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Table of Content

    20 November 2021 Volume 35 Issue 6
      
    Importance of standardized methods in corneal refractive surgery and the prevention of complications
    LI Ying
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  1-6.  doi:10.6040/j.issn.1673-3770.0.2021.347
    Abstract ( 813 )   PDF (759KB) ( 168 )   Save
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    With the increasing varieties of treatment techniques, laser corneal refractive surgery has become an important method of correcting ametropia. Quality control of all steps of the surgical procedure is crucial for the success of the operation and for complications reduction. Strict control of surgical indications, personalized surgical management, and standardization of perioperative medication regimens are helpful in improving the quality and ensuring the overall safety of surgery.
    The application of corneal stromal lenticules extracted from small incision lenticule extraction surgery for hyperopia correction
    WANG Lixiang,LI Ying, DENG Yingping
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  7-12.  doi:10.6040/j.issn.1673-3770.0.2021.328
    Abstract ( 1237 )   PDF (934KB) ( 271 )   Save
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    With the development and extensive application of small incision lenticule extraction(SMILE)surgeries, the possible use of extracted corneal stromal lenticules from patients has recently received increasing attention. Due to their low immunogenicity, low risk of cross-transmission, and high tissue compatibility, corneal stromal lenticules are good materials for corneal repair and transplantation, and refractive power correction. Recently, corneal stromal lenticules have been primarily applied for hyperopia correction. Compared to conventional subtraction surgeries, implantation of corneal stromal lenticules to correct hyperopia has some unique advantages, including reduced corneal tissue ablation, stronger corneal biomechanical properties, and broader indications, making it suitable specifically for hyperopic patients with thin corneas or extremely high hyperopia who are not indicated for subtraction surgeries. This review introduces recent applications of corneal stromal lenticule implantation for hyperopia correction, and discusses the remaining research problems of this surgical approach.
    Advances of machine learning in the diagnosis of ocular surface diseases and guiding corneal surgical procedures
    Huang Tianze, Chen Di,LI Ying
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  13-19.  doi:10.6040/j.issn.1673-3770.0.2021.329
    Abstract ( 913 )   PDF (456KB) ( 183 )   Save
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    Machine learning and its subdivision deep learning, has sparked considerable interest regarding their applications in medicine, including the screening of ophthalmological diseases and the subsequent treatment design. This article summarizes recent development of machine learning in ocular surface diseases and surgical procedures, including screening of keratoconus, diabetic peripheral neuropathy, dry eye disease, and guiding refractive surgery, intracorneal ring implantation and corneal transplant.
    Active suction loss to treat complications of small-incision lenticule extraction
    CHEN Tao, LI Yaoyu, YANG Majun, YAN Hongxin, LIU Guangyi, ZHAI Changbin
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  20-24.  doi:10.6040/j.issn.1673-3770.0.2021.008
    Abstract ( 1643 )   PDF (609KB) ( 220 )   Save
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    Objective To guide the treatment of complications, such as suction loss or potential suction loss, during small-incision lenticule extraction(SMILE). Methods Causes and treatment methods of suction loss or potential suction loss during SMILE were retrospectively analyzed at our hospital from January 2018 to April 2019. Twenty-two eyes experienced passive suction loss; five eyes experienced suction loss when the Laser microlens bottom scanning exceeded <10%, necessitating re-scanning; two eyes experienced suction loss when the Laser microlens bottom scanning exceeded >10%, necessitating the termination of SMILE and treatment with femtosecond laser-assisted laser in situkeratomileusis; two eyes experienced suction loss during lens circumcision; nine eyes experienced suction loss during cap scanning; and four eyes experienced suction loss during scanning incision, when the repair program was started to adjust parameters to scan corneal cap again. Active suction loss occurred in seven eyes, including two eyes with a scanning black area, four eyes with poor coordination, and one eye with active suction in the secondary SMILE remediation surgery. Results Patients with active suction loss recovered well owing to treatments of the black spot during scanning; patients with potential suction loss were treated with active suction loss and re-scanned after their mood relaxed, and their recovery was good. Conclusion Preoperative fixation training, education, and stabilization of patients' tension could effectively reduce passive suction loss. Before negative pressure suction, excess water on the ocular surface should be removed, and cleaning the eye surface can effectively prevent passive suction loss. Passive suction loss can be prevented in femtosecond surgery, and active suction loss can be effectively used to deal with complications of the whole femtosecond laser scanning process to ensure good postoperative effects.
    Corneal nerve fiber regeneration after SPT-TPRK combined with 0.02% MMC for moderate myopia: a random control study
    YAN Chunxiao, JIN Lin, FANG Shifeng, WEI Yushan, WANG Lijing, CUI Lin, ZHAO Dan, MU Yanan,
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  25-32.  doi:10.6040/j.issn.1673-3770.0.2021.363
    Abstract ( 833 )   PDF (6854KB) ( 113 )   Save
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    Objective To observe the regeneration of nerve fibers in the corneal ablation area after transepithelial photorefractive keratectomy with smart pulse technology(SPT-TPRK)combination of 0.02% mitomycin C(MMC). Methods This random control study included 25 patients(50 eyes)with spherical equivalent(SE)from -3.00D to -6.00D. After SPT-TPRK, MMC was applied for 20 s in a concentration of 0.02% on one random eye(SPT-TPRK+MMC group)and no MMC on the other eye(SPT-TPRK group)for the contrl. All patients were observed by HRTⅢ confocal microscopy in order to compare CNFD and CNFL in peripheral and centeral corneal ablation area at preoperatively and 14 days,1month,and 3months postoperatively. Results Preoperatively, the CNFD in the central corneal zone was(52.40±12.61)nerves/mm2, and the CNFL was(73.00±12.61)mm/mm2. The neural changes in the central cornea ablation area are described below. Fourteen days after surgery, the CNFD and CNFL in the SPT-TPRK+MMC and SPT-TPRK groups were(13.41±4.99)nerves/mm2 and(5.73±3.27)nerves/mm2, and(17.44±7.30)mm/mm2 and(5.03±3.52)mm/mm2, respectively. The difference between the two groups was statistically significant(P<0.000 1). One month postoperatively, the CNFD and CNFL in the SPT-TPRK+MMC and SPT-TPRK groups were(20.57±5.43)nerves/mm2 and(8.46±5.07)nerves/mm2, and(27.57±8.97)mm/mm2 and(9.46±4.81)mm/mm2, respectively, with statistically significant differences between the two groups(P<0.000 1). Three months postoperatively, the CNFD in the SPT-TPRK+MMC and SPT-TPRK groups were(23.47±7.28)nerves/mm2 and(13.75±5.78)nerves/mm2, and(33.87±9.49)mm/mm2 and(17.00±5.90)mm/mm2, respectively, with statistically significant differences between the two groups(P<0.000 1). Conclusion SPT-TPRK combined with 0.02% MMC may promote nerve fiber regeneration in the early postoperative period(14 days, 1 month, 3 months). The nerve fibers have not returned to the preoperative situation at three months postoperatively.
    Agreement study of implantable collamer lens based on NK and KS formulas in the early stage after surgery
    LI Bin, FANG Xuejun, WU De, HUANG Min
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  33-41.  doi:10.6040/j.issn.1673-3770.0.2021.346
    Abstract ( 1177 )   PDF (1611KB) ( 252 )   Save
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    Objective To investigate the agreement of NK and KS formulas based on CASIA OCT in predicting the vault after implantation of an implantable collamer lens(ICL). Methods This prospective case study included 25 patients(50 eyes)with moderate to high myopia undergoing ICL implantation. CASIA OCT was used to analyze the vault change at one day, one week, and one month after surgery, and the difference and agreement between the vault predicted by the NK and KS formulas and the actual vault postoperatively. Variation of the vault at each follow-up was analyzed using One-way Repeated Measures Anova. NK and KS formulas were used to predict the vault and vault differences at different time points. A paired t-test was used to analyze the difference between the actual vault after surgery at each follow-up and the vault predicted by the NK/KS formulas. The agreement between the actual vault after surgery at each follow-up and the vault predicted by the NK/KS formulas were analyzed using Bland-Altman analysis. Multiple linear regression was used to analyze the relationship between the vault and the preoperative parameters of the anterior segment. Results The vault decreased with time in the early stage after surgery. The difference of the vault at one day and one week was(122.22±81.03)μm(P<0.05), at one day and one month after the operation was(169.04±84.20)μm(P<0.05), and at one week and one month after the operation was(46.83±45.70)μm(P<0.05). There was a statistical difference between the predicted value of the NK formula and the actual vault measured one day after the operation(P<0.05). There was a statistically significant difference between the predicted vault value of the KS formula and the actual vault measured one day and one month after surgery(P<0.05). The agreement between the actual vault after surgery at one week and the vault predicted by the NK/KS formulas was the highest. The postoperative vault was correlated with the anterior chamber width, crystalline lens rise, and angle to angle distance. The consistency between the vault prediction value of the NK formula and the first day after the operation was lower than the KS formula but higher than the KS formula in terms of one week and one month. Conclusion The vault decreased with time during the early postoperative period. The predicted vault of the two prediction formulas of CASIA OCT was the most consistent with the vault at one week after surgery. The NK formula could accurately predict the actual value of the postoperative vault. Furthermore, the NK formula is better than the KS formula in predicting the postoperative vault at early stage.
    Effect of high-energy accelerated corneal collagen cross-linking on the ocular surface of keratoconus
    XIA Yanyun, ZHONG Dingjuan, WANG Hua, LI Mengting, LI Qian, CHEN Jiao, HE Shuxi
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  42-51.  doi:10.6040/j.issn.1673-3770.0.2021.432
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    Objective To study the changes in ocular surface before and after corneal collagen cross-linking in patients with keratoconus. Methods A retrospective study was conducted on 42 patients(60 eyes)diagnosed with keratoconus at the Ophthalmology Center of Hunan Provincial People's Hospital from November 2020 to May 2021 who met the inclusion and exclusion criteria and received high-energy accelerated corneal collagen cross-linking after providing informed consent. Based on corneal maximum curvature(Kmax), the patients were divided into the following three groups: mild, moderate, and severe. Further, the patients were divided into three groups according to the difference between flat keratometry(K1)and steep keratometry(K2), namely astigmatism: group A(0≤K2-K1≤2.5D), group B(2.5D < K2-K1≤5D), and group C(K2-K1>5D). The changes and characteristics of Kmax, K1, K2, corneal thickness, astigmatism, tear breakup time, tear meniscus height at 1 and 3 months before and after corneal collagen, and cross-linking were recorded. SPSS 26.0 software was used for statistical analysis to determine any difference in parameters at different time points before and after surgery. The test level was considered as α=0.05, and P<0.05 was considered statistically significant. Results For the Kmax group, preoperative baseline corneal thickness, K1, K2 showed statistical significance(P<0.001), whereas age, astigmatism, tear meniscus height, and tear breakup time did not(P=0.35、0.22、0.63、0.57). Significant differences were noted in corneal thickness, Kmax, tear meniscus height, K1, and K2 at different time points before and after surgery among the three groups(Ftime=52.72, 5.22, 3.30, 5.06, 5.25, respectively, P<0.05; Fgroup=9.25,38.28,P<0.05,2.48,P>0.05,13.37,P<0.05,6.28,P>0.05). There were no significant differences in tear breakup time at different time points before and after surgery among the three groups(Ftime=1.001,P=0.38;Fgroup=0.953,P=0.40). For the astigmatism group, preoperative baseline Kmax, K1, K2 were statistically significant(P=0.001、0.02、<0.001), whereas age, corneal thickness, tear meniscus height, and tear breakup time were not(P=0.13、0.43、0.96、0.11). Significant differences were noted in corneal thickness, Kmax, tear meniscus height, K1, and K2 at different time points before and after surgery among the three groups(Ftime=45.91, 6.61, 4.06, 5.19, 8.4, P<0.05; Fgroup =0.53,0.6,0.75,1.19,P>0.05,7.63,P<0.05). There were no significant differences in tear breakup time among the three groups at different time points before and after surgery(Ftime=1.103,P=0.34;Fgroup=1.121,P=0.34). Correlation analysis was conducted between the tear meniscus height and tear breakup time of ocular surface parameters and the values of corneal topography parameters Kmax, K1, K2 and astigmatism before, 1 and 3 months after surgery. The tear meniscus height was negatively correlated with astigmatism 3 months after surgery(P=0.04), while there was no correlation between the tear meniscus height and astigmatism before and 1 month after surgery(P=0.88、0.13). The tear break up time 1 month after operation was negatively correlated with astigmatism(P=0.03), but there was no correlation with astigmatism at other time points(P=0.13、0.29). Conclusion High-energy accelerated corneal collagen cross-linking has no adverse effect on tear film stability in the early stage; it can affect the amount of tear secretion and cause a slight decrease in the amount of tear secretion in the early stage. In the early stage of high-energy accelerated corneal collagen cross-linking, the amount of tear secretion decreased, especially in severe astigmatism.
    Early clinical observation of corneal densitometry after SMILE combined with rapid corneal cross-linking
    ZHANG Ying, LEI Yulin, MA Zhixing, YANG Xinghua, ZHANG Jing, HOU Jie
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  52-58.  doi:10.6040/j.issn.1673-3770.0.2021.110
    Abstract ( 957 )   PDF (652KB) ( 194 )   Save
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    Objective To study the effect of small incision lenticule extraction combined with rapid corneal collagen crosslinking(SMILE Xtra)on corneal densitometry(CD). Methods Seventy-eight patients with myopia and myopic astigmatism were collected during March 2017 and July 2019 in Jinan Mingshui Eye Hospital. The right eye data(78 eyes)were included for analysis.They were divided into two groups: SMILE Xtra(39 patients,39 eyes)and SMILE alone(39 patients,39eyes). CD data of two groups were measured by the pentacam system preoperatively and postperatively at 3 months. According to the software analysis, the average CD data of three concentric radial zones centered on the apex of the cornea(0-2 mm, 2-6 mm, 6-10 mm diameters)were applied, and three layers were defined according to different corneal depths(the anterior 120 μm as the 1st layer, the posterior 60 μm as the 3rd layer, and the center part between them as the 2nd layer). Results UCVA of 78 eyes(100%)in both groups achieved the expected corrected visual acuity postperatively at 3 months. The overall CD data of SMILE Xtra in the central two zones(0-2 mm and 2-6 mm diameter of cornea)were significantly higher than that before surgery(P<0.001). The value of the first 120μm layer was increased more than that of the other two layers.There was a significant difference in the CD data of SMILE between the preoperative and postoperative(P<0.05). There was a significant difference in the CD data of central corneal tissue and posterior 60 μm before and after operation(P< 0.05). In SMILE Xtra group, the CD data of the three zones(0-2 mm, 2-6 mm, 6-10 mm)and the anterior 120μm were higher than that of SMILE group postperatively at 3 months.The difference was statistically significant(P<0.05).There was no significant correlation between the change of CD data and the change of spherical equivalent, central corneal thickness, corneal curvature and corneal epithelial thickness(P>0.05), but negative correlation was found with age(r=-0.542, P=0.01). Conclusion In the early postoperative period, CD data increased and the corneal transparency decreased after SMILE Xtra, but only changed within the surgical area.
    Experience and lessons of evaluation of corneal morphologic parameters following laser in situ keratomileusis combined with corneal cross-linking surgery
    WEI Shengsheng, LI Jing, LIU Jianguo, WANG Li, DU Jing, GAO Jinrong, LI Yong
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  59-64.  doi:10.6040/j.issn.1673-3770.0.2021.337
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    Secondary posterior corneal ectasia is a rare disease characterized by the progressive thinning of the corneal thickness and increased anterior surface curvature and posterior surface height following corneal surgery. It is usually observed in months to years following laser corneal refractive surgery. Patients often had or did not have atypical early manifestations of keratoconus before the operation. Corneal cross-linking surgery strengthens the cornea by increasing the connection between the corneal collagen fibers. Laser in situ keratomileusis combined with corneal cross-linking surgery can increase the biomechanics of the cornea after LASIK, and prevent postoperative refractive regression and secondary corneal ectasia. We report the case of a 31-year-old female with rare changes in the corneal morphological parameters following LASIK combined with corneal crosslinking surgery. One month after the operation, Pentacam revealed abnormal thinning of the corneal thickness and increased height of the posterior corneal surface, which was easily misdiagnosed as secondary corneal ectasia. Upon measurement by anterior segment optical coherence tomography, a significant difference in the corneal thickness was observed, and the results of the Pentacam returned to normal during long-term follow-up. Although Pentacam can relatively accurately measure the corneal thickness, corneal curvature, and height of the anterior and posterior surfaces, other equipment should be used simultaneously to examine suspected secondary corneal ectasia following LASIK combined with corneal cross-linking surgery in order to avoid the possibility of a false positive.
    Diffusion-weighted imaging for accurate diagnosis of congenital middle ear cholesteatoma and JOS staging
    WAN Yining, ZHANG Dejun, FU Zeming, GUO Fang, GUO Yingyuan, GUAN Guofang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  65-69.  doi:10.6040/j.issn.1673-3770.0.2020.527
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    Objective To investigate the utility of diffusion-weighted imaging(DWI)for the accurate diagnosis of congenital middle ear cholesteatoma and the use of combining DWI with high-resolution computed tomography(HRCT)for the preoperative staging of congenital middle ear cholesteatoma. Methods Twelve patients with congenital middle ear cholesteatoma were selected to assess the diagnostic efficacy of DWI for congenital middle ear cholesteatoma. Preoperative staging was performed in accordance with the Japan Otology Society(JOS)staging criteria by performing both HRCT and DWI examinations. All patients underwent surgery and intraoperative staging. The findings of preoperative staging and intraoperative staging were compared to assess the consistency between them. Results DWI diagnosis was 100% accurate. HRCT combined with DWI for preoperative staging revealed congenital middle ear cholesteatoma of stage Ib in two cases, stage Ic in one case, stage II in eight cases, and stage III in one case. Intraoperative staging revealed the condition to be in stage Ib in one case, stage Ic in two cases, stage II in eight cases, and stage III in one case. The consistency between the two methods of staging was as high as 92%. Conclusion DWI has high sensitivity and specificity for detecting congenital middle ear cholesteatoma and can accurately diagnose the condition. At the same time, the combined use of HRCT and DWI can help establish precise staging before surgery, which can guide surgical treatment and indicate patient prognosis.
    Analysis of factors related to the severity of persistent idiopathic tinnitus
    ZHOU Lamei, JIANG Wen, LIU Wen, QIAO Yuehua
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  70-76.  doi:10.6040/j.issn.1673-3770.0.2021.009
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    Objective To analyze factors related to the severity of persistent idiopathic subjective tinnitus. Methods The general data, medical history, audiological results, tinnitus matching test results, tinnitus disability scale score, Pittsburgh Sleep Quality Index score, and self-rating anxiety scale score were analyzed in 870 patients with persistent idiopathic subjective tinnitus. The multivariate Logistic regression analysis was performed to elucidate factors related to the severity of tinnitus. Results (1)There were significant differences in sex(P<0.001), age(P=0.010), tinnitus frequency(P=0.005), hearing loss(P=0.037), anxiety degree(P<0.001)and sleep status(P<0.001)in THI classification. (2)There was no significant difference in course(P=0.053), side(P=0.437)and tone loudness(P=0.120)in THI classification. Conclusion The degree of idiopathic tinnitus in female patients is more serious than that in men; low frequency is more disturbing than high frequency; anxiety degree and sleep status are the factors affecting the severity of tinnitus, while the course of disease, lateral classification and tinnitus main tone loudness are not the factors affecting the severity of idiopathic tinnitus.
    Neuroendocrine carcinoma of the nasal cavity and paranasal sinus: eight cases and literature review
    CHEN Xuejun, GAO Wen, YIN Gaofei, GUO Wei, HUANG Junwei, ZHANG Yang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  77-82.  doi:10.6040/j.issn.1673-3770.0.2020.537
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    ObjectiveTo investigate the clinical and pathological features, treatment, prognosis, and prognostic factors of neuroendocrine carcinoma of the nasal cavity and paranasal sinus. MethodsThe clinical data of 8 pathologically confirmed primary neuroendocrine carcinomas of the nasal cavity and paranasal sinus were reviewed. ResultsThe followup durations were 570 months, with a median of 23 months. Eight cases of nasal sinus neuroendocrine carcinoma were reviewed: 1 case of typical carcinoid tumor, 4 cases of atypical carcinoid tumor, 2 cases of small cell neuroendocrine carcinoma, and 1 case of complex neuroendocrine carcinoma (poorly differentiated neuroendocrine carcinoma with varus papilloma). The mean age of the patients was 46 years (3457 years). The stage of the malignant tumor in the nasal cavity and paranasal sinus was T2 in 2 patients and T4 in 6 patients. The cases were treated as follows: surgery, 7 cases; radiotherapy, 6 cases; and chemotherapy, 6 cases. Surgery plus postoperative chemoradiotherapy was the most common treatment. Conclusion The final diagnosis of neuroendocrine carcinoma depends on postoperative pathological and immunohistochemical indicators. The major adverse prognostic factors affecting the survival rate included the pathological subtypes and the associated treatment options. Surgical treatment is the first choice for typical and atypical carcinomas. For poorly differentiated subtypes of neuroendocrine carcinoma, comprehensive treatment is the most effective method for local tumor control and prolonged survival.
    A comparative study on the treatment of severe chronic hypertrophic rhinitis by modified inferior turbinate plasty under nasal endoscopy and low-temperature plasma ablation with fracture displacement of the inferior turbinate
    ZHANG Min, LIU Yongliang, SONG Daoliang, HAN Xuefeng, FENG Xinrong, ZHAO Yunpei
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  83-88.  doi:10.6040/j.issn.1673-3770.0.2021.227
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    Objective To compare the clinical effect of modified inferior turbinate plasty under nasal endoscopy and low-temperature plasma ablation with fracture displacement of the inferior turbinate in the treatment of severe chronic hypertrophic rhinitis(hypertrophy of the inferior turbinate mucosa and periosteum, abnormal turbinate morphology, and severe VAS score). Methods A total of 124 patients with severe chronic hypertrophic rhinitis were retrospectively analyzed. Patients were randomly divided into two groups according to the surgical method used: 64 patients in group A were treated with modified inferior turbinate plasty, and 60 patients in group B were treated with low-temperature plasma ablation of the inferior turbinate plus external fracture removal. The VAS standard score was used to evaluate nasal symptoms 1 week before as well as 6 and 12 months after surgery. Saccharin test was used to evaluate the nasal mucociliary transport function of patients in both groups, 1 week before and 6 months after surgery. Nasal resistance was measured 1 week before and 6 months after surgery, and the improvement in nasal obstruction was evaluated. Results Intraoperative hemorrhage was reduced, operative time was shorter, and the complications rate was lower in group B compared with group A. Six months after the surgery, nasal congestion significantly improved in both groups. Nasal mucociliary function was not significantly affected by either surgical methods. The average operation times were 27.80 min and 19.10 min, and the complication rates were 9.38% and 6.67%, in groups A and B, respectively. Comparison of the average VAS score after surgery between the two groups showed no statistically significant difference at 6 months after surgery(P=0.12); however, a statistically significant difference was found at 12 months after surgery(P=0.03) Conclusion Both surgical methods, modified inferior turbinate plasty and low-temperature plasma ablation of the inferior turbinate combined with fracture displacement, had good short-term effects(6 months)in the treatment of severe chronic hypertrophic rhinitis; further, modified inferior turbinate plasty had better long-term effect(>1 year). Therefore, it is suggested that precise diagnosis should be made and treatment should be accordingly performed in different patients with severe chronic hypertrophic rhinitis.
    Surgical clinical treatment outcomes of 25 gauge vitrectomy for superior rhegmatogenous retinal detachment with air tamponade
    LU Wenrui, YAN Duan, XU Nuo
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  89-91.  doi:10.6040/j.issn.1673-3770.0.2020.220
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    Objective To observe the clinical treatment outcomes and safety of 25-gauge vitrectomy with air tamponade for superior rhegmatogenous retinal detachment. Methods Retrospective analysis 32 eyes with superior rhegmatogenous retinal detachment from 32 patients who received 25-gauge vitrectomy with air tamponade from December 2018 to March 2020. Best corrected visual acuity(BCVA)(LogMAR)and intraocular pressor(IOP)were test before surgery, 1 week, and the last follow-up time after surgery. Retinal reattachment condition and intraoperative and postoperative complications were recorded. Results The mean BCVA was significantly different among before surgery,1 week and the last follow-up time after surgery,and the BCVA at 1 week and the last follow-up time after surgery was evidently improved in comparison with before surgery(1.4(0.2-1.7), 0.83±0.35, 0.52±0.34, Mann Whitney U text, P<0.05).The mean IOP was(15.15±3.04 mmHg)before surgery and(17.75±2.75 mmHg)1 week after surgery, showing a significant difference among them(t text, P<0.05), the IOP 1 week after surgery was evidently higher than that before surgery.The mean IOP was(15.20±1.81 mmHg)at the last follow-up time, have not difference between the mean IOP before the surgery(t text, P>0.05). The retinal reattachment rate following a single procedure was 100%. Conclusion 25-Gauge vitrectomy and air tamponade for superior rhegmatogenous retinal detachment is an effective and safe approach, and fewer complications and higher success rates.
    The effectiveness and safety of orthokeratology on controlling myopia of children: a meta-analysis
    LIU Yi, YU Mingkun, SUN Wei, SHAO Zhen, HU Yuanyuan, BI Hongsheng
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  92-100.  doi:10.6040/j.issn.1673-3770.0.2021.037
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    Objective To access the effectiveness and safety of orthokeratology(OK)on slowing myopia progression in school-aged children in different treatment duration. Methods PubMed, Cochrane Library, Embase, OVID, CNKI, Wanfang database, VIP, and CBM were searched, including randomized controlled trials(RCT)and prospective non-randomized control studies(PNC). Two reviewers independently screened literature, extracted data, and assessed the quality of included studies. The Meta-analysis was performed using RevMan 5.3 version for statistical analysis. Results 4 RCTs and 12 PNCs involving 1 453 participants were included. There were significant differences in the effect of OK group versus control group on slowing axial elongation at 0.5, 1, 1.5, 2 years follow-up periods(0.5a:MD:-0.10 mm, 95%CI: -0.12 to -0.08, P<0.001; 1a: MD: -0.18 mm, 95%CI:-0.19 to -0.17, P<0.001; 1.5a: MD: -0.21 mm, 95%CI: -0.26 to -0.15, P<0.001; 2a: MD:-0.26 mm, 95%CI: -0.30 to -0.22, P<0.001). The myopia control rate decreased with the duration of treatment. Except for the 0.5 years follow-up period, when the effect of OK lens on the reduction of axial elongation in Asian children was better than that in Caucasian, there was no statistical difference in other follow-up periods(P>0.05). The RR of incidence of adverse events in the OK and the control groups at 2-year was 5.75(95%CI:2.23 to 14.81, P=0.000 3). Conclusion Orthokeratology is an effective and safe method on controlling the progression of myopia for school-aged children. However, long-term and additional RCT studies are required to find out its continuing effectiveness.
    The application of MRI technology with intratympanic gadolinium injection in the diagnosis and treatment of Meniere's disease
    ZHANG Yaoyao,WANG Haitao
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  101-107.  doi:10.6040/j.issn.1673-3770.0.2020.504
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    The emergence of magnetic resonance imaging(MRI)with intratympanic gadolinium injection in the inner ear provides a new diagnostic technique for a variety of inner ear diseases, hence a new method for diagnosis Meniere's disease, which is expected to become the gold standard for the diagnosis of the condition. Based on the developmental progress of MRI of with intratympanic gadolinium at home and abroad, this paper summarizes the characteristics of gadolinium MRI echnology, a variety of drug delivery methods, evaluation methods, and comparison with traditional examination methods, and summarizes the research status of inner ear gadolinium MRI technology in the diagnosis and treatment of Meniere's disease.
    Treatment progress of endoscopic surgery for first diagnosed nasopharyngeal carcinoma
    ZHOU Yuxiang,MIAO Beiping, LU Yongtian
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  108-112.  doi:10.6040/j.issn.1673-3770.0.2020.493
    Abstract ( 801 )   PDF (405KB) ( 115 )   Save
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    Nasopharyngeal carcinoma(NPC)ranks first among head and neck tumors in terms of incidence. Radiotherapy is the first choice modality for treatment, although simultaneous chemotherapy, induced chemotherapy, molecular targeted therapy, surgery, and other comprehensive treatments are also feasible. With the development of endoscopic techniques and nasocranial base surgery in clinical practice, the early diagnosis and treatment of nasopharyngeal carcinoma have recently advanced. Head and neck surgeons have gradually applied the minimally invasive endoscopic surgery concept to the first diagnosis of nasopharyngeal carcinoma, with the purpose of improving the quality of life and survival rate of patients. In this paper, the status and progress of minimally invasive endoscopic surgery for the first nasopharyngeal carcinoma in recent years are reviewed.
    A review of squamous cell lines originating from the nasopharynx, oropharynx, laryngopharynx and larynx
    FENG Chengmin, JIN Yidan,LIU Hai, WANG Bing
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  113-124.  doi:10.6040/j.issn.1673-3770.0.2020.478
    Abstract ( 3949 )   PDF (470KB) ( 543 )   Save
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    Larynx squamous cell carcinoma is a common malignant tumor of the head and neck region. The head and neck have complicated anatomical structure, and squamous cell carcinomas with different primary sites have different incidences, strategies of diagnosis and therapy, and even molecular pathogeneses. Therefore, selecting the suitable squamous cell carcinoma cell lines is important for researchers to determine appropriate preclinical research models and to have a better understanding of the mechanisms of tumorigenesis and progression. To provide a reference for researchers, this study summarizes the currently available squamous cell carcinoma cell lines originating from the nasopharynx, oropharynx, laryngopharynx and larynx.
    Application of artificial intelligence based on machine learning in clinical diagnosis and treatment in otolaryngology
    WANG Di, CHENG Jinzhang,YU Dan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  125-131.  doi:10.6040/j.issn.1673-3770.0.2021.026
    Abstract ( 1224 )   PDF (2119KB) ( 272 )   Save
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    Artificial intelligence(AI)is a branch of computer science, which has been applied in various fields, and its role has been fully demonstrated. In the field of medicine, AI is changing the traditional medical model, and will become the direction of human medical development in the future. Machine learning is an important method to realize AI technology. At present, it is widely used in clinical data deep mining, imageomics feature analysis, disease prediction model building and other related aspects,and it plays an important auxiliary role in clinical diagnosis, treatment and prognosis. In the field of Otolaryngology, there are image analysis and classification, voice signal processing,construction of various disease prediction models to assist medical decision-making. Only by recognizing and understanding the AI technology based on machine learning, and applying it in clinic, can we maximize its effect. In view of this, this paper will briefly introduce the concept of artificial intelligence and its application status in the medical field, focusing on the application progress of AI technology based on machine learning in the clinical diagnosis and treatment of Otolaryngology related diseases, so as to provide reference for otolaryngologists in clinical diagnosis and treatment
    Research progress of miRNA-29b involved in EMT-related signaling pathway regulation
    WANG Junxin,SUN Yan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  132-137.  doi:10.6040/j.issn.1673-3770.0.2021.096
    Abstract ( 686 )   PDF (413KB) ( 237 )   Save
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    Epithelial-mesenchymal transition(EMT)is a biological process of epithelial cells transforming into mesenchymal cells, conferring the ability of cell metastasis and invasion. This process is closely related to the progression of organ fibrosis and tumors. MiRNA-29b is a small noncoding RNA closely related to the EMT process. By modulating TGF-β/Smad, PI3K/AKT, Wnt/β-catenin, and other signaling pathways, miRNA-29b mediates the development of type II and type III EMT, and then delays the process of organ fibrosis, regulates the invasion and metastasis of tumors. The targeted therapy of miRNA-29b is expected to provide a new perspective for the clinical diagnosis and treatment of organ fibrosis and tumor invasion and metastasis. The research status of miRNA-29b regulating the process of organ fibrosis and tumor invasion and metastasis through various EMT-related signaling pathways was reviewed in this study.
    The application and progress of optical coherence topography in choroidal osteoma
    ZHANG Xiaoyan, HAO Xiaofeng,XIE Like
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  138-141.  doi:10.6040/j.issn.1673-3770.0.2020.487
    Abstract ( 822 )   PDF (349KB) ( 114 )   Save
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    Choroidal osteoma is a rare, benign intraocular tumor characterized by mature cancellous bone involving the choroid. Visual loss in eyes with choroidal osteoma can be the result of tumour growth, decalcification, retinal pigment epithelium disturbance, subretinal haemorrhage, choroidal neovascularization, and subretinal fluid. The clinical application of optical coherence topography(OCT)in choroidal osteoma is also widely investigated recent years. In this paper, we reviewed the clinical application and research progress of OCT in choroidal osteoma, in order to provide some assistant for clinical practice and correct interpretation of the reports.
    Research progress and clinical application of Catquest-9SF
    HAI Yue,LIAO Xuan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  142-146.  doi:10.6040/j.issn.1673-3770.0.2020.521
    Abstract ( 768 )   PDF (400KB) ( 311 )   Save
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    With the development of surgical technology, materials, and equipment, cataract surgery has become refractive, and its treatment goals have evolved from early simple rehabilitation to functional vision and precision medicine. Although subjective and objective visual qualities of some patients with cataract recover well, they are dissatisfied with postoperative results. As a tool to evaluate effects of cataract surgery, visual function-related quality of life research can provide information other than the aforementioned indicators and has been receiving increasing clinical attention. Catquest-9SF, which is a scale to evaluate the quality of life related to cataract visual function, has been widely used worldwide after translation, back translation, and cross-cultural debugging. In this article, we will review its evolution and application in clinical and scientific research in recent years.
    A case of long-term ocular complications caused by toxic epidermal necrolysis
    CIREN Qiongda, WU Yuan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(6):  147-150.  doi:10.6040/j.issn.1673-3770.0.2019.484
    Abstract ( 891 )   PDF (4338KB) ( 124 )   Save
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    Toxic epidermal necrolysis is a serious adverse drug reaction of the epidermis and mucosae that most commonly occurs in adults and is associated with the use of sulfonamides, barbiturates, non-steroid anti-inflammatory drugs, phenytoin, methazolamide, allopurinol, and penicillin. Approximately one out of five patients denied a history of medication, and in approximately one out of three cases, the causes were unknown due to both serious illness and drug treatment. Toxic epidermal necrolysis is one of the few critical diseases in dermatology, with an associated mortality rate of 30%-35%; 20%-40% of the survivors have ocular complications. A few patients can have teary eyes due to tear duct obstruction, but most patients have hyperplasia with eyelashes and blephral epithelium, with squamous biochemical, conjunctival, and corneal new angiogenesis, causing a toxic epidermal necrosis and pyrolysis eye syndrome. Toxic epidermal necrolysis could be managed with timely treatment; however, in some patients, the condition could persist, leading to photophobia, burning pain, vision loss, and even blindness. Here, we report a case of long-term ocular complications of toxic epidermal necrolysis in Tibet.