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Application of optical tomography angiography and artificial intelligence in choroidal neovascularization secondary to pathologic myopia WU Lili, QU Yi Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 144-149.   DOI: 10.6040/j.issn.1673-3770.0.2022.042 Abstract （818）      PDF（pc） （1043KB）（404）       Save In recent years, the incidence of pathological myopia (PM) has increased. PM is a global eyeblinding problem and a heavy social burden. Choroidal neovascularization (CNV) is a severe complication of PM that can cause macular disorders. This may lead to central scotoma, metamorphopsia, visual field loss, and eventually blindness if left treated. Optical coherence tomography angiography (OCTA) provides an automatic and accurate visualization of the layers of the retina and choroid, which allows a qualitative and quantitative description of the microvascular areas of the retina and choroid. OCTA can be used to detect the pathogenesis of high myopia, at the microvascular level of the retina. OCTA helps diagnose CNV secondary to PM due to its ability to show the position and size of the CNV. As management, photodynamic and antivascular endothelial growth factor therapies have been used. OCTA can be used to evaluate the therapeutic effect of PMCNV. This article provides an overview of the current research options on the diagnosis and treatment of CNV and discusses the problems and prospects when they are combined with artificial intelligence for choroidal imaging, to provide reference for clinical work. Reference | Related Articles | Metrics

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Endoscopic transnasal fenestration for maxillary bone cysts: a report of nine cases and a review of the literature LIU Jiaxin, JIANG Ye, SONG Daoliang Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 84-88.   DOI: 10.6040/j.issn.1673-3770.0.2022.382 Abstract （726）      PDF（pc） （2891KB）（314）       Save Objective To investigate the feasibility of endoscopic transnasal fenestration in the treatment of maxillary bone cysts. Methods Nine patients with maxillary bone cysts, including eight adults and one child, were retrospectively analyzed. The corresponding surgical approach of endoscopic transnasal fenestration for maxillary bone cysts was selected based on the location of the cyst and the relationship between the cyst and the maxillary sinus and nasal cavity. The related literature on jaw cysts from China and abroad was retrieved through the China National Knowledge Infrastructure, Wanfang medical network, and foreign medical information resource retrieval platforms. Results Among the nine cases, only one 1-year-old patient had recurrence after surgery, while the other patients were successfully operated. The cyst cavity had unobstructed drainage and was epithelialized during a follow-up period of 6-24 months. The related literature showed that the transnasal endoscopic fenestration of maxillary bone cysts has the following advantages: it is highly minimally invasive, causing less nerve damage, and can effectively improve the quality of life of patients. It has become the first choice of treatment in rhinology. Conclusion Endoscopic transnasal fenestration for maxillary bone cysts has clinical application value; however, its indications and contraindications need to be further studied. Reference | Related Articles | Metrics

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Effect of 577 nm subthreshold micropulse laser photocoagulation combined with anti-VEGF on the treatment of refractory diabetic macular edema ZHOU Jinglin, LI Jinxiang, ZENG Qi Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 18-25.   DOI: 10.6040/j.issn.1673-3770.0.2023.313 Abstract （708）      PDF（pc） （2900KB）（877）       Save Objective We compared the clinical efficacy of subthreshold micropulse laser photocoagulation(SMLP)with a threshold of 577 nm, combined with intravitreal injection of compacept(intravitreal conbercept, IVC), with that of IVC alone in the treatment of refractory diabetic macular edema(DME). Methods We designed and performed a non-randomized controlled study. Patients with refractory DME who were admitted to the Department of Ophthalmology, Hunan Provincial People's Hospital from January 2022 to December 2022 were selected and divided into an experimental group(10 cases, 16 eyes)and a control group(12 cases, 17 eyes). The experimental group received 577 nm SMLP combined with IVC treatment, and the control group received IVC alone. The changes in best corrected visual acuity(BCVA), central macular retinal thickness(CMT), hard exudates(HE)area, microangioma(MA), and the number of intravitreal injections were collected after 6 months of treatment in the two groups. The incidence of complications was recorded after treatment. Results After 6 months of treatment, the respective Log MAR BCVA values in the experimental and control groups were 0.300(0.100, 0.400)and 0.400(0.300, 0.600), respectively. The difference between these two groups was statistically significant(t=-2.575, P=0.015). The respective CMT values were 237.00(230.75, 254.75)μm and 263.00(237.00, 341.50)μm, and the difference was statistically significant(t=-2.252, P=0.035). No significant difference was observed between HE ［411.50(72.25, 8 757.50)pixels2］ vs. ［3 000.00(10.00, 6 604.00)pixels2］ and MA ［1.00(0.00, 7.25)vs.(4.55±4.78)］(t=0.766, P=0.452; t=-0.861, P=0.400). The numbers of injections in the experimental and control groups were(4.6±0.2)and(5.3±0.2), respectively. This difference was statistically significant(t=-2.182, P=0.039). After 6 months of treatment, no obvious pigment deposition or sign of laser scar was observed in the fundus examination of the affected eyes in the experimental group. No obvious complications were observed in the experimental group or the control group after 6 months of treatment. Conclusion SMLP at 577 nm demonstrated good safety. Compared with simple IVC treatment, 577 nm SMLP combined with IVC treatment improves HE area, number of bleeding points, and MA with the same efficacy in patients with refractory DME. However, combined treatment can better reduce macular edema in some patients in the short term, improve BCVA, prolong the interval of intravitreal injection, and reduce the frequency of intravitreal injection, offering promising prospects for clinical application. Reference | Related Articles | Metrics

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Association of glycosylated hemoglobin variation index with diabetic retinopathy severity HE Jing, LEI Chunyan, ZHANG Meixia Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 34-40.   DOI: 10.6040/j.issn.1673-3770.0.2023.376 Abstract （698）      PDF（pc） （1067KB）（428）       Save Objective This study investigated the correlation between hemoglobin variation index(HGI)and the severity of retinopathy and macular edema in patients with type 2 diabetes mellitus(T2DM). Methods A total of 294 T2DM patients were enrolled. Based on the 2022 International Academy of Ophthalmology diagnostic criteria for diabetic retinopathy(DR), patients were classified into: proliferative DR(PDR), non-PDR(NPDR), and no microangiopathy(NC). DR severity was further categorized as mild NPDR, moderate NPDR, severe NPDR, and PDR. According to the international grading standards for diabetic macular edema(DME), patients were categorized as: central involved DME(CI-DME), non-central involved DME(NCI-DME), and no central involved DME(NDME). DME severity: NCI-DME <CI-DME. General clinical data were collected, and HGI differences between groups were analyzed. Results Patients with NPDR and PDR group had significantly higher HGI than those with NC. PDR patients had higher HGI than NPDR patients. Similarly, NCI-DME and CI-DME patients had significantly higher HGI than NDME patients, with CI-DME having the highest HGI. Univariate Logistic regression analysis revealed significant correlations between the presence of DR and T2DM, course of diabetes(P<0.01), body mass index(P=0.01), diastolic blood pressure(P=0.04), HGI(P=0.01), fasting plasma glucose(P=0.04), and HbA1c(P=0.01). Additionally, a significant correlation(P<0.001)was found between HGI and DR severity. Conclusion HGI is closely associated with the severity of both DR And DME in T2DM patients. Reference | Related Articles | Metrics

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Elucidation of the Mongolian medicine Huricha-6 mechanism in treating allergic rhinitis via network pharmacology and animal experiments SU Riguge, LI Hua, WU Richaifu, HAN Eerdemutu, MENG Yongmei Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 41-51.   DOI: 10.6040/j.issn.1673-3770.0.2023.217 Abstract （695）      PDF（pc） （15879KB）（144）       Save Objective To explore the possible mechanism of Mongolian medicine Huricha-6 in treating allergic rhinitis,based on network pharmacology and animal experiments. Methods Compounds and targets of Huricha-6 were obtained from the TCMSP database and literature. Allergic rhinitis(AR)-related targets were identified via searches of the OMIM, TTD, Disgenet, and GeneCards databases. Then, the Huricha-6 target and AR target intersection was identified by constructing a "compound-intersection target" network and selecting key compounds. The STRING database was used to draw the protein interaction network to screen core targets, and R language was used to conduct gene ontology(GO)and kyto encyclopedia of genes and genomes(KEGG)pathway analysis on intersection targets. AutoDockVina software was used to verify key compounds and targets by molecular docking. An AR guinea pig model was constructed for Huricha-6 testing. Guinea pigs were treated with Huricha-6 for 6 weeks, then their nasal symptoms were evaluated by behavioral assessment. Nasal mucosa tissue was taken for HE staining to observe lesions, and IL-4 and IFN-γ levels were detected by ELISA. Results Network pharmacology analysis identified 107 possible targets for Huricha-6 relevant to AR treatment, and 30 compounds related to Huricha-6 in the treatment of AR. Quercetin, luteolin, kaolin, isorhamnetin and quinine were the key compounds, and the key target include VEGFA, STAT3, IL-1B, IL-6 and ALB. KEGG pathway enrichment revealed involvement of TNF, IL-17, Toll and HIF-1 pathways. Molecular docking supports the premise that key compounds will exhibit strong binding to core targets. Animal experiments demonstrate that Huricha-6 can effectively reduce nasal symptoms, improve pathological changes in the nasal mucosa, significantly reduce serum IL-4 levels, and increase IFN-γ levels. Conclusion Huricha -6 can ameliorate AR symptoms via interactions with multiple targets that act in multiple pathways, may alleviate inflammatory cell infiltration of nasal mucosal tissue, and alleviate AR symptoms by modulating the inflammatory response. Reference | Related Articles | Metrics

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Expression and clinical significance of IL-29 and TLR4 in eosinophil infiltrated nasal polyps YAN Huijuan, XIAO Xuping, ZHONG Yu Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 122-127.   DOI: 10.6040/j.issn.1673-3770.0.2022.516 Abstract （695）      PDF（pc） （1041KB）（321）       Save Nasal polyp is a chronic inflammatory disease of the nasal cavity and the nasal sinus mucosal epithelium. It is a common condition in otorhinolaryngology. Nasal polyp result from inflammation and fibrin deposition and are related to epithelial barrier dysfunction. Although endoscopic sinus surgery is relatively mature, some nasal polyps are difficult to treat and the condition has a high recurrence rate. Previous studies reported a 50% recurrence in patients with. Interleukin-29(IL-29), a newly discovered member of type Ⅲ interferon, mediates signal transduction by binding to its receptor complex, activates downstream signalling pathways, and induces the generation of inflammatory components. Toll-like receptor 4(TLR4), a member of the Toll-like receptor family, is involved in innate immunity and mediates inflammatory responses by recognizing lipopolysaccharide or bacterial endotoxins. Studies have shown that the expression of TLR4 in patients with nasal polyps is significantly increased. Although IL-29 and TLR4 are important in regulating inflammatory responses, their relationship and their correlation with eosinophil infiltration in patients with nasal polyps are unclear. An exploration of the clinical indicators related to eosinophil infiltration in nasal polyps may provide new ideas for the diagnosis and treatment of nasal polyps. Reference | Related Articles | Metrics

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Application and progress of three-dimensional-printing technology in rhinology CHENG Xiqiao, QU Shenhong Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 128-136.   DOI: 10.6040/j.issn.1673-3770.0.2023.270 Abstract （689）      PDF（pc） （1123KB）（771）       Save Three-dimensional(3D)-printing technology is based on a digital model and 3D-printed structures from powdered metal or other materials printed layer by layer. The application of 3D-printing-technology in the medical field, combined with advanced imaging technology and artificial intelligence, facilitates clinical teaching, preoperative planning, and doctor-patient communication, and enhances tissue and organ repair and reconstruction. The nasal anatomy is fine, the adjacent structure is complex, the individual differences are evident, and the operation is difficult. With the improvement of quality of life, the demand for defect repair caused by rhinoplasty and other diseases have increased gradually, and conventional surgery cannot fully satisfy various needs. The combination of 3D-printing and various technologies is consistent with this trend and has become a hot topic in rhinology and other disciplines in recent years. Therefore, this review summarizes the 3D-printing technology methods in this research direction, and presents recent progress in rhinology in nasal reconstruction and plastic surgery, 3D-printing nasal bones, postoperative tissue reconstruction, improvement of nasal ventilation function, assisted surgery, teaching and anatomical training, and drug delivery. Furthermore, future research directions and prospects for practical applications are highlighted. Reference | Related Articles | Metrics

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Clinical and anatomical features of upside-down reversal of vision YE Qiang, LUO Song Bazong, WANG Hao, LIU Xiaoyan, MA Jinghai, NAN Suting, WANG Jing, YANG Yi, LYU Peng, WANG Degui, ZHANG Wenfang Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 137-143.   DOI: 10.6040/j.issn.1673-3770.0.2023.111 Abstract （678）      PDF（pc） （3413KB）（595）       Save Upside-down reversal of vision(UDRV)is a rare clinica symptom of visual distortion or visual illusion that can distort the size, shape, or tilt of an object. Its characteristic is that the patient's visual image undergoes an instantaneous 180° inversion in the coronal position. So far, UDRV has not been reported in China, but in foreign literature, it seriously affects patients' vision and life, bringing unprecedented psychological impact to patients. Here, we discuss the potential etiology and clinical features of UDRV to further improve the understanding of this condition by clinicians, scientifically diagnose and treat the condition, and reduce the psychological distress of patients. Although existing studies on UDRV help us understand the mechanisms of vision formation and possible regulatory mechanisms of vision, the specific etiology and mechanisms are not yet clear. Therefore we propose a hypothesis of visual regulation: "visual-independent regulation center" to explain it. Reference | Related Articles | Metrics

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Related retinal manifestations in Parkinson's disease WANG Xinyu, GAO Lifen, LU Hui, SONG Wenqi, YANG Yu Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 156-162.   DOI: 10.6040/j.issn.1673-3770.0.2023.409 Abstract （670）      PDF（pc） （1066KB）（983）       Save Parkinson's disease is a neurodegenerative disorder characterized by bradykinesia, resting tremor, and other symptoms caused by abnormal α-synuclein deposition in the nervous system and dopaminergic nerve damage. As visual impairments can be detected during the early stages, functional and structural changes in the retina can play an important role in diagnosis and treatment strategies for Parkinson's disease. This review examines the retinal changes associated with Parkinson's disease, such as a decreased number of retinal dopaminergic neurons, thinning of the retinal nerve fiber layer and macula(measured by using optical coherence tomography), and a decrease in amplitude and shortening of the latency period in electroretinograms, to explain the effects of Parkinson's disease on the retina. This paper concludes that retinal abnormalities in patients with Parkinson's can be used as a potential marker for early assessment of Parkinson's disease onset and can help to stage the disease, which is important for diagnosis and therapeutic strategies. Reference | Related Articles | Metrics

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Role of Toll-like receptor 4/nuclear transcription factor-κB channels in diabetic retinopathy LUN Yingjun, CHEN Chen, GAO Hongcheng, FAN Qinglin, TAI Renqing Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 163-168.   DOI: 10.6040/j.issn.1673-3770.0.2023.333 Abstract （669）      PDF（pc） （1054KB）（2448）       Save Diabetic retinopathy(DR)is a microvascular complication caused by diabetes mellitus and is the primary cause of blindness in patients. Its pathogenesis is influenced by various factors,such as immune inflammation, oxidative stress, and polyol pathways. Currently, immune-inflammatory responses are considered to play important roles in the development of DR. The Toll-like receptor 4(TLR4)/nuclear transcription factor-κB(NF-κB)pathway mediates the release of inflammatory factors and plays a key role in inflammatory mechanisms. Several studies have demonstrated that inhibition of the TLR4/NF-κB signaling pathway can effectively treat DR.This review addresses the role of TLR4/NF-κB channels in DR, which may provide novel treatment targets for this disease. Reference | Related Articles | Metrics

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A case report of a new pathogenic gene mutation in neurofibromatosis type I and literature review ZHANG Jin, QI Zhiling, WANG Shaohua, ZHAO Yufeng, MA Xu, WU Yungang Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 73-78.   DOI: 10.6040/j.issn.1673-3770.0.2023.030 Abstract （654）      PDF（pc） （4556KB）（395）       Save Objective To summarize the clinical data of a patient with neurofibromatosis type Ⅰ(NFⅠ)and a new pathogenic gene mutation, so as to improve the understanding of the diagnosis and treatment of NFⅠ. Methods One case of a 15-year-old patient with NFⅠ was analyzed retrospectively and the relevant literature was summarized. Results NFⅠ patient had bilateral ear swelling, scattered skin plaques of variable size throughout the body, soft tissue swelling in the bilateral maxillofacial, cervical, and subchin areas, and scoliosis, his father had a similar history. Genetic testing revealed one new mutant locus. The patient recovered well after ear mass resection. Conclusion For NFⅠ patients, it is necessary to trace their family history, conduct detailed consultation and general physical examination and check whether patients are complicated with malignant tumors. At the same time, the mental health of patients should not be ignored. Although there is no cure for NFⅠ, surgery may be recommended for cases with significant symptoms that affect the patient's life as well as for malignant changes. For NFⅠ patients, we should follow up regularly, care about their mental health, and conduct genetic counseling and education. Reference | Related Articles | Metrics

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Expression and significance of CXCL10 and IFN-γ in antrochoanal polyp ZHANG Yongcai, ZHANG Jiang, LU Hui, XING Kexin, WU Jingfang, XUE Gang, LI Yanping, LIU Yanbin Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 7-12.   DOI: 10.6040/j.issn.1673-3770.0.2023.233 Abstract （646）      PDF（pc） （5629KB）（202）       Save Objective To investigate the expression and significance of inflammatory cells,CXC chemokine ligand 10(CXCL10), and interferon-γ(IFN-γ)in the antrochoanal polyp(ACP). Methods A total of 58 samples were collected from the First Affiliated Hospital of Hebei North University between October 2015 and July 2020, including 40 cases of ACP and 18 case of maxillary sinus cysts. Preoperative serum and surgical samples were collected. Paraffin embedding and HE staining were performed on surgical specimens, and the number and percentage of various inflammatory cells were counted. The epithelial hyperplasia of patients with ACP was comprehensively scored. The expression of CXCL10 and IFN-γ in ACP and control groups was observed by immunohistochemical staining. The enzyme-linked immunosorbent assay detected the protein concentration of serum CXCL10 in two groups, and the correlation between protein concentration and inflammatory cells in peripheral blood of the two groups was analyzed. Results HE staining revealed obvious epithelial remodeling and heterogeneity with inflammatory cell infiltration, primarily neutrophils, lymphocytes, and plasma cells in group ACP. A positive correlation was found between ACP neutrophils and lymphocytes with the analysis by routine blood examination. Immunohistochemistry showed that CXCL10 and IFN-γ in the experimental group were strongly positive compared with those in the control group. The concentration of CXCL10 was(32.15±4.60)pg/mL vs(12.11± 3.54)pg/mL in ACP and control groups as determined by ELISA(P<0.05). Conclusion The expression of CXCL10 and IFN-γ were significantly upregulated in the ACP group, which may be related to non-type Ⅱ inflammation, especially Th1 inflammatory factors. Reference | Related Articles | Metrics

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Progress in metabolomics research in sensorineural hearing loss YANG Min, ZHU Xiaoyan, WANG Xu Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 113-121.   DOI: 10.6040/j.issn.1673-3770.0.2023.263 Abstract （641）      PDF（pc） （1101KB）（3884）       Save Sensorineural hearing loss is a common clinical disease in otology, which is hearing loss or hearing loss caused by cochlea, auditory nerve or auditory center organic lesions, and its incidence is related to genetics, age, noise exposure, ototoxic drugs and other factors, and the current incidence is increasing year by year and showing a younger trend. Metabolomics is a life science research that uses high-throughput omics technology to identify and quantify all metabolites, and has been applied to the pathophysiological mechanism of the inner ear in recent years, metabolomics provides new ideas for etiological exploration from the perspective of metabolic changes, and its research problems include analyzing the association between metabolites and sensorineural hearing loss, discovering new metabolic markers, and finding new strategies for preventing and treating sensorineural hearing loss. The application of metabolomics in sensorineural hearing loss contributes to the early diagnosis, individualized treatment and prediction of sensorineural hearing loss. In this paper, the research progress of metabolomics of sensorineural hearing loss is reviewed at home and abroad, and the experimental methods and results of clinical trials and animal experiments are integrated and analyzed, in order to provide a basis for the research and clinical application of metabolomics of sensorineural hearing loss, and put forward a prospect. Reference | Related Articles | Metrics

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Fungal endophthalmitis in a patient with no history of vegetative trauma: a case report and literature review LI Shuting, ZHAO Hui, SI Mingwei, CUI Wenxuan, YANG Mengyao, WANG Hong Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 103-108.   DOI: 10.6040/j.issn.1673-3770.0.2023.024 Abstract （625）      PDF（pc） （6743KB）（402）       Save Objective This report describes the pathogenesis in a patient with no history of vegetative trauma who was diagnosed with fungal endophthalmitis combined with diabetes mellitus. Methods A 53-year-old male patient with sharply decreased visual acuity in the left eye did not significantly improve after receiving glucocorticoid treatment for shock in an outside hospital. Fifteen d later, intraocular fluids analysis was performed in the Ophthalmology Department of Qilu Hospital of Shandong University to identify the causative organism. Moreover, ultrasonic emulsification for cataract, vitrectomy, intraocular laser, silicone oil filling, and intravitreal injection(voriconazole, 0.02 mg)were performed in the left eye. Results Postoperative vitreous fluid was submitted for staining: fungus(-). Corrected visual acuity: 0.1 in the right eye and HM/5 cm in the left eye and stable condition of the posterior anterior segment of the eye were found. Conclusion Fusarium is a rare but recognized cause of endogenous endophthalmitis in immunocompromised patients via various routes of infection. Diabetes mellitus and steroid hormone application could reduce the stability of the patient's immune system. Timely diagnosis and antifungal treatment were very important for improving the patient's prognosis. Reference | Related Articles | Metrics

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Epidemiological characteristics and prognostic factors associated with 4 526 cases of open globe injuries: a retrospective study FU Qingyu, LIU Tiantian, WANG Pingping, LIU Longqian Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 26-33.   DOI: 10.6040/j.issn.1673-3770.0.2023.085 Abstract （603）      PDF（pc） （1081KB）（372）       Save Objective To study the epidemiological features and prognostic factors of open globe injuries(OGI). Methods A retrospective study was conducted, focusing on OGI treated at West China Hospital, Sichuan University, between January 2009 and December 2020. Univariate analysis was used to determine the impact of various factors, including general patient information, causes of injury, complications, and the interval between injury and presentation to the hospital, on the visual outcomes at discharge. Factors that showed statistically significant differences were further analyzed using a multivariate binary Logistic regression model. Results Multivariate binary Logistic regression analysis revealed that, ethnic minorities, age groups of(45, 60)years, age groups of(60, 75)years, blunt object resulting in injury, falls resulting in injury, rehospitalization, prolonged hospital stay, complications included intraocular hemorrhage, dislocated lens, and orbital fractures are risk factors for discharge visual acuity <0.05(OR=1.355, 1.380, 2.387, 1.716, 1.601, 2.013, 1.889, 1.983, 1.857, 3.311; 95%CI=1.050-1.748, 1.140-1.670, 1.632-3.490, 1.290-2.282, 1.066-2.403, 1.668-2.429, 1.581-2.258, 1.627-2.417, 1.351-2.553, 2.109-5.198; all P<0.05). Conclusion OGI predominantly affect young and middle-aged males, with many injuries related to the workplace. Visual prognosis of OGI is generally poor, emphasizing the need for targeted preventive interventions. Reference | Related Articles | Metrics

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Treatment of complex steel-sharps-based ear puncture wound: a case report and literature review SUO Anqi, SUN Juxing, NIU Hongyan, ZHOU Yanqiu, NIU Penghao, MAO Wenwei, LI Xiaoyu, YANG Xinxin Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 79-83.   DOI: 10.6040/j.issn.1673-3770.0.2023.199 Abstract （595）      PDF（pc） （4928KB）（424）       Save Objective To investigate the emergency management of complex sharps-based ear injuries and the management of complications. Methods This report describes the treatment and prognosis of a patient with an ear sharpshooter injury. Results After treatment, the patient's hearing partially improved and the facial palsy improved significantly. Conclusion There are many important blood vessels and nerves in the vicinity of the ear. Therefore, serious sharps injuries to the ear can lead to not only serious complications but also life-threatening injuries. Injuries to the external auditory canal by sharp instruments are inevitable, and multiple injuries greatly increase the difficulty of the surgical intervention, related postoperative care, and management of postoperative complications. This case report describes a personalized treatment plan that was used to improve the patient's prognosis and quality of life. Reference | Related Articles | Metrics

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Analysis of clinical characteristics of vaccine-associated uveitis: a retrospective study based on American vaccine adverse event reporting system HOU Ning, YANG Junxing, ZHANG Yupeng, LIN Zichun, DENG Aijun Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 13-17.   DOI: 10.6040/j.issn.1673-3770.0.2023.044 Abstract （589）      PDF（pc） （1028KB）（379）       Save Objective To investigate the clinical characteristics of vaccine-associated uveitis in order to provide a reference for vaccine safety monitoring, vaccination, and clinical diagnosis and treatment. Methods The vaccine-associated uveitis reports from 1990 to 2022 were collected from the American Vaccine Adverse Event Reporting System. Moreover, sex, age, type of vaccination, dose series, time of occurrence, and type of uveitis of vaccine-associated uveitis reports were retrospectively analyzed. Results Of the 317 cases of vaccine-associated uveitis, more than 10 types of vaccine were involved, mainly the COVID-19 vaccine, human papillomavirus vaccine, and hepatitis B vaccine. There were 86 males and 231 females, with a male-to-female ratio of 1:2.7. Patients aged 18-<60 years, accounted for the majority of the total cases(65.3%). Uveitis is common under 8 days after vaccination and after the first dose of vaccination, accounting for 56.8% and 47.0%, respectively. Iridocyclitis represented the highest proportion of 184(56.5%)cases of uveitis. Conclusion Fully understand and study this adverse reaction to vaccination in depth, continue to monitor vaccine safety, better vaccination, and clinical diagnosis and treatment. Reference | Related Articles | Metrics

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A global study on quality of life related to dry eye in the last ten years: bibliometrics and visualization analysis through VOSviewer and CiteSpace WANG Jiahui, LIU Xueqin Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 61-72.   DOI: 10.6040/j.issn.1673-3770.0.2023.035 Abstract （581）      PDF（pc） （11083KB）（268）       Save Objective To explore the current status, hot spots and developmental trends of research on the quality of life related to dry eye in the past ten years, and to provide a basis for subsequent research. Methods Existing literature on the quality of life related to dry eye in the Web of Science(core collection)database from 2012 to 2022 was retrieved. VOSviewer software was used for the visual analysis of authors, journals, countries, institutions, keyword co-occurrence and clustering and co-citation. The CiteSpace software was used to analyze the number of publications, publication time, and burst keywords. Results In the last ten years, the number of papers published in this field has increased,the current research focuses on the management and treatment of dry eye-related quality of life, the influence of dry eye on quality of life, pathogenesis, pathophysiology, and definition and classification of dry eye. The current research frontiers are: investigation of quality of life related to dry eye disease, management and treatment of quality of life related to dry eye disease, exploration of dry eye treatment with modern characteristics, relationship between common psychological problems and quality of life in patients with dry eye disease, prevention and management of dry eye complications. Conclusion In this study, bibliometric analysis of dry eye-related quality of life articles in the Web of Science database over the past ten years was conducted using VOSviewer and CiteSpace software to visualize the research status, hotspots and frontiers in this research field and provide a reference and basis for future research on dry eye. Reference | Related Articles | Metrics

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Cytokine expression among patients with acute secretory otitis media after SARS-CoV-2 infection FAN Yongjiang, HUANG Wei, HE Chengshan, SHEN Haitao, XU Zheng, HAO Yanan Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 1-6.   DOI: 10.6040/j.issn.1673-3770.0.2023.215 Abstract （580）      PDF（pc） （1069KB）（203）       Save Objective We investigated the role of middle ear effusion and serum cytokines in the pathogenesis of acute secretory otitis media caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection in adults. Methods Forty-five adult patients with acute secretory otitis media after SARS-CoV-2 infection were enrolled in this study. All patients had been infected with SARS-CoV-2 within the past 4 weeks. Blood samples were collected for cytokine analyses, and cytokines and SARS-CoV-2 nucleic acid were detected by ear effusion after tympanocentesis, to analyze changes in serum and middle ear effusion cytokines. Results The expression of cytokines IL-5, IL-6, IL-8, and IL-10 in middle ear effusions was significantly elevated relative to their levels in serum(P<0.05); IL-2, IFN-α, IFN-γ and TNF-α expression was not significantly different between serum and middle ear effusion(P>0.05). IL-5, IL-6, IL-8, and IL-10 expression level in middle ear effusion displayed no significant difference between SARS-CoV-2 positive individuals(including suspected positive individuals)and negative individuals(P>0.05). Individuals with mixed hearing loss exhibited significantly elevated IL-6 and IL-8 expression in middle ear effusion than individuals with conductive hearing loss(P<0.05). Conclusion SARS-CoV-2 can infect the middle ear through the eustachian tube and induce middle ear immune cells to produce high levels of cytokines, promoting secretory otitis media. IL-5, IL-6, IL-8, and IL-10 were the main inflammatory cytokines that promoted adult acute secretory otitis media caused by the novel coronavirus. IL-6 and IL-8 can be used as primary indicators to predict the severity of impairment of sensory nerve function in patients. Reference | Related Articles | Metrics

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Bibliometric analysis based on Web of Science for nasal irrigation for nasal diseases in the last decade LI Xia, HOU Ran, WANG Liping Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 52-60.   DOI: 10.6040/j.issn.1673-3770.0.2022.540 Abstract （572）      PDF（pc） （3944KB）（806）       Save Objective To analyze the nasal irrigation treatment in the field of nasal disease at home and abroad in the last decade, analyze the research hotspots and trends, in order to provide a reference for the development of nasal flushing research in China. Methods The literature of nasal irrigation treatment from 2011 to 2021 was searched from the Web of Science citation database, and statistical and visual analysis was performed based on Citespace software. Results A total of 413 publications were included, and the overall number of publications on nasal rinse treatment diseases has been on the rise in the past decade, with the most publications in the United States and China. The research content mainly focused on saline nasal rinse, quality of life, efficacy and spray. The research frontiers focused on the study of rinse solution components, the advantages and disadvantages of the tools used for irrigation. Conclusion The use of nasal rinses for the treatment of diseases has gained clinical recognition and is attracting more and more attention of scholars, and there are more literature in this field in China, but it is still need to improve the quality of research and the impact of publications. Reference | Related Articles | Metrics

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Adolescent oropharyngeal teratoma:a case report and literature review MA Jing, ZHANG Min, ZHU Xinjie Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 89-97.   DOI: 10.6040/j.issn.1673-3770.0.2023.521 Abstract （567）      PDF（pc） （6240KB）（215）       Save Objective To explore the clinical characteristics, diagnosis and treatment of oropharyngeal teratoma. Methods A retrospective analysis was conducted on the clinical data of a teenage patient with oropharyngeal teratoma, and relevant literature published in Chinese and English was analyzed and discussed. Results A total of 45 articles published domestically and internationally from 1980 to 2023 were retrieved, and a total of 56 cases of oropharyngeal teratomas were retrieved, including this case. Most of the 56 cases of oropharyngeal teratomas were discovered at birth, mainly in the soft palate and tonsils, with more females than males. Some patients had deformities in other areas, with cleft palate being more common. The pathological classification was mainly mature teratomas, most of which could be removed through the mouth, and the prognosis was good. Conclusion Most oropharyngeal teratomas are benign lesions, which are more common in newborns and infants. High resolution CT combined with MRI can help clarify the diagnosis and lesion range, and serum AFP testing can help determine whether it is benign or malignant before surgery, and can be used for efficacy observation and prognosis assessment after surgery. Surgery is the preferred treatment method for removing oropharyngeal teratomas. Early resection has a good prognosis, and regular follow-up is required after surgery. Reference | Related Articles | Metrics

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Congenital midline cervical cleft: a case report and literature review PENG Yaqi, CHEN Liangsi, XU Mimi, HUNAG Yunye, SHENG Xiaoli Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 98-102.   DOI: 10.6040/j.issn.1673-3770.0.2022.505 Abstract （557）      PDF（pc） （6075KB）（284）       Save Objective To explore the characteristics, therapy, and embryological etiology of congenital midline cervical cleft(CMCC). Methods After pathological diagnosis revealed a skin fistula, the patient underwent surgical treatment: resection of a contractile, longitudinal neck sinus, skin tag, skin lesion and followed by double Z-plasty. And the clinical data of a case of CMCC was retrospectively reviewed along with a review of related literature. Results The postoperative neck incision of the patient healed in one stage. No evidence of recurrence was found during the 1-year follow-up. Conclusion CMCC is a rare congenital abnormality of the neck. CMCC is thought to occur through a failure of the first or second branchial arch fusion. Double Z-plasty is a common technique for the prevention of contracture and restoration of the anterior contour of the neck. Reference | Related Articles | Metrics

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Traumatic dislocation of the eyeball with optic nerve transection: a case report and literature review ZHANG Yiran, HUANG Jingyi, LIN Tao, LIU Hui, DENG Ling, PAN Yingzhe Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 109-112.   DOI: 10.6040/j.issn.1673-3770.0.2023.076 Abstract （525）      PDF（pc） （4289KB）（405）       Save Objective To report the clinical characteristics and diagnosis and treatment of a patient with traumatic total dislocation of the eyeball combined with optic nerve rupture and to explore the treatment options for dislocation of the eyeball. Methods A patient with total dislocation of the right eye and complete disconnection of the optic nerve due to trauma was treated in the emergency department. The patient's right eye was treated with repayment of total dislocation, lateral canthus incision, eye exploration, extraocular muscle suture, debridement, and eyelid laceration suture to restore the eyeball. The patient's right eye was then further treated with amniotic membrane covering, corneal debridement, and eyelid laceration to promote corneal repair. Results After surgery, the eyeball was repositioned, and the cornea healed well. There were no complications in the follow-up 6 months after surgery. The patient was satisfied with the treatment results. Conclusion Patients with dislocation of the eyeball should be treated in time, and the surgical plan should be formulated according to the specific situation. Although patients with complete dislocation do not have the possibility of vision recovery, retaining the eyeball may be a better option considering the psychological burden of the patients. Reference | Related Articles | Metrics

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Research progress on the preferred retinal locus in patients with central vision loss DENG Yu, WANG Jianwei, LIU Ziqiang, LI Yuanyuan, HOU Xiaoyu, JIE Chuanhong Journal of Otolaryngology and Ophthalmology of Shandong University    2024, 38 (2): 150-155.   DOI: 10.6040/j.issn.1673-3770.0.2022.442 Abstract （504）      PDF（pc） （1680KB）（287）       Save Low central visual acuity is mainly caused by decreases or deficiencies in contrast sensitivity, color vision, and other visual functions in patients with age-related macular degeneration. Studies have found that patients with central visual acuity loss can form a new visual task area, called the preferred retinal locus, at a relatively good position outside the foveal retina. In this paper, relevant articles about the optimal fixation point location and the training of the preferred retinal locus using microvisual field instruments are reviewed, and the current research status and shortcomings are summarized. The purpose of this paper is to review the progress of research on the visual condition of patients with central vision loss and to provide information that will aid the selection of visual rehabilitation programs for such patients. Reference | Related Articles | Metrics

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Expert consensus on clinical management recommendations for carotid blowout syndrome secondary to NPC treatment QIU Qianhui, XIAO Xuping, YANG Qintai, YE Jing, DENG Zeyi, WANG Desheng, TAN Guolin, JIANG weihong, Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 1-18.   DOI: 10.6040/j.issn.1673-3770.0.2023.500 Abstract （487）      PDF（pc） （18342KB）（77）       Save Carotid Blowout Syndrome(CBS)refers to rupture of the carotid artery and/or its branches. CBS is a life-threatening complication of head and neck cancer after radiotherapy. Because radiotherapy is the first-line treatment for nasopharyngeal carcinoma, radiation-induced necrosis and tumor recurrence increase patient risk of experiencing CBS. The high mortality and morbidity of CBS after nasopharyngeal carcinoma radiotherapy poses a great challenge for clinicians. To enhance understanding and develop standards for application of CBS management, we organized an expert consensus on a comprehensive management strategy for nasopharyngeal carcinoma-related CBS, based on domestic and international guidelines and relevant literature. Emergency processing, a comprehensive management strategy, and a clinical nursing and prevention program are presented in detail in this consensus, which aims to provide a theoretical basis and clinical recommendations for more effective treatment of nasopharyngeal carcinoma-related CBS based on pathogenesis mechanism, predisposing factors, and characteristics of imaging during examination. Reference | Related Articles | Metrics

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Evaluation of the efficacy and safety of site-specific acupuncture for the treatment of sudden hearing loss: a systematic review and network Meta-analysis ZHENG Zehao, WEI Jiali, LIU Jiatao, ZHOU Yuqi, SUN Wenting, LI Yuxuan, BAI Peng Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 114-127.   DOI: 10.6040/j.issn.1673-3770.0.2024.354 Abstract （324）      PDF（pc） （8640KB）（155）       Save Objective To systematically evaluate and compare the efficacy and safety of site-specific acupuncture in the treatment of sudden hearing loss. Methods Randomized controlled trials on the efficacy and safety of acupuncture for sudden hearing loss were retrieved from PubMed, the Cochrane Library, Web of Science, SinoMed, CNKi, Wanfang, and VIP databases. Literature was screened and checked independently by two investigators using NoteExpress software to determine the inclusion of literature, data were extracted using Excel, risk of bias was assessed using the Cochrane Collaboration's Risk of Bias(RoB)2.0 tool, and Meta-analysis was performed using R software. Results A total of 20 studies involving 1,453 patients were included, evaluating 13 different interventions. The RoB 2.0 assessment revealed that one study had a low risk of bias, while the remaining studies exhibited a moderate risk of bias. The results of the Meta-analysis indicated that acupuncture was effective in sudden hearing loss, with cervical acupuncture combined with auricular acupuncture showing the greatest efficacy. Additionally, the combination of acupuncture and western medicine demonstrated superior effectiveness. In the ranking of the surface under the cumulative ranking curve(SUCRA)value for the primary outcome(the number of patients with hearing enhancement of more than 15 dB after treatment), cervical acupuncture + auricular acupuncture + western medicine(92.3)ranked highest, followed by cephalic and facial acupuncture(80.84), cervical acupuncture + western medicine(70.64), and so on. The ranking of the secondary outcome pure tone hearing threshold was highest for cephalic and facial acupuncture(88.42), followed by cephalic and facial acupuncture + auricular acupuncture + western medicine(74.15). Regarding safety, five studies reported relevant outcomes, with one study observing a case of subcutaneous hematoma and bruising in both groups, though this did not impact the progress of the trial. Conclusion Site-specific acupuncture is effective in treating sudden hearing loss, especially cervical acupuncture combined with auricular acupuncture, and shows a favorable safety profile. However given the limited number of included studies, further high-quality randomized controlled trials are needed to validate these findings. Reference | Related Articles | Metrics

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Bioinformatic analysis of miRNA-mRNA network involved in thyroid function impairment by high-fat diet DOU Tao, DOU Naixin, WANG Ru, YANG Qian, GUAN Qingbo, WANG Lei, YU Chunxiao Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 151-160.   DOI: 10.6040/j.issn.1673-3770.0.2024.161 Abstract （313）      PDF（pc） （8846KB）（31）       Save Objective To analyze the miRNA-mRNA regulatory network involved in high-fat diet-induced damage to thyroid function using bioinformatics methods, and to provide new targets for early intervention in lipid toxicity-induced thyroid dysfunction. Methods Rats were fed a high-fat diet for 8 weeks to establish a model of thyroid function damage, with a normal diet group as control. Agilent chips were used to detect thyroid miRNA and mRNA expression, and the “limma” package in RStudio was used to screen for differentially expressed miRNA and mRNA. The miRwalk was used to predict potential downstream target genes regulated by differentially expressed miRNA. The predicted target genes and differentially expressed mRNA were intersected using weishengxin websites to establish a differential miRNA-mRNA network. Gene ontology(GO)annotation and kyoto encyclopedia of genes and genomes(KEGG)pathway analysis of the intersected mRNA were performed using the Metascape website. protein-protein interaction(PPI)analysis was conducted using the String online platform, and the PPI network hub was visualized using Cytoscape,hub genes were selected using the CytoNCA plugin in Cytoscape. A potential miRNA-mRNA network affecting thyroid function due to high-fat diet was established based on the selected hub genes. Results 27 upregulated and 6 downregulated miRNAs, 775 upregulated and 543 downregulated mRNAs were screened, with 301 overlapping mRNAs between downregulated miRNA targets and upregulated mRNAs, and 278 overlapping mRNAs between upregulated miRNA targets and downregulated mRNAs, resulting in 491 and 777 miRNA-mRNA pairs, respectively. GO and KEGG analysis revealed that differential mRNAs were enriched in pathways related to thyroid hormone synthesis and cell proliferation. Further screening identified 10 hub genes including Src, Pebp1, Il1b, Plcg1, Igf1, etc. A key miRNA-mRNA regulatory network was established based on these hub genes, including regulatory pairs such as miR-3473/Src、miR-339-3p/Igf1、miR-674-5p/Igf1、miR-339-3p/Ntrk2、miR-99b-3p/Ntrk2. Conclusion The miRNA and mRNA, such as miR-3473、Igf1 and Ntrk2 may be involved in high-fat diet-induced damage to thyroid function. Reference | Related Articles | Metrics

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Treatment of internal carotid artery rupture caused by tumor recurrence and skull base osteonecrosis after radiotherapy for nasopharyngeal carcinoma WANG Zaixing, TANG Zhiyuan, LI Dingbo, SHI Zhaohui, ZENG Xianhai, ZHANG Qiuhang Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 49-58.   DOI: 10.6040/j.issn.1673-3770.0.2024.228 Abstract （309）      PDF（pc） （8342KB）（53）       Save Objective To investigate the internal carotid artery protection techniques and perioperative management strategies of endoscopic surgery for local recurrent nasopharyngeal carcinoma or skull base osteonecrosis after radiotherapy for nasopharyngeal carcinoma. Methods The clinical data of patients with local recurrent nasopharyngeal carcinoma and skull base osteonecrosis of nasopharyngeal carcinoma who received endoscopic surgery at Department of Otolaryngology, Shenzhen Longgang Otolaryngology hospital from January 2019 to December 2023 were retrospectively analyzed. The gender and age of the patients near or involving the internal carotid artery were analyzed and summarized, the lesion site and its relationship with the internal carotid artery, the resection of the lesion, the protection methods of important blood vessels during the operation, the postoperative internal carotid artery bleeding and its management, and the postoperative recovery were analyzed and summarized. Results A total of 47 patients were included, with a male to female ratio of 25∶22 and an average age of 50.98±10.93 years. There were 29 cases of recurrence and 9 cases of internal carotid artery invasion. In the osteonecrosis group, the lesion invaded the internal carotid artery in 6 cases. During the postoperative follow-up, 5 patients in the recurrence group had tumour recurrence at the site adjacent to surgery, and the average recurrence time was 15 months. The incidence of postoperative internal carotid artery rupture bleeding was 6.9% and the mortality rate was 10.34%. In the osteonecrosis group, 1 patient was found to have recurrent osteonecrosis at 7 months after surgery and was treated again. The incidence of postoperative internal carotid artery rupture bleeding was 5.6% and the mortality was 11.11%. Bleeding occurred in the high internal carotid artery in both groups, and the lesions were found to have invaded the internal carotid artery before surgery. Conclusion For patients with local recurrence of nasopharyngeal carcinoma or with skull base osteonecrosis near or involving the internal carotid artery after radiotherapy, the extent of the tumour and surrounding major blood vessels should be fully evaluated before surgery, and the appropriate surgical protocols and management methods should be formulated. Surgical safety can be improved by mastering the surgical skills to protect the internal carotid artery and by paying attention to the protection of major blood vessels. Reference | Related Articles | Metrics

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Efficacy analysis of concurrent chemoradiotherapy with high and low cumulative cisplatin doses in the treatment of nasopharyngeal carcinoma SUN Chunxiao, WANG Wenqing, YUE Tian, LIU Jisheng Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 31-41.   DOI: 10.6040/j.issn.1673-3770.0.2025.123 Abstract （308）      PDF（pc） （6073KB）（65）       Save Objective The objective of this study is to conduct a quantitative comparison of the survival efficacy and adverse reactions between the cumulative cisplatin dose(CCD)≤200 mg/m2 cohort and the CCD>200 mg/m2 cohort through meta-analysis, providing an evidence-based rationale for individualised treatment. Methods A systematic search was conducted across PubMed, Embase, Web of Science, Cochrane Library and Chinese Biomedical Literature Database up to February 2025. The observational indexes included 5-year overall survival(5-OS), 5-year progression free survival(5-PFS), 5-year distant metastasis free survival(5-DMFS)and adverse events(AEs). RevMan 5.4 software was utilized to perform the meta-analysis. The heterogeneity among the included studies was assessed using I2 values. Furthermore, funnel plots were used to evaluate potential publication bias. Results Nine cohort studies were included. Data covering 7,418 patients diagnosed with nasopharyngeal cancer were collected, includeding 5,899 cases in the CCD≤200 mg/m2 cohort and 1,519 cases in the CCD >200 mg/m2 cohort. In comparison with the cohort of CCD >200 mg/m2, the CCD≤200 mg/m2 cohort did not exhibit a statistically significant reduction in 5-OS(RR=0.98,95%CI:0.96-1.00), 5-PFS(RR=0.96,95%CI:0.91-1.01)and 5-DMFS(RR=0.97,95%CI:0.93-1.01). Further subgroup analyses of 5-OS and 5-DMFS yielded consistent results. In relation to AEs, the CCD≤200 mg/m2 cohort demonstrated a conspicuously diminished occurrence of acute toxic reactions compared to the CCD >200 mg/m2 cohort. This was observed in grade 1-4 leukopenia(RR=0.91,95%CI:0.86-0.97),grade 1-4 ALT elevation(RR=0.69,95%CI:0.58-0.82)and any grade of creatinine elevation(grade 1-4: RR=0.73,95%CI:0.60-0.88; grade 3-4: RR=0.20,95%CI:0.04-0.89). With regard to late toxicities, both grade 1-4 hearing impairment(RR=0.81,95%CI:0.70-0.94)and any grade of dermal fibrosis(grade 1-4:RR=0.77,95%CI:0.64-0.92; grade 3-4: RR=0.43,95%CI:0.21-0.89)exhibited a substantial reduction within the CCD≤200 mg/m2 cohort. However, no statistically significant differences were found between the two cohorts in other AEs, including grade 3-4 leukopenia, grade 3-4 ALT increase, grade 3-4 hearing impairment and any grade of anemia, thrombocytopenia, neutrophilic leukopenia, AST increase, dry mouth, clenching of teeth or cranial neuropathy. Conclusion This study indicates that in the treatment of nasopharyngeal carcinoma with concurrent chemoradiotherapy(CCRT), CCD≤200 mg/m2 may achieve therapeutic efficacy comparable to that of CCD>200 mg/m2, and may potentially reduce the risk of AEs. Reference | Related Articles | Metrics

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Changing the diagnosis and treatment of nasopharyngeal cancer: biomarkers and nasal endoscopic surgery synergise to advance early treatment development QIN Debo, XUE Jiancheng, YANG Wenyue, HU Bing, CHEN Tao, YU Yanping, MENG Qingguo, SUN Huanji, MIAO Beiping, LU Yongtian Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 85-92.   DOI: 10.6040/j.issn.1673-3770.0.2024.542 Abstract （296）      PDF（pc） （555KB）（45）       Save The diagnosis and treatment of nasopharyngeal carcinoma has entered a new era characterized by “precision screening, minimally invasive intervention, and preservation of function”. In the screening arena, breakthroughs in Epstein-Barr virus biomarker detection technologies-including CRISPR-associated protein 12a amplification-free assays, P85 antibody testing, and T-cell receptor sequencing-have achieved sensitivity and specificity of 97.9% and 99.3%, respectively, enabling disease prediction 6-12 months before clinical diagnosis. The synergistic application of multi-microRNA panels with narrow-band imaging(NBI)and I-scan virtual chromoendoscopy has shifted screening paradigms from single-marker approaches to multimodal integration.In therapeutics, endoscopic nasopharyngectomy(ENPG)demonstrates superior precision(negative margin rate ≥90%)and functional preservation, achieving a 5-year survival rate of 92.1% in early stage patients while significantly improving quality of life compared to conventional radiotherapy. However, challenges remain, including tumor heterogeneity, limited accessibility of advanced technologies in primary care settings, and restrictive eligibility criteria for ENPG. Future efforts should focus on:(1)multi-omics AI-driven risk stratification models;(2)synergy between surgery and immunotherapy(e.g., neoadjuvant PD-1 inhibitors);(3)portable diagnostic tools;(4)multicenter trials to validate long-term outcomes. Through interdisciplinary collaboration, the management of NPC is moving from empirical to precision medicine with the goal of achieving “early detection rates >80% and functional preservation rates >90%” and ultimately overcoming the global burden of this regionally prevalent malignancy. Reference | Related Articles | Metrics

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Comparison of safety and efficacy between transaxillary endoscopic thyroidectomy and conventional open thyroidectomy for Stage T1 thyroid carcinoma ZHANG Zhonghua, WANG Hui, WANG Junxin, ZHANG Meiling, ZHANG Jian, ZHANG Endong, PAN Xinliang Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 161-167.   DOI: 10.6040/j.issn.1673-3770.0.2025.100 Abstract （292）      PDF（pc） （3419KB）（56）       Save Objective The objective of this study is to compare the safety and efficacy of transaxillary non-inflatable endoscopic thyroidectomy versus conventional open thyroidectomy in the treatment of stage T1 thyroid carcinoma. Methods A retrospective analysis was performed on 50 patients who underwent transaxillary non-inflatable endoscopic thyroidectomy(experimental group)and 50 patients who received conventional open thyroidectomy(control group). Patients were selected from cases of stage T1 thyroid carcinoma between July 16, 2022 and July 16, 2024. Using propensity score matching(1∶1 ratio)based on gender, age, body mass index, tumor size, and tumor location. Comparison of operative outcomes between the two groups included: operative time, intraoperative blood loss, number of lymph nodes harvested, positive lymph nodes detection rate, postoperative hospitalization time, hospitalization costs, postoperative neck pain(assessed by VRS-5), complication rates, and neck cosmetic satisfaction. Results The operation time, hospitalization costs and satisfaction with the neck appearance of the experimental group were significantly higher than those of the control group, and the differences were statistically significant(both P<0.05). The experimental group showed significantly lower postoperative neck pain intensity compared to the control group, with a statistically significant difference(Z=-4.22, P<0.001). No statistically significant differences were observed in intraoperative blood loss, number of lymph nodes harvested, positive lymph nodes detection rate, postoperative hospitalization time, or complication rates(both P>0.05). During follow-up(6-24 months), no tumor recurrence occurred in either group. Conclusion Transaxillary non-inflatable endoscopic thyroidectomy has been shown to provide an effective radical treatment for stage T1 thyroid carcinoma. In comparison with the conventional open thyroidectomy, this approach has been shown to yield superior cosmetic outcomes, significantly reduce postoperative neck pain, and may enhance patients' quality of life. Reference | Related Articles | Metrics

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Computed tomography angiography-based assessment of internal carotid artery stenosis after radiotherapy for nasopharyngeal carcinoma and its associated factors ZHU Ruikai, WU Jiarong, SUN Fang, XIE Chubo, QIU Qianhui Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 77-84.   DOI: 10.6040/j.issn.1673-3770.0.2025.156 Abstract （289）      PDF（pc） （1032KB）（62）       Save Objective To investigate the incidence and risk factors of internal carotid artery(ICA)stenosis after radiotherapy for nasopharyngeal carcinoma(NPC)based on computed tomography angiography(CTA)evaluation, and to provide a basis for early screening and intervention. Methods Clinical data of 151 NPC patients who underwent radiotherapy and were admitted to the Department of Otorhinolaryngology Head and Neck Surgery, Guangdong Provincial People's Hospital, between February 2018 and November 2022, were retrospectively analyzed. All patients underwent head and neck CTA to assess ICA stenosis. Patients were categorized into a normal group(no stenosis, n=77)and an abnormal group(including mild, moderate, severe stenosis, or complete occlusion, n=74)based on post-radiotherapy ICA status. Clinical characteristics were compared between these groups, and Logistic regression analysis was used to identify potential influencing factors, such as gender, age, hypertension, diabetes mellitus, hyperlipidemia, smoking history, post-radiotherapy interval, radiotherapy course, and TNM staging. Results Among the 151 NPC patients after radiotherapy, ICA stenosis severity was evaluated using the North American Symptomatic Carotid Endarterectomy Trial(NASCET)method. The distribution was as follows: no stenosis accounted for 50.99%, mild stenosis for 12.58%, moderate stenosis for 27.15%, severe stenosis for 5.31%, and complete occlusion for 3.97%. Univariate analysis revealed statistically significant differences between the normal and abnormal groups in terms of gender, age distribution, presence or absence of hypertension, smoking history, post-radiotherapy interval, radiotherapy course, and TNM stage(P<0.05). Logistic regression analysis indicated that age(51-70 years)(OR=7.917, 95%CI: 5.913-9.921), female gender(OR=3.394, 95%CI: 1.980-4.808), hypertension(OR=2.872, 95%CI: 1.640-4.104), smoking history(OR=2.219, 95%CI: 1.103-3.335), post-radiotherapy interval(>10 years)(OR=4.125, 95%CI: 2.081-6.169), re-irradiation(OR=5.912, 95%CI: 4.474-7.350), and local/regional recurrence(OR=3.056, 95%CI: 1.790-4.332)were all identified as independent risk factors significantly associated with ICA stenosis in NPC patients after radiotherapy(P< 0.05). Conclusion Regular screening for ICA stenosis is recommended for NPC survivors, especially those aged >50 years, female, with hypertension, a history of smoking, a post-radiotherapy interval >10 years, undergoing re-irradiation, or experiencing local/regional recurrence, to enable early intervention and improve prognosis and quality of life. Reference | Related Articles | Metrics

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The role and significance of the skull base fascial tissue barrier in endoscopic resection of locally early recurrent nasopharyngeal carcinoma WU Jiarong, QIU Qianhui Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 108-113.   DOI: 10.6040/j.issn.1673-3770.0.2024.382 Abstract （285）      PDF（pc） （454KB）（70）       Save Historically, the standard management of recurrent nasopharyngeal carcinoma(rNPC)involved two cycles of radiotherapy. However, the efficacy of the second cycle was suboptimal, resulting in a 5-year survival rate that fell below expectations and severe side effects, including radionecrosis, multiple cranial nerve deficits, and nasopharyngeal hemorrhage. These complications significantly impaired patients' quality of life and, in some cases, led to fatal outcomes.Recently, advancements in surgical techniques have emerged, offering a novel approach to managing rT1-rT3 recurrent nasopharyngeal carcinoma. For early-stage rNPC patients with rT1-rT3 tumors located in the midline area, the ability of endoscopic surgery to achieve complete tumor resection and R0 status is critical for their prognosis. The skull base fascial tissue, an integral connective tissue on the surface of the skull base, plays a crucial role. It adheres to the superficial aspect of the skull base muscles and the deep aspect of the mucous membranes. Its dense structure and strategic location provide a natural barrier against malignant tumors.Consequently, examining the clinical significance of the skull base fascial tissue in determining the extent of nasopharyngeal surgical resection can enhance clinical diagnostics and therapeutic strategies. This paper reviews the structural characteristics of the skull base fascia and its role and significance in resisting tumor invasion during early rNPC nasopharyngeal resection, highlighting its potential to improve clinical guidance in the management of this disease. Reference | Related Articles | Metrics

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Genetic analysis of MARVELD2 gene variants in two deafness cases LI Jie, SU Weina, LIN Qian, ZHANG Qishu, HOU Cheng, YANG Zhenjiao, XIANG Lili Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 128-134.   DOI: 10.6040/j.issn.1673-3770.0.2025.101 Abstract （272）      PDF（pc） （4079KB）（85）       Save Objective Next generation sequencing technology was used to investigate the potential genetic causes of deafness in two probands and their families. Methods A retrospective analysis was conducted on two probands and their family members. This analysis included collecting medical histories, performing physical examinations, conducting audiological evaluations, and performing genetic testing and analysis for deafness. Results Both probands exhibited bilateral profound sensorineural hearing loss and had no other systemic abnormalities or syndromic features. Genetic testing revealed pathogenic variants in the MARVELD2 gene in both probands,either homozygous or compound heterozygous. The proband in family A carried a homozygous c.1331+1G>A variant that she inherited from her parents. The proband in family B carried compound heterozygous variants c.1331+1G>A/c.782G>A(p.Gly261Glu)and transmitted the heterozygous c.1331+1G>A variant to her daughter. Conclusion This study strengthens the evidence that loss-of-function variants in the MARVELD2 gene can cause profound sensorineural hearing loss. Testing for the MARVELD2 gene is significant for screening, diagnosing, and providing prenatal genetic counseling for deafness. Reference | Related Articles | Metrics

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Immune mechanism and clinical application of the intranasal vaccine in nasopharyngeal-associated lymphoid tissues FU Lijun, WANG Haiyang, WANG Yuqi, ZOU Yuhao, ZOU Jian Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 93-99.   DOI: 10.6040/j.issn.1673-3770.0.2024.499 Abstract （269）      PDF（pc） （1107KB）（38）       Save Intranasal vaccines are used to prevent respiratory infectious diseases by inducing local mucosal and systemic immune responses through action on nasopharyngeal-associated lymphoid tissue and have demonstrated potential for the treatment of brain and autoimmune diseases. Intranasal vaccines combined with new adjuvants and delivery systems can significantly enhance antigen immunogenicity and have shown initial results in the prevention of diseases such as influenza and new coronaviruses. On the contrary, tonsil-like organs, as an emerging three-dimensional experimental model, can accurately mimic the immune microenvironment and provide new tools for vaccine evaluation and design optimization. This article reviews the progress of intranasal vaccine research in clinical applications and analyzes the role of novel adjuvants, delivery systems, and tonsil-like organs in their optimization, with the aim of providing theoretical support for the development and application of intranasal vaccines in the future. Reference | Related Articles | Metrics

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Research status and progress in diagnosis and treatment of laryngeal inflammatory myofibroblastic tumor SHI Jinlian, LI Jianxing, HUANG Yousheng, LIN Mingxuan, LIU Lingyun, LU Yongtian Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 186-192.   DOI: 10.6040/j.issn.1673-3770.0.2024.297 Abstract （258）      PDF（pc） （495KB）（39）       Save Inflammatory myofibroblastic tumor(IMT)is a rare mesenchymal neoplasm that occurs predominantly in the lung, with laryngeal involvement being relatively rare. Clinical manifestations of laryngeal IMT typically include hoarseness and breathing difficulties, which, due to their non-specific nature, often lead to misdiagnoses as other laryngeal conditions. Pathologically, laryngeal IMT is predominantly composed of inflammatory cells such as giant cells, plasma cells, and lymphocytes, together with spindle-shaped tumor cells that exhibit phenotypes of smooth muscle cells or myofibroblasts. These cells are interspersed with varying degrees of cell density and vascular distribution. The definitive diagnosis of laryngeal IMT is based on a combination of imaging studies, pathological evaluation, and immunohistochemical testing.Surgical excision remains the treatment of choice for laryngeal IMT. For cases where surgery is not feasible or there is recurrence or metastasis, targeted therapies, such as ALK inhibitors, have shown potential benefits. Tumor size, staging, and extent of surgical resection are important prognostic factors. This article reviews recent research advancements in the pathogenesis, clinical characteristics, diagnostic methods, and treatment strategies for laryngeal IMT, with the aim of improving the precision of diagnosis and effectiveness of treatments for this condition. Reference | Related Articles | Metrics

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Risk factors for epiretinal membrane formation following pars plana vitrectomy for rhegmatogenous retinal detachment WANG Huanxia, WANG Shuya, WANG Ying, SUN Xuan, HUANG Jie, WANG Xingrong Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 181-185.   DOI: 10.6040/j.issn.1673-3770.0.2024.370 Abstract （257）      PDF（pc） （394KB）（34）       Save Objective To analyze the influencing factors of epiretinal membrane formation after pars plana vitrectomy for primary rhegmatogenous retinal detachment(RRD). Methods A total of 109 patients(109 eyes)who underwent vitrectomy for rhegmatogenous retinal detachment(RRD)were included. Based on the postoperative occurrence of secondary epiretinal membrane(ERM), they were divided into two groups: the secondary ERM group(12 patients, 12 eyes)and the non-secondary ERM group(97 patients, 97 eyes). After 6 months of postoperative follow-up, the age, lens status, retinal hiatus, retinal detachment involved in macular area, PVR grade, vitreous hematoma, intraoperative fillings and laser number were compared between the two groups, and the influencing factors on the formation of macular anterior membrane were analyzed by binary Logistic regression. Results The incidence of epiretinal membrane after pars plana vitrectomy for RRD was 11.01%. There were statistically significant differences in the lens status and PVR grade between the two groups(χ2=11.608, P=0.001; χ2=14.492, P=0.001). The results of binary Logistic regression analysis showed that lens status and PVR C grade were influencing factors for postoperative epiretinal membrane(OR=0.074, 95%CI: 0.008~0.670, P=0.021; OR=0.018, 95%CI: 0.001~0.503, P=0.018). Conclusion Aphakic eye, intraocular lens eye, and PVR C grade were risk factors for postoperative epiretinal membrane. Reference | Related Articles | Metrics

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The study on the accuracy of TORIC IOL axis examination and its influencing factors using OPD Overview mode ZHOU Weiwei, LIU Zhen, ZHANG Yi, LIU Hanjing, ZHU Yan, ZHU Yuguang Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 174-180.   DOI: 10.6040/j.issn.1673-3770.0.2024.106 Abstract （252）      PDF（pc） （484KB）（31）       Save Objective To study the accuracy of Toric IOL axial position examination with the OPD Scan Ⅲ Overview mode after the implantation of Toric IOL, and analyze the factors affecting the measurement accuracy of Toric IOL axial position. Method Petrospective cohort study. From November 2021 to November 2022, a total of 100 patients(100 eyes)who underwent phacoemulsification combined with TECNIS Toric IOL(AMO)implantation in our hospital were selected. The patients were followed up with residual corneal astigmatism examination 1 day, 1 week and 1 month after the operation. The axial position of Toric IOL was measured with the OPD overview mode, the mydriatic OPD overview mode, the OPD Toric mode and the slit-lamp method. Based on the measurement results in the OPD Toric mode, the differences and consistency of the measurement results of the 4 methods were analyzed. To analyze the accuracy of TORIC IOL axis examination according to IOL axial position deviation(APD), the OPD data of patients with a large IOL APD(APD>5°)and those with an accurate IOL APD(APD≤3°)were selected for comparisons such as the photopic pupil diameter(Photopic), the mesopic pupil diameter(Mesopic), the photopic Kappa angle(PDist), the mesopic Kappa angle(MDist), the distance from the mesopic pupil center to the photopic pupil center(MPDist)and so on. Results The residual astigmatism of the patients was significantly lower than that before the surgeries at 1 day, 1 week and 1 month after the operation(P<0.05). The results showed that the absolute values of the axial deviation of Toric IOL measured with OPD Overview mode, OPD Toric mode and slit lamp method were 2.37±2.21°, 0° and 0.74±0.64°, respectively, with high accuracy and consistency. The absolute value of the axial deviation in the mydriatic OPD overview mode was 4.34±3.98°, which was significantly different from that in the other three modes. The differences of the IOL axial position measurement were statistically significant with the OPD Overview mode, the mydriatic OPD Overview mode, the OPD Toric mode and the slit-lamp mode(Z=104.97, P<0.001). There were no statistically significant differences between OPD Overview mode and OPD Toric mode, OPD Overview mode and slit lamp method, and OPD Toric method and slit lamp method(P>0.05). There was a positive correlation between the APD and PDist(Photopic Kappa angle)(r=0.135, P=0.034).There was no significant correlation between APD and the Photopic pupil diameter(Photopic), Mesopic pupil diameter(Mesopic), MDist and MPDist(P>0.05). Conclusion The OPD Overview mode was an objective and accurate IOL axial position measurement method with certain application value in ophthalmology. PDist is one of the factors affecting the APD measurement with the OPD Overview mode. Reference | Related Articles | Metrics

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Through the orbit with sinus huge foreign bodies embedded in the base of the skull: a case report and literature review GUO Rongchang, LIU Qinghang, WANG Hongzeng, SUN Shujun Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 135-141.   DOI: 10.6040/j.issn.1673-3770.0.2023.486 Abstract （249）      PDF（pc） （3833KB）（42）       Save Objective To explore the clinical diagnosis and treatment plan for traumatic foreign bodies in the nasal cavity and paranasal sinuses, in order to avoid clinical misdiagnosis or missed diagnosis, and to provide a clinical reference for the treatment of traumatic foreign bodies in the nasal cavity and paranasal sinuses. Methods A retrospective analysis was performed on the clinical data of a patient with giant nasal eye penetration and skull base entrapment foreign body injury, and relevant literature on foreign bodies in the nasal cavity and paranasal sinuses was reviewed. Results Based on the patient's history and CT examination, the foreign body in the paranasal sinus and the orbital penetration injury were confirmed. The foreign body was successfully removed by nasal endoscopy combined with external eye approach during surgery, and the patient recovered well after surgery. Conclusion Foreign bodies in the nasal cavity and paranasal sinuses are common emergencies in the otolaryngology department. Some foreign bodies in the nasal cavity and paranasal sinuses caused by trauma often bring difficulties in clinical diagnosis and treatment. Detailed history taking, imaging examination and nasal endoscopic examination can provide the basis for diagnosis to avoid misdiagnosis or missed diagnosis. Surgeons must choose surgical techniques flexibly according to specific circumstances, among which endoscopic nasal surgery has gradually become the preferred treatment method. Reference | Related Articles | Metrics

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Imaging-based observation and analysis of the pharyngeal internal carotid artery trajectory JIANG Zhilin, ZHU Ruikai, QIU Qianhui Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 69-76.   DOI: 10.6040/j.issn.1673-3770.0.2024.376 Abstract （246）      PDF（pc） （3396KB）（52）       Save Objective The objective of this study was to delineate the course of the pharyngeal segment of the internal carotid artery(ICA)through imaging analysis, with the aim of providing guidance to prevent ICA injury during endonasal endoscopic surgeries. Methods A retrospective analysis of MRI and CTA imaging data from patients' ICAs was conducted, with arterial morphologies being classified based on inflection points. The distances and angles between the ICA and key anatomical landmarks(midline, intracranial entry plane, pharyngeal wall)were measured in multiple dimensions to identify any patterns that could inform surgical approaches. Results In the course of the evaluation of 124 ICA sides, it was found that nine of these exhibited complex trajectories with multiple inflection points. The conventional ICA course exhibited a medial trend, with a mean coronal distance from the midline of(21.85±3.26)mm, an intracranial entry angle of(76.32±15.53)°, and a mean sagittal entry angle of(71.84±11.55)°. It is noteworthy that a critical intracranial entry angle of 60° was identified in the coronal view of CTA scans, suggesting a threshold for surgical risk. Conclusion Variations in the ICA have the potential to result in surgical channel stenosis and alterations in anatomical landmark relationships, which are of critical importance for the purpose of planning. Comprehensive imaging assessments are essential for identifying pharyngeal ICA anomalies, and preoperative interventions should be considered when indicated to mitigate surgical risks. Reference | Related Articles | Metrics

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Expression of EphB2 in nasopharyngeal carcinoma tissues and its correlation with clinicopathological characteristics HUANG Qiao, REN Yi, HOU Tao, LIAO Xingwei, ZHU Zi’ang, ZHAN Xiaolin, LIU Ying, YIN Shihua Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 26-30.   DOI: 10.6040/j.issn.1673-3770.0.2024.367 Abstract （245）      PDF（pc） （2702KB）（28）       Save Objective To investigate the expression and clinical significance of erythropoietin-producing human hepatocellular B2(EphB2)in tissues of patients with nasopharyngeal carcinoma(NPC). Methods 194 NPC patients were enrolled as the study group, and 80 patients with chronic nasopharyngeal mucosal inflammation were included as the control group. Immunohistochemistry(IHC)and Western blot were used to detect the EphB2 levels in tissues. Kaplan-Meier survival analysis was performed to evaluate the relationship between the expression of EphB2 and the prognosis of patients with NPC, and Cox regression analysis was used to identify independent risk factors for poor prognosis. Results Immunohistochemistry and protein blotting experiments showed that EphB2 protein level was highly expressed in NPC tissues compared with chronic inflammatory tissues of nasopharyngeal mucosa(t=157, P<0.001). The expression level of EphB2 in NPC tissues was correlated with clinical stage(χ2=24.573, P<0.001), depth of tumor invasion(χ2=6.280, P=0.012), presence of cervical lymph node metastasis(χ2=5.576, P=0.018), distant metastasis(χ2=7.588, P=0.006), EBV infection(χ2=6.754, P=0.009), and the presence of recurrence(χ2=9.182, P=0.002). Kaplan-Meier curves revealed that NPC patients with high EphB2 expression had a poor prognosis(χ2=7.010, P=0.008). Cox regression analysis further revealed that EphB2 was an independent risk factor affecting the prognosis of NPC. Conclusion EphB2 is an independent risk factor affecting the prognosis of NPC, which may be involved in the process of NPC occurrence and development, and it is expected to be a biological marker and potential therapeutic target for the early diagnosis and prognosis evaluation of NPC. Reference | Related Articles | Metrics

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Tonsillar microbiota of children, immune regulation and diseases YUE Bingyan, ZOU Jian, LEI Lei, WEN Qiao, QIAN Yingxue Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 193-200.   DOI: 10.6040/j.issn.1673-3770.0.2025.230 Abstract （244）      PDF（pc） （541KB）（47）       Save The dynamic balance and diversity of the tonsillar microbiota constitute a core component of the upper respiratory immune defense system in children. Therefore, in-depth analysis of the composition and functions of the tonsillar microbiota is imperative for maintaining optimal pediatric health. Traditional culture techniques can detect a limited range of pathogenic bacteria, but are inherently restricted by the spectrum of culturable microorganisms. In contrast, 16S rRNA gene sequencing has the potential to overcome these limitations, offering a novel and comprehensive perspective for profiling the microbiota.This article systematically reviews the current advances in detection technologies, characteristics of core microbial communities, genetic and environmental influencing factors, causal relationships between microbiota dysbiosis and disease, and clinical intervention strategies based on microbiota modulation in pediatric tonsils. This review aims to provide a theoretical basis for the precision diagnosis, treatment, and health management of pediatric tonsillar diseases, and to guide future research into the interaction mechanisms between the tonsillar microbiota and host immunity. Reference | Related Articles | Metrics

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Analysis of factors associated with stroke and cranial nerve palsy after unilateral internal carotid artery embolization in patients with nasopharyngeal carcinoma after radiotherapy WANG Siquan, ZHU Hongshen, ZHANG Xiaobin, ZHAO Zhouyang, MA Yue, YANG Yimei, HUANG Lijin Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 19-25.   DOI: 10.6040/j.issn.1673-3770.0.2024.421 Abstract （243）      PDF（pc） （1283KB）（58）       Save Objective To analyze the factors related to stroke and cranial nerve paralysis following unilateral internal carotid artery(ICA)embolization in patients with nasopharyngeal carcinoma after radiotherapy, in order to reduce the probability of postoperative complications and improve the quality of life for these patients. Methods A retrospective analysis was conducted on the clinical data of 109 patients who underwent unilateral ICA embolization in the Department of Neurosurgery at the Third Affiliated Hospital of Southern Medical University between March 1, 2018, and October 31, 2022. These patients were followed up for one month. Patients with postoperative symptoms of stroke or cranial nerve paralysis were defined as the symptomatic group(17 cases), while the rest were classified as the asymptomatic group(92 cases). Logistic regression analysis was performed on factors such as gender, age, body mass index(BMI), blood pressure, preoperative hemoglobin levels, the status of the ipsilateral ICA, whether the contralateral ICA was stenosed, whether the ophthalmic artery compensated for the middle cerebral artery, the occlusion segment, and the side of occlusion. Results There were no statistically significant differences between the symptomatic and asymptomatic groups in terms of gender, age, BMI, whether the contralateral ICA was stenosed, the side of occlusion, or the balloon occlusion test(BOT)(all P>0.05). However, there were statistically significant differences in the occlusion segment(P=0.001), the status of the occluded ICA(stenosis, normal, or presence of a pseudoaneurysm)(P=0.010), and preoperative hemoglobin levels(P=0.024)with respect to the occurrence of postoperative stroke/cranial nerve paralysis. Elevated hemoglobin levels(OR=0.971)were identified as a protective factor, while occlusion extending to the cavernous sinus segment(OR=2.292)was identified as a risk factor. Conclusion For patients with nasopharyngeal carcinoma requiring ICA occlusion, preoperative hemoglobin levels should be maintained at ≥90 g/L. Occlusion at segments below the cavernous sinus can reduce postoperative symptoms of cranial nerve paralysis, particularly oculomotor and abducens nerve paralysis. Reference | Related Articles | Metrics

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Syndrome differentiation treatment and understanding of traditional Chinese medicine in carotid blowout syndrome GU Zhanxin, ZHAO Zhouyang, ZHANG Xiaobin, YANG Yimei, HUANG Lijin, HUANG Yan Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 100-107.   DOI: 10.6040/j.issn.1673-3770.0.2024.224 Abstract （242）      PDF（pc） （583KB）（30）       Save Carotid blowout syndrome is one of the acute and critical complications secondary to the comprehensive treatment of nasopharyngeal carcinoma. In the field of traditional medicine of the motherland, due to different clinical manifestations, it can be classified as “hang sang yan”, “bi nv” or “bi hong”. The treatment of carotid blowout syndrome is a comprehensive treatment model. It can be treated with a multi-disciplinary approach. Traditional Chinese medicine intervention plays an important role in the clinical symptoms and prognosis of CBS patients. It can be improving the clinical symptoms and the quality of life of patients. In this paper, we cover the carotid blowout syndrome recognizing and syndrome differentiation treatment. We examine the name,“hang sang yan”,and its connotations,as well as discuss the etiology,pathological mechanism,and Integrated traditional Chinese and western medicine nursing and recuperation. In order to provide a reference for the treatment of carotid blowout syndrome. Reference | Related Articles | Metrics

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The effect of environmental and meteorological factors on the outbreak of acute epiglottitis and tonsillitis in downtown Yangzhou LIU Di, WANG Zhenzhen, GUAN Bing, ZHU Bing Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 142-150.   DOI: 10.6040/j.issn.1673-3770.0.2024.435 Abstract （237）      PDF（pc） （1304KB）（29）       Save Objective To study the relationship between environmental and meteorological factors and the incidence of acute epiglottitis and tonsillitis in downtown Yangzhou, and to provide a basis for clinical prevention. Methods A retrospective study was conducted on patients with acute epiglottitis and tonsillitis admitted to the Northern Jiangsu People's Hospital from January 1, 2014 to December 31, 2022. Air pollutant concentration data from the National Urban Air Quality Real-Time Publishing Platform and meteorological data from the United States National Centers for Environmental Information(NCEI)were collected. Group differences were compared using the Kruskal-Wallis H test with Bonferroni correction for pairwise comparisons. The Spearman correlation coefficient was used to analyze the correlation between environmental-meteorological factors and the incidence of acute epiglottitis and tonsillitis, followed by linear regression to identify the environmental risk factors for acute epiglottitis and tonsillitis. Results A total of 1,256 patients with acute epiglottitis were enrolled from 2014 to 2022, with cases occurring predominantly in spring and a higher prevalence in males ［(53.15±5.90)years］. A significant positive correlation was observed between the onset of acute epiglottitis and PM10, SO2, CO, O3, and wind speed(P<0.05). Linear regression analysis showed that season, CO and O3 significantly influenced the onset of acute epiglottitis(P<0.05). Seasonal analysis showed: Spring: positive correlation with SO2 and temperature difference. Summer: Positive correlation with SO2, CO and NO2. Fall: Positive correlation with SO2 and CO, but negative correlation with temperature difference. Winter: positive correlation with PM2.5, PM10, SO2 and CO. A total of 65,272 patients with acute tonsillitis were included, mainly in summer with male predominance(mean age: 22.46±3.72 years). Positive correlations were found with PM2.5, PM10, SO2, NO2, CO, wind speed and precipitation, whereas a negative correlation was observed with temperature difference(P<0.05 ). Through linear regression analysis, the effects of temperature difference, NO2 and wind speed on the onset of acute tonsillitis are statistically significant(P<0.05 ). Conclusion In downtown Yangzhou, acute epiglottitis occurs predominantly in the spring and disproportionately affects the middle-aged and elderly population, while acute tonsillitis occurs in the summer, especially among the young. Both diseases have a male predominance. Environmental and meteorological factors are significantly associated with the onset of acute epiglottitis and tonsillitis. It suggests that we need to prevent the impact of environmental and meteorological factors on acute epiglottitis and tonsillitis in our daily lives. Reference | Related Articles | Metrics

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Construction of a decision tree algorithm to predict the risk of radiation oral mucositis in nasopharyngeal carcinoma patients after radiotherapy XU Fei, ZHU Guangxi, WANG Kexin Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 42-48.   DOI: 10.6040/j.issn.1673-3770.0.2023.447 Abstract （232）      PDF（pc） （1447KB）（40）       Save Objective To construct a decision tree model for predicting the risk of radiation oral mucositis(ROM)in nasopharyngeal cancer patients after radiotherapy. Methods One hundred nasopharyngeal cancer patients admitted to the hospital from January 2022 to June 2023 were prospectively selected as study subjects, and the patients were categorized into <3 ROM(n=81)and ≥3 ROM(n=19)according to whether or not ≥3 ROM occurred. Risk factors for the occurrence of grade ≥3 ROM after radiotherapy in nasopharyngeal cancer patients were analyzed using univariate and multivariate logistic regression, and an associated decision tree prediction model was established. Results The incidence of ROM after radiotherapy in 100 nasopharyngeal cancer patients was 96.0%. Univariate and multifactorial logistic regression analyses showed that smoking, concurrent chemotherapy, albumin level <35 g/L, and oral pH <7.0 were independent risk factors for the occurrence of grade ≥3 ROM after radiotherapy in nasopharyngeal carcinoma patients, whereas the use of oral mucosal protectants was a protective factor(P<0.05). The results of the accuracy validation of the decision tree model constructed using it showed that the area under the working characteristic curve(ROC)(AUC)of its subjects was 0.924(95%CI: 0.901~0.946). Conclusion There are more influencing factors for the occurrence of grade ≥3 ROM after radiotherapy in nasopharyngeal cancer patients, and the decision tree model constructed based on the influencing factors has good predictive ability for the risk of grade ≥3 ROM after radiotherapy in nasopharyngeal cancer patients. Reference | Related Articles | Metrics

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Retrospective analysis of nutritional indexes and their impact on wound healing in patients with radiation-induced skull base osteoradionecrosis after treatment with nasopharyngeal carcinoma SUN Fang, XIE Chubo, QIU Qianhui Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 59-68.   DOI: 10.6040/j.issn.1673-3770.0.2024.244 Abstract （213）      PDF（pc） （2796KB）（51）       Save Objective The aim of this study was to investigate the influence of relevant nutritional indicators on the success of trauma repair in patients with nasopharyngeal carcinoma with osteoradionecrosis of the skull base, and to provide clinical guidance. Methods We retrospectively analyzed 100 clinically documented complete cases who underwent endoscopic removal of necrotic tissue from the skull base and tissue trauma repair for skull base osteoradionecrosis. The effects of nutritional indicators on surgical wound repair were analyzed using univariate and multivariate Logistic regression. Also chi-square tests were used to analyze the relationship between repair success and postoperative internal carotid artery hemorrhage, and continuity-corrected chi-square tests were used to deal with the theoretical frequency 1≤T < 5 cases. Results Univariate analysis showed that the success rate of surgical repair in normal-weight ［body mass index(BMI)=(18.5-23.9)kg/m2］ patients was 6.43 times higher(OR=6.43, P<0.001)than that in low-body-weight(BMI<18.5 kg/m2)patients, whereas the success rate in obese patients(BMI≥24 kg/m2)was weight patient by 27 times(OR=27.00, P=0.003). In addition, total protein(OR=1.10, P=0.035), albumin(OR=1.29, P=0.001), total cholesterol(OR=1.69, P=0.019), and hemoglobin(OR=1.04, P=0.005)were significantly associated with successful surgical repair. Although peripheral blood lymphocyte count was associated with successful surgical repair(OR=2.32, P=0.068), the difference did not reach statistical significance. Surgical repair success was significantly lower in patients with a Controlling Nutrition Status(CONUT)score of ≥2(OR=0.20, P=0.042). After multivariate analysis further corrected for confounders, surgical repair success rates remained significantly higher in normal-weight and obese weight than in low-weight patients(OR=9.99 and 77.14, respectively; both P<0.001). However, the independent effects of other nutritional indicators were diminished in the multivariate analysis. In addition, the rate of internal carotid artery bleeding after three months was significantly lower in the successful repair group than in the failed repair group(4.62% vs. 28.57%, P=0.002). Conclusion The findings of this study suggest that BMI is a important factor that influencing the success of surgical wound repair, with normal weigh and obese patients having significantly higher surgical repair success rates than low weight patients. In addition, nutritional indices such as total protein, albumin, total cholesterol, and hemoglobin were also significantly associated with surgical repair success, whereas higher CONUT scores were associated with lower success rate. However the independent effect of BMI remained significant in the multivariate analysis, while the independent effects of the remaining nutritional metrics were attenuated. The rate of internal carotid artery bleeding after three months was significantly lower in the successful repair group than in the failed repair group, suggesting that successful surgical repair may reduce the risk of postoperative complications. Reference | Related Articles | Metrics

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Analysis of the reasons and prognostic outcomes for tracheostomy in pediatric patients following posterior fossa tumor resection WANG Hua, ZHANG Fengzhen, LONG Ting, ZHAO Jing, LI Hongbin, WANG Shengcai, WANG Guixiang Journal of Otolaryngology and Ophthalmology of Shandong University    2025, 39 (4): 168-173.   DOI: 10.6040/j.issn.1673-3770.0.2025.028 Abstract （198）      PDF（pc） （1598KB）（43）       Save Objective This study aims to explore the clinical characteristics and outcomes of children who underwent tracheostomy after posterior cranial fossa tumor resection. Methods A retrospective analysis was conducted on 26 pediatric cases that underwent tracheostomy due to posterior fossa tumors. The following data were collected and analyzed: basic patient information, postoperative intubation duration, postoperative respiratory and swallowing conditions, tracheotomy indications, tracheotomy complications, and tracheotomy duration. Patients were observed for at least one year, with follow-ups conducted in outpatient settings or via telephone. Results This study included a total of 26 patients, consisting of 19 males and 7 females. The patients’ ages of the patients ranged from 1 to 13 years old, with an average age of(4.60±3.08)years. The tumor locations were as follows: the fourth ventricle/vermis of the cerebellum in 15 cases, the medulla oblongata and brainstem in 7 cases, the pons in 2 cases, the jugular foramen area in 1 case, and the cerebellar hemisphere in 1 case. Postoperative pathology results were as follows: astrocytoma in 6 cases, ependymoma in 8 cases, meningioma 1 case, craniopharyngioma 1 case, lipoma 1 case, and medulloblastoma in 9 cases. The tracheotomy operation was performed in 25 children for the purpose of persistent mechanical ventilation. The average duration of anesthetic intubation was 14 days. One child was extubated post-surgically but subsequently underwent tracheotomy one month after the operation due to breathing difficulties. Of the 26 patients, two were lost to follow-up, two died, thirteen underwent decannulation, and nine did not. The mean duration of tracheotomy tube usage was 7.8 months. Thirteen children received nasal feeding due to swallowing problems. There were two cases of left vocal cord paralysis, two cases of right vocal cord paralysis, and four cases of bilateral vocal cord paralysis. No patient experienced complications within a period of two weeks following their tracheotomy surgery. Following-decannulation, there were no complications related to tracheal stenosis or tracheomalacia. Conclusion The safety and efficacy of tracheotomy in children diagnosed with posterior cranial nerve dysfunction following surgical intervention for posterior cranial fossa tumors has been well-documented. Children who undergo tracheotomy after posterior cranial fossa tumor surgery require regular evaluation for respiratory and swallowing recovery. The timing of decannulation should be determined based on the individual situation of the child. Reference | Related Articles | Metrics