Table of Content

20 July 2021 Volume 35 Issue 4

  

Mechanism of inhibition of ovalbumin-induced inflammation by catechins in an OVA-induced mouse model of allergic rhinitis

LI Huajing, HAO Runmei, DAI Hao, ZHANG Ling, SHEN Zhen, QUAN Fang, SHAO Yuan

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  1-7.  doi:10.6040/j.issn.1673-3770.0.2020.399

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Objective This study aimed to analyze the mechanism of inhibition of ovalbumin(OVA)-induced inflammation by catechins in mice with allergic rhinitis. Methods BALB/c mice were randomly divided into a control group(OVA-induced mouse model of allergic rhinitis; model group); low-, medium-, and high-dose catechin groups(mice with allergic rhinitis treated with 50, 100, and 200 mg/kg of catechins, respectively), and a loratadine group(mice with allergic rhinitis treated with 2 mg/kg of loratadine). Each group included 10 mice. After treatment, the symptoms in each group were scored. Hematoxylin and eosin, Giemsa, periodic acid-Schiff, and toluidine blue were used to stain the nasal tissue sections. ELISA kits were used to detect Th1-related(TNF-α and IL-12), Th2-related(TNF-α, IL-1β, and IL-6), and Th17-related cytokine(IL-17A)levels in the mouse nasal lavage fluid(NALF). ELISA kits were also used to detect OVA-specific IgE and IgG1 in the mouse serum. Furthermore, we detected the protein expression of NF-κB p65, nucleus NF-κB p65, STAT3, p-STAT3, and ROR-γt in the mouse nasal mucosa using western blotting. Results The symptom scores of the middle- and high-dose catechin treatment groups were significantly lower than those of the model group(F=13.245, P<0.001). The catechin treatment groups had a lesser number of eosinophils, goblet cells, and mast cells in the nasal mucosa and lower levels of OVA-specific IgE and IgG1(F=15.462, P<0.001 and F=21.544, P<0.001, respectively)than the model group. The number of the abovementioned cells and levels OVA-specific IgE and IgG1 were reduced in a dose-dependent manner. In all groups, the levels of Th1-related cytokines in the NALF of mice did not significantly change(TNF-γ: F=0.753, P=0.600; IL-12: F=0.846, P=0.519).Furthermore, the catechin treatment groups had lower levels of Th2-related cytokines(TNF-α: F=11.100, P<0.001; IL-1β: F=12.554, P<0.001; IL-6: F=17.853, P<0.001), Th17-related cytokines(IL-17A: F=28.139, P<0.001), nucleus-NF-κB p65(F=17.573, P<0.001), ROR-γt(F=26.463, P<0.001), and p-STAT3(F=17.859, P<0.001)than the model group; there was a dose-dependent reduction in these levels. Conclusion Catechins have a good anti-inflammatory effect in mice with OVA-induced allergic rhinitis. The anti-inflammatory mechanism of catechins is related to correction of the Th1/Th2 cytokine balance, inhibition of the Th17 response, and inhibition of the NF-κB and ROR-γt/STAT3 pathways.

Comparative study of holmium and CO₂ laser surgeries for early glottic carcinoma

CHEN Guoping, FU Minyi, YE Fei, XU Jianhui

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  8-11.  doi:10.6040/j.issn.1673-3770.0.2020.421

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Objective To compare the clinical efficacies of holmium and CO₂ lasers in the treatment of early glottic carcinoma. Methods The clinical data of 91 patients with early glottic laryngeal carcinoma treated by laser surgery were retrospectively analyzed(T_is, T₁N₀M₀). Based on the treatment methods, the patients were divided into the holmium(56 cases)and CO₂(35 cases)laser surgery groups. The duration of surgery, blood loss, complications, hospital stay, wound recovery time, and survival rate were analyzed in the two groups. Results There were no statistically significant differences between the postoperative pain scores(P=0.55), hospital stay durations(P=0.99), complications rates(P=0.43), recurrence rates(P=0.59), and laryngeal preservation rates of the Holmium and CO₂ laser groups(P=0.64). The blood loss(P=0.02)and the durations of surgery(P<0.01)and wound healing of the two groups(P<0.01)were statistically significant. There was no significant difference between the 3-year survival rates of the two groups(P=0.69). Conclusion Holmium and CO₂ laser cordectomies have the same effect in the treatment of early glottic carcinoma, and the duration of the former is shorter. With familiarity with the application of the two types of laser, patients can avoid open surgery and undergo minimally invasive treatment of tumors.

Three cases of diagnosis and treatment of cervical necrotizing fasciitis with a primary diagnosis of acute epiglottitis

ZHAO Yaming, SHI Song

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  12-16.  doi:10.6040/j.issn.1673-3770.0.2020.403

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Objective To investigate the relationship between acute epiglottitis and cervical necrotizing fasciitis and its’ clinical course. Methods A retrospective analysis of the clinical data of 3 cases of cervical necrotizing fasciitis with acute epiglottitis as the primary diagnosis. The correlation, diagnosis, and treatment of acute epiglottitisand cervical necrotizing fasciitis were analyzed. Results Three patients underwentsurgery after a definite diagnosis by neck CT.(1fatality and 2recoveries). Conclusion The possibility of cervical necrotizing fasciitis should be considered inpatients with acute epiglottitis who fail to respond to active anti-infective and anti-inflammatory treatment. Early surgery, drainage, and vigilance regarding the basic treatment of systemic diseases are keys to the treatment of cervical necrotizing fasciitis.

Analysis of the clinical efficacy of endoscopy-assisted intraoral removal of an elongated styloid process without tonsillectomy

WANG Xuechang, WANG Tao, REN Xin, ZHAO Mingjun

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  17-21.  doi:10.6040/j.issn.1673-3770.0.2020.413

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Objective To investigate the surgical methods and clinical effects of tonsil-sparing styloid process truncation assisted by endoscopy via an oral approach. Methods We retrospectively analyzed the clinical data of 36 patients with styloid process syndrome(65 sides), the data included the main complaints, course of disease, misdiagnosis, length of the styloid process, and the degree of tonsil enlargement. Results Among the 36 patients, 7 had a unilateral styloid process, 29 had bilateral styloid processes, and 65 had styloid processes. The main complaints were pharyngeal foreign body sensation in 27, neck and shoulder pain or discomfort in 12, sore throat and pain associated with swallowing in 11, dry throat and cough in 7, facial pain in 1, and ear pain in 3 patients. The duration of illness ranged from 20 days to 3 years, with an average of 10 months. Of the misdiagnoses, twenty were pharyngitis, four were gastroesophageal reflux, two were thyroid disease, one was cervical spondylosis, and one was upper respiratory tract infection. The misdiagnosis ratio was 77.8%. Among the 36 patients, 14 had no tonsil hypertrophy, 20 had first-degree enlargement, and 2 had second-degree enlargement. None of the patients had a history of chronic tonsillitis or a tonsil mass. The average length of the preoperative styloid process is(4.38±0.78)cm; the longest is 7.89cm. The average length of the truncated styloid process is(2.09±0.93)cm. The duration of surgery was(67.08±28.4)min, and the blood loss during surgery was(8.42±5.58)mL. In six patients, seven side styloid processes were fractured externally due to the deep position or difficulty of separation. After postoperative follow-up for more than 3 months, 27 cases had resolved symptoms, 4 cases had symptom relief, 4 cases had no change in symptoms. One case was lost to follow-up. Conclusion Tonsil-sparing styloidectomy assisted by the endoscopic transoral approach preserves normal tonsils, with less surgical trauma, less pain, faster recovery, less bleeding, and good surgical results. It is effective for treating styloid process syndrome, which is a safe and minimally invasive surgical method.

Analysis of the characteristics of excessive daytime sleepiness in adult patients with obstructive sleep apnea-hypopnea syndrome

CHEN Jinhui, HUANG Ting, DONG Jie, XU Yong, HAN Jibo, LUO Zhihong, TAO Zezhang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  22-29.  doi:10.6040/j.issn.1673-3770.0.2020.422

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Objective Clinical and polysomnography(PSG)data of obstructive sleep apnea(OSA)patients with and without excessive daytime sleepiness(EDS)were analyzed to investigate correlation factors for the Epworth Sleepiness Scale(ESS)and to explore the effect of surgical intervention for OSA on patients' level of EDS. Methods In total, 565 adult patients diagnosed with OSAHS using PSG in the otorhinolaryngology clinic of our hospital between June 2018 and June 2019 were analyzed retrospectively. The patients were divided into the non-EDS group(ESS≤10 points)and the EDS group(ESS>10 points)according to their ESS scores, of which 400 were assigned to the non-EDS group and 165 to the EDS group. General clinical data of all patients(such as sex, age, body mass index(BMI), neck and chest circumference, waist-to-hip ratio, etc.), PSG parameters(including indexes of sleep respiratory events such as the apnea-hypopnea index(AHI), nocturnal blood oxygen parameters such as LSaO₂ and TS90%, indexes of sleep structure such as the proportion of each sleep period, etc.), and subjective ESS scores were observed; the incidence of EDS and the distribution of the EDS degree were investigated statistically, and the differences in clinical characteristics between the non-EDS and EDS groups were compared. The influencing factors for EDS were explored. Results (1) EDS incidence in adult patients with OSAHS was 29.2%. There were significant differences in sex, age(P=0.001), BMI(P<0.001), level of AHI(P=0.001), and hypoxemia(P<0.001)(P<0.05)between the groups, all of which influenced the incidence of EDS. (2) The distribution of age was similar between the EDS and non-EDS groups(P>0.05). Patients' height(P=0.016), weight(P<0.001), BMI(P<0.001), neck circumference(P<0.001), chest circumference(P=0.002), waist circumference(P<0.001), abdominal circumference(P<0.001), and hip circumference(P=0.002)measurements in the EDS group were all higher than those of patients in the non-EDS group, and all the differences were statistically significant(P<0.05). There were statistically significant differences in total sleep time(P<0.001), sleep efficiency (P=0.003), overall AHI(P<0.001), REM AHI(P=0.001), non-REM AHI(P<0.001), LSaO₂(P<0.001), ASaO₂(P<0.001), TS90%(P<0.001), oxygen reduction index(P<0.001), microarousal index(P<0.001), maximum apnea time(P<0.001), and other sleep respiratory parameters between the EDS and non-EDS groups(P<0.05). (3) The mean age of daytime sleepiness patients with different degrees of sleepiness was similar, and there were statistical differences in body weight(P=0.002), BMI(P<0.001), neck circumference(P=0.010), chest circumference(P=0.028), waist circumference(P=0.006)and abdominal circumference(P=0.003)(P<0.05). The higher the degree of sleepiness, the longer the sleep duration(P=0.047), The higher sleep efficiency(P=0.019), AHI(P<0.001), REM AHI(P<0.001), and NREM The higher the indexes of AHI(P<0.001), TS90%(P<0.001), oxygen deactivation index(P<0.001), microarousal index(P=0.004), maximum apnea time(P=0.030), morning systolic blood pressure(P=0.047)and diastolic blood pressure(P=0.024),LSaO2(P<0.001)and AsaO2(P<0.001)were gradually decreased, and the differences were statistically significant(P<0.05).(4) The subjective ESS score was significantly correlated with AHI(r=0.263, P<0.001), non-REM AHI(r=0.267, P<0.001), LSaO₂(r=-0.266, P<0.001), ASaO₂(r=-0.236, P<0.001), TS90%(r=0.240, P<0.001), oxygen reduction index(r=0.275, P<0.001), microarousal index(r=0.253, P<0.001), and maximum apnea duration(r=0.219, P<0.001)(P<0.05). (5) Binary logistic regression analysis showed that TS90%(P=0.001)and oxygen decrease(P=0.029)index were risk factors for EDS(P<0.05). The oxygen decrease index(P<0.001)may determine the degree of daytime sleepiness. Conclusion The incidence of EDS can be affected by sex, age, BMI, AHI, and severity of hypoxemia. The severity of EDS can be influenced by BMI, severity of OSAHS, and hypoxemia level. Compared with the non-EDS group, the EDS group had a longer sleep time, higher sleep efficiency, and a higher index of PSG parameters. TS90% and oxygen decrease index were risk factors for EDS. The oxygen decrease index may determine the degree of daytime sleepiness.

Excision of T1B glottic carcinoma using the combined approach of cricothyroid membrane and laryngeal ventricle

WU Yungang, ZHANG Hui, SUN Juxing, LIU Tao, WANG Caihua, YANG Xinxin, MA Linxiang, LI Xiaoying, PANG Taizhong, LI Xiaoyu

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  30-34.  doi:10.6040/j.issn.1673-3770.0.2020.426

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Objective This study aimed to explore the curative effect of glottic laryngeal carcinoma excision by the combined approach of cricothyroid membrane and laryngeal ventricle. Methods The clinical data of 16 patients with glottic carcinoma(T1bN0M013, T1bN1M03)were retrospectively analyzed. The tumor was excised using the combined approach of cricothyroid membrane and laryngeal ventricle, and the vocal cords were repaired by pulling down the ventricular zone. The recurrent rate, the extubation rate, hoarseness, glottis morphology, and swallowing were analyzed. Results Of the 16 patients, only one patient developed local recurrence after surgery. The extubation rate was 100%. In all patients, the hoarseness improved to different degrees, the morphology of the glottis was close to the normal triangle, and the patients started to eat on day 5 postoperatively. Conclusion The combined approach of cricothyroid membrane and laryngeal ventricle is safe and effective for T1B glottic carcinoma.

Laryngeal involvement in progressive nodular histiocytosis: a case report with literature review

LIAO Jingwen, CHEN Min, LI Na, HUANG Yichuan, ZHAO Han

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  35-39.  doi:10.6040/j.issn.1673-3770.0.2021.140

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Objective To explore the diagnosis and treatment, the clinical characteristic, as well as the pathological features, of a rare case of progressive nodular histiocytosis involving the larynx. Methods Patient case data, pathological sections were extracted and observed by immunohistochemical staining to summarize the characteristics of this case and to consult the literature related to PNH. Results The pathology of the patient in this case suggested a diffuse infiltration of spindle cells, and immunohistochemistry was positive for CD68 and CD163. The patient presented with supraglottic stenosis, thickening of the tracheal wall, and multiple nodules in the trachea. The patient had undergone a tracheotomy due to dyspnea. This disease involves the skin, and it manifests in multiple nodules and facial nodules that give rise to a “lion face” appearance. After diagnosis, treatment with anlotinib can delay the development of this disease. Conclusion The disease is diagnosed based on pathological examination. It can involve the larynx and cause breathing difficulties. Surgical removal of the facial nodules is not recommended unless body function is seriously affected.

Pyriform sinus fistula in neonates: a clinical report of 3 cases and literature review

YANG Hong, TENG Yishu, LI Lan, PAN Hongguang, LIANG Zhenjiang, HAN Saihong

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  40-44.  doi:10.6040/j.issn.1673-3770.0.2020.385

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Objective To summarize the clinical characteristics, diagnosis and treatment of pyriform sinus fistula in neonates. Methods The clinical manifestation, auxiliary examination, treatment and prognosis of 3 cases of pyriform sinus fistula in our department were analyzed retrospectively between January 2018 and June 2020. Results 3 cases of pyriform sinus fistula were reported, there were 2 boys and 1 girl. One male child was found to have neck tumor 10 days after birth, and the other two cases were found in prenatal examination; 3 cases of pyriform sinus fistula were all on the left side; 3 cases of neck B-ultrasound showed cystic mass in the neck, with thick wall, punctate gas echo in the cavity, and enhanced CT showed gas-liquid level in the cavity. All the 3 cases were treated by operation. Two of them were founded the fistula after removing the tumor and ligated it smoothly. The internal fistula of pyriform sinus was not treated specially. The other one was cut and drained and then cauterized by laser under endoscope. The patients were followed up for 5 months to 2 years after surgery. No recurrence or repeated infection was found. Conclusion The neonatal pyriform sinus fistula usually starts with painless neck mass or is founded in prenatal examination. B-ultrasound and CT examination of the neck showed that the masses were often seen Gas shadow, progressive enlargement of tumor after birth, At this time, we need to highly suspect the pyriform sinus fistula. Surgical treatment is the fundamental method to eliminate the pyriform sinus fistula. No recurrence was found in the laser cauterization of the internal fistula and high ligation of the fistula after removal of the neck mass.

Five cases of metastatic clear cell carcinoma of the head and neck: a case report and literature review

LIU Pan, WANG Chuan, ZHAO Zeqi, WU Mei, XU Jifeng, LI Wei, ZHANG Weiqiang, LIU Wen

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  45-50.  doi:10.6040/j.issn.1673-3770.0.2020.481

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Objective To explore the location and treatment of the metastasis of clear cell carcinoma of the urinary system to the head and neck. Methods Five cases of metastatic clear cell carcinoma of the head and neck admitted to our hospital during 2011-2018 were summarized. The clinical data and treatment method of the primary disease, time of metastasis, site of metastasis, treatment approach for the metastasis, and prognosis were recorded. Results Five cases of clear cell carcinoma involved primary lesions in the kidney(4 cases)and bladder(1 case), all of which underwent radical surgery. The metastases developed 1-10 years after the surgery of the primary lesions, including 1 case involving the maxillary sinus, 1 case involving the frontal sinus and bone, 1 case involving the frontal and ethmoid sinus, 1 case involving the ventricular band, and 1 case involving the frontal subcutaneous area. All four patients had recurrence and died of systemic metastasis, and only 1 patient with subcutaneous metastasis survived. Conclusion Metastasis of clear cell carcinoma to the head and neck is rare. Radical surgical resection is the main method for treating metastatic clear cell carcinoma of the head and neck. Most patients die due to multiple metastases throughout the body.

CT-based radiomics nomogram for the preoperative prediction of central lymph node metastases of papillary thyroid carcinoma

LI Jingjing, WU Xinxin, MAO Ning, ZHENG Guibin, MU Yakui, CHU Tongpeng, JIA Chuanliang, ZHENG Haitao, MI Jia, SONG Xicheng

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  51-59.  doi:10.6040/j.issn.1673-3770.0.2020.490

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Objective To evaluate the value of a nomogram based on CT radiomics and clinical risk factors for the preoperative prediction of lymph node metastases of papillary thyroid carcinomas(PTCs)in the central neck. Methods The cases of 114 patients with PTCs diagnosed and treated surgically at Yantai Yuhuangding hospital were retrospectively analyzed, and the clinical and CT imaging data before treatment were collected. The data of the 114 patients were randomly divided into the training(n=85)and test(n=29)sets using a ratio of 7∶3. Radiological features were extracted from the images during the plain CT scan and the enhanced CT arterial phases. Analysis of variance(ANOVA)and the least absolute shrinkage and selection operator(LASSO)algorithm were used to reduce the dimensionality of the radiomics features in the training set to screen out the features with statistical significance. Combining the clinical risk factors and CT-reported lymph nodes status, the efficacy predictors were screened by multivariate logistic regression, and a radiomics nomogram was established for the preoperative prediction of lymph node metastases of PTCs in the central cervical region. The ROC curve was used to evaluate the diagnostic efficiency of the model, and the model was internally verified, calibrated, and clinically applied. Results A total of 2818 CT radiomics features were extracted from the plain and enhanced CT images of 114 patients. After dimensional reduction, 25 features were highly correlated with lymph node metastases of PTCs in the central neck area. The radiomic nomogram, which incorporated the radiomic signature and CT-reported lymph node status, also showed good calibration and discrimination for the test set(AUC 0.858), which were higher than those of the individual CT image nomogram model for the test set(AUC 0.769)those of the prediction model for the individual lymph node status test set(AUC 0.721). The degree of calibration, internal verification consistency, and clinical value were high for this nomogram. Conclusion The presented radiomics nomogram, a non-invasive preoperative tool that incorporates the radiomic signature and CT-reported lymph node status, showed a favorable predictive accuracy for central lymph node metastases in patients with PTCs.

Factors related to the short-term curative effects of the benign thyroid nodules after microwave ablation

SUN Xiaojing, LI Xinying, LI Siyao, CAO Xiaoli, XUE Jie, QU Nina, GAO Ying

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  60-63.  doi:10.6040/j.issn.1673-3770.0.2020.538

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Objective The aim of this research is to investigate the effects and related factors of microwave ablation for benign thyroid nodules. Methods 133 benign thyroid nodules were followed up after 1, 3, 6 months. The volume reduction rate were calculated respectively. The related factors were analyzed, such as the age, gender, the ablation power, ablation energy and energy per ml, The component of nodules, initial volume and blood supply of nodules. Results The volume of nodules were reduced gradually, and the reduction rate were(47.48±23.24)%,(73.06±16.63)%,(84.44±14.68)%, respectively. Gender, ablation energy and component of the thyroid nodules were independent factors(P<0.05). Conclusion The microwave ablation is an effective and safe treatment for benign thyroid nodules, the short-term curative effects of male patients, nodules with, appropriate ablation energy and mixed nodules could be more ideal.

Expression and clinical significance of the KCNK5 double-pore potassium channel protein in papillary thyroid carcinoma

XUE Gang, SUN Xinmin, LIN Xu, WU Jingfang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  64-69.  doi:10.6040/j.issn.1673-3770.0.2021.004

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Objective To detect the expression of KCNK5 in papillary thyroid carcinoma(PTC)tissues and investigate its correlation with clinicopathological characteristics and prognosis in patients with PTC. Methods Immunohistochemistry and western blotting were used to detect the expression of KCNK5 in PTC tissues and paraneoplastic normal tissues, and the relationship between KCNK5 and the clinicopathological characteristics of PTC was analyzed; moreover, the relationship between KCNK5 and the prognosis of PTC was analyzed using the KM Plotter database. Results Immunohistochemical results showed that KCNK5 was expressed in the cytosol, nuclear membrane, and cytoplasm of PTC cells, and KCNK5 was either not expressed or weakly positively expressed in paraneoplastic normal tissues. Western blotting and immunohistochemical semi-quantitative integration showed that the expression level of KCNK5 in PTC tissues was significantly higher than that in paraneoplastic normal tissues(P<0.05). KCNK5 expression was positively correlated with TNM stage and lymph node metastasis in PTC patients(both P<0.05); multivariate logistic regression analysis further indicated that KCNK5 expression was related to lymph node metastasis(P<0.05). Kaplan-Meier analysis showed that the survival rate of patients with a high KCNK5 expression was significantly lower than that of patients with a low KCNK5 expression(P<0.01). Conclusion KCNK5 is closely associated with lymph node metastasis and prognosis of PTC patients and has the potential to become an indicator of PTC prognosis.

Correlation between changes in blood glucose levels and the duration of surgery in the perioperative period

GAO Lang, CHEN Hongmei, BAI Ye, QIN Xuejiao

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  70-75.  doi:10.6040/j.issn.1673-3770.0.2020.395

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A controlled Study of the accommodative parameters of eyes with uncorrected myopic anisometropia

YUE Pengcheng, DU Qiuxuan, KONG Ling, QIAO Zhentao

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  76-80.  doi:10.6040/j.issn.1673-3770.0.2020.432

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Objective To study the effect of myopic anisometropia on binocular accommodative parameters. Methods The study involved 63 patients with different refractive parameters in their two eyes but no history of refractive correction for anisometropia. They were divided into anisometropia group and control group according to the difference in refractive status. Their cycloplegic refraction were measured using a comprehensive refractometer. The monocular and binocular negative relative accommodation, accommodative responses, positive relative accommodation, accommodative facilities, amplitudes of accommodation, and the differences in adjustment parameters of the two groups were analyzed. Results There were 34 patients in the anisometropia group. The monocular PRA in the eyes with higher degree was -2.10±0.88, and that of the eyes with lower degree was -2.46±0.70; the difference was statistically significant(t=2.96, P<0.05). The monocular accommodative response value of the eyes in the in the eyes with higher degree was +0.51±0.42, and that of the eyes in eyes with lower degree was +0.35±0.35, the difference was statistically significant(Z=-2.45, P<0.05). The monocular accommodative facility of the eyes in the eyes with higher degree was 4.47±2.38, and that of the eyes with lower degree was 5.53±3.03; the difference was statistically significant(t=-2.42, P<0.05). The monocular NRA in the eyes with higher degree was +2.21±0.28, and that of the eyes with lower degree was +2.21±0.40; the difference was not statistically significant(Z=-0.43, P>0.05). There were 29 patients in the control group, they were no statistically significant differences between the NRA, accommodation responses, PRA, and accommodative facilities of the two eyes in the control group(NRA: Z=-0.42, P>0.05; accommodative response: Z=-0.95, P>0.05; PRA: Z=-1.37, P>0.05; accommodative facility: Z=-0.04, P> 0.05). The binocular NRA of the anisometropia group was +2.39±1.58, whereas that of the control group was +2.24±0.31; the difference was statistically significant(Z=-2.54, P<0.01). The binocular PRA was -2.00±0.81 in the anisometropia group and -2.49±0.81 in the control group; the difference was statistically significant(Z=-2.31, P<0.05). The binocular accommodative response was +0.38±0.30 in the anisometropia group and +0.41±0.30 in the control group; the difference was not statistically significant(Z=-0.58, P>0.05). The binocular flexibility was 4.57±2.50 in the anisometropia group and 4.59±2.18 in the control group, and the difference was not statistically significant(Z=-0.04, P>0.05). Conclusion Myopic anisometropia may cause abnormal interbinocular accommodative parameters.

The law of medication for the treatment of endogenous eye disease in chinese medical code based on data mining

WANG Shushu, FU Yahui, YU Ruoyu, HOU Yi, YANG Jiguo

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  81-87.  doi:10.6040/j.issn.1673-3770.0.2021.020

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Objective To collect the prescription of Chinese Medical Code the treatment of cataract, and to summarize the clinical application of traditional Chinese medicine in the treatment of cataract by using the cloud platform(V2.3.5)database of ancient and modern medical records. Methods To search the prescription of Chinese Medical Code for treating cataract, to select the prescription for treating cataract according to the inclusion and exclusion criteria, to establish a Excel database, and to import the cloud platform of ancient and modern medical records(V2.3.5)in batches. Results A total of 249 prescriptions were selected, Contains 244 herbs, The total frequency was 2 596 times; efficacy 396, Total efficacy frequency 5 486 times; Four, properties 9 times. Total frequency 2 922 times; Five tastes,11 times. The total frequency is 3 697 times; The total frequency was 3 750. The top 3 drugs with high frequency of cataract treatment were Fangfeng, Angelica sinensis and Glycyrrhiza uralensis; The drug with high correlation was the highest in people participating in windbreak. Four properties 9 with cold, warm, slightly cold, flat. Conclusion Using the cloud platform(V1.4.5)of ancient and modern medical records to analyze the data, to show the law of drug use in the treatment of cataract eye disease in Chinese Medical Code, and to provide a reference for the summary of clinical practice of traditional Chinese medicine in the treatment of cataract eye disease.

Comparison of pain between two eye operations in patients undergoing implantable collamer lens implantation

XIAO Yu, ZHANG Youyin, DENG Yingping

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  88-95.  doi:10.6040/j.issn.1673-3770.0.2021.076

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Objective The objective of this study was to compare the degree of tension, pain, and cooperation between patients who underwent two implantable collamer lens(ICL)implantation surgeries under surface anesthesia, and to analyze whether there was a difference in pain between the two eyes and explore the possible causes of the pain in order to examine the ideal interval between two ICL operations. Methods A total of 120 patients who underwent binocular ICL surgery were enrolled. Among them, 18 were men and 102 were women. Patients were randomly divided into 1-day and 1-week interval groups. ICL implantation surgeries were performed in both eyes according to the research plan. All operations were performed under surface anesthesia, and ICL implantation was performed using a transparent corneal incision. The degree of tension of patients was evaluated by a visual analog scale(VAS)before the operation. The degree of cooperation of patients and the operation duration were evaluated and recorded during the operation, and the degrees of pain and overall satisfaction were evaluated by a VAS scale after the operation. Additionally, patients were asked to estimate the operation duration. The difference between binocular score in the two groups was statistically analyzed and compared, as well as the relationship between the degree of pain and the general information of patients such as gender, age and so on. Results In both the 1-day and 1-week interval groups, the tension of the patients during the second eye surgery was reduced(1-day interval group: P<0.01; 1-week interval group: P=0.011), the degree of pain significantly increased(both groups: P<0.01), the degree of satisfaction decreased(both groups: P=0.001), and the estimated operation duration was longer(both groups: P<0.01). In the second eye surgery, the degree of cooperation of patients declined(both groups: P=0.002), but it did not lead to an increase in the estimation of operation duration(1-day interval group: P=0.481; 1-week interval group: P=0.499). Also during the second eye surgery, a significant number of patients underestimated the pain they had experienced during the first eye surgery. The bias of memory of the 1-week interval group was statistically significant(1-day interval group: P=0.082; 1-week interval group: P=0.011. The changes in all indexes between the first and second eyes in the 1-week interval group were greater than those in the 1-day interval group, but there were no significant differences between groups(P>0.05). Multivariate regression analysis and nonparametric tests with multiple independent samples showed that young people without childbirth history tended to experience higher levels of pain during surgery. Conclusion Compared with the first eye surgery, the degree of tension decreased, the amount of pain increased, and the degree of cooperation decreased in the second eye surgery. This result may be mainly related to psychological factors; therefore, psychological intervention is warranted before the second eye surgery. No significant difference in pain existed between the 1-day and 1-week interval groups. Our results indicate that the time interval between two eye surgeries can be determined according to the patient's request.

Progress in the surgical treatment of recurrent laryngeal papillomatosis

NIU Zijie, XIAO Yang,WANG Jun,MA Lijinng

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  96-100.  doi:10.6040/j.issn.1673-3770.0.2020.330

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The treatment of laryngeal papilloma is challenging for otolaryngologists. Administering the appropriate treatment can reduce the recurrence rate and the incidence of complications and improve the quality of life of patients. Laryngeal papilloma is the most common benign tumor of the larynx and the common cause of hoarseness in children. Because of recurrence, laryngeal papilloma requires multiple surgeries, and this places psychological and economic burdens on children and their families. In this paper, the common surgical methods and treatment approaches are reviewed to guide the selection of surgical methods by clinicians.

Application of enhanced recovery after surgery in the perioperative period of thyroidectomy

WANG He,SONG Xicheng

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  101-107.  doi:10.6040/j.issn.1673-3770.0.2020.402

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Surgery is the main treatment for thyroid tumors. The commonly used surgical methods include traditional open surgery, endoscopic surgery, and Da Vinci robotic surgery. For any surgical technique employed, strict quality control standards should be maintained, which include minimal surgical trauma, shorter postoperative recovery time, and good recovery. With the increasing number of thyroid surgeries, the postoperative rehabilitation outcomes have attracted considerable attention from both doctors and patients. In the perioperative management of thyroid surgery, adopting a management method based on the premise of enhanced recovery after surgery(ERAS)can greatly improve and expedite the recovery of patients in the perioperative period. This innovative concept and method will surely become the springboard for future developments. The application of ERAS surgery in the perioperative period of thyroidectomy is reviewed in our paper.

Advancements in orofacial myofunctional therapy for obstructive sleep apnea

LI Danyang,LIANG Hui

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  108-114.  doi:10.6040/j.issn.1673-3770.0.2020.286

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Objective The purpose of this study was to systematically review exercises of orofacial myofunctional therapy(OMT)and the mechanism of OMT to treat obstructive sleep apnea(OSA). Methods Studies extracted from PubMed, China National Knowledge Infrastructure, and Wanfang Medical Online up to June 2020 were included. Results Twenty-four studies involving adults and children were analyzed. Among them, 14 studies were on OSA in adults, while 10 were on OSA in children. Twenty studies measured the Apnea-Hypopnea Index and showed improvement, but the degree of improvement varied with the OSA severity and treatment time. Conclusion This study showed that OMT significantly affected simple snoring and mild to severe OSA in adults and pediatric OSA and could be used as an alternative treatment for OSA. However, the mechanism of OSA is unclear, and further studies are required because of the small number of clinical trials and sample size.

The pathomechanism and treatment progress of trigeminal neuralgia

XU Feifei,WU Hao

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  115-122.  doi:10.6040/j.issn.1673-3770.0.2020.354

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Trigeminal neuralgia(TN)is the most common craniofacial pain, but its pathogenesis has not been fully understood. TN often manifests as a sudden, severe, brief, stabbing, and recurrent pain in one or more branches of the trigeminal nerve. Classification methods, various pathogenesis(such as central hypothesis, nerve compression theory, inflammatory response theory, bioresonance hypothesis, and ion channel alteration theory)and clinical multidisciplinary treatment progress were reviewed to provide references for personalized treatment of TN.

Drug therapy for myopia

LIU Ling,ZHANG Meixia

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  123-128.  doi:10.6040/j.issn.1673-3770.0.2020.313

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Myopia is the most common refractive error.Uncorrected refractive error, causing visual impairment, has become an important question of commonality sanitation, owing to affecting the quality of life of individuals and the weightily economy burden.With the prevalence of myopia increasing, controlling myopia progression and protecting eye health have gradually become the hot issue of global concern. And its current treatments include drugs, glasses, and surgery. In recent years, progress has been made in the treatment of myopia. This article focuses on the progress of research on drugs for controlling myopia, including muscarinic receptor antagonists, nicotinic receptor antagonists, and vasoactive intestinal peptides, and their mechanisms of action.

Experience and lessons of diagnosis and treatment of laryngeal infection after low temperature plasma radiofrequency surgery for early glottic carcinoma

SHI Yuqi, SHE Cuiping, ZHANG Qingfeng, LIU Delong, JIAO Mengsi

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(4):  129-134.  doi:10.6040/j.issn.1673-3770.0.2021.163

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A retrospective analysis was made of the diagnosis and treatment of laryngeal infection after low-temperature plasma radiofrequency ablation in two cases of early glottic carcinoma. It is considered that the main factors causing thermal injury of laryngeal cartilage in the operation are too deep cuttng, too high gear, too large range and excessive electrocoagulation hemostasis. And laryngeal infection was secondary to cartilage necrosis. Two cases were cured by debridement in the larynx and combined debridement inside and outside larynx, together with anti-infection therapy. Therefore, by analyzing improper diagnosis and treatment, we can draw lessons, so as to provide reference for improving clinicians' ability of diagnosis and treatment of similar diseases.