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    Analysis of the efficacy of balloon eustachian tuboplasty combined with adenoidectomy in the treatment of otitis media with effusion in children
    GAO Xinzhong, LING Zongtong, SHEN Ling, LIU Pingfang, LIN Xin, XU Yangyang
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (1): 7-12.   DOI: 10.6040/j.issn.1673-3770.0.2021.506
    Abstract2853)      PDF(pc) (447KB)(317)       Save
    Objective To investigate the medium-and short-term efficacy and safety of Eustachian tube balloon dilatation combined with adenoidectomy in the treatment of secretory otitis media in children. Methods Sixty-six children with secretory otitis media and adenoid hypertrophy in our department from July 2020 to February 2021 were analyzed retrospectively. Among them, 35 cases were treated with Eustachian tube balloon dilatation combined with adenoidectomy as the treatment group, and 31 cases with simple adenoidectomy as the control group. The postoperative curative effect and the proportion of complications were compared between the two groups. Results The curative effects at 1 month and 3 months after the operation in the treatment group were significantly better than those in the control group(all P<0.05), with the best curative effect observed at 3 months after the operation in the treatment group, which was significantly better than that at 1 month post-operation(P<0.05). There was no significant difference in the curative effects 6 months after the operation(P>0.05)and in intraoperative blood loss and postoperative complications between the two groups(all P>0.05). Conclusion Eustachian tube balloon dilatation combined with adenoidectomy can improve the curative effect in the short term, and it is minimally invasive and safe, with no obvious complications.
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    Clinical application of target gene panel testing in genetic diagnosis of deafness
    ZHANG Yanhong, LI Juanjuan, ZENG Xianhai, GOU Lingshan, WANG Zhaoxia, WEI Jianfang, MA Fang, QIU Shuqi
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (4): 27-34.   DOI: 10.6040/j.issn.1673-3770.0.2022.190
    Abstract1278)      PDF(pc) (1505KB)(220)       Save
    Objective This study aimed to explore the application of the deafness gene panel in the genetic analysis of patients with hearing loss. Methods The combination of real-time polymerase chain reaction(PCR)and Sanger sequencing was used to identify the 25 mutations of four common deafness genes in 40 deaf patients. Patients with heterozygous mutations, detected via deafness gene sequencing, underwent further single deafness gene sequencing or target gene panel testing. Those with negative real-time PCR results underwent target gene panel testing. The parents of the 16 patients underwent genetic analysis to identify inherited mutations. Results Among the 40 patients, there were eight patients with a homozygous or compound heterozygous mutation in the GJB2 gene and two patients with a single heterozygous mutation, according to the deafness genetic screening. Moreover, one patient had a homozygous mutation, while two had a single heterozygous mutation in the SLC26A4 gene. The four patients with single heterozygous mutations underwent further single deafness gene sequencing or target gene panel testing. Two patients had the compound heterozygous mutation, GJB2 c.235delC/c.610delC or c.235delC/c.109G>A. Meanwhile, two patients had SLC26A4 c.919-2A>G/c.1548_1549insC. Among the 27 patients with negative real-time PCR results, there were four patients with the homozygous mutation, GJB2 c.109G>A, one patient with c.571T>C/c.G109A, one patient with MYO7A c.397dupC/c.3484A>T, one patient with MYO15A c.4779+2T>C/c.5008-2A>G, and one patient with the heterozygous mutation, ACTG1 c.118C>T, based on target gene panel testing. Additionally, there were two patients with the compound heterozygous mutations, CDH23 c.1765G>A/c.6504T>A and c.6049G>A/c.7225-1G>A, respectively. Among the 16 patients, 15 inherited the deafness genetic mutations from their parents, according to the genetic analysis. Conclusion The deafness gene panel improved the genetic diagnostic rate among deaf patients with negative results of hotspot deafness gene mutations.
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    Cervical vertebral osteomyelitis secondary to necrotizing otitis externa:a case report and review of literature
    TIAN Jun, LIU Liangfa, BAI Jiaqi
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (4): 1-5.   DOI: 10.6040/j.issn.1673-3770.0.2022.174
    Abstract1055)      PDF(pc) (5816KB)(354)       Save
    Objective To outline and analyze the clinical features and treatment option of cervical osteomyelitis secondary to necrotizing otitis externa. Methods We performed a retrospective review, along with literature review, of a case of C2-C6 osteomyelitis secondary to a necrotizing otitis externa in a diabetic patient, in order to outline its clinical manifestation, diagnosis, treatment option and prognosis. Results A total of five relevant studies published in Chinese and English from 2005 to 2022 were reviewed, and four cases(including the case presented in this study)were analyzed. The four cases involved three men and one woman(age range: 54-72 years). Only one patient had a history of head and neck radiotherapy, the remaining three were known diabetic patients. The lesions were extensive, involving two to five vertebral bodies. The causative pathogens isolated were all bacteria; however, the strains varied among the cases. After a systematic treatment, three patients(75%)succumbed to the disease as a result of bacterial resistance, poor compliance to medications, and severe comorbidity. Conclusion The lesions of necrotizing otitis externa can extend from the skull base to the cervical vertebrae, causing cervical osteomyelitis: a life-threatening condition that requires an aggressive treatment.
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    Progress on diagnosis and treatment of middle ear cholesteatoma in children
    YANG Yang, WANG Xiaoxu, ZHANG Jie
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (1): 1-6.   DOI: 10.6040/j.issn.1673-3770.0.2021.503
    Abstract994)      PDF(pc) (701KB)(404)       Save
    Middle ear cholesteatoma in children has population specificity in terms of prevalence, pathogenesis, and clinical manifestations. Due to its gradual onset, early diagnosis and treatment have become difficult clinically. With the improvement and popularization of middle ear cholesteatoma in children, this disease is becoming of increasing interest. The application of clinical staging and the accuracy of surgical treatment have greatly improved. The long-term prognosis management of middle ear cholesteatoma in children with cleft palate, Turner syndrome, Down syndrome, and other special populations has also been given importance.
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    Research in the field of olfactory disorders in China—An analysis based on Citespace
    LI Dan, CHEN Tengyu, HUANG Yanfen, ZHOU Min, ZHOU Yixing, RUAN Yan, YAN Yajie
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (4): 40-48.   DOI: 10.6040/j.issn.1673-3770.0.2021.349
    Abstract918)      PDF(pc) (3035KB)(161)       Save
    Objective To visually analyze and evaluate olfactory disorders in domestic research, in an attempt to provide scholars with current research trends and possible future areas of investigation in this field. Methods “Olfactory disorder” was selected as the subject term, academic papers from the China National Knowledge Infrastructure(CNKI)database were explored, with a time-frame from the present to October 20, 2020. Articles were screened according to the inclusion criteria, Citespace software was then used to screen for authors, journals/units and subject headings by means of graphs. Results It was found that the amount of literature published on “olfactory disorders” has increased rapidly. The top authors with the highest number of publications are Wei Yongxiang, Ni Daofeng, Liu Gang, Hang Wei, Yao Linyin, Han Demin, and Liu Jianfeng. The journals ranked 1-3 regarding “olfactory research” are: Journal of Clinical Otorhinolaryngology Head & Neck Surgery; International Journal of Otorhinolaryngology Head & Neck Surgery; and the Chinese Journal of Otorhinolaryngology Head & Neck Surgery. The high-yield cooperative and influential institutions are Beijing An Zhen Hospital of the Capital University of Medical Sciences and Peking Union Medical College Hospital et al. The subject heading cluster analysis showed 7 clusters: chronic rhinosinusitis, Parkinson's disease, Kallmann's Syndrome, rhinitis, Corona Virus Disease 2019(COVID-19), ultrastructure and acupuncture. Conclusion In the field of olfactory disorders, early domestic authors such as Han Demin and Li Zhichun conducted in-depth research. In recent years, authors such as Wei Yongxiang and Ni Daofeng studied the detection methods, etiology, and pathogenesis of olfactory disorders. Although the core authors conducted combinations of research and inductive classifications of olfactory dysfunction in recent years, the central mediation value was less than 0.1, indicating that their relationship was a short liaison. It is recommended that should be strengthened in the service of forming an academic community with which to increase the overall influence of research findings. According to cluster analysis, the current research hotspots of “olfactory disorders” are mainly focused on: The associations between olfactory and chronic rhinosinusitis, Parkinson's disease, novel coronavirus pneumonia(COVID-19), nasal polyps and other primary diseases, and explorations of their pathogenesis. Clinical characteristics and epidemiological investigations of different types of olfactory disorders. Explorations of the efficacy of different treatments, such as endoscopic sinus surgery and acupuncture, on olfactory disorders. It is considered that the above seven clustering research areas may continue to be important hotspots in this field. Among them, chronic rhinosinusitis has been a topic of interest from ancient times to the present, and COVID-19 will become a great source of research work in the next 5 to 10 years. Furthermore, it is possible olfactory disorders caused by COVID-19 may be related to nasal inflammation, and the correlation between them will become a target of future research on olfactory disorders.
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    Advances in the treatment of congenital choanal atresia
    LU Xiaoyan, WEN Shuxin
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (1): 138-142.   DOI: 10.6040/j.issn.1673-3770.0.2020.457
    Abstract910)      PDF(pc) (427KB)(117)       Save
    Congenital choanal atresia(CCA)refers to the anatomical closure of the posterior nostril, which is clinically characterized by no nasal respiratory airflow. The typical manifestations of CT are thickening of the bone of the posterior vomer, pterygoid plate, and closure of the choana with bony/and or membranous plate. According to the extent of the lesion, it can be divided into bilateral atresia and unilateral atresia, and the former often needs timely treatment. Transnasal endoscopic surgery is the first choice of surgery, and its safety and effectiveness have been certified in the past decade. However, postoperative stenosis is still the most important complication. It has been controversial whether the application of traditional stent and mitomycin C is beneficial to avoid postoperative stenosis. At present, some new methods to prevent postoperative stenosis(steroid-eluting stent, and balloon dilatation, and local application of the carboxymethyl cellulose gel-sodium salt)are still emerging, Which may offer promising prospects for the treatment of choanal atresia.
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    Application of 1 000 Hz acoustic immittance in hearing screenings of high-risk newborns
    NI Kun, SUN Shibing, LI Xiaoyan
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (1): 43-47.   DOI: 10.6040/j.issn.1673-3770.0.2021.378
    Abstract863)      PDF(pc) (410KB)(166)       Save
    Objective To explore the significance of the 1 000 Hz acoustic immittance test combined with automatic auditory brainstem response(AABR)and distortion product otoacoustic emission(DPOAE)in hearing screenings of high-risk newborns. Methods A total of 318 high-risk newborns(636 ears)were included as the research subjects. The triple hearing screening scheme of AABR + DPOAE + 1 000 Hz acoustic immittance was adopted. The newborns who failed the screening test were examined for diagnostic hearing at 3 months of age, and the sensitivity, specificity, missed diagnosis rate, false diagnosis rate, and accuracy of the triple screening results were calculated. In this study, the normal triple screening results included AABR(-)DPOAE(+)acoustic immittance(+), AABR(-)DPOAE(-)acoustic immittance(+), and AABR(-)DPOAE(-)acoustic immittance(-). The abnormal triple screening results include AABR(+)DPOAE(+)acoustic immittance(+), AABR(+)DPOAE(+)acoustic immittance(-), AABR(+)DPOAE(-), AABR(-)DPOAE(+)acoustic immittance(-), and AABR(+)DPOAE(-)acoustic immittance(-). Results A total of 318 high-risk newborns(636 ears)were included. The sensitivity of triple screening(96.77%)was higher than that of the AABR-only screening method(80.64%)and DPOAE-only screening method(83.87%), which was consistent with that of the double AABR + OAE screening method(96.77%). The specificity of triple screening(91.24%)was higher than that of AABR + OAE double screening(87.44%). Triple screening can further reduce the false-positive rate of double screening and is suitable for high-risk neonatal screening. Conclusion Triple screening has high sensitivity and a low missed diagnosis rate for hearing screening of high-risk newborns. Triple hearing examinations can be applied to hearing screening of high-risk newborns. Some false-positive infants with simple middle-ear dysfunction can be screened out in the early stage, which can alleviate parental anxiety.
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    Advances on the effect of OSAHS on pulmonary function in children
    YUAN Chenyang, LIU Yan, FANG Zhensheng
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (1): 143-148.   DOI: 10.6040/j.issn.1673-3770.0.2020.386
    Abstract862)      PDF(pc) (440KB)(198)    PDF(mobile) (440KB)(6)    Save
    The incidence of obstructive sleep apnea-hypopnea syndrome in children is gradually increasing. OSAHS not only affects the sleep quality of children; it also leads to the impairment of cardiopulmonary and multi-system function and affects their growth and development. The pulmonary function test, as a non-invasive examination modality, can detect the effect of OSAHS on small airways at an early stage. In this review, the author evaluated recently published literature on the relationships between pediatric OSAHS and pulmonary function and changes after treatment.
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    Clinical analysis of facial nerve decompression via an external transmastoid-subtemporal labyrinth approach in eight children
    DANG Panhong, ZHANG Rui, HU Chunyan, WANG Jie, FAN Mengyun
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (1): 37-42.   DOI: 10.6040/j.issn.1673-3770.0.2021.405
    Abstract830)      PDF(pc) (3237KB)(198)       Save
    Objective To explore the curative effect of the external transmastoid-subtemporal labyrinth approach for facial nerve decompression in children with traumatic facial paralysis. Methods Eight cases of traumatic facial paralysis that were treated by facial nerve decompression with an external transmastoid-subtemporal labyrinth approach within 1 month between January 2014 and July 2019 were retrospectively analyzed. Some cases underwent ossicular chain reconstruction at the same time. Patients were followed up for 1 to 2 years, and the degree of hearing and facial nerve function(House-Brackmann, H-B)were assessed. Results There were seven cases of H-B grade V and one case of grade Ⅳ preoperatively, which reduced to five cases of grade I and three cases of grade Ⅱ postoperatively; Two cases had severe conductive hearing loss preoperatively, which returned to normal and mild postoperatively; One case had normal hearing preoperatively with no hearing loss postoperatively; The remaining five cases had severe or profound sensorineural hearing loss preoperatively. Conclusions Facial nerve function and hearing can be satisfactorily recovered by facial nerve decompression via an external transmastoid-subtemporal labyrinth approach within 1 month of temporal bone fracture.
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    A clinical observation on effect of auricle deformity type and age on outcomes of auricle correction in 1-year-old infants
    MA Xiaobao, LI Yue, SHEN Jiali, SUN Jin, CHEN Xiangping, YANG Jun, CHEN Jianyong
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (1): 25-30.   DOI: 10.6040/j.issn.1673-3770.0.2021.401
    Abstract814)      PDF(pc) (869KB)(93)       Save
    Objective To explore the influence of auricle deformity type and age at the time of correction on the outcomes in order to provide references for clinical non-surgical correction of the auricle. Methods Infants with auricle deformity diagnosed in the ENT department between September 2017 and September 2019 were selected as the subjects. They were divided into two groups based on the age within 1 year. Infants less than 42 days were in the younger group, and infants more than 42 days were in the older group. The type of auricle deformity was divided into prominent ears, cup ears, lop ears, and cryptotia. The modified visual analogue scale in non-surgical auricle correction(MVAS-NAC)was used to evaluate the outcomes. Results The outcomes of the younger group were better than those of the older group(P<0.05). The relationship between the age at correction and the outcome was generally negative(P<0.05). The difference in the duration of treatment between the younger group and the older group was not statistically significant(P>0.05). No significant difference was found in the outcome among the different type of deformity groups (P>0.05). No statistical difference was seen between parents' score and doctor's score(P>0.05). The Spearman rank correlation coefficient between the parents and the doctor was 0.810. The incidence of skin complications in the younger group was lower than that in the older group(P<0.05). Conclusion The age of correction is the main factor affecting the effect of correction. Infants with age above 6 months must not be recommended for auricle correction; for infants with cryptotia, the age limitation can be relaxed. MVAS-NAC can initially be used to evaluate the effect of non-invasive correction of auricle deformities in infants.
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    Short-term and long-term outcomes of endolymphatic sac decompression with instillation of local steroids for intractable Meniere's disease
    XU Jia, LI Xin, CHEN Wenjing, GAO Juanjuan, LU Xingxing, YI Haijin
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (4): 17-21.   DOI: 10.6040/j.issn.1673-3770.0.2021.272
    Abstract799)      PDF(pc) (2247KB)(135)       Save
    Objective To investigate the short-term and long-term effects of endolymphatic sac decompression with instillation of local steroids for intractable Meniere's disease. Methods Twenty-three patients who underwent surgery for intractable Meniere's disease were enrolled. The surgical strategy included traditional endolymphatic sac decompression, opening of the facial recess, placement of gelatin sponge around the round window, and injection of steroids into the tympanic cavity and onto the surface of the endolymphatic sac. Frequency of vertigo episodes and hearing function(pure tone averages)were compared before surgery, 6~12 months after surgery, and 18~24 months after surgery. Results Twenty-three patients completed the short-term effect evaluation at 12 months after surgery. The frequency of vertigo episodes decreased from(5.7±5.9)to(0.4±1.0)times. The vertigo control rate was 87.0%, while the hearing maintenance rate was 95.7%. Thirteen patients completed the long-term effect evaluation at 24 months after surgery. The frequency of vertigo episodes decreased from(4.2±2.6)to(0.1±0.3)times. The vertigo control rate was 92.3%, while the hearing maintenance rate was 100%. Conclusion Endolymphatic sac decompression with instillation of local steroids for the treatment of intractable Meniere's disease had favorable effects on vertigo control and the maintenance of hearing function.
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    Correlation between sinonasal inverted papilloma and peripheral inflammatory blood markers
    MA Jingyuan, WU Tianyi, SUN Zhanwei, WANG Weiwei, LI Shichao, WANG Guangke
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (4): 35-39.   DOI: 10.6040/j.issn.1673-3770.0.2021.264
    Abstract793)      PDF(pc) (430KB)(245)       Save
    Objective To investigate the correlation between sinonasal inverted papilloma(SNIP)and peripheral inflammatory blood markers. Methods 62 patients with SNIP who received endoscopic sinus surgery in the Department of Otolaryngology of Henan People's Hospital from February 2019 to March 2021 were selected as the research objects. 62 age-and-sex-mached healthy controls were included in the study. The number of various peripheral blood cells and inflammatory blood markers such as neutrophil-lymphocyte ratio(NLR), platelet-lymphocyte ratio(PLR)of the patient and control groups were compared. According to whether with malignant transformation and recurrence patients, the research groups were further divided into the SNIP group(38 cases), the recurrence group(14 cases)and the cancer group(10 cases). Multiple comparative analysis were performed on the three sets of data. Results There were statistically significant differences between the patients and controls for neutrophil(P<0.001), eosinophil counts(P<0.001), NLR(P=0.016)and PLR(P=0.005). Logistic regression analysis model showed that the increase of NLR(P<0.001), decrease of PLR(P=0.002)and increase of eosinophil counts(P=0.013)were statistically significant. Further multiple comparative analysis showed that the basophil count in the experimental group was statistically different among the three groups. There was statistically significant difference in the basophil count between SNIP and recurrence group(P=0.045), canceration and recurrence group(P=0.017). Conclusion The peripheral blood eosinophil, neutrophil counts, NLR and PLR are correlated with SNIP, and can be used as peripheral blood inflammation markers of SNIP. The increase of NLR、eosinophil counts, and decrease of PLR may be the risk factors of SNIP.
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    Analysis of audiological and imaging characteristics of 149 children with unilateral sensorineural hearing loss
    HU Chunyan, DANG Panhong, ZHANG Rui, FAN Mengyun
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (1): 31-36.   DOI: 10.6040/j.issn.1673-3770.0.2021.418
    Abstract777)      PDF(pc) (2241KB)(164)       Save
    Objective To analyze the clinical audiological data and imaging manifestations of unilateral sensorineural hearing loss(USHL)in children, and explore its etiology. Methods A total of 149 patients with USHL, aged from one month to 14 years, were analyzed retrospectively. Results 95.97% of the analyzed patients had severe or extremely severe hearing loss, namely single-sided deafness. 38.26% of the patients with USHL were detected through hearing examinations after their hearing screenings were not passed suffered from unilateral hearing loss as per the findings 20.13% children were found by perceiving unicat eral hearing loss. No obvious imaging abnormalities were found in 47 patients. Among the other 102 patients with imaging abnormalities, one had complete dysplasia(Michel malformation), one had dysplasia of the cochlea, and three had common cavity malformation. Two patients had dysplasia of the cochlea and seven patients had dysplasia of the cochlea. These included four patients with IP-Ⅰ malformation, two with IP-Ⅱ malformation, and one with IP-Ⅲ malformation. Seven patients had vestibular aqueduct enlargement, while 28 patients had bony internal auditory canal stenosis or cochlear foramina stenosis. One patient had internal auditory canal enlargement, while 46 patients had cochlear dysplasia, including 10 patients with cochlear nerve absence and 26 with cochlear nerve tenaciousness. Conclusion Most children with USHL experience severe and extremely severe deafness. The proportion of cochlear neurodysplasia and cochlear dysplasia are high in children with USHL. It is also closely related to congenital dysplasia. Therefore, routine temporal bone imaging examinations should be performed for children with USHL.
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    Research progress on auditory risk factors and hearing screening methods among neonates
    PAN Linlin, KONG LingyiOverview, ZHAI Feng, CHEN JieGuidance
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (1): 131-137.   DOI: 10.6040/j.issn.1673-3770.0.2021.080
    Abstract777)      PDF(pc) (477KB)(167)       Save
    Newborn hearing loss results in not only delayed language and speech development but also poor social, recognitional, and educational performance. Several factors have an impact on neonatal hearing. However, the pathogenesis and characteristics of the factors vary based on the type of factor contributing to hearing impairment in neonates. Non-genetic factors mainly include preterm birth, low birth weight, neonatal hyperbilirubinemia, newborn hypoxia, infection, and ototoxic medication, whereas genetic factors mainly include GJB2, GJB3, SLC26A4, and mitochondrially encoded MT-RNR1 variation. Combined application of otoacoustic emission, automatic auditory brainstem response, and acoustic immittance test can effectively improve the accuracy of neonatal hearing impairment screening, which is helpful for early diagnosis and intervention.
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    The correlation between arterial blood gas analysis and hearing screening results in neonates
    PAN Linlin, FANG Xuhua, ZHAI Feng, GUI Yiding, BIAN Zhouliang, CHEN Jie
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (1): 20-24.   DOI: 10.6040/j.issn.1673-3770.0.2021.350
    Abstract753)      PDF(pc) (543KB)(173)       Save
    Objective This study aimed to examine the relationship between arterial blood gas and hearing screening test in neonates. Methods The results of hearing screening test and arterial blood gas analysis of 496 newborns in the Neonatal Department of Shanghai Children's Medical Center were retrospectively analyzed. Results The pass rate of automated auditory brainstem response(AABR), distortion product otoacoustic emissions(DPOAE)and acoustic immittance is 61.9%(307/496), 61.3%(304/496), 90.1%(447/496)and 56.7%(281/496)respectively. There were significant differences in the pass rates of the three hearing screening methods(χ2=131.00, P<0.001). The pass rate of AABR was in extremely strong consistency with that of DPOAE(Kappa=0.817, P<0.001), while the pass rate of both AABR and DPOAE were in very weak consistency with that of acoustic immittance(Kappa=0.262 and 0.256, respectively. all P<0.001). Univariate Logistic regression analysis showed that the failure of hearing screening was correlated with increased lactic acid(OR=0.544, P=0.001), increased partial pressure of carbon dioxide(OR=1.917, P=0.009)and decreased pH value(OR=1.692, P=0.021). Multivariate Logistic regression analysis showed that failed hearing screening results were correlated with increased lactic acid(OR=0.627, P=0.018)and decreased partial oxygen pressure(OR=1.493, P=0.047). No significant correlations were found between hearing screening and the results of partial pressure of carbon dioxide, pH and blood oxygen saturation(P>0.05). Conclusion Neonatal hypoxia and the accompanying change of blood gas might have an impact on hearing screening results.
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    Clinical characteristics and management of pediatric temporal bone fractures
    MA Ning, CHEN Min, LIU Wei, YANG Yang, SHAO Jianbo, HAO Jinsheng, LIU Bing, ZHANG Xiao, DUAN Xiaomin, ZHANG Qifeng, ZHANG Jie
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (1): 13-19.   DOI: 10.6040/j.issn.1673-3770.0.2021.436
    Abstract739)      PDF(pc) (4697KB)(72)       Save
    Objective To summarize the clinical characteristics and treatment strategies of temporal bone fracture in children. Methods Medical records of 477 children under 18 years old who were diagnosed with temporal bone fracture in Beijing Children's Hospital from July 2014 to July 2021 were retrospectively analyzed. Including age, gender, injury causes, imaging, facial nerve and audiological assessment, complications, treatment and prognosis. Results 483 sides of 477 children,6 of which were bilateral. The age range was from birth to 18 years old, the median age was 9 years old, and the male to female ratio was 3.01∶1. Traffic accidents were the main cause of injuries, accounting for 57.23%, followed by falls, accounting for 23.69%. The most common clinical symptoms are tympanema and ear hemorrhage, which usually disappear from 3 weeks to 1 month. Longitudinal fracture accounted for 52.38%, transverse fracture 35, 7.25%; 48 cases of mixed fracture, accounting for 9.93%, and 147 cases, accounting for 30.43%, which could not be classified, were presented as minor fracture lines.372 cases(77.02%)had hearing impairment. Facial nerve injury occurred in 28 cases(5.80%), including 8 cases of internal auditory canal injury. Cerebrospinal fluid otorrhea(CSF)was found in 47 cases(9.73%). Tympanic membrane perforation occurred in 15 cases(3.11%). 6.35% with intracranial injury. 3.98% complicated with multiple fractures or multiple organ injuries. There were 10 cases of immediate facial paralysis, 1 case recovered well, accounting for 10.00%, and 18 cases of delayed facial paralysis, 15 cases recovered well, accounting for 83.33%. 10 cases were treated by operation, including 8 cases of tympanum exploration and ossicular chain reconstruction. Facial nerve HB Ⅴ was recovered to HB Ⅱafter decompression in 2 cases. Conclusion Temporal bone fracture in children is most common in boys, and the most common cause of injury is traffic accident. Tympanic hemorrhage, tympanic membrane perforation, cerebrospinal fluid otorrhea and conductive deafness can be cured by conservative treatment. Trauma caused ossicular chain fracture or dislocation has a good prognosis by surgical treatment. Trauma caused internal auditory canal fracture can cause extremely severe sensorineural deafness and complete facial paralysis with poor prognosis.
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    Bilateral ossification of the auricular cartilage: a case report and literature review
    LIU Bo, XIAO Xuping, LI Yunqiu, ZHOU En, GUO Renbin
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (4): 12-16.   DOI: 10.6040/j.issn.1673-3770.0.2021.234
    Abstract737)      PDF(pc) (4119KB)(191)       Save
    Objective The study aimed to explore the pathogenesis, clinical manifestations, diagnostic basis, differential diagnoses, and treatment methods of auricular cartilage ossification. Methods The clinical data of a patient with auricular cartilage ossification was retrospectively analyzed. A review of related literature was included for summary. Results The pathogenesis of auricular cartilage ossification is yet to be elucidated. Obvious discomfort is not a common finding; however, a few cases may present with local pain, hearing loss, and other symptoms. Computerized tomography of the temporal bone aids in diagnosis, but histopathological examination dictates the final diagnosis. Patients with no obvious symptoms may opt for temporary observation. However, surgical management is the treatment of choice if quality of life and function are affected. Conclusion Auricular cartilage ossification is relatively uncommon in clinical practice, and currently, no treatments have been developed to reverse its course. Active risk identification and early intervention are key to prevent disease progression.
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    Comparative study of ototoxicity between kanamycin and 2-hydroxypropyl-β-cyclodextrin
    YANG Kun, CHEN Lijuan, HE Xiaodan, LIU Zhiqi, SHA Suhua
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (4): 6-11.   DOI: 10.6040/j.issn.1673-3770.0.2021.195
    Abstract730)      PDF(pc) (7521KB)(167)       Save
    Objective This study aimed to investigate the effects of ototoxic injury induced by kanamycin and 2-hydroxypropyl-β-cyclodextrin(HPβCD)in CBA/J mice. Methods Male CBA/J mice were intraperitoneally administered kanamycin for 15 days at the optimal dosage of 700 mg/kg and were subcutaneously administered HPβCD at the optimal dosage of 8 000 mg/kg. The control group was administered 0.9 % sterile sodium chloride. Auditory brainstem response tests were performed. Cochlear preparations and diaminobenzidine staining were used for hair cell observation. Data were analyzed using the statistical software GraphPad Prism 13 for Windows. Results In the control group, at 8 kHz, 16 kHz, and 32 kHz, the thresholds were 21±2.24 dB, 21±2.24 dB, and 21±2.24 dB, respectively. After kanamycin treatment, the thresholds were 22±2.74 dB(t=0.632 5, P=0.544 7), 67± 4.47 dB(t=20.571 8, P<0.001), and 77±4.47 dB(t=25.044 0, P<0.001), respectively. After 6 hours, the thresholds in the HPβCD group were 29±4.18 dB, 30±4.47 dB, and 37±2.74 dB, respectively. After 7 hours, the thresholds were 65±3.54 dB, 71±2.24 dB, and 80±3.54 dB, and after 8 hours, the thresholds were 70±3.54 dB, 78±5.70 dB, and 85±5.00 dB, respectively. Comparison of the data revealed significant differences(F=20.590, P<0.001). Prolonging HPβCD treatment resulted in hearing loss being gradually aggravated at all frequencies. In the kanamycin group, outer hair cell(OHC)loss from the top to the base was significantly different(F=7.840, P=0.000 3), with 9.17±6.03% at 2.0 mm, 89.76±3.12% at 2.5 mm, and 100% at 4.0 mm. Inner hair cell(IHC)loss was also significantly different(F=3.549, P<0.05), with values of 0.71±0.00%, 6.79±6.01%, and 20.71±6.00% being recorded. Six hours of HPβCD treatment resulted in obvious damage to OHCs of the cochlea. Damage occurred at the apex, the middle, and the base of the basement membrane. After 7 to 8 hours, the IHCs and OHCs had practically disappeared. After 8 hours, no IHCs were found. Conclusion Kanamycin and HPβCD induced hearing loss and hair cell damage in mice. OHC damage occurred earlier than the IHC damage, with the degree of damage being dependent on the time and concentration of treatment.The difference is that Kanamycin damaged hearing at the onset of high frequencies, while HPβCD starts from full frequency.
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    A study on the relationship between mastoid pneumatization degree and endolymphatic sac development based on a propensity score matching analysis
    HAN Shuhui, FAN Xintai, WANG Na, WANG Zhe, HOU Lingxiao, XU Anting
    Journal of Otolaryngology and Ophthalmology of Shandong University    2022, 36 (4): 22-26.   DOI: 10.6040/j.issn.1673-3770.0.2021.369
    Abstract621)      PDF(pc) (451KB)(96)       Save
    Objective To explore the relationship between the degree of mastoid pneumatization and the development of the endolymphatic sac. Methods A retrospective study of 145 patients(290 ears)who underwent temporal bone CT examination from January 2019 to May 2021 in the Department of Otolaryngology. After screening, the patients were divided into the well- pneumatized and the poorly-pneumatized groups, according to the degree of mastoid pneumatization. The 1∶1 closest match was adopted. The propensity score(PS)was set at 0.02. The propensity score matching(PSM)analysis was performed on covariates based on age and otitis media. The analysis produced 58 sets of paired data. The shortest distance between the middle of the posterior semicircular canal and the posterior edge of the posterior petrous surface(P-P value)was used to indirectly reflect the development of the endolymphatic sac. The shortest distance between the middle of the posterior semicircular canal and the posterior edge of the posterior petrous surface(P-P value)of different degrees of pneumatization was analyzed statistically. Results The median(interquartile range)of the shortest distance between the middle of the posterior semicircular canal and the posterior edge of the posterior petrous surface(P-P value)was 2.26(1.49, 3.08)mm. The difference between the degree of mastoid pneumatization and the shortest distance between the middle of the posterior semicircular canal and the posterior edge of the posterior petrous surface(P-P value)was not statistically significant. That is, the degree of mastoid pneumatization was not associated with the development of the endolymphatic sac. There were no statistically significant differences in the general data processed after PSM in the two mastoid pneumatization groups. That is, the propensity score matching was effective in managing the selection deviation of non-random experimental data in clinical research. There was a statistically significant difference in the degree of mastoid pneumatization and otitis media; in the group with good mastoid pneumatization, the incidence of otitis media is lower. Conclusion There is no correlation between the degree of mastoid pneumatization and the development of the endolymphatic sac.
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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
    Abstract94)      PDF(pc) (11083KB)(53)       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.
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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
    Abstract94)      PDF(pc) (1101KB)(90)       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.
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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
    Abstract93)      PDF(pc) (3944KB)(63)       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.
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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
    Abstract93)      PDF(pc) (1069KB)(85)       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.
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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
    Abstract91)      PDF(pc) (1043KB)(36)       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.
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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
    Abstract90)      PDF(pc) (5629KB)(39)       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.
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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
    Abstract90)      PDF(pc) (1067KB)(72)       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.
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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
    Abstract87)      PDF(pc) (2891KB)(44)       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.
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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
    Abstract86)      PDF(pc) (2900KB)(46)       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)pixels2vs. [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.
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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
    Abstract86)      PDF(pc) (1123KB)(253)       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.
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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
    Abstract85)      PDF(pc) (1041KB)(63)       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.
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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
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    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.
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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
    Abstract81)      PDF(pc) (4556KB)(23)       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.
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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
    Abstract80)      PDF(pc) (4928KB)(27)       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.
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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
    Abstract80)      PDF(pc) (6240KB)(32)       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.
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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
    Abstract79)      PDF(pc) (6075KB)(29)       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.
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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
    Abstract76)      PDF(pc) (1081KB)(35)       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.
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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
    Abstract74)      PDF(pc) (1054KB)(74)       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.
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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
    Abstract73)      PDF(pc) (3413KB)(53)       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.
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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
    Abstract69)      PDF(pc) (6743KB)(27)       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.
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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
    Abstract66)      PDF(pc) (4289KB)(48)       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.
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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
    Abstract63)      PDF(pc) (1680KB)(22)       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.
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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
    Abstract61)      PDF(pc) (1066KB)(36)       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.
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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
    Abstract61)      PDF(pc) (1028KB)(28)       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.
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