Table of Content

20 September 2021 Volume 35 Issue 5

  

Intratympanic injections and systemic glucocorticoid treatment for sudden hearing loss: a systematic review and Meta-analysis

ZHONG Liping, GUAN Xilong, WANG Jingjing, TANG Yong

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  1-10.  doi:10.6040/j.issn.1673-3770.0.2021.010

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Objective To assess the efficacy, healing rate, and safety of intratympanic injections and systemic glucocorticoids in the initial treatment of sudden hearing loss. Methods The Web of Science, PubMed, Embase, Cochrane Library, CNKI, Wanfang and VIP databases were searched, and all RCTs involving intratympanic injection and systemic glucocorticoids in the treatment of sudden hearing loss before July 2020 were extracted. The literature was analyzed according to their inclusion and exclusion criteria, and their quality was evaluated using the Cochrane Handbook 5.1. Data were extracted and analyzed using RevMan 5.3 Meta-analysis software. Results Nine randomized controlled trials were identified, comprising three papers in Chinese and six in English.A total of 757 cases were included, of which 396 had been treated with intratympanic injections and 361 with systemic glucocorticoids. The Meta-analysis revealed no differences in the total effectiveness rate, healing rate, and mean pure tone average(PTA)gain between intratympanic injections and systemic glucocorticoid treatment(Relative Risk(RR)=1.05, 95% Confidence Interval(CI)=0.65-1.23; RR=1.01, 95%CI=0.79-1.30; and RR=1.18, 95%CI=-0.60-2.96, respectively). The subgroup analysis revealed no significant difference in PTA gain between the severe group and the moderate-to-severe group, and internal research revealed that intratympanic injections were more efficient than systemic glucocorticoids, while foreign research reported no significant difference between them. The major complications of intratympanic injection were transient vertigo and tinnitus, while the incidence of local complications was lower than that observed with systemic steroid treatment, which included high blood glucose, high blood pressure, and insomnia. Conclusion This study revealed no difference in the effectiveness and cure rates of sudden sensorineural hearing loss between intratympanic injections and systematic steroid use. Fewer side effects are associated with postauricular injections than systematic steroid therapy.

Effects of simulated weightlessness and continuous noise in a spaceship on auditory function of rats

LI Yuanchao, WU Wei, WANG Gang, QU Changbei, WANG Lei, LU Wenjun, LI Dan, HAN Haolun, LIU Gang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  11-16.  doi:10.6040/j.issn.1673-3770.0.2021.126

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Objective To explore the time-effect relationship of simulated weightlessness and moderate-intensity continuous noise in a spaceship on the auditory function of rats. Methods Ninety-six male Sprague-Dawley(SD)rats were randomly divided into the weightlessness group, noise group, weightlessness + noise group, and a control group(n=24 per group). On this basis, the rats in each group were divided into 1-week and 4-week groups according to exposure time(n=12 per subgroup). Half of the rats were killed immediately after exposure(P0)as the immediate after exposure group, and the other half were killed 7 days after exposure(P7)as the recovery group(n=6). The tail suspension method(Morey Holton method)was used to simulate weightlessness, and the white noise signal generation system was used to simulate moderate continuous noise:(72±2)dB sound pressure level(SPL)continuous noise for 8 h /d and(50±2)dB SPL continuous noise for 16 h /d in the spaceship. Auditory brainstem response(ABR)thresholds and distortion product otoacoustic emission(DPOAE)were measured at B0, P0, and P7. Results ABR thresholds were(10.83±5.25),(8.13±4.62),(13.54±8.53),(7.08±2.52)dB SPL in the weightlessness group, noise group, weightlessness + noise group, and control group at 1 week P0;(6.67±2.46),(5.83±1.95),(8.75±4.33),(7.92±3.34)dB SPL at 1 week P7;(18.13±7.19),(16.04±5.71),(19.58±8.33),(6.04±2.54)dB SPL at 4 weeks P0; and(7.92±3.96),(7.92±3.34),(14.17±7.93), and(6.25±2.26)dB SPL at 4 weeks P7. The ABR threshold of rats in the weightlessness and weightlessness + noise groups after exposure for 1 week were higher than before exposure and became further aggravated as time progressed. However, there was no significant difference in ABR threshold of noise group between after 1 week exposure and before exposure, although there was significant difference 4 weeks after exposure. There was no significant difference in ABR threshold in the weightlessness + noise group between P7 and P0; thus, the ABR threshold showed no recovery. The ABR threshold of the other exposure groups recovered completely at P7. There was no significant difference in the DPOAE extraction rate between the experimental groups before and after exposure. Conclusion Weightlessness and continuous noise have a significant cumulative and synergistic effect on hearing impairment, with weightlessness being dominant. The ABR threshold shift induced by 4-week simulated weightlessness or moderate continuous noise exposure alone is reversible, but the combined exposure for 4 weeks may have caused irreversible hearing damage, with damage mainly linked to the function of inner hair cells.

Application of decellularized dermal matrix after benign tumor resection in the nasal sinus

JIN Xin, SHI Lei, JIN Mengyuan

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  17-22.  doi:10.6040/j.issn.1673-3770.0.2020.379

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Objective This study aimed to observe and investigate the application of acellular dermal matrix in the nasal sinuses after resection of benign tumors of the nasal cavity and paranasal sinuses, mucosal morphology recovery, and epithelialization. It also compared and analyzed the patient's symptom scores and nasal endoscopy results for the mucous membrane, to evaluate the value of acellular dermal matrix in promoting functional repair and epithelialization of the postoperative nasal mucosa. Finally, it aimed to provide new ideas and methods of improving postoperative recovery of nasal endoscopy. Methods 32 Patients were randomly divided into the experimental group(with acellular dermal matrix)and the control group(without acellular dermal matrix). The Visual Analog Scale(VAS)score and Lund-Kennedy Score(LKES)at 1, 2, 4, and 12 weeks before and after surgery were determined for each of the two groups, and the clinical efficacy of the methods used in the two groups was compared. Results At 2 weeks after surgery, the recovery of the mucosa of the experimental group was significantly better than that of the control group(P<0.05). Regarding the separate signs, the LKES achieved by the experimental group was significantly lower than that achieved by the control group(P<0.05). At 12 weeks after surgery, the scar LKES of the experimental group was significantly lower than that of the control group(P<0.05). The rate of epithelialization in the experimental group was significantly higher than that in the control group(P<0.05). No complications occurred after the operation. The epithelialization rates were compared between the two groups at 4, 8, and 12 weeks. Conclusion Covering the acellular dermal matrix with mucosa in the operative area of benign tumors of the nasal cavity and paranasal sinuses resection can effectively promote the epithelialization of mucosa, accelerate the epithelialization, and improve the scab scar of the nasal mucosa, the symptoms of patients, and patients’ quality of life, which is worthy of clinical application.

Serum 25-(OH)D₃ and tissue TGF-β₁ levels in patients with chronic rhino sinusitis with nasal polyps and their clinical significance

HAN Jiaqi, YUAN Guoqing, ZHU Yutong, JIANG Feifei, YAN Aihui

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  23-27.  doi:10.6040/j.issn.1673-3770.0.2020.536

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Objective To investigate the relationship between serum 25-(OH)D₃ levels and transforming growth factor-β₁(TGF-β₁)expression in patients with chronic rhinosinusitis with nasal polyps(CRSwNP). Methods Forty-seven patients with CRSwNP who were diagnosed by pathology were selected as an observation group and 21 patients with maxillary sinus cysts were selected as the control group. The level of serum 25-(OH)D₃ and the mean optical density of TGF-β₁ in the tissue samples were compared between the two factors. Results The level of serum 25-(OH)D₃ in the observation group(16.97±7.35 μg/L)was lower than that in the control group(22.07±11.60 μg/L), the difference was statistically significant (P=0.032); the mean optical density of the TGF-β₁ in the nasal polyps(0.052 4±0.019 1)was higher in the observation group than the control group(0.041 0±0.014 5); the difference was statistically significant(P=0.018). There was a significant correlation between serum 25-(OH)D₃ levels and TGF-β₁ expression in the nasal polyps(R2=0.204,|R|=0.452, P=0.019). Conclusion The level of serum 25-(OH)D₃ in patients with CRSwNP decreased, while the expression of TGF-β₁ in the nasal polyps increased, and there was a significant correlation between them in CRSwNP.

A study on the associations between psychological factors and allergic rhinitis among residents

WANG Fei, LIU Yuying, XIAO Qiyi, DING Jian, GAO Shang, MAO Wei

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  28-31.  doi:10.6040/j.issn.1673-3770.0.2021.021

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Objective To study the effect of psychosocial factors on the QoL(Quality of Life)of residents with allergic rhinitis, to determine whether psychosocial factors, such as anxiety and depression, are related to QoL. Methods A total of 70 residents with allergic rhinitis, assessed using the fiberoptic rhinoscopic method, were screened. The effects of psychological factors, such as anxiety and depression, on the QoL of these in-patients were investigated based on their self-ratings for anxiety and depression using the QoL scale(SF-36), and the results were statistically analyzed. Results There were negative associations between anxiety, depression, and QoL in residents with allergic rhinitis. Conclusion With the aggravation of anxiety and depression, the QoL of residents with allergic rhinitis decreased significantly.

Computed tomography-based preoperative diagnosis of fungal ball sinusitis

QIN He, WAN Baogang, WANG Hongli, ZHAO Benqi

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  32-35.  doi:10.6040/j.issn.1673-3770.0.2021.041

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Objective To investigate the computed tomography(CT)features of fungal ball sinusitis and evaluate their preoperative usefulness in differential diagnosis. Methods The CT scans of 32 patients preoperatively diagnosed with fungal ball sinusitis between January 2019 and December 2020 were retrospectively analyzed. The perioperative findings were compared with the preoperative CT findings. Histopathology and fungal smears were performed postoperatively. Results Of the 32 patients, 30 were diagnosed with fungal ball sinusitis based on the perioperative findings and postoperative histopathology; the diagnostic accuracy was 93.7%. In these 30 patients, the CT characteristics included intralesional hyperdensity, calcification spots, irregular surfaces, and sclerosis of the lateral sinus wall. Among the two other patients, one was diagnosed with eosinophilic papilloma of the maxillary sinus and the other was pathologically diagnosed with hemorrhagic necrotizing polyps. Conclusion Intralesional hyperdensity with calcification spots is a specific CT feature of fungal ball sinusitis. Partial opacification with an irregular surface and bony sclerosis in the areas affected by sinusitis are also CT characteristics. There is a risk of misdiagnosis when diagnosis is based solely on CT examinations.

Diagnosis and treatment of renal clear cell carcinoma that has metastasized to the nasal cavity and paranasal sinuses: a case report and systematic review

XIA Caifeng, XIE Ruiling, ZHEN Zhen, WEN Feng, WANG Quangui

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  36-45.  doi:10.6040/j.issn.1673-3770.0.2021.065

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Objective To summarize and analyze the clinical features, diagnostic methods, treatment, and prognosis of patients with renal clear cell carcinoma(RCCC)that has metastasized to the nasal cavity and paranasal sinuses. Methods We conducted a retrospective review of the records of one patient with RCCC that had metastasized to the paranasal sinuses. We also performed a literature review and included 64 relevant studies published in Chinese and English from 1993 to 2020, including this case. A total of 76 patients with renal clear cell carcinoma that had metastasized to the paranasal sinuses were included, and their clinical manifestations, diagnosis, treatment methods, and prognosis were summarized. Results The 76 patients included 61 men and 15 women, with the most common symptoms being epistaxis in 58 patients and nasal obstruction in 25. The metastases were located in the nasal cavity(n=52), ethmoid sinus(n=41), and maxillary sinus(n=22). Twent-eight patients had sinonasal metastasis of renal clear cell carcinoma at first presentation. The delay between the diagnosis of the primary tumor and the diagnosis of metastasis to the sinonasal cavity ranged from 15 days to 27 years(mean, 46 months; median, 12 months). On CT and MRI, the lesions exhibited osteolysis and strong enhancement after contrast injection. The misdiagnosis rate was 22%. Immunohistochemistry was crucial for the correct diagnosis, and the most commonly used markers were CK, Vimentin, CD10, PAX8. Twenty-five patients(32.9%)underwent surgical management alone, 28 patients(36.8%)had surgical management combined with radiotherapy/chemotherapy/targeted therapy, 19 patients(25.0%)received targeted therapy alone and/or chemoradiotherapy, and 4 patients received no treatment. Follow-up data were available for 51 patients, and the duration of follow-up ranged from 1 month to 14 years(median, 12 months). There was a strong statistically significant association between surgery and a better prognosis(P<0.001). The overall survival was significantly better for patients whose duration between the primary tumor and metastasis was more than 4 months vs. no more than 4 months(P=0.008 7). There was no statistical difference in overall survival between patients who had sinonasal metastasis at first presentation of RCCC and those who had already been diagnosed with RCCC earlier(P=0.14), an isolated metastasis rather than multiple metastases(P=0.1), and surgery alone rather than surgery combined with radiotherapy(P=0.52). Conclusion Metastatic renal clear cell carcinoma to the nasal cavity and paranasal sinuses is rare. It mainly affects elderly males and can be diagnosed at the initial presentation of RCCC or long after treatment of the primary tumor. The most common symptoms are epistaxis and nasal obstruction. On CT and MRI, the lesions exhibit strong enhancement after contrast injection. The diagnosis depends on pathology and immunohistochemistry. It can easily be misdiagnosed as hemangioma. Surgical resection is the main treatment, and nasal endoscopic surgery after vascular embolization is recommended as it can improve the prognosis of the patients. Patients who cannot undergo surgery can undergo targeted therapy or chemoradiotherapy, with a poor overall prognosis.

A study on the mechanism of action of the Xiaoqinglong Decoction in treating allergic rhinitis based on network pharmacology

WANG Xin, LIU Qiaoping, YAN Zhanfeng, LIU Siming, ZHU Yajing, DING Qian, ZHANG Ying, TIAN Yuan, ZHANG Jingran

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  46-55.  doi:10.6040/j.issn.1673-3770.0.2021.134

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Objective To analyze the mechanism of action of the Xiaoqinglong decoction in allergic rhinitis treatment based on network pharmacology in order to provide direction and reference for its clinical application and further research. Methods Multiple data platforms were used to analyze the mechanism of action of the Xiaoqinglong decoction in allergic rhinitis. Through the screening of OB and DL values in the TCMSP database, the effective chemical components of the decoction, as well as their action targets, were obtained. The Cytoscape 3.7.1 software was used to draw the network diagram of the decoction's effective component-target and screening the drug's key components. Meanwhile, potential allergic rhinitis targets were obtained using the GenCards and OMIM databases, and the different genes were obtained from the GEO database and were included in the next analysis. Using an online drawing software, a Venn diagram was drawn to extract the intersection targets of the Xiaoqinglong decoction and allergic rhinitis disease targets for further analysis. Protein interaction analysis was then carried out for the intersection targets on the String platform for PPI network construction, which was imported into the Cytoscape3.7.1 software to screen the decoction core targets in allergic rhinitis treatment. The Metascape platform was used to analyze the biological processes and pathways involved in the intersection targets of Xiaoqinglong decoction-allergic rhinitis, and the GO and KEGG analyses data were obtained afterwards. The OriginPro2020 was then used to visualize the results obtained and analyzed using the Cytoscape 3.7.1 software, constructing the “Xiaoqinglong Decoction-allergic rhinitis intersection targets-signal pathway” diagram in the process. Additionally, AutoDock was used for molecular docking verification of these key components and core targets. Results The effective chemical components of the Xiaoqinglong decoction in allergic rhinitis treatment included quercetin, kaempferol, and naringenin, among others. Meanwhile, the identified core targets were STAT3, IL6, and TNF, among others. Moreover, the signaling pathway of the Xiaoqinglong decoction in allergic rhinitis treatment mainly acted on the TNF, MAPK, PI3K-Akt, IL-17, and HIF signaling pathways, wherein the molecular function was mainly found to mediate receptor ligand and receptor regulator activities, among others. Conclusion This study initially revealed the multi-component, multi-targeted, and multi-pathway mechanisms of action the Xiaoqinglong decoction in allergic rhinitis treatment, providing references for the drug's clinical applications.

Application of Voxel-man ENT surgery simulation system in the training of nasal operation technique

BA Guangyi, MAO Song, SUN Xiwen, TANG Ru, LI Zhipeng, LIN Hai, ZHANG Weitian

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  56-61.  doi:10.6040/j.issn.1673-3770.0.2021.102

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Objective To explore the effect of Voxel-man ENT surgery simulation system on the training of basic skills of nasal anatomy and nasal endoscopy for trainers with different clinical experiences. Methods A total of 12 residents and further study doctors in our department received virtual reality surgery system anatomy training and nasal endoscopic surgery skills training for 1 hour every other day for 6 weeks. The scores of the subjects were compared before and after the training, and paired t-test was performed with SPSS 26.0 and Graphpad Prism 9. Results After 6 weeks of training, the anatomical skills and surgical operation scores of the overall participants were significantly improved as compared with those before training(P<0.05). Conclusion Virtual reality surgery simulation system can obviously improve the teaching effect of nasal endoscopic surgery, shorten the initial learning curve of endoscopic surgery, and help to improve the teaching quality.

Application of the ultrasonic scalpel in tonsillectomy for biopsy of patients with suspected tonsillar tumor

SHEN Nimei, QIAN Maohua, JIN Jiaxin, QIN Yang, WANG Jun, WU Ying, GAO Gang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  62-66.  doi:10.6040/j.issn.1673-3770.0.2020.430

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Objective We aimed to explore the application of the ultrasonic scalpel in tonsillar tumor resection. Methods Seventy cases of adult patients with abnormally shaped unilateral tonsils suspected of being tumors were divided into ultrasonic scalpel(35 cases)and electric scalpel(35 cases)groups. The general clinical data, operation time, intraoperative blood loss, postoperative pharyngeal pain and complications of the patients were recorded, and the data of the two groups were compared. Results The postoperative pathologies of the two groups were revealed to be mostly benign lesions, with the most chronic inflammation, followed by papilloma and cysts. Most malignant lesions were lymphoma. The ultrasonic scalpel group was superior to the electrosurgical group in terms of operative time and intraoperative blood loss(P<0.001), although it exhibited no obvious advantages in terms of postoperative secondary bleeding, postoperative infection, and duration of hospitalization. No postoperative primary hemorrhage was observed in the ultrasonic scalpel group and 5 patients in the electrosurgical group; however, the difference between the two groups was not statistically significant(P=0.054). The pain visual analogue scale(VAS)score of the ultrasonic scalpel group on the first day after surgery was superior to that of the electrosurgical group(P=0.009), and the difference was not statistically significant at 2, 5, and 10 days after surgery. Conclusion The ultrasonic scalpel is an ideal surgical instrument for tonsillectomy in patients with suspected tonsillar tumors.

Adjunctive treatment of refractory by adjustable laryngoscope Hemorrhage after tonsillectomy

FENG Shiqiang, JIANG Xian

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  67-69.  doi:10.6040/j.issn.1673-3770.0.2021.019

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Objective To provide a more convenient treatment method for tonsillar hemorrhage that is difficult to handle by conventional openers. Methods Eleven patients with bleeding after tonsillectomy were changed to an adjustable supporting laryngoscope to assist in finding the bleeding point to stop bleeding because the bleeding point was not clearly exposed. Results the adjustable laryngoscope had clear vision, fully exposed the hidden and deep bleeding points, which could quickly stop bleeding and significantly shorten the observation time in hospital. Conclusion the adjustable laryngoscope is a reliable method to find the bleeding point after tonsillectomy, especially for the difficult tonsillar wound bleeding which is very hidden and deep under the tonsil, and provides an optional method for the treatment of postoperative bleeding of tonsil.

Study on the value of tumor abnormal protein in clinical diagnosis of laryngeal carcinoma

LI Yanjie, JIA Jian, YANG Ping, WAN Baoluo

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  70-74.  doi:10.6040/j.issn.1673-3770.0.2021.043

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Objective Detection of tumor abnormal protein in patients with laryngeal cancer and healthy people was conducted to analyze the clinical value of tumor abnormal protein in the diagnosis of laryngeal cancer. Methods A total of 95 patients with laryngeal cancer diagnosed in pathology department, People's Hospital from September 2017 to September 2019 were selected as the experimental group, while 95 healthy patients were selected as the control group. All subjects were tested for tumor abnormal protein to explore its application value in the clinical diagnosis of patients with laryngeal cancer. Results The positive rate of tumor abnormal protein in patients with laryngeal cancer was 83.16%, which was higher than that in healthy people(15.79%), and the difference was statistically significant(P<0.001).The positive expression rate of TAP in peripheral blood of patients with lymph node metastasis and stage Ⅲ+Ⅳ laryngeal cancer was higher, and the difference was statistically significant(P<0.05).There was no significant difference in the expression level of abnormal tumor protein in peripheral blood of laryngeal cancer patients with different genders and ages(P>0.05). Conclusion The expression of tumor abnormal protein in peripheral blood of patients with laryngeal cancer has high sensitivity, and tumor abnormal protein has high application value in the clinical diagnosis of laryngeal cancer.

Potential biomarkers and bioinformatics analysis of differentially expressed genes in recurrent laryngeal papilloma

QI Wenwen, CHEN Luqiu, JIA Tao, CHEN Xuemei, ZHANG Jie, ZHANG Hao, JIN Peng, ZHANG Hu

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  75-84.  doi:10.6040/j.issn.1673-3770.0.2021.068

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Objective This study aimed to provide new ideas or targets for recurrent laryngeal papilloma using bioinformatics. Methods The chip dataset GSE10935 was downloaded from the Gene Expression Omnibus(GEO)database, and the online analysis tool GEO2R was used to screen differentially expressed genes(DEGs)between recurrent laryngeal papilloma tissues and their adjacent normal laryngeal mucosal tissues. Gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses of the DEGs were performed using the online software Metascape. The STRING online software was used to analyze the protein interactions of the DEGs. Module analysis of the hub genes was performed using the Cytoscape software. Finally, the online transcription factor enrichment analysis database CHEA3 was used to predict the key transcription factors in recurrent laryngeal papilloma tissues. Results A total of 53 DEGs(|logFC|>1, adj P<0.05)including 30 upregulated and 23 down-regulated genes were screened from 10 pairs of recurrent laryngeal papilloma tissues and their adjacent normal laryngeal mucosal tissues. GO and KEGG pathway enrichment analyses suggested that these DEGs were mainly enriched in multiple metabolic processes, including immunomodulation and PPAR signaling pathways. SLC27A2, SCD, ECI2 and FADS2 were screened as the hub genes through protein-protein interaction network construction and module analysis. Further analysis revealed that TP63 was the most important transcription factor in recurrent laryngeal papilloma. Conclusion This study provides new ideas for in-depth understanding of the biological mechanism of recurrent laryngeal papilloma and exploring effective treatment for recurrent laryngeal papilloma.

Comparison of anterior segment analyzers: the Oculyzer and CASIA2

XU Wen, ZHENG Yan, FU Caiyun, ZHANG Li, WANG Yue, ZHANG Qiulu, LIU Jing, HU Yabin, ZHAI Changbin

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  85-92.  doi:10.6040/j.issn.1673-3770.0.2021.145

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Objective To compare the differences in corneal refractive power, corneal thickness, and Q value measured by the Oculyzer and CASIA2 devices in patients with myopia. Methods This study evaluated 249 eyes in 125 patients with myopia. The steep keratometry diopter(Ks), flat keratometry diopter(Kf), mean keratometry diopter(Km), astigmatism degree, Q values of the anterior and posterior corneal surfaces, central corneal thickness(CCT), and thinnest point of the corneal thickness(TCT)were recorded. The differences and agreement between measurements were evaluated using paired t-tests and Bland Altman plots., respectively. Results The Ks, Kf, and Km values of the anterior corneal surface measured by the Oculyzer and CASIA2 differed significantly ［(44.23±1.71)D vs(44.38±1.64)D,(42.71±1.39)D vs(42.87±1.35)D, and(43.45±1.48)D vs(43.63±1.44)D, respectively)］(all P<0.001). The astigmatism degrees of the anterior corneal surface(1.51±0.90)D vs(1.50±0.87)D did not differ significantly(P=0.98). The Ks, Kf, and astigmatism degrees of the posterior corneal surface measured by the two instruments also differed significantly ［(-6.50±0.86)D vs(-6.35±0.29)D,(-6.02±0.26)vs(-5.97±0.24)D, and(0.52±0.22)D vs(0.38±0.15)D, respectively］(all P<0.001). The Km values of the posterior corneal surface(-6.17±1.15)D vs(-6.16±0.25)D did not differ significantly(P=0.87). The CCT and TCT measured by the two instruments ［(542.86±33.04)μm vs(529.53±32.35)μm and(539.72±33.39)μm vs(524.66±32.40)μm differed significantly(all P<0.001). The Q values of the anterior corneal surface measured by the two instruments(-0.33±0.12)vs(-0.33±0.13)did not differ significantly(P=0.62). The Q values of the posterior corneal surface(-0.28±0.17)vs(-0.38±0.16)significantly(P<0.001). Bland-Altman analysis showed that the 95% limit of agreement(LoA)of the anterior and posterior corneal surface refractive power, astigmatism degree, and Q values measured by the two devices were relatively narrow and showed good consistency. However, the 95%LoA of CCT and TCT between the two devices was relatively wide and showed poor consistency. Conclusions The differences in corneal refractive power, corneal thicknesses, and Q values between the Oculyzer and CASIA2 suggest the need for comprehensive analysis and selection in clinical practice.

Advancements of HIF-1α and VEGF in middle ear cholesteatoma

FAN Huijuan，,ZHANG Haili

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  93-97.  doi:10.6040/j.issn.1673-3770.0.2020.466

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Cholesteatoma of the middle ear is an aggressive disease mainly composed of keratin fragments, keratinized squamous epithelium and its surrounding connective tissue. It is influenced by many factors and its pathogenesis is unclear.With the progress of science and technology, researchers began to study the pathogenesis of middle ear cholesteatoma from the aspect of molecular biology.hypoxia-inducible factor 1 alpha(HIF - 1α)and vascular endothelial growth factor(VEGF)have a variety of biological functions, they may play important roles in the middle ear cholesteatoma.In this review, we summarized the biological characteristics of HIF-1α and VEGF, and their possible roles in proliferation, apoptosis, immune response and aggressive growth of middle ear cholesteatoma, so as to provide the possibility for understanding the role of HIF-1α and VEGF in the pathogenesis of cholesteatoma and the non-surgical treatment and drug development of middle ear cholesteatoma

Research developments on microRNA in the pathogenesis of allergic rhinitis

WANG Yuting，,WANG Jiaxi

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  98-104.  doi:10.6040/j.issn.1673-3770.0.2020.365

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The pathogenesis of allergic rhinitis, a common clinical disease, is relatively complex, and there are still defects in its diagnosis and treatment. The microRNA has been a research hotspot in recent years, and studies on allergic rhinitis provided a new understanding of the disease. This study summarizes the relationship between microRNA and allergic rhinitis in the perspectives of innate immunity, adaptive immunity, and epigenetic factors, in order to determine its pathogenesis.

Research progress on circRNAs in allergic rhinitis

LIU Zhai，,YING Minzheng

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  105-112.  doi:10.6040/j.issn.1673-3770.0.2020.393

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CircRNAs are newly discovered non-coding RNAs found widely in eukaryotes. They lack the 5' cap structure and 3' adenosine tail. It has been confirmed that circRNAs can regulate gene expression in several ways. For example, we found that some circRNAs contain binding sites of the corresponding sequence in microRNAs. These circRNAs act as molecular sponges to bind miRNAs and intercept their suppressive function on mRNAs. The latest research has showed that some circRNAs expressed at high levels can be found in the nasal mucosa in AR, and that they are involved in the regulation of some cytokines related to AR. However, current research has failed to find a correlation between circRNAs and the degree of severity of AR in humans. In summary, this study evaluated the formation mechanisms, characteristics, and biological functions of circRNAs. The study has also described the post-transcriptional control and “molecular sponges” affect in AR, and it has summarized their potential in the diagnosis and treatment of AR. The study findings provide theoretical support for the analysis of AR in the future.

Advancements in surgical repair after maxillectomy

LI Yanan，,HUANGFU Hui

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  113-117.  doi:10.6040/j.issn.1673-3770.0.2020.326

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Maxillary defects can result from trauma, congenital malformation and other causes, but are mostly caused after malignant tumor resection. Postoperative defects of key anatomical structures severely damage the patient's esthetic appearance and cause the loss of swallowing, pronunciation, chewing and others functions, leading to physical and mental trauma. Therefore, the anatomical complexity of the maxilla makes reconstruction surgery one of the most difficult challenge for surgeons. However, there is no unified classification system or corresponding method for maxillary defect repair. This review is aimed at summarizing the classification system for maxillary defects, repair types, advantages and disadvantages, repair methods and future prospects of maxillary defect classification.

Analysis of underlying factors of refractive errors in infants with retinopathy of prematurity

RAN Hongyun, JIANG Keke，,ZHANG Jie

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  118-124.  doi:10.6040/j.issn.1673-3770.0.2020.418

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Preterm birth refers to delivery within 37 weeks of pregnancy; newborns delivered within this time are called premature babies. Retinopathy of prematurity(ROP)is a type of retinal vascular dysplasia that occurs in premature and low-weight infants. It is the main cause of blindness in children globally. Infants with retinopathy of prematurity have a high risk of developing refractive errors. The underlying factors, which include gestational age, birth weight, refractive parameters, treatment methods, and early detection and intervention of ROP, are very important for the visual prognosis of children. We provide an introduction and summary of the factors that may affect the visual development and refractive status of infants with retinopathy of prematurity.

Model preparation of infectious keratitis

YAN Yu, ZENG Ao，,HE Yuxi

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  125-131.  doi:10.6040/j.issn.1673-3770.0.2020.449

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Infectious keratitis is an inflammation caused by the invasion of pathogenic microorganisms on corneal tissue. It is a common cause of blindness in the world. The main pathogenic microorganisms are bacteria, fungi, viruses, and Acanthamoeba. Bacteria is the main cause of infectious keratitis, but fungal keratitis has been increasing year by year in recent years. At present, the effective treatment is local use or subconjunctival injection of anti-bacterial and fungal agents, and systemic use of antiviral drugs, based on the different pathogenic microorganisms. We systematically describe models preparation of infectious keratitis caused by bacteria, fungi, viruses, and Acanthamoeba, including the preparation of the bacterial solution, operation methods and scoring detection methods. This paper elaborates how to prepare a targeted animal model to provide theoretical basis for evaluating and exploring the treatment effect and adverse reactions of infectious keratitis.

Retinochoriodal changes associated with silicone oil tamponade detected by optical coherence tomography and optical coherence tomography angiography

ZHANG Xinyu，,LEI Chunyan, ZHANG Meixia

Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(5):  132-136.  doi:10.6040/j.issn.1673-3770.0.2020.539

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Silicone oil, as a vitreous substitute, is widely applied to the surgical treatment of complicated vitreoretinal diseases. Although silicone oil is generally recognized for its safety and efficacy, its intraocular tamponade can cause various complications in the anterior and posterior segments of the eyes. With the emergence and application of Optical Coherence Tomography(OCT)and Optical Coherence Tomography Angiography(OCTA)in recent years, retinochoroidal changes associated with silicone oil tamponade have been further studied. This review summarizes the changes in the blood flow and structure of the retina and choroid associated with silicone oil tamponade, which were detected by OCT and OCTA.