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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 Abstract （480）      PDF（pc） （5816KB）（193）       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. Reference | Related Articles | Metrics

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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 Abstract （358）      PDF（pc） （4119KB）（116）       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. Reference | Related Articles | Metrics

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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 Abstract （565）      PDF（pc） （1505KB）（91）       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. Reference | Related Articles | Metrics

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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 Abstract （404）      PDF（pc） （7521KB）（85）       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. Reference | Related Articles | Metrics

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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 Abstract （401）      PDF（pc） （3035KB）（77）       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. Reference | Related Articles | Metrics

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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 Abstract （338）      PDF（pc） （2247KB）（51）       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. Reference | Related Articles | Metrics

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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 Abstract （350）      PDF（pc） （430KB）（48）       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. Reference | Related Articles | Metrics

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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 Abstract （289）      PDF（pc） （451KB）（37）       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. Reference | Related Articles | Metrics