It has been reported that chronic rhinosinusitis may contribute to asthma and that there is a close interaction between them. The concept of ‘united airway disease’ has been well accepted, and is supported by the coexistence of upper and lower airway inflammation as well as similar potential mechanisms involved in the pathogenesis. For patients with asthma, particularly those with severe asthma, the presence of rhinosinusitis needs to be detected, as it can influence asthma severity and clinical management. Therefore, controlling rhinosinusitis may benefit asthma. Physicians should be aware of these conditions, and an improved understanding of the underlying pathophysiological mechanisms may be useful for diagnostic and therapeutic purposes. In this article, we discuss the clinical features, pathogenesis, medical intervention, and biological treatment of rhinosinusitis and asthma in children.
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    PU.1 transcription factor and helper Th9 cells with allergic rhinitis
    Xiaohan LIU,Xiaobing ZHANG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 139-143.   DOI: 10.6040/j.issn.1673-3770.0.2018.456
    Abstract242)   HTML2)    PDF(pc) (429KB)(63)       Save

    Allergic rhinitis is an IgE-mediated type I allergic disease of the nasal mucosa. Previous knowledge of AR has been extended from the imbalance of Th1/Th2 type cytokines to the Th1/Th2/Th17/Treg cell pattern. The Th9 cells discovered in recent years play an important role in the occurrence and development of allergic diseases. PU.1 is an important transcription factor in the Ets family and plays an important role in the regulation of natural immunity and acquired immunity. The activation of PU.1 directly affects the developmental differentiation and biological characteristics of Th9 cells. This article summarizes the possible roles of transcription factors PU.1 and Th9 cells in the pathogenesis of allergic rhinitis.

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    Effects of surgery in patients with venous pulsatile tinnitus
    Yongbo ZHENG, Yu ZHAO, Lin LOU, Yao SONG, Yijun DONG, Jianjun REN, Jing WANG, Yang XU, Lei LEI
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 26-31.   DOI: 10.6040/j.issn.1673-3770.1.2019.049
    Abstract229)   HTML1)    PDF(pc) (1794KB)(46)       Save
    Objective

    To summarize the clinical characteristics of patients with venous pulsatile tinnitus and provide reference data for clinical diagnosis and treatment of this disease.

    Methods

    Clinical data of 25 patients with venous pulsatile tinnitus were analyzed. During surgery, a small incision was made in the posterior auricular region under local anesthesia, and mastoid exploration plus sigmoid sinus constriction or sigmoid sinus retraction were performed. The tinnitus evaluation questionnaire (TEQ) was used to quantify improvement in tinnitus after the operation (1st, 3rd, and 6th months). The preoperative hearing test results were compared with those obtained in the 1st month postoperatively to determine whether the surgery had adverse effects on hearing.

    Results

    As reported by the patients, pulsatile tinnitus had disappeared during the follow-up period in 21 patients. Four patients had mild pulsatile tinnitus in the 6th month postoperatively; however, this conscious tinnitus did not affect the patients’daily lives. The preoperative TEQ score of the patients was 10.44±3.08. The postoperative TEQ scores in the 1st, 3rd, and 6th months were 3.68±1.75, 2.76±1.23, and 2.72±1.17, respectively, which were significantly lower than the preoperative TEQ score. The postoperative TEQ scores in the 3rd and 6th months were lower than that in the 1st month postoperatively, but there was no statistical difference between the TEQ scores in the 3rd and 6th months postoperatively. It was observed that the improvement in postoperative tinnitus stabilized gradually. There was no significant difference between the preoperative and postoperative hearing test results.

    Conclusion

    Venous pulsatile tinnitus can be diagnosed by careful medical history taking, physical examination, and imaging. Surgery under local anesthesia is convenient for the surgeon to observe real-time improvement in tinnitus, which aids in accurate evaluation of the shape of the sigmoid sinus and reducing the incidence of complications. Therefore, its clinical application is recommended.

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    Electronic nasopharyngoscopy for the diagnosis and treatment of otorhinolaryngologic diseases: A retrospective study of 27400 cases
    Chengcheng LIANG,Xin WANG,Dapeng LEI
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 107-110.   DOI: 10.6040/j.issn.1673-3770.0.2018.579
    Abstract224)   HTML3)    PDF(pc) (457KB)(52)       Save
    Objective

    To evaluate the efficiency of electronic nasopharyngoscopy in the diagnosis and treatment of otorhinolaryngologic diseases.

    Methods

    A retrospective analysis of patients who underwent electronic nasopharyngoscopy in the department of otolaryngology from December 1, 2016, to October 1, 2018.

    Results

    In total, 27400 patients underwent electronic nasopharyngoscopy for a definitive diagnosis of otorhinolaryngologic diseases. There were 16661 cases of oral or otolaryngologic lesions: 122 cases of foreign bodies in otolaryngological organs, 85 cases of wounds caused by foreign bodies, 32 cases of functional dysphonia, 122 cases of otic lesions, 598 cases of nasal lesions, 498 cases of oral and oropharyngeal lesions, 1364 cases of nasopharyngeal lesions, 13751 cases of laryngeal and hypopharyngeal lesions, 75 cases of tracheal lesions, and 14 cases of parapharyngeal lesions. Electronic nasopharyngoscopy-assisted biopsies performed on 1452 patients with suspected malignant tumors presented with a positive rate of 94.77%. Surgeries were performed on 84 patients and foreign body extractions were performed on 101 patients with the electronic nasopharyngoscopy,

    Conclusion

    Electronic nasopharyngoscopy is safe, effective, and specific in the diagnosis and treatment of otolaryngology diseases. It is helpful for the early detection and treatment of minute lesions and otolaryngological tumors.

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    Applied anatomy of endoscopic resection of the petrous apex through the transcanal infracochlear approach
    Feiyan LU,Yongtian LU,Junwei ZHOU,Yuan LIU
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 62-68.   DOI: 10.6040/j.issn.1673-3770.0.2019.177
    Abstract221)   HTML1)    PDF(pc) (3146KB)(49)       Save
    Objective

    To explore endoscopic transcanal infracochlear approach for resection of the petrous apex and observe structures of the middle ear. The study also aimed to identify anatomical landmarks for locating the infracochlear corridor as well as quantify the corridor under three-dimensional reconstruction of high-resolution CT(HRCT) of temporal bone. The purpose is to provide a constant anatomical landmark and imaging basis for surgical intervention.

    Methods

    1.Ten (20 sides) fresh frozen adult cadaver heads were used. Preoperative temporal bone CT was used to measure the vertical distance between the basal turn of the cochlea and angle between the internal carotid artery and jugular bulb, as well as the distance between the basal turn of the cochlea and jugular vein bulb. 2. Retrospective analysis of high-resolution CT(HRCT) of the temporal bone in 85 patients (170 sides) was performed to record and summarize the imaging characteristics between the infracochlear corridor and cells of the petrous apex.

    Results

    1. CT measurements of temporal bones of 20 sides in the frozen cadavers and 170 sides in patients showed that vertical distance between the basal turn of the cochlea and angle between the internal carotid artery and jugular bulb were (6.46 ±1.02) mm and (6.83 ±1.50) mm, respectively, and that between the basal turn of the cochlea and jugular bulb were (3.67±0.58) mm and (3.82±1.29) mm, respectively. Among them, the vertical distance between the pneumatized petrous apices were (6.79 ± 0.60) mm and (7.19 ± 1.44) mm, and that between the non-pneumatized apices were (6.28 ± 1.17) mm and (6.68 ± 1.50) mm, respectively. The distances from the basal turn of the cochlea to the jugular bulb with respect to the pneumatized petrous apices were (4.06 ± 0.36) mm and (4.06 ± 1.42) mm, respectively; and that of the non-pneumatized portions were (3.45 ± 0.58) mm and (3.74 ± 1.22) mm, respectively. 2. Results of CT classification of the infracochlear corridor and petrous apex of the temporal bone were as follows: Type A, pneumatized type 31.18% (53 ears); Type B, marrow type 57.65% (98 ears), and Type C, sclerosed type 11.18% (19 ears).

    Conclusion

    High-resolution CT (HRCT) may be considered an important pre-operative reference tool for endoscopic transcanal infracochlear approach for resection of the petrous apex. From an anatomical point of view, endoscopic resection of lesions in the petrous apex is feasible using the transcanal infracochlear approach as it can avoid damage to the internal auditory canal, cochlea, and labyrinth, and preserve hearing. The technique can be considered one of the important surgical methods for treatment of minor lesions in the posterior and inferior aspects of the upper petrous apex.

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    A child with acute rhinosinusitis, acute glomerulonephritis and an orbital abscess: case report
    ZHU Luping, CHEN Juan, ZHU Lei, CHEN Renjie
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (6): 41-44.   DOI: 10.6040/j.issn.1673-3770.0.2019.505
    Abstract217)      PDF(pc) (3650KB)(64)       Save
    Acute rhinosinusitis is an acute infection of the mucous membrane in the nasal cavity and sinus that results in inflammation. The nasal sinus is adjacent to the orbit anatomically, which makes it easy for a sinus infection to break through the anatomical barrier into the orbit. Due to antibiotics being widely used, this does not commonly occur. However, in children with a weakened immune system, it can result in orbital cellulitis and an orbital abscess. However, glomerulonephritis is a very rare complication. In this case report, we report a child with acute rhinosinusitis accompanied with acute glomerulonephritis and an orbital abscess. We also discuss our diagnosis and treatment process for the case.
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    Advances in phonomicrosurgery for glottic webs
    Meijun ZHENG,Hui YANG,Juanjuan HU
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 144-147.   DOI: 10.6040/j.issn.1673-3770.0.2018.388
    Abstract210)   HTML1)    PDF(pc) (450KB)(31)       Save

    The management of glottic webs is clinically challenging secondary to the high incidence of postoperative re-adhesions. Conventionally, T-tube placement, balloon dilation, and external techniques that need laryngofissure and tracheostomy were performed to treat this condition. However, conventional surgical procedures are invasive and may be associated with significant risks and high failure rates. Recently, phonomicrosurgery is being widely used to treat glottic webs owing to the success and efficacy of this procedure.

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    JOS staging and clinical features of middle ear cholesteatoma in children
    Yang YANG,Xiao XIAO,Min CHEN,Jinsheng HAO,Bing LIU,Wei LIU,Jie ZHANG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 52-55.   DOI: 10.6040/j.issn.1673-3770.0.2019.376
    Abstract208)   HTML1)    PDF(pc) (728KB)(46)       Save
    Objective

    To summarize and analyze the clinical features and postoperative performance of children with middle ear cholesteatoma, using the Japan Otological Society (JOS) 2015 edition of the cholesteatoma staging criteria.

    Methods

    From January 2016 to December 2016, 19 children with middle ear cholesteatoma who underwent primary surgery were enrolled. The JOS staging criteria were used to evaluate the clinical manifestations, surgical procedures, and efficacy.

    Results

    The total of 19 cases consisted of 18 boys and 1 girl. Age at the time of surgery ranged from 3 years and 1 month to 10 years and 8 months, with an average of 6 years and 7 months. All cases were unilaterally affected, including eight left ears and 11 right ears: acquired primary cholesteatoma in 2 cases (10.5%), JOS stage: I in both cases; acquired secondary cholesteatoma in 15 cases (79%), JOS stage: I in 1 case, II in 12 cases, III in 2 cases; 2 cases of congenital cholesteatoma (10.5%), JOS stage: I in 1 case, II in 1 case. The average preoperative air-conduction hearing threshold range was 10 dB HL-65 dB HL. Follow-up time was 15 to 24 months. Three patients underwent endoscopic tympanoplasty with external auditory canal; 2 underwent mastoidectomy + canal wall-down tympanoplasty; 14 underwent mastoidectomy + canal wall-up tympanoplasty, one of whom showed recurrence 8 months after surgery. No recurrence resulted after the second surgery to clear the lesion.

    Conclusion

    The proportion of children with JOS II was the highest in the study population, and the proportion of subsequent gallbladder complications was the highest. Use of the JOS middle ear cholesteatoma staging standard may help to summarize the condition of children with middle ear cholesteatoma, and to guide and optimize surgical treatment .

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    Clinical effects of different middle turbinate treatments on chronic rhinosinusitis with nasal polyps during endoscopic sinusitis
    Guohui CHEN,Shouhuan HE,Qing SUN,Tianle GAO,Guangping BAI
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 82-86.   DOI: 10.6040/j.issn.1673-3770.0.2018.447
    Abstract208)   HTML4)    PDF(pc) (557KB)(58)       Save
    Objective

    To explore the clinical effects of different middle turbinate treatments on on chronic rhinosinusitis with nasal polyps (CRSwNP) during endoscopic sinusitis.

    Methods

    115 patients with CRSwNP were selected and treated with endoscopic sinus surgery, the patients were divided into study group (n=60, Middle conchoplasty) and control group (n=55, excision) according to the treatment of middle turbinate during operation, after operation they had follow-up for 3 months, the improvement of clinical symptoms, the changes of nasal function and olfactory function before and after operation of the 2 groups were compared, and the assessment of the Lund-Mackay and SNOT-20 scales was carried out.

    Results

    Compared with the preoperative group, the scores of dizziness, cough, nasal obstruction and purulent discharge in the 2 groups were lower, and the scores of dizziness, cough and purulent discharge in the study group were lower than those in the control group (t=12.979、13.298、9.216;P<0.001); 3 months after operation, the airway resistance, DCAN and olfactory function scores of the 2 groups decreased, and the nasal function indexes of the study group were lower than those of the control group (t=14.999, 3.611, 3.798;P<0.001); the nasal function indexes of the 2 groups increased, and the study group was higher than the control group (t=2.216, 11.379; P<0.001); Lund-Kennedy score and SNOT-20 score of the 2 groups decreased 3 months after operation, and that of the study group was lower than that of the control group (t=17.025,11.822; P<0.001).

    Conclusion

    The application of middle turbinate in endoscopic sinusitis. for CRSwNP patients is more effective, which can promote the recovery of nasal function and olfactory function and improve the quality of life of the patients.

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    Therapeutic outcome analysis of 704 cases of sudden deafness
    Yiliang YE,Biaoqing LU
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 44-47.   DOI: 10.6040/j.issn.1673-3770.0.2019.052
    Abstract207)   HTML10)    PDF(pc) (477KB)(51)       Save
    Objective

    To analyze the therapeutic outcome based on the hearing loss level and hearing curve in sudden deafness and to provide clinical treatment strategies.

    Methods

    In total, 704 patients (805 ears) with sudden deafness hospitalized in the Otorhinolaryngology Department of Zhongshan Hospital of Traditional Chinese Medicine from January 2015 to December 2018 were selected for the study. The therapeutic outcomes based on the hearing loss level and hearing curve in sudden deafness were compared and analyzed.

    Results

    Among 172 cases of low frequency hearing loss, the recovery rates of cases involving mild and moderate deafness were 64.66% and 53.33%, respectively, with no significant differences (χ2 = 0.122; P = 0.727), and the total effective rates were 78.66% and 73.33%, respectively, with no significant differences (χ2 = 0.012; P = 0.913). Among 205 cases involving high frequency hearing loss, the recovery rates of cases involving mild, moderate, moderate-severe, and severe deafness were 5.98%, 4.34%, 0%, and 0%, respectively, with no significant differences (χ2 = 0.012; P = 0.913), and the total effective rates were 22.22%, 19.56%, 38.46%, and 40.00%, respectively, with no significant differences (χ2 = 5.067; P = 0.167). Among 226 cases of flat hearing loss, the recovery rates of those with mild, moderate, moderate-severe, and severe deafness were 34.14%, 4.76%, 10.44%, and 9.21%, respectively, with no significant differences (χ2 = 9.325, 6.956, and 7.852, respectively; P = 0.007, 0.021, and 0.013, respectively), and the total effective rates were 57.44%, 37.09%, 50.74%, and 52.63%, respectively, with no significant differences (χ2 = 4.103; P = 0.129). Among 101 cases of total deafness, the recovery rates of cases involving severe and extremely severe deafness were 12.50% and 1.07%, respectively, which was statistically significant (χ2 = 4.954; P = 0.026), and the total effective rates were 62.50% and 34.40%, respectively, with no significant differences (χ2 = 2.504; P = 0.114).

    Conclusions

    The degree of hearing loss is a factor influencing the therapeutic outcome in sudden deafness. Except for low frequency hearing loss, all other types showed a poor therapeutic outcome.

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    Advances in the surgical treatment of pediatric patients with chronic rhinosinusitis
    LIU Jia, FU Yong
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (6): 29-33.   DOI: 10.6040/j.issn.1673-3770.1.2019.060
    Abstract201)      PDF(pc) (595KB)(54)       Save
    In recent years, increasing attention has been given by otolaryngology doctors to pediatric patients with chronic rhinosinusitis(CRS). Pediatric patients with CRS are often successfully managed using standard drug therapy of no less than 12 weeks. However, some pediatric patients with CRS suffer from frequent recurrences and treatmentfailure. Surgery is an option when medical management fails.However, the decision regarding surgical therapy inchildren is difficult.Balloon sinuplasty was introduced to otolaryngology in 2005 to treat nasal sinus inflammatory diseases. Evidence now strongly supports its safety and efficacy in treating chronic rhinosinusitis(CRS). As it requires no bone or tissue removal and retains most or all of the sinus mucosa, this procedure could be suitable for children.We will review the literature relating to the surgical treatment of chronic rhinosinusitis in children.
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    Meta analysis of the nasal cavity bacterial culture in chronic rhinosinusitis
    Shujing HAN,Jie LU,Ping CHU,Lixing TANG,Huiwen ZHENG,Xiaojian YANG,Wei ZHANG,Pengpeng WANG,Jie ZHANG,Yongli GUO,Wentong GE
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 132-138.   DOI: 10.6040/j.issn.1673-3770.0.2018.603
    Abstract200)   HTML3)    PDF(pc) (1478KB)(52)       Save
    Objective

    To clarify the bacterial distribution in the nasal cavity of patients with chronic rhinosinusitis and provide a basis for the diagnosis and treatment of Chronic Rhinosinusitis (CRS).

    Methods

    PubMed, EMBASE, MEDLINE, CNKI, VIP Information and Wanfang data were searched for studies on the nasal cavity bacterial culture in CRS. Search strategy: chronic rhinosinusitis AND (microbio* OR bacteria OR virus); Chinese retrieval (rhinosinusitis) AND (microecology OR bacteria OR virus).

    Results

    Totally, 2141 cases of CRS were included in 20 studies. The pooled positive rates of Staphylococcus aureus, S. epidermidis, Streptococcus pneumoniae, Pseudomonas aeruginosa and Haemophilus influenzae were 0.24(95%CI: 0.17 ~ 0.31), 0.17(95%CI: 0.11 ~ 0.23), 0.06(95%CI: 0.02 ~ 0.11), 0.09(95%CI: 0.05 ~ 0.14), and 0.09(95%CI: 0.03 ~ 0.15), respectively.

    Conclusion

    S. aureus and S. epidermidis are the main pathogenic bacteria present in the nasal cavity of CRS patients, followed by S. pneumoniae, P. aeruginosa, and H. influenzae.

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    A retrospective study on clinic manifestation and pathological of the larynx leukoplakia in 76 cases
    Yangfan LIU,Jian JIA,Baoluo WAN
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 162-165.   DOI: 10.6040/j.issn.1673-3770.0.2019.240
    Abstract199)   HTML27)    PDF(pc) (828KB)(58)       Save
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    Lens vault changes and associated factors after implantation of implantable collamer lenses with central flow
    Bo WAN,Donghui LI,Yan LUO,Ying LI
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 36-41.   DOI: 10.6040/j.issn.1673-3770.1.2020.008
    Abstract199)   HTML8)    PDF(pc) (1740KB)(84)       Save
    Objective

    To investigate the changes to the lens vault (LV) and anterior chamber structures after implantation of implantable collamer lenses (ICL) with central flow in patients with myopia. The relationship between LV and its associated factors, both preoperatively and postoperatively, will also be analyzed.

    Methods

    One hundred and forty eyes of 72 patients who underwent ICL implantations were enrolled between January 2015 and January 2017. Visual acuity, intraocular pressure (IOP), corneal endothelial cell count (ECD), refractive outcomes, LV, and other anterior chamber structures were evaluated and compared after 1 week, 1 month, 3 months and 1 year, postoperatively. We analyzed the relationship between LV and other anterior chamber structures.

    Results

    After 1 year, 73% of eyes had gained 1 or more lines of corrected distance visual acuity, progressively fewer eyes had gained an uncorrected distance visual acuity above 20/20, more than 63% were within±0.5D of the prospective mean refractive spherical equivalent (MRSE), and more than 86% were within±0.1D of the prospective MRSE. There were no significant differences in MRSE, IOP, and ECD, postoperatively (p>0.05). No complications occurred during the postoperative time. There were no significant LV differences at 1 month and 3 months postoperatively. Meanwhile, LV had decreased significantly in the first postoperative year and was negatively correlated with age, keratometric power, 500 μm angle open distance, 500 μm trabecular iris space area, and the anterior chamber angle. LV was positively correlated with the white-to-white distance, angle-to-angle distance, anterior chamber depth, axial length, and ICL length. Axial length and ICL length were independent factors of LV.

    Conclusion

    Implantations of phakic ICL with center flow are safe, effective, and predictable in correcting myopia. LV decreased significantly at 1 year postoperatively, which correlated with multiple factors, both preoperatively and postoperatively.

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    The efficacy and disadvantages of three excimer laser surface cutting surgeries
    Ge CUI
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 67-71.   DOI: 10.6040/j.issn.1673-3770.1.2020.010
    Abstract198)   HTML3)    PDF(pc) (939KB)(37)       Save

    Contemporary excimer laser surgery includes both stoma and surface cutting surgeries. The advantages of surface cutting surgery are stable postoperative biomechanics and no flap related complications. However, the disadvantages include postoperative pain, haze under the corneal epithelium, long term use of glucocorticoids, and refractive regression. Surface cutting operations include photorefractive keratectomy (PRK), TransPRK, laser-assisted sub-epithelial keratectomy (LASEK), and Epi-laser assisted in-situ keratomileusis (Epi-LASIK). Of these, TransPRK is a truly contactless operation and involves only one set of epithelial and matrix cutting. The procedure is widely favored due to the ability to make more accurate cuts. Complications such as postoperative pain, haze, and retractive regression are the three most common complications after surface cutting surgery.

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    Standardized treatment of auricular complications with temporal bone fractures
    Jia XU,Haijin YI
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (1): 4-8.   DOI: 10.6040/j.issn.1673-3770.1.2019.048
    Abstract198)   HTML2)    PDF(pc) (1133KB)(86)       Save

    Temporal bone contains cochlea and vestibule, with numerous vessels and nerves. Auricular complications commonly occur when the temporal bone is fractured. Auricular complications must be identified when dealing with craniocerebral trauma, especially with temporal bone fractures. The principles to use for auricular complications with a temporal bone fracture depend on the position and severity of the injury. Individualized treatment can improve the patient's prognosis and quality of life.

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    The clinical application of surgical scene preconditioning for patients with phobia undergoing ocular surgery
    Rui ZHANG,Chunbei GONG,Wenchun YU,Zhen WANG,Chunlian YAO
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 125-128.   DOI: 10.6040/j.issn.1673-3770.0.2018.543
    Abstract198)   HTML5)    PDF(pc) (510KB)(42)       Save
    Objective

    To investigate the clinical application of surgical scene preconditioning for patients with phobia undergoing ocular surgery.

    Methods

    A total of 210 patients who underwent a routine ophthalmic surgery in our hospital from September 2017 to September 2017 were randomly divided into a preconditioning group (108 cases) and a control group (102 cases). The routine care methods were used in the control group, and the patients in the preconditioning group were pre-adapted using a simulation of the ophthalmic surgical scene based on the routine care method. The intraoperative interruption rate, changes in the vital signs at 7 am on the day of surgery, preoperative and postoperative vital signs, postoperative pain level, and surgical satisfaction were recorded and compared between the two groups.

    Results

    There were no significant changes in the systolic blood pressure and heart rate at 7 am on the day of surgery, preoperatively, and postoperatively in the preconditioning group. The between-group differences were not statistically significant. The control group had a higher blood pressure and faster heart rate after the surgery, and the difference between the two groups was statistically significant. The number of postoperative interruptions and postoperative pain level in the preconditioning group were significantly lower than those in the control group, and the preconditioning group was more satisfied than the control group; the difference was statistically significant.

    Conclusion

    The surgical scene preconditioning for patients with phobia undergoing ocular surgery can improve the patients’ tolerance and reduce their physiological and psychological stress response. This finding should be considered for promotion in clinical settings.

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    Diagnosis and treatment of pediatric rhinosinusitis
    LI Huabin, CAO Yujie
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (6): 16-19.   DOI: 10.6040/j.issn.1673-3770.0.2019.057
    Abstract196)      PDF(pc) (543KB)(80)       Save
    Pediatric rhinosinusitis has distinctly different clinical characteristics and outcomes compared to rhinosinusitis in adults. This is due to the immature development of the paranasal sinuses and immune system. Pediatric rhinosinusitis and other airway diseases, such as allergic rhinitis, otitis media, tonsillitis, and asthma, are closely related. Additionally, patients with pediatric rhinosinusitis are at risk of developing orbital and intracranial complications. Therefore, pediatric rhinosinusitis deserves great attention. This article discusses the pathogenesis, diagnosis, and treatment of chronic rhinosinusitis in children as well as the medication and surgical treatment options.
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    The correlation between sleep disorders and depression in the aging population in a rural area of Shandong province
    Xiaobing JIANG,Yifeng DU
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 116-120.   DOI: 10.6040/j.issn.1673-3770.0.2019.188
    Abstract192)   HTML0)    PDF(pc) (526KB)(36)       Save
    Objective

    To investigate the correlation between sleep disorders and depression among the elderly population in a rural area of Yangu county in Shandong Province.

    Methods

    From August 2014 to November 2014, a cross-sectional survey was conducted in elderly patients aged 65~85 years in Yanlou Town of Yanggu County in Shandong Province. The study population was assessed for sleep impairment using the Pittsburgh Sleep Quality Index Scale (PSQI) and the Hamilton Depression Rating Scale (HAMD) was used to evaluate depression.

    Results

    1. A total of 145 elderly patients were found to have depression, an incidence of 20.4%. 2. Women and people with low level education were more easily depressed. 3. There was a significant difference in PSQI score between the non-depressed group and the possible or positive depression group (P<0.05). 4. Sleep disorder is a risk factor for depression among the elderly population.

    Conclusion

    Sleep disorder is a risk factor for depression among the elderly population in a rural area of Shandong Province. We should take active measures to intervene against sleep disorders.

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    Clinical analysis of 15 cases of adenoid cystic carcinoma in the paranasal sinuses and nasal cavity
    Jian FENG,Han ZHOU,Shenghua SONG,Qing ZHAO,Jiacheng ZHANG,Yaqin LIU,Yujie SHEN,Weida DONG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 87-91.   DOI: 10.6040/j.issn.1673-3770.0.2018.545
    Abstract191)   HTML1)    PDF(pc) (559KB)(44)       Save
    Objective

    To explore the clinical features, diagnosis, treatment, and prognosis of adenoid cystic carcinoma of the nasal cavity and paranasal sinuses.

    Method

    We performed a retrospective analysis of the clinical data of 15 patients with adenoid cystic carcinoma of the nasal cavity and paranasal sinuses admitted to the First Affiliated Hospital of Nanjing Medical University in the period from January to October 2008. The prognostic factors of the disease were statistically analyzed.

    Result

    The initial diagnoses in the 15 patients included: nasal congestion in 5 cases (33%), nose bleeding in 5 cases (33%), eye pain and tearing in 3 cases (20%), local uplift in 3 cases (20%), facial numbness in 2 cases (13%), headache in 1 case (7%), and 1 case (7%) without symptoms. All 15 patients underwent surgical resection; 4 underwent endoscopic sinus surgery (26.7%), 9 underwent nasal resection and postoperative radiotherapy (60%), and 2 underwent nasal excision and postoperative radiochemotherapy (13.3%). Postoperative pathological examination revealed highly differentiated (tubular type, sieve type) adenoid cystic carcinoma in 10 cases (66.7%) and poorly differentiated (solid type) in 5 cases (33.3%). All 15 patients were followed up for a period of 6 months to 10 years. As of October 2018, 8 of the 15 patients survived (53%), and 7 had died (47%). Of the 4 patients at an early stage of the disease (I and II), one died, and among the 11 patients that were in the advanced stage of the disease (III, IV), there were 6 deaths. The overall 1-, 3-, 5-, and 10-year survival rates were 93%, 87%, 73%, and 53%, respectively. There was a positive correlation between the surgical mode and the life span (t=4.406, P=0.003), and a negative correlation between age, differentiation, and life span (t= -2.390, -6.126 P=0.048, <0.001, respectively). Gender, surgical procedure, clinical stage, and life span were not correlated (P=0.154, P=0.262, P=0.052, respectively).

    Conclusion

    The clinical manifestations of adenoid cystic carcinoma of the nasal cavity and paranasal sinuses are diverse and non-specific, and early diagnosis is difficult. Surgery is the main treatment for this type of carcinoma. Endoscopic surgery or endoscopic-assisted open surgery has good clinical application value. The age and degree of pathological differentiation are related to the prognosis. For patients with poorly differentiated and advanced tumors, comprehensive treatment mode should be adopted, and regular follow-up time should be shortened for increasing the lifespan.

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    Clinical analysis of 43 cases of nasal septum correction by a two-line method of decompression using a nasal endoscope
    Haiying WANG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 166-168.   DOI: 10.6040/j.issn.1673-3770.0.2019.041
    Abstract187)   HTML2)    PDF(pc) (464KB)(74)       Save
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    Analysis of the proportion of benign paroxysmal positional vertigo in patients with vertigo and dizziness
    Yueqi ZHANG, Qiaomei DENG, Wei WANG, Kaixu XU, Chao WEN, Qiang LIU, Taisheng CHEN, Peng LIN
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 18-21.   DOI: 10.6040/j.issn.1673-3770.1.2019.040
    Abstract187)   HTML7)    PDF(pc) (468KB)(93)       Save
    Objective

    The occurrence and proportion of benign paroxysmal positional vertigo (BPPV) in patients presenting with vertigo and dizziness were analyzed.

    Methods

    A retrospective analysis of medical records, including patients’ complaints, symptom characteristics, medical history and related test results, preliminary diagnosis, etc. of 4 227 patients was conducted from June 2017 to May 2018 at the otolaryngology, head and neck surgery and vertigo clinic at our hospital. Based on the collected data, the patients were divided into two groups, a dizziness group and a vertigo group. We performed a statistical analysis of the above data and calculated the proportion of BPPV patients in the total number of cases, and in cases of vertigo or dizziness.

    Results

    Among the 4 227 patients in the analysis, 3 188 (approximately 74.54%) were patients with vertigo and 1 039 (approximately 24.59%) were patients with dizziness. Among all patients, there were 450 cases (approximately 10.65%) of BPPV of which 437 (approximately 13.66% of the total cases) BPPV patients belonged to the vertigo group, and the remaining 13 patients with BPPV (approximately 1.26% of the total) belonged to the dizziness group.

    Conclusion

    The proportion of BPPV cases in the vertigo and dizziness groups were 13.66% and 1.26%, respectively; middle-aged and older women accounted for the majority of the cases.

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    Surgical repair of orbital floor fracture with content prolapse and inferior rectus incarceration through maxillary sinus approach
    Yuzhu LIU,Yingkai GAO,Guiyun JIANG,Haoxu PEI,Xiaoxue YUE
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 79-81.   DOI: 10.6040/j.issn.1673-3770.0.2019.022
    Abstract182)   HTML0)    PDF(pc) (534KB)(57)       Save
    Objective

    To explore the effects of surgical repair of orbital floor fracture with content prolapse and inferior rectus incarceration through the maxillary sinus approach.

    Methods

    From January 2002 to December 2017, 7 patients with orbital floor fracture with content prolapse and inferior rectus incarceration were treated in our hospital. The patients underwent nasal endoscopic reduction of orbital floor fracture through the maxillary sinus approach, restoration of content prolapse, and lysis of inferior rectus incarceration, supporting the bottom with a Foley′s urethral balloon catheter.

    Results

    The maxillary sinus balloon catheter was withdrawn 14 days after the surgery. Seven cases of double vision disappeared, and the eye position and movement returned to normal. Seven patients had no change in visual acuity compared to their preoperative values.

    Conclusion

    Surgical repair through the maxillary sinus approach of orbital floor fracture with sacral content prolapse and inferior rectus incarceration reduction is characterized by less trauma, no incision on the face, clear visual field, and wide space available for operation.

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    A discussion on the choice of surgical methods for correction of myopia
    Ying LI,Yang JIANG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 1-6.   DOI: 10.6040/j.issn.1673-3770.1.2020.001
    Abstract178)   HTML7)    PDF(pc) (1288KB)(59)       Save

    Adult myopia refractive surgery has developed rapidly over the past 30 years, and the number of operations has increased yearly. The main surgical methods include laser corneal refractive surgery and posterior chamber intraocular lens implantation (ICL). Laser corneal refractive surgery is suitable for low to moderate myopia and high myopia customized correction, which is safe, effective, and predictable and provides good long-term stability. Some special cases, however, including high refractive diopters, high corneal curvature, high corneal astigmatism, high corneal topography asymmetry, and thin corneal thickness, as well as too small a corneal diameter and irregular corneal shape, are not appropriate for laser corneal refractive surgery. For these cases, ICL provides many advantages, such as wide range of correction, stable effect, no need to remove corneal tissue, small effect of aberration, and good visual quality. ICL has been widely used in clinical practice, and the number of operations has increased year by year. However, ICL is not recommended for conditions such as insufficient anterior chamber depth, large corneal aberration, intraocular structural variation, and special occupation. These two surgical methods complement each other, widening the scope of refractive surgery indications and correction, and therefore, patients can receive the best choice of operation.

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    Surgical skills required for small incision lenticule extraction (SMILE), and the prevention and management of SMILE-related complications
    Caipei SU,Yabo YANG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 13-16.   DOI: 10.6040/j.issn.1673-3770.1.2020.007
    Abstract178)   HTML2)    PDF(pc) (1058KB)(70)       Save

    The rising incidence of myopia is a major global public-health problem. Small incision lenticule extraction (SMILE) is widely accepted by refractive experts and patients, owing to its advantages, such as its flap-free nature, requirement for a small incision, good safety, effectiveness, and predictability. However, SMILE surgery requires corneal micro-surgical skills, and the learning curve is relatively steep. Thus, surgical skills required for SMILE as well as the prevention and management of complications associated with SMILE will be discussed in this article.

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    Preliminary study on screening cochlear proteins interacting with myosin VI
    Qingxiu YAO,Hui WANG,Zhuangzhuang LI,Dongzhen YU,Shankai YIN
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 40-43.   DOI: 10.6040/j.issn.1673-3770.0.2019.063
    Abstract178)   HTML0)    PDF(pc) (1297KB)(40)       Save
    Objective

    To screen for cochlear proteins that interact with myosin VI.

    Method

    Cochlear proteins from SD rats were extracted for co-immunoprecipitation and mass spectrometry to screen for proteins interacting with myosin VI, which were further verified by immunofluorescence of whole mount basilar membrane and cryostat sections of cochleae.

    Result

    Combined immunoprecipitation and mass spectrometry yielded more than 20 proteins interacting with myosin VI, and immunofluorescence showed that spectrin αII is primarily located at the cuticular plate and the lateral wall while myosin VI is mainly located in the cell body and cuticular plate. Both myosin VI and spectrin αII were co-localized in the cuticular plate.

    Conclusion

    More than 20 cochlear proteins could interact with myosin VI, suggesting that myosin VI may interact with a variety of proteins to maintain stereociliary stability.

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    Quantitative analysis of behavior pattern in vertiginous patients
    Chuanshuo LI,Yongtuan LI,Hainan CAO,Menglu ZHANG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 32-36.   DOI: 10.6040/j.issn.1673-3770.0.2019.030
    Abstract176)   HTML0)    PDF(pc) (545KB)(48)       Save
    Objective

    To investigate the relationship between behavior patterns and vertigo in patients experiencing vertigo, and the relationship between different behavior patterns and symptoms.

    Methods

    This retrospective study was conducted in 56 patients with vertigo at the Department of Otolaryngology of Eastern Qingdao Municipal Hospital from December 2017 to December 2018. Sixty people with no previous vertigo were recruited as the control group. The participants were evaluated with the Dizziness Handicap Inventory(DHI) and Type A Behavior Pattern (TABP) scale. The control group was evaluated using only TABP scale. We compared the proportion of different behavior patterns between vertigo patients and the control group, and then analyzed the influence of different behavior patterns on otogenic vertigo symptoms.

    Results

    The proportion of Type A behavior and tendency to Type A behavior was 46.43% in the vertigo patients and 23.33% in the individuals without vertigo. The difference between the two groups was statistically significant ( χ 2 = 6.839, Ρ <0.05). The proportion of Type A behaviors in patients with vertigo was significantly higher than that in the control group. The degree of dizziness in patients with Type A behavior was not statistically significant compared with patients with non-Type A behavior ( χ 2 =0.020, Ρ >0.05).

    Conclusion

    The proportion of Type A behavior in vertigo patients with vertigo was significantly higher than that in the normal perple without vertigo attacks, suggesting that patients with vertigo are more likely to have Type A behavior. However, the symptoms of Type A behavior in patients with vertigo did not have a greater impact on their emotions and life compared with other behavioral pattern types.

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    Clinical analysis of cochlear implants in 16 patients with large vestibular aqueduct syndrome
    Kaili SUN,Xiaoyuan WU,Xu BIE,Xiuzhen SUN
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 48-51.   DOI: 10.6040/j.issn.1673-3770.0.2018.536
    Abstract173)   HTML0)    PDF(pc) (505KB)(38)       Save
    Objective

    To study the pathogenesis, audiometry, and the current preventive and treatment measures of large vestibular aqueduct syndrome (LVAS).

    Methods

    A retrospective analysis was performed on the clinical data of 16 cases (32 ears) from 2012 to 2017 that underwent temporal bone high-resolution computed tomography (HRCT), audiology, and cochlear implantation (CI) at Second Affiliated Hospital of Dalian Medical University for LVAS (predisposing factors, diagnosis, surgical cases, preimplantation audiological examination, and prelingual and post-language deafness).

    Results

    Among the 16 patients who underwent HRCT, 11 had prelingual deafness, 2 had a family history of genetic diseases, 13 also underwent an MRI of the inner ear and brain, 9 underwent acoustic impedance tests, 6 underwent the otoacoustic emission tests, 15 underwent auditory brainstem response and audio steady-state response tests, and 6 underwent pure tone audiometry. Of the 32 ears, 1 had moderate-to-severe acoustic deafness, 1 had severe acoustic deafness, and the remaining had severe sensorineural hearing loss. The patients were treated with CI, following which 1 had dizziness, and 1 had facial paralysis.

    Conclusion

    LVAS with progressive, fluctuating hearing loss has an autosomal recessive inheritance. Early diagnosis can be made using HRCT and audiological examination. The preventive and treatment measures of LVAS currently include genetic screening for prenatal and postnatal deafness and CI.

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    Correlation analysis between benign paroxysmal positional vertigo and associated comorbidities
    Qiaomei DENG, Yueqi ZHANG, Wei WANG, Kaixu XU, Chao WEN, Qiang LIU, Taisheng CHEN, Peng LIN
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 22-25.   DOI: 10.6040/j.issn.1673-3770.1.2019.041
    Abstract164)   HTML3)    PDF(pc) (468KB)(43)       Save
    Objective

    To investigate the etiology and risk factors of benign paroxysmal positional vertigo (BPPV).

    Methods

    We retrospectively analyzed and statistically compared the incidence, etiology, and possible risk factors in 450 cases of BPPV in the Department of Otolaryngology Head and Neck Surgery at our hospital from 2017.

    Results

    The average age of BPPV patients was 55.52±13.89 years, and the ratio of males to females was 1∶2.21. Of these cases, 159 patients (35.33%) did not have any comorbidities, while 291 patients (64.67%) presented with associated comorbidities. Among them, 78 (17.33%) patients presented with a clear cause such as idiopathic sudden hearing loss, head trauma, vestibular neuritis, or vestibular migraine. A total of 253 (56.22%) patients had associated risk factors such as hypertension, diabetes mellitus, cervical spondylosis, and coronary heart disease. Hypertension and diabetes were the most common comorbidities present in the group, accounting for 32.44% and 11.56%, respectively. However, using binary logistic analysis, only cervical spondylosis appeared to have a significant correlation with the occurrence of BPPV.

    Conclusion

    About 64.67% of patients presenting with BPPV in this study also had a comorbidity. The majority of patients with BPPV had idiopathic BPPV. After otolith reduction, pathological injury still existed. Treatment of comorbidities should be considered carefully so as to prevent the occurrence and recurrence of BPPV.

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    Clinical diagnosis and treatment of orbital complications following pediatric acute rhinosinusitis
    ZHANG Chanyuan, SUN Yulin, WANG Lin, ZHANG Li, CHEN Min, YI Longgang, LI Na, CUI Xin, JIANG Yan
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (6): 34-40.   DOI: 10.6040/j.issn.1673-3770.1.2019.062
    Abstract163)      PDF(pc) (5143KB)(71)       Save
    Objective To study the clinical features and therapeutic strategies for orbital complications of pediatric rhinosinusitis. Methods The clinical data of 31 children with orbital complications caused by sinusitis treated in the Department of Otorhinolaryngology Head and Neck Surgery from October 2010 onwards were retrospectively analyzed and summarized. Results The orbital complications of pediatric sinusitis have different stages, which correspond with clinical characteristics and imaging findings. All cases were cured and discharged from our hospital. No recurrence occurred during the follow-up period of 9 to 24 months. One case was left with an eyelid ectropion, and one with a saddle nose. No serious complications such as cavernous sinus suppurative inflammation or an intracranial infection occurred. The bacterial culture rate in the patients pus and nasal secretions was 55%, including 4 cases of Staphylococcus aureus and 4 of Streptococcus pneumoniae. Conclusions In children, orbital complications caused by sinusitis occur more often in winter and spring, and males. It is closely related to other upper respiratory tract infections. The primary symptoms are atypical resulting in delayed treatment. Adequate and sensitive antibiotics should be used to control any infection early. Cefoperazone sodium and sulbactam sodium are usually used for treating children with rhinogenic orbital complications. If conservative treatment is ineffective, the stage of the disease should be assessed along with any changes in clinical and imaging manifestations examined. Satisfactory results can be obtained according to surgical indications.
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    Expression and biological function of long chain non-coding cytoskeleton regulator RNA in nasopharyngeal carcinoma
    Lin LI,Heng ZHANG,Yufei XIAN,Xiaoli SHENG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 69-72.   DOI: 10.6040/j.issn.1673-3770.0.2018.425
    Abstract160)   HTML16)    PDF(pc) (711KB)(43)       Save
    Objective

    To investigate the expression and biological function of long non-coding cytoskeleton regulator RNA (CYTOR) in nasopharyngeal carcinoma.

    Methods

    Real-time PCR was used to examine CYTOR expression in nasopharyngeal carcinoma tissues (n = 32), nasopharyngeal carcinoma cell lines (CNE1 and HONE1), 28 patients with benign nasopharyngeal lesions, and human nasopharyngeal epithelial cells (NP69). Moreover, CYTOR expression in the CNE1 and HONE1 cell lines was knocked down using RNAi assay. MTT, Transwell, and wound healing assays were also used to detect the proliferation and migration of nasopharyngeal carcinoma cells from CNE1 and HONE1 after downregulating CYTOR expression.

    Results

    CYTOR expression in the nasopharyngeal carcinoma tissues and nasopharyngeal carcinoma cell lines was observed to be significantly higher than that in the nasopharyngeal benign lesion mucosal tissues and NP69. After transient inhibition of CYTOR expression, the migration and proliferation abilities of the nasopharyngeal carcinoma cell lines were also observed to decrease significantly (P < 0.05).

    Conclusion

    CYTOR expression is elevated in pharyngeal cancer tissues and nasopharyngeal carcinoma cell lines and is positively correlated with the migration ability of nasopharyngeal carcinoma.

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    Morphological structure analysis of the macular area after anti-VEGF treatment for short-term retinal vein occlusion
    Keyang HAN,Beibei YU,Bojun ZHAO
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 129-131.   DOI: 10.6040/j.issn.1673-3770.0.2017.515
    Abstract159)   HTML0)    PDF(pc) (412KB)(58)       Save
    Objective

    To observe the morphological changes in the macular area in patients with macular edema secondary to retinal vein occlusion after intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs, using optical coherence tomography (OCT).

    Methods

    Fifty-six patients with retinal vein occlusion complicated with macular edema were randomly selected from the clinic. An intravitreal injection with 0.05ml of an anti-VEGF drug was administered. OCT was performed before and 7 days after the intervention. The relationship between the best corrected visual acuity, neuroepithelial effusion, external membrane, ellipsoidal band, and choroidal thickness was assessed.

    Results

    The best corrected visual acuity improved significantly from 0.89±0.52 to 0.56±0.46. The neuroepithelial effusion decreased from 66% to 29%; the structural integrity of the external membrane and ellipsoidal zone significantly improved from 0.88±0.79 and 0.86±0.72 to 0.30±0.54 and 0.21±0.41, respectively. The choroid thickness did not change significantly with preoperative short-term treatment (318.18±47.42) or postoperatively (320.54±45.55).

    Conclusion

    Patients with retinal vein occlusion secondary to macular edema with short-term morphological changes in the macular area showed improvement in visual acuity after the injection of anti-VEGF drugs, with no significant effect on the choroid.

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    Value the diagnosis and treatment of ear trauma
    Haijin YI,Shiming YANG
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (1): 1-3.   DOI: 10.6040/j.issn.1673-3770.1.2019.045
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    Comparative study of the effects of different protective measures of the non-operative eye during SMILE surgery on tear film stability
    Tao ZHANG,Kaiwei CAO,Lina LIU,Ting LIU,Ji BAI
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 32-35.   DOI: 10.6040/j.issn.1673-3770.1.2020.004
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    Objective

    To observe the changes in the first non-invasive keratograph tear break-up time (NIKBUTf) and average non-invasive keratograph tear break-up time (NIKBUTav) of the non-operative eye with different protective measures during small incision lenticule extraction (SMILE) using the Keratograph 5M ocular surface analyzer and to observe the effects of different protective measures on tear film stability.

    Methods

    A prospective cohort study was conducted. From September 2019 to November 2019, patients who underwent SMILE in the Chongqing Vision Institute were included. The left eye was the observation eye. During SMILE of the right eye, the left eye was protected using deproteinized calf blood eye gel or eyeshade. The control group did not receive protective measures. The NIKBUTf and NIKBUTav of the left eye were measured using the Keratograph 5M ocular surface analyzer before and after the surgery of the right eye. SPSS 25.0 was used for statistical analysis.

    Results

    Thirty-five patients accounting for 35 left eyes were included in the study, of which 12 were allocated to the gel group, 11 to the eyeshade group, and 12 to the blank control group. Per the results of repeated-measurement analysis of variance, the variations in the NIKBUTf and NIKBUTav were significant in each group regarding time and grouping (P < 0.05). These two parameters also showed an interaction between time and grouping (P < 0.05). There was no significant difference in the left eye NIKBUTf of the gel group before and after surgery of the right eye (P<0.05). The NIKBUTav of the left eye in the gel group was longer immediately after surgery of the right eye (P < 0.05). In the eyeshade and blank control groups, both the NIKBUTf and NIKBUTav in the left eye decreased immediately after surgery of the right eye (P < 0.05). In the control group, the reductions in the NIKBUTf and NIKBUTav were the most significant (P < 0.05).

    Conclusion

    Different protective measures and time changes had an impact on the NIKBUTf and NIKBUTav. The protective measure of deproteinized calf blood eye gel in the non-operative eyes during SMILE played a protective role in the stability of the tear film. The protective effect of eyeshade on the tear film of the non-operative eye was not obvious, and the stability of the tear film was the worst during the conventional surgery with no protective measures for the non-operative eye.

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    Epidemic control practices of an otolaryngology-head and neck surgery ward in an area with non-high incidence of COVID-19
    Zhenhua JIANG,Lijun ZHANG,Ying LI,Yanqin XIAO,Chao LI,Bo SHI,Guiying ZHANG,Bin XU,Wei DENG,Gang LUO,Jifang LUO,Guoqi LIU
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (2): 93-98.   DOI: 10.6040/j.issn.1673-3770.0.2020.057
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    The COVID-19 epidemic is still severe. As a non-high incidence area outside Hubei, the epidemic prevention and control of primary otolaryngology-head and neck surgery has its own characteristics. Daily diagnosis and treatment are performed in the ward to prevent cross infection by medical staff. This article combines our department's experience and the measures taken in this area with respect to ward diagnosis and treatment practices. We hope that our experience will be helpful to our otolaryngology-head and neck surgery colleagues in non-high incidence areas outside Hubei.

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    Surgical treatment of iatrogenic facial paralysis
    Yuxin TIAN,Jingjing WANG,Hui WANG,Yaqin WU,Haibo SHI,Zhengnong CHEN
    Journal of Otolaryngology and Ophthalmology of Shandong University    2020, 34 (1): 20-24.   DOI: 10.6040/j.issn.1673-3770.1.2019.054
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    Objective

    To evaluate the surgical treatment of iatrogenic facial paralysis and discuss its cause, treatment and therapeutic effect.

    Methods

    A retrospective study of 21 iatrogenic facial paralysis cases who underwent ear surgery in the ear, nose, and throat (ENT) Department between 2015 and 2017.

    Results

    Of those that underwent middle ear surgery, 10 iatrogenic facial nerve injuries cases were observed in the following segments: the horizontal segment in 7 cases, the pyramidal segment in 2 cases, and the vertical segment in 1 case. After evaluating the degree of damage, decompression was performed in 7 cases, and facial nerve-great auricular nerve transplantation in 3 cases. The other 11 cases with facial paralysis after acoustic neuroma surgery underwent hypoglossal-facial anastomosis. Sixteen cases (about 76%) achieved HB Ⅰ-Ⅲ one year after surgery.

    Conclusions

    Although scientific and technological developments have reduced the probability of facial nerve injuries, iatrogenic facial paralysis cannot be entirely avoided. Clinical doctors need to have excellent anatomical knowledge and correct operation technique to prevent iatrogenic facial paralysis. Once iatrogenic facial paralysis occurs, early diagnosis and treatment are required to achieve ideal outcomes of patients' facial nerve function.

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    The role of antibiotics for pediatric sinusitis
    LI Yong
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (6): 20-24.   DOI: 10.6040/j.issn.1673-3770.1.2019.056
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    Pediatric sinusitis is one of the most common childhood diseases. Recurrent upper respiratory infections are associated with its high incidence and relapse rates, which increases the burden on families and society. In the past, the use of antibiotics has been advised in Chinese and foreign guidelines for the treatment of sinusitis as the first-line response. However, differences between children and adults in anatomy, pathophysiology, and associated diseases have led to controversy regarding antibiotic treatment for pediatric sinusitis. Further, in recent years, there have been debates about the use of antibiotics as the first-line therapy. This paper reviews the efficacy of antibiotics in the treatment of pediatric sinusitis.
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    Clinical analysis of endoscopic ligation of the sphenopalatine artery in elderly patients with intractable epistaxis
    Qiang LI,Zhiyuan LIU,Han ZHOU
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 92-95.   DOI: 10.6040/j.issn.1673-3770.0.2018.366
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    Objective

    To investigate the efficacy of endoscopic ligation of the sphenopalatine artery in elderly patients with intractable epistaxis.

    Methods

    The study included 41 elderly patients with intractable epistaxis. All patients were randomly assigned to two groups, namely, the treatment group (21 patients undergoing an endoscopic ligation of the sphenopalatine artery) and the control group (20 patients undergoing an endoscopic nasal packing). During the hospitalization and the 6-month follow-up, the epistaxis relapse rate, the postoperative pain, a satisfaction survey, the length of the hospital stay, and complications were evaluated.

    Results

    A significantly higher cure rate was obtained in the treatment group compared with the control group (81.0% vs. 50%, P<0.05). The average hospitalization duration of the treatment group was significantly shorter than that of the control group (6.5 days vs. 10.7 days, P<0.05). The treatment group was remarkably superior to the control group in both the degree of postoperative pain and satisfaction (both P<0.001). No severe complications were observed in any patient.

    Conclusion

    For elderly patients with intractable epistaxis, endoscopic ligation of the sphenopalatine artery should be considered as a first-line treatment due to its advantages such as fast and effective action, short hospital stay, little postoperative pain, and few complications.

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    Autophagy and its research progress in glaucoma
    Ruibao LIU,Ying ZHAO,Minglu GUO,Yu DUAN,Yanxia WU,Xuejing LU
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 158-161.   DOI: 10.6040/j.issn.1673-3770.0.2018.606
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    Autophagy is a cellular metabolic process in which cells degrade and renew abnormal proteins, glycogen, damaged organelles, and other accumulations and release small molecules favorable for secondary utilization by cells to maintain intracellular homeostasis. It is a unique life phenomenon in eukaryotic cells and plays an important role in cell growth, development, and aging. Activation of abnormal autophagy is associated with various diseases, including tumor, immune disorders, and neurodegenerative diseases, in the human body. In recent years, it has been found that autophagy is involved in the physiological and pathological process of glaucoma; however, whether autophagy promotes the survival or death of retinal ganglion cells remains controversial. Therefore, an in-depth study on the occurrence and mechanism of autophagy is of great significance for a comprehensive understanding of the role of autophagy in the pathogenesis of glaucoma.

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    Can adenotonsillectomy adequately cure children with obstructive sleep apnea syndrome
    Zhaokun WU,Xinhua ZHU
    Journal of Otolaryngology and Ophthalmology of Shandong University    2019, 33 (5): 148-152.   DOI: 10.6040/j.issn.1673-3770.0.2019.127
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    The incidence of obstructive sleep apnea syndrome (OSAS) in Chinese children is 5.8 per cent in boys and 3.8 per cent in girlsand is therefore, a common group of diseases in childhood. The occurrence and development of OSAS affects the normal growth and development of children, resulting in growth retardation, neurocognitive defects, abnormalities in intellectual development and behavior, and other problems. Therefore, early recognition, diagnosis, and initiation of appropriate treatment is crucial in OSAS. The treatment methods for OSAS in children varies, including; Conservative treatment with internal medicine, surgery, specialized otolaryngology treatment, and a multi-disciplinary combined treatment with varying therapeutic effects. However, surgery continues to be the recognized first-line treatment for pediatric OSAS with adenotonsillectomy (AT) being the mainstay treatment. However, there are differing opinions on the efficacy and postoperative complications of AT. Some scholars believe that AT results in significant improvements and that the symptoms of OSAS can be completely relieved after this procedure. Other scholars believe that the efficacy of AT is still questionable and that postoperative complications and residual disease are difficult to avoid, and therefore, AT is not enough to cure OSAS in children. After reviewing the literature exhaustively, this paper elucidates AT treatment of OSAS in children, to provide a reference for the clinical treatment of this syndrome.

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