Table of Content

20 March 2023 Volume 37 Issue 2

  

论著

Analysis of hearing screening results of dizygotic and monozygotic twins

LI Wei, ZHAO Yi, GE Yueming, FU Hongtao, WANG Jindong, ZHANG Xiaolong, DONG Jie, CHENG Yuxiang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  1-6.  doi:10.6040/j.issn.1673-3770.0.2022.065

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Objective In this study we analyzed the hearing screening results of dizygotic and monozygotic twins in neonatal intensive care unit(NICU), to compare and discuss the hearing characteristics and factors related to positive screening. Methods Overall, 120 pairs of twins, totaling 240 infants in the NICU of the Tangshan Maternal and Child Health Hospital were analyzed. Participants were divided into the dizygotic and monozygotic twin groups, and data regarding the method of conception(in vitro fertilization embryo implantation or natural conception), gender, and b-ultrasound results of pregnancy examination were collected. A transient otoacoustic emission(TEOAE)instrument was used for hearing screening after the infants' condition was stabilized, and vital signs had become stable. SPSS 23.0 software was used to calculate the failure rate of initial screening, and the risk factors and related factors were analyzed and summarized. Results In total, we analyzed 240 infants, including 124 dizygotic twins with a failure rate of 37.10%(46/124)and 116 monozygotic twins with a failure rate of 31.90%(37/116).The two groups were significantly different in terms of the methods of conception and delivery(P<0.001, P=0.006), but no significant difference was found in any other indices. Conclusion Dizygotic and monozygotic sources had no significant effect on the failure rate of hearing screening in twins. Dizygotic twins were found to be mostly conceived by in vitro fertilization embryo implantation, while monozygotic twins were predominantly naturally conceived. The cesarean section rate of dizygotic twins was high. Factors such as sex pair and birth weight <1 500 g had no significant effect on the results of preliminary screening.

Prognosis and influencing factors in sudden deafness patients with acoustic stapedius reflex threshold

SUN Yongqiang, SONG Zhongyi, WANG Chunfang, LI Xiao, FU Ying, PAN Xinliang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  7-14.  doi:10.6040/j.issn.1673-3770.0.2022.418

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Objective Analyze the prognosis of sudden deafness patients with acoustic stapedius reflex threshold and explore its influencing factors. Methods This study was a retrospective analysis of the clinical data of 282 patients who suffered sudden deafness with acoustic stapedius reflex threshold from January 2018 to December 2021. Excel was used for data processing, and SPSS 26.0 was used for descriptive and statistical analysis of the collected data. Statistical analyses were conducted on factors such as gender, age, time of medical treatment, tinnitus, vertigo, basic diseases(diabetes, hypertension, coronary heart disease), hearing curve type, degree of hearing loss, acoustic stapedius reflex threshold, difference between acoustic stapedius reflex threshold and hearing threshold(A-T). Results Among 282 cases of sudden deafness with acoustic stapedius reflex threshold, 101 cases were cured, 8 cases were markedly effective, 54 cases were effective, and 119 cases were ineffective. The total effective rate was 57.8%. Deafness side(P=0.907), accompanying symptoms(P_vertigo=0.686, P_tinnitus=0.534), basic diseases(P_hypertension= 0.338, P_diabetes=0.262, P_{coronary heart disease}=0.780), acoustic stapedius reflex threshold(P_{0.5 kHz}=0.152, P_{1.0 kHz}=0.701, P_{2.0 kHz}=0.810), the difference between acoustic stapedius reflex threshold and the pure tone hearing threshold(P_{0.5 kHz A-T}=0.413,P_{2 kHz A-T}=0.092)of patients who suffered sudden deafness with acoustic stapedius reflex threshold had no significant difference in prognosis. However, age(P=0.022), sex(P=0.001), visit time of sudden deafness(P<0.001), type of hearing curve(P=0.004), degree of hearing loss(P=0.008)and difference between 1 kHz acoustic stapedius reflex threshold and hearing threshold(P_{1 kHz A-T}<0.001)were effective prognostic factors. Conclusion In sudden deafness patients with acoustic stapedius reflex threshold, gender, age, visit time of sudden deafness, type of hearing curve, degree of hearing loss and difference between 1 kHz acoustic stapedius reflex threshold and hearing threshold have an impact on the prognosis of deafness. The change of acoustic stapedius reflex threshold has no significant correlation with the prognosis of sudden deafness patients. However, the effect of sudden deafness patients can be estimated by the 1 kHz acoustic stapedius reflex threshold and hearing threshold difference to improve patients confidence in treatment.

Characteristic analysis of during the coronavirus disease 2019 pandemic

SHI Bin, GE Jianrong, LIU Jisheng

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  15-20.  doi:10.6040/j.issn.1673-3770.0.2022.228

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Objective To confirm the changes in the disease spectrum in the department of otorhinolaryngology and whether the demand for emergency treatment of Suzhou citizens had been ensured during the epidemic. Methods Patients who underwent electronic nasopharyngoscopy in the department of otolaryngology at the First Affiliated Hospital of Soochow University during the epidemic when only emergency service was available were selected as the study group. Meanwhile, patients who underwent electronic nasopharyngoscopy during the normal prevention and control of the epidemic in the same period in 2021 were selected as the control group. The clinical data of the two groups of patients were collected for statistical analysis. Results The study and control groups included 1 393 and 2 457 patients, respectively. The proportion of acute and severe cases was higher, showing an increase by 22.7%, in the study group than in the control group; the difference was statistically significant(P<0.001). The difference between the number of daily cases was also statistically significant(P<0.001). However, there was no statistically significant difference in the number of daily acute and severe disease cases(P>0.05)between the groups. Additionally, there were no statistically significant differences between the number of foreign bodies in the pharynx, malignant tumors of the pharynx and laryngopharynx, laryngeal paralysis, and nasopharyngeal neoplasm and epistaxis(P>0.05). There was a statistically significant difference in the number of daily non-acute and non-serve disease cases(P<0.001)between the groups. Among these, statistically significant differences were observed for the number of pharyngitis, precancerous laryngeal lesions, benign lesions of the larynx and laryngopharynx, chronic inflammation of the larynx, laryngeal cyst, postoperative reexamination, and others(P<0.01). A statistically significant difference was also found in the age distribution between the two groups(P<0.001). Compared with the control group, the proportion of patients in the study group decreased 1.8% among patients aged 18 or younger, 1.7% among patients aged 46-60, and 3.3% among patients aged 61 or older respectively. Meanwhile, the proportion increased 6.8% among patients aged 19-45. Conclusion During the epidemic in Suzhou in 2022, citizens’ acute and severe medical needs in the department of otorhinolaryngology were ensured. However, the diagnosis and treatment of some patients with chronic inflammatory diseases or precancerous laryngeal lesions may be delayed. Compared with young people, minors, middle-aged, and older adults were less likely to go to the hospital. We can consider promoting telemedicine services to meet the public's need for medical treatment while reducing unnecessary contact.

Clinical analysis of 13 cases of neurilemmomas in the nasal cavity and paranasal sinuses

HAN Feiyan, WANG Ying

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  21-25.  doi:10.6040/j.issn.1673-3770.0.2022.229

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Objective Neurilemmomas in the nasal cavity or paranasal sinuses are rare. This study aimed to improve our understanding of this phenomenon by exploring the clinical features, diagnosis, and management of neurilemmomas in the nasal cavity or paranasal sinuses. Methods Clinical records of all patients with neurilemmomas in the nasal cavity or paranasal sinuses treated at our hospital between 2012 and 2021 were retrospectively reviewed. Results Ten female and three male patients were included. One case was malignant and twelve were benign. All patients underwent surgery, and the patient with malignancy received postoperative radiotherapy. The follow-up duration of the study was 4-110 months, and the clinical follow-up data revealed no recurrences in the 12 benign cases; however, the patient with malignancy died of recurrence. Conclusion Neurilemmomas in the nasal cavity and paranasal sinuses are typically benign, with no specific clinical manifestations. In our study, the most common complaints were unilateral nasal congestion and headaches, and the most common sites were the nasal cavity and ethmoid sinus. Imaging examination is valuable in identifying the range of the lesions and in diagnosing benign and malignant tumors. Complete surgical excision using the appropriate approaches has been demonstrated to be effective, with a low recurrence rate, whereas postoperative radiotherapy is necessary for malignant cases because the risk of relapse is high.

Clinical analysis of three endoscopy-assisted transoral approaches in the operative management of parapharyngeal space tumors

CHEN Minghao, ZHANG Qiuhang, HOU Jiameng, TIAN Xiufen

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  26-32.  doi:10.6040/j.issn.1673-3770.0.2022.066

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Objective To investigate the transoral approaches selection factors of parapharyngeal space(PPS)tumors assisted by endoscope and low-temperature plasma radiofrequency ablation. Methods We retrospectively collected the data of 56 patients who underwent surgical removal of PPS tumors at The First Affiliated Hospital, between March 2015 and December 2021. The patients were divided into two groups based on the technique used: the endoscopr-assisted transoral approach(EATA)group(n=24)and the external approach(EA)group(n=32). Results Total tumor resection was achieved in all the cases. We designed three kinds of transoral approaches: posterior pharyngeal wall approach(n=12), lateral pharyngeal wall approach(n=7), and soft palate approach(n=5). Postoperative pathology examination confirmed benign tumors in 54(96.4%)cases and malignant tumor in 2(3.6%)cases. The operation time and the bleeding volume in the EATA group were significantly less than those in the EA group. Postoperative complications were noted in 7 cases in the EA group and in 3 cases in the EATA(P=0.489). The mean follow-up time was(46.04±27.88)months. There was only one case of recurrence in the EATA group. Conclusion The transoral approach can provide the same or even better therapeutic effect as the external approach, such as the amount of operative blood loss, operation time, no neck scars and so on, but it is also a challenging operation and needs to be improved.

Single-cell sequencing analysis of laryngeal cancer and its microenvironmental metabolism-related target genes

XU Chong, WANG Xiaoting, YI Hongliang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  33-38.  doi:10.6040/j.issn.1673-3770.0.2021.542

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Objective Single cell sequence was used to find the possible targets of metabolism related small molecular drugs targeted on laryngeal cancer glycolysis and glutaminolysis. Methods R language reanalyzed the results of single cell sequence, cells were classified with TSNE and metabolic related genes expression were measured. Results The target genes of glycolysis in laryngeal cancer include glucose transporters, hexokinase, pyruvate kinase. Genes in glutaminolysis include: Na⁺ coupled transporter for glutamine, glutaminase, glutamate dehydrogenase 1, malate dehydrogenase, lactate dehydrogenase, isocitrate hydrogenase 2. Conclusion In the process of glycolysis and glutaminolysis exist targets for metabolic drugs and this may be used for the develop of new target drugs.

Study on the diagnostic value of children's cephalometric roentgenogram measurement parameters for adenoid hypertrophy

NI Shoujie, ZOU Juanjuan, GUO Ruixiang, HAN Yingying, JIN Xiaoxue, LI Yanzhong, WANG Yan

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  39-44.  doi:10.6040/j.issn.1673-3770.0.2022.002

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Objective To identify the parameters of lateral cephalometric radiograph assessment in children with the aim of establishing relevant diagnostic indicators for adenoid hypertrophy. Methods A total of 480 children aged 3-10 years diagnosed with adenoid hypertrophy(A/N≥0.71)in the Department of Otolaryngology, Qilu Hospital of Shandong University, between July 2020 and July 2021 were selected(240 female and 240 male cases). MIMICS 21.0 was used to observe and analyze nine observation indexes of lateral cephalometric radiograph assessment in 480 children. Results There was a strong linear correlation between NS/TS(X₂), PNS-UPW(X₅), SPP-SPPW(X₆), ∠U1-LI(X₇), ∠UI-NA(X₈), ∠LI-NB(X₉), and A/N(X₁)indicators(P<0.001). Conclusion The relevant indicators related to lateral cephalometric radiograph assessment had high diagnostic and treatment values for adenoid hypertrophy in children, among which NS/TS(X₂), PNS-UPW(X₅), SPP-SPPW(X₆), ∠U1-LI(X₇), ∠UI-NA(X₈), and ∠LI-NB(X₉)can be used as indicators to assist in adenoid hypertrophy diagnosis(A/N indicators)in children aged 3-8 years.

Analysis of pulmonary function changes in patients with obstructive sleep apnea hypopnea syndrome

LI Zhuojun, SONG Xicheng, CHEN Xiumei

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  45-50.  doi:10.6040/j.issn.1673-3770.0.2022.043

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Objective To investigate the relationship between pulmonary function and obesity in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods A total of 169 cases of patients with and without OSAHS who were hospitalized in the Department of Otolaryngology & Head and Neck Surgery, Yuhuangding Hospital, Yantai from January 2015 to June 2021 were retrospectively analyzed. Analysis of pulmonary function and polysomnography(PSG)monitoring results and comparison of pulmonary function indicators of the non-OSAHS group and OSAHS group were conducted. The correlation between the pulmonary function indices and PSG results of patients with OSAHS was also identified. Results Apnea-hypopnea index(AHI)and body mass index(BMI)were positively correlated. Maximum vital capacity(Vcmax), forced vital capacity(FVCex), tidal volume(VT), inspiratory capacity(IC), and forced expiratory volume in one second(FEV1)were different between the severe and control groups. AHI was negatively correlated with VCmax, FVCex, PEF, FEV1, and IC. BMI was negatively correlated with VCmax, IC, and FVCex. Conclusion Patients with OSAHS had pulmonary function impairment, which was more apparent in severe patients. Obesity may be a factor leading to pulmonary function impairment in patients with OSAHS.

Metastatic Merkel cell carcinoma of the neck:A case report and literature review

WANG Yubing, ZHENG Yuebin, YANG Yirong, YAN Bincheng, PENG Shunlin

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  51-55.  doi:10.6040/j.issn.1673-3770.0.2021.571

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232 children with congenital pyriform sinus fistula treated by endoscopic radiofrequency ablation

XU Dongjiao, TIAN Xiufen

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  56-62.  doi:10.6040/j.issn.1673-3770.0.2021.580

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Objective To evaluate the diagnosis, indications, and surgical outcomes of congenital pyriform sinus fistula(CPSF)treated by endoscopic radiofrequency ablation. Methods The data of 232 children with CPSF treated at the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively. Results The lesions were predominantly on the left side(217/232, 93.5%), 14 cases were on the right side, and only 1 case was bilateral. The ratio of males to females was about 1.1∶0. Of all 232 cases who underwent endoscopic radiofrequency ablation, 17 cases(7.3%)had recurrence. Postoperative hoarseness occurred in 12 cases, and disappeared within 0.5-2.0 months and there was no irritating cough, esophageal injury, or pharyngeal fistula post operation. Conclusion Endoscopic radiofrequency ablation is one of the best choices for the treatment of CPSF, with advantages such as minimal invasiveness, few complications, and a low recurrence rate.

Electroacupuncture combined with manual moxibustion in the treatment of Meige syndrome: a case report and literature review

REN Wei, LI Jia, ZHANG Xiong, ZHANG Shengjie

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  63-66.  doi:10.6040/j.issn.1673-3770.0.2021.516

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Objective To observe the effectiveness and advantages of electroacupuncture combined with manual moxibustion in the treatment of Meige syndrome. Methods One patient with Meige syndrome was collected, dialectical acupoints were selected, qi was obtained by acupuncture, and electroacupuncture apparatus was connected. The needle was left for 30 min and then the needle was pulled out and moxibustion was performed for 10-15 min. Once a day, 7 days as a course of treatment, 5 courses of treatment to observe the improvement of symptoms. Results After 5 courses of treatment, the patient's symptoms disappeared without recurrence. Conclusion Electroacupuncture combined with manual moxibustion has remarkable efficacy and advantages in the treatment of Meige syndrome, which is worthy of clinical promotion and application.

Isolated congenital retinal arteriovenous malformation with vitreous hemorrhage and sub-inner limiting membrane hemorrhage:a case report and literature review

CHAI Lina, LEI Chunyan, GAO Sheng, ZHANG Meixia

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  67-70.  doi:10.6040/j.issn.1673-3770.0.2021.521

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Objective To describe an uncommon case of vitreous hemorrhage and sub-inner limiting membrane hemorrhage(sub-ILM)in isolated congenital retinal arteriovenous malformation. Methods A 19-year-old patient with a 2-day history of sudden painless vision loss in her left eye and underwent comprehensive ophthalmic examinations. Based on medical history and multimodal imaging, she was clinically diagnosed to have isolated congenital retinal arteriovenous malformation and Valsalva retinopathy. She was then observed and advised for follow up. Results After 3 years of follow-up, the patient's left eye was stable, with an improved best corrected visual acuity of 1.0. Conclusion Congenital retinal arteriovenous malformation is a relatively stable condition that requires long-term follow-up. Moreover, it may also be one of the risk factors of Valsalva retinopathy. Once complications are found, appropriate treatments should be provided to avoid serious consequences. Multimodal imaging provides clinicians with more comprehensive information, which is helpful in the diagnosis, treatment, and follow-up of retinal arteriovenous malformations.

Nasolacrimal duct recanalization under nasal endoscopy for neonatal dacryocystitis

LV Ping, LI Dandan, SONG Wei, HONG Liu

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  71-74.  doi:10.6040/j.issn.1673-3770.0.2021.530

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Objective To investigate the operative timing and clinical observations of nasal endoscopy-assisted probing of the nasolacrimal duct in the treatment of neonatal dacryocystitis. Methods 22 cases(43 eyes)of neonatal dacryocystitis in Dalian municipal women and children's medical center(group)were selected including 6 males and 16 females, with an average age of 22 days. All the children had symptoms such as elevated body temperature and obvious swelling of the nose on the affected side, redness, swelling and tenderness of the lacrimal sac area below the medial canthus of the ipsilateral side, accompanied by a large number of purulent secretions and other symptoms for which conservative treatment was ineffective. Under the circumstance of patients, nasal endoscopy-assisted inferior nasolacrimal duct probing was performed, and a therapeutic effect on dacryocystitis was observed after the operation. Results All the 22 children with dacryocystitis were treated with lacrimal duct probing. All the children's symptoms improved during the follow-up period of 8 months to 2 years. Conclusion In the case of infection, redness, and other symptoms due to lacrimal duct obstruction in children within 3 months, lacrimal duct probing is feasible if conservative treatment is ineffective, and an endoscopic nasal surgery can accurately locate and avoid nasal mucosal damage.

Agreement of intraocular pressure measured by Icare Home tonometer and Goldmann applanation tonometer: a Meta-analysis

YIN Kexin, SUN Wu, LIU Hongyan, XIA Yanting, WEI Qiping, ZHOU Jian

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  75-83.  doi:10.6040/j.issn.1673-3770.0.2021.532

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Objective To evaluate the consistency between Icare Home tonometer and Goldmann applanation tonometer. Methods Systematic evaluation and meta-analysis were conducted on the consistency of intraocular measured by Icare Home tonometer and Goldmann applanation tonometer. Pubmed, Embase, Web of Science, Cochrane Library, CNKI, VIP, WANFANG and Sinomed databases were retrieved from inception to November 26, 2021. Stata 14 and Review Manager 5.3 software were used for data processing. Results A total of 12 studies were included, with a total sample size of 922 people(1 284 eyes). The results of the meta-analysis indicated that there was no statistical difference between Icare Home and Goldmann tonometers in measuring intraocular pressure ［MD=0.12, 95%CI(-0.07,0.10), P=0.691, I2=30%］; the difference between the two tonometers was ［MD=0.01,95%CI(-0.16,0.17), I2=86.3%］. Conclusion The results of intraocular pressure measured by Icare Home and Goldmann tonometer are consistent.

Study characteristics and trend analysis of macular hole retinal detachment in high myopia based on wos database

MENG Bo, WANG Kang, LUO Lihua, WANG Yanling, LI Shuang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  84-90.  doi:10.6040/j.issn.1673-3770.0.2022.047

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Objective To carry out a quantitative analysis of the literature related to macular hole retinal detachment with high myopia in the past 20 years, and to discuss its research characteristics, hotspots and trends. 〖WTHZ〗Methods Based on the core collection of Web of Science, VOSviewer software was used to construct the relationship network and visualize the overall characteristics of the literature related to macular hole retinal detachment in high myopia from 2001 to 2020. Results There were 237 articles in this analysis, with a total of 5272 citations, with an average of 22 citations. The number of SCI publications has been on the rise for two decades, reaching a peak in 2016. The country with the largest number of published papers is China, followed by Japan, Italy and the United States. The institution with the largest number of published papers and the highest hindex is Osaka University, Japan. The top two journals for the number of published papers are Retina and American Journal of Ophthalmology. Key words cooccurrence analysis found that researches related to macular hole retinal detachment in high myopia mainly focus on the exploration of vitrectomyrelated surgery. The top ten most cited papers in this field indicate that the focus of research in different years is different. From 2001 to 2011, it was mainly the use and promotion of vitrectomy and the filling of the contents, and after 2011, the internal limiting membrane tamponade, inverted internal limiting membrane insertion and combined internal and external surgery. ConclusionIn recent years, research on macular retinal detachment in high myopia has mainly focused on the improvement of vitrectomybased surgical procedures. How to properly handle the internal limiting membrane during vitrectomy is a hot topic of international scholars and has a broad prospect.

Preparation of siIKKβ loaded lipid nanoparticles and assessment of their effect on repolarization of macrophages

CHU Baorui, QU Yi

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  91-97.  doi:10.6040/j.issn.1673-3770.0.2022.187

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Objective We aim to construct lipid nanoparticles loaded with siRNA targeting IKKβ and explore their ability to inhibit choroidal neovascularization(CNV)by repolarizing the macrophage phenotype. Methods Cationic lipid nanoparticles were prepared by thin film dispersion, and the optimal gene nanoparticle loading ratio was screened for by agarose gel electrophoresis. Particles were characterized using transmission electron microscopy and a Malvern particle sizer; Expression of IKKβmRNA and mRNAs encoding molecules associated with macrophage polarization phenotype in M2 cells was detected via qRT-PCR; Expression of IKKβprotein in M2 cells was detected by Western blotting. A laser-induced CNV model was established in mice and used to investigate treatment. Macrophage phenotypic molecular protein expression in CNV lesions after drug administration was detected by Western blotting. The therapeutic effect of gene loaded nanoparticles on CNV was detected by OCTA. Results LNs-siIKKβ were successfully prepared. Particle size was(133.3±0.62)nm, and zeta potential was(6.72±0.17)mV at the optimal loading ratio. In vitro, macrophages can be repolarized from M2 to M1 phenotype by suppressing IKKβ expression in M2-type macrophages using LNs-siIKKb. In vivo, after treatment, macrophages in CNV lesions tended to repolarize from M2 to M1 phenotype and CNV production was suppressed. Conclusion The constructed siIKKβ-loaded cationic lipid nanoparticles were able to repolarize macrophages from M2 to M1 in vitro and in CNV lesions in vivo, and inhibited the generation of CNV.

Analysis of a new-onset FBN1 gene mutation in a patient with Marfan syndrome

ZHAO Shuang, ZHAO Jun, XUE Youyu, ZHANG Juanmei

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  98-103.  doi:10.6040/j.issn.1673-3770.0.2022.207

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Objective To identify the genetic etiology, sequencing analysis of the causative gene was performed in a child with a clinical diagnosis of Marfan syndrome. Methods Genomic DNA was extracted from the peripheral blood samples of the proband and his parents for whole exome sequencing analysis; the suspected loci were then verified using Sanger sequencing. The pathogenicity of the variants was assessed according to the guidelines issued by the American College of Medical Genetics and Genomics(ACMG), and predictive analysis was performed using REVEL-a bioinformatics software for the comprehensive prediction of the pathogenicity of missense variants. Results The results of whole exome sequencing analysis showed that the FBN1 gene was associated with the c. 4016G > T(p.C1339F)heterozygous missense mutation in the child. Results of Sanger sequencing showed that his parents had no variation at this locus and exhibited spontaneous mutations. According to the ACMG guidelines, this variant was tentatively determined to be a pathogenic variant. REVEL predicted the missense variant as harmful, and SIFT, PolyPhen 2, Mutation Taster, and GERP + predicted it to be deleterious. Conclusion The c.4016G > T(p.C1339F)heterozygous mutation in the FBN1 gene may be the cause of the disease in our patient with Marfan syndrome; this new variant further expands the FBN1 variant spectrum.

Investigating the correlation between the macular ganglion cell complex and the ratio of deep and superficial vessel density in patients with idiopathic epiretinal membrane

LEI Min, CHEN Ting, AI Ming

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  104-113.  doi:10.6040/j.issn.1673-3770.0.2022.322

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Objective We monitored and investigated the correlation between the thickness of the macular ganglion cell complex(mGCC)and the ratio of deep to superficial vessel density(DSFR)in patients with idiopathic epiretinal membrane(iERM). Methods A retrospective, non-randomized, and controlled clinical study was conducted. Twenty-four patients diagnosed with monocular iERM at the Renmin Hospital of Wuhan University were included in the experimental group, with the normal contralateral eyes serving as the control group. Retinal thickness in the macular fovea, para-fovea, and peripheral area was measured by optical coherence tomography(OCT). In contrast, the thickness of the mGCC was measured using the GCC mode of OCT. The vessel density of the superficial retinal capillary plexus(SCP)and deep retinal capillary plexus(DCP)in the macular area was measured by optical coherence tomography angiography(OCTA). The DSFR was recorded using an ETDRS-GRIDrid recording. Statistical differences and correlations of the above parameters between the iERM and control groups were analyzed. Results OCT-related and mGCC-related parameters in the iERM group differed significantly from those in the contralateral eye control group(all P<0.05). The parafovea DSFR(pPrDSFR)of the experimental group was significantly correlated with the average GCC, Superior GCC, and Inferior GCC(r=-0.308, r=-0.263, and r=-0.307, respectively; all P<0.05). The fovea DSFR FDSFR was significantly correlated with the thickness of the Inferior GCC(r=-0.380, P<0.01). While the thickness of the average GCC was not significantly correlated with superficial vessel density(SVD)SVD and deep vessel densityDVD; however, the thickness of the Superior GCC was correlated with the foveal vessel densityFVD of the DCP, and the thickness of the Inferior GCC was correlated with SVD. D-MVR was significantly correlated with the average GCC thickness, superior GCC, inferior GCC, and prDSFR(r=0.434, r=0.521, r=0.341, r=0.295, all P<0.05). Conclusion We observed that prDSFR and D-MVR were significantly correlated with the thickness of the average GCC and that the prDSFR was also significantly correlated with D-MVR, suggesting a significant relationship between the structural changes in the macular area of iERM and vessel density.

Analysis of retinal choroidal blood flow changes and correlation with tessellated fundus in highly myopic eyes

XIONG Pianpian, WANG Jialin, SUN Jiao, ZHOU Zhuohua, WANG Yanling

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  114-121.  doi:10.6040/j.issn.1673-3770.0.2022.421

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Objective To observe and quantify the changes of parameters related to the macular, optic disc, and choroidal blood flow of high myopia patients with different degrees of fundus tessellation. Methods A cross-sectional study. From June 2018 to December 2018, 76 eyes of 42 individuals with high myopia were included in the study. Participants underwent color fundus photography and optical coherence tomography angiography(OCTA). The degree of tessellated fundus was assessed by an application of ETDRS grid and then divided into four groups(grade 0, grade 1, grade 2, and grade 3). The vascular density of superficial retinal capillary plexus and deep retinal capillary plexus(DCP)in the macular region, optic nerve head and radial peripapillary capillary(RPC)in the optic disc were measured by OCTA. The subfoveal choroidal thickness(SFCT), the total choroidal area(TCA), luminal area(LA), and stromal area(SA)were measured as well, and then the choroidal vascular index(CVI)was calculated. Kruskal-Wallis H test,analysis of variance, Dunnett's test, and multiple linear regression were used to analyze the collected data from the four groups. Partial correlation analysis was used to analyze the relationship between fundus tessellation and retinal choroidal blood flow parameters. Results There were significant differences in the DCP vascular density in the fovea, vascular density of RPC in the optic disc, SFCT, TCA, LA, SA, and CVI(all P<0.05). The degree of fundus tessellation was positively correlated with the vascular density of DCP in the fovea and CVI(r=0.441, 0.280,all P<0.05); while negatively correlated with the vascular density of RPC in the optic disc, SFCT, TCA, LA, and SA(r=-0.290, -0.567, -0.511, -0.475, -0.512, all P<0.05). Conclusion As the degree of fundus tessellation increases, the vascular density of the deep retinal capillary plexus in the fovea and choroidal vascular index increase as well, while the vascular density of radial peripapillary capillary in the optic disc and subfoveal choroidal thickness decrease.

综述

Current research on the relationship between obstructive sleep apnea hypopnea syndrome and tinnitus

WANG Nan, HUANG Jing, PEN Tao, FENG Bo

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  122-127.  doi:10.6040/j.issn.1673-3770.0.2021.518

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Obstructive sleep apnea hypopnea syndrome(OSAHS)is a common type of sleep disorder. Long-term Obstructive sleep apnea and hypopnea can cause different degrees of hypoxemia, followed by tissue ischemia and hypoxia. Cause central and surrounding auditory system damage, auditory conduction pathway abnormalities, central auditory cortex adaptive changes, and then lead to tinnitus perception. The increase of 5-hydroxytryptamine(5-HT)neurotransmitter in OSAHS patients activates the auditory nucleus controlled by 5-HT and affects the neural electrical activity of the auditory nucleus, resulting in secondary tinnitus. The autonomic sympathetic nervous system of OSAHS patients excites and stimulates cochlear nerve fibers to induce tinnitus. At the same time activate limbic system and plant nervous system, and then produce anxiety, depression and other adverse emotions aggravate tinnitus. OSAHS patients suffer from long-term sleep structure disorder, resulting in sleep deprivation and accumulation of toxic metabolites in the brain, leading to central compensation disorder of tinnitus and secondary tinnitus.

Research progress on influencing factors of aminoglycoside antibiotic ototoxicity

LI Cong, LI Ling, LIU Tingyan, CHEN Liang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  128-134.  doi:10.6040/j.issn.1673-3770.0.2021.097

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Aminoglycoside antibiotics are potent and widely used primarily in the treatment of serious bacterial infections.A serious complication from using these antibiotics is ototoxicity.The main cause of ototoxicity is drug-triggered sensory hair cell damage in the inner ear.Molecular events that engender aminoglycoside-induced sensory hair cell death have been extensively studied.Recent reports have revealed the external factors that increase drug toxicity and the genetic factors that lead to increased sensitivity in individuals, which may provide prospective approach for individualized treatment and prevention of ototoxicity. In this review,we discuss the ototoxicity mechanism of aminoglycoside antibiotics, factors affecting drug ototoxicity,and potential intervention strategies to prevent ototoxicity.

Research progress on the application of artificial intelligence in the diagnosis and treatment of nasopharyngeal carcinoma

LIU Jiayu, FAN Huiming, ZOU You, CHEN Shiming

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  135-142.  doi:10.6040/j.issn.1673-3770.0.2022.089

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The incidence of nasopharyngeal carcinoma is high in southern China. As traditional diagnosis and treatment methods are affected by both low efficiency and subjective and objective factors, a more objective, stable and efficient method of diagnosis and treatment is urgently needed. Artificial intelligence has been widely used in tumor diagnosis and treatment, and has shown high accuracy in image recognition, segmentation, risk prediction, and efficacy prediction. In addition, the application of AI models to assist clinicians in diagnosis and treatment can significantly reduce the amount of time required, improve the accuracy of clinicians' performance, and reduce observer variability among physicians, establishing conditions for enhanced tumor diagnosis and treatment. In this paper, the application status and value of artificial intelligence in the diagnosis and treatment of nasopharyngeal carcinoma are reviewed and summarized, and its future development direction is discussed.

Advances in immune vaccines for head and neck squamous cell carcinoma

AI Ziqin, LI Junzheng

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  143-150.  doi:10.6040/j.issn.1673-3770.0.2022.016

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Head and neck squamous cell carcinoma is the most common pathological type of the head and neck tumor, and its incidence is increasing annually. Most cases are discovered only in the middle and late stages, when prognosis is poor and mortality rate is high. With increasing research, the treatment mechanism is becoming clearer and the available therapies are more diverse. Immune vaccines, as an emerging immunotherapy modality, are gradually becoming one of the hot topics in the treatment of head and neck squamous cell carcinoma because of their unique advantages. It is divided into preventive vaccine and therapeutic vaccine, which are effective on the treatment of head and neck squamous cell carcinoma by different mechanisms. Compared with other immunotherapy methods, immune vaccine can treat more accurately with mild side effects. As the immune vaccine moves toward individualized customization, it is expected to become a powerful tool for anticancer immunotherapy. We reviewed and summarized the progress of immune vaccines in head and neck squamous cell carcinoma research, and discussed its future development prospects.

Research progress of inflammatory factors in Keratoconus

LI Mengting, HE Shuxi, WANG Hua

Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(2):  151-158.  doi:10.6040/j.issn.1673-3770.0.2021.536

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Keratoconus(KC)is a progressive corneal dilation disease, which aggravates myopia and astigmatism. The pathophysiological mechanism of KC remains vague. The role of genetic and inflammatory factors on KC has been investigated by previous studies. Detectable levels of inflammatory factors and proteases were found in the tears of patients with KC. Interleukin-6, tumor necrosis factor-α, and matrix metalloproteinase-9 were found in the tears of patients with KC. A higher level was positively correlated with the clinical course of KC. In addition, some external factors can indirectly lead to the aggravation of inflammation through certain behaviors, thus accelerating the occurrence and development of KC, such as eye rubbing, allergic reaction, etc. Pathological eye rubbing will change the corneal morphology, change the corneal environment, and cause indirect corneal injury. Immunoglobulin E in allergic reaction is the potential inflammatory molecule of KC. This paper aimed to review previous studies on inflammatory factors and the pathways leading to KC.