Table of Content

24 June 2007 Volume 21 Issue 3

  

Articles

Prognostic significance of COX-2,PCNA and p53 in nasopharyngeal carcinoma

MIAO Bei-ping,LU Yong-tian,XU An-ting

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  193-196 . 

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Objective: To ascertain the possible roles of COX-2，PCNA and p53 in the tumorigenesis and development of nasopharyngeal carcinoma, and to evalulate their impact on the prognosis of nasopharyngeal carcinoma. Methods: Immunohistochemical assay was used to determine COX-2, PCNA and p53 in all specimens, including 60 cases of nasopharyngeal carcinoma and 30 cases of normal nasopharynx. Results: （1） The overall positive expression rate of COX-2， PCNA and p53 in nasopharyngeal carcinoma was 90%, 75% and 68% respectively, higher than that in the normal nasopharynx. （2） Intensity of expression of COX-2, PCNA and p53 in nasopharyngeal carcinoma was related to tumor stage, tumor differentiation and lymph node metastasis (P＜0.05). （3） Expressions of COX-2, PCNA and p53 were correlated with each other in nasopharyngeal carcinoma. （4） Positive COX-2 and PCNA were associated with a lower 5-year survival and they were significant prognostic variables for recurrence(P＜0.05). Conclusion: COX-2, PCNA and p53 may play vital roles in the tumorigenesis and development of the cancer via different methods. Unfavorable prognosis was associated with expression of COX-2 and PCNA while not with p53. Immunohistochemical assessment of COX-2 and PCNA might be a useful molecular marker for predicting prognosis in nasopharyngeal cancer.

A survey on the physical and psychological factors of tinnitus patients

YANG Chuan-hua,SUN Hua-qing,HAN Chao-dong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  197-198 . 

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Objective: To explore the physical and psychological factors of tinnitus patients and its prevention measurement. Methods: A symptom checklist questionnaire was performed on 197 cases and the mental health status of patients was analyzed. Results: Tinnitus purely impacted the body and mind of patients in different degrees. 89.3% of them had tension, 61.73% amenities, and 76.6% depression. Conclusion: Tinnitus is shown by questionnaires to be closely related to a patient′s body and mind .

Open tympanoplasty for otitis media with cholesteatoma

MU Shan-yu,QIAO Xiu-jun,LI Jian-sheng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  199-200 . 

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Objective： To investigate the effect of open tympanoplasty for patients with cholesteatoma of the middle ear. Method: Twenty-hree ears with cholesteatoma were treated by open tympanoplasty. Results: During a follow-p of one to three years, all had dry ears without relapse and vertigo or facial paralysis. Among them, 20 cases had normal tympanic membranes, 2 had perforation, and 1 had a sunken tympanic membrane. Hearing was improved by 25 to 30dBHL in 5 ears, 15 to 20dBHL in 13 ears, 10dBHL in 2 ears, and not improved in 3 ears. Conclusion: Open tympanoplasty should be carried out in treating otitis media with cholesteatoma to improve the hearing and decrease relapse.

UItra-violet blood irradiation for sudden deafness

JIANG Feng-na,SUN Xiu-mei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  201-202 . 

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Objective: To study the clinical value of ultra-violet blood irradiation for sudden deafness. Method: Ultra-violet blood irradiation (the UBI group) plus conventional drugs, hyperbaric oxygen ( the HO group）plus conventional drugs, and only conventional drugs(the control group) were respectively performed on 42 cases of sudden deafness. Results: The total response rate was 90.5% in the UBI group， 90.5% in the HO group, and 69.0% in the control group. There was a significant difference between the UBI and the control groups and between the HO and the control groups (P＜0.01), but no significant difference between the UBI and the HO groups (P＞0.05). Conclusion: UBI is an effective treatment for sudden deafness.

Imaging-navigated transnasal endoscopic repair of cerebrospinal fluid rhinorrhea in 14 cases

ZHANG Hua,SONG Xi-cheng,ZHANG Qing-quan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  203-205 . 

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Objective: To explore the effect of imaging-navigated transnasal endoscopic repair of cerebrospinal fluid rhinorrhea. Method: The clinical data of 14 cases subjected to imaging-navigated transnasal endoscopic repair of cerebrospinal fluid rhinorrhea were retrospectively analyzed. Results: Of them, 10 were induced by trauma, 1 by iatrogenic cerebrospinal fluid rhinorrhea, and 3 by unknown causes. The fistulas were between 1mm×1mm and 20mm×10mm in size. Ten cases were repaired by the onlay method, 3 by underlay, and 2 by “Button with fascia". All were cured by one treatment under imaging-navigated transnasal endoscopic repair. Conclusion: Endoscopic technique under image navigation is great in identification, vision, complication and placement of a graft. The application of EC ear-brain glue increases the success rate of the operation.

Expression of cyclin D1 in nasal sinus neoplasm

HAN Ming,CHEN Ying

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  206-208 . 

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Objective: To investigate the expression of cyclin D1 in nasal sinus neoplasm and its clinical significance. Method: SABC immunohistochemical technique was used to determine the expression of cyclin D1 in 20 samples of nasal sinus carcinoma and 10 samples of benign lesion. Results: Cyclin D1 was over-expressed in all nasal sinus carcinoma, whereas no or weak expression was determined in benign lesions. The cyclin D1 integral was not correlated with age, gender, site of tumor or pathologic type（P＞0.05） but correlated with the TNM stage and histological grade（P＜0.05). Moreover, it gradually increased following the increase of stage and histological grade. There were significances between cyclin D1 integral of preliminary cases and recurrence cases（P＜0.05). Conclusion: Cyclin D1 may play an important role in tumor genesis.

Transnasal endoscopic management of septal cartilage augmentation in repairing medial orbital wall fracture

WANG Shao-mei,LIU De-sheng,LI Yin-zhu

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  209-211 . 

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Objective: To explore the possibility of transnasal endoscopic management of septal cartilage augmentation in repairing medial orbital wall fracture. Methods: Eleven patients (11 eyes) with medial orbital wall fracture were enrolled in this study. Before surgery, all the patients had more or less enophthalmos, diplopia and hypopsia. Eye socket CT examination showed that ocular contents were herniated into the ethmoid sinus accompanied with hydrocele. Among them, 6 patients had medial rectus swelling. Under endoscopy, ethmoid sinus was opened via the nasal cavity, the ethmoid cells were extirpated to uncover the fractured lamina, herniated contents were returned back to the eye socket, and the fracture zone was overlaid with septal cartilage. Results: All were cured after surgery. The exophthalmos of both eyes was less than 1mm (with a mean of 0.11mm). The eyesight of the patients showed no change or was slightly improved. Nasal endoscopy showed epithelization of nasal and sinus cavities and un-shift augmented septal cartilage. There was no infection or rejection. Conclusion: Transnasal endoscopic management of septal cartilage augmentation in repairing medial orbital wall fracture is simple, quick and has a high success rate. Autogenous septal cartilage has no rejection response.

A comparison of pedicle buccinator flap transplantation and silicagel implantatipn into the nasal basis for atrophic rhinitis

MA Kun-peng,MA Li-min,LIU Qing-ming

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  212-213 . 

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Objective: To evaluate the therapeutic effect of pedicle buccinator flap transplantation and silica gel implantation into the nasal basis for atrophic rhinitis. Method: Eighty patients with atrophic rhinitis were randomly divided into two groups: the pedicle buccinator flap transplantation group (group A, n=43) and the silica gel implantation group (group B, n=37). Result: The total effective rate of group A was significantly higher than that of group B (P＜0.05), and the incidence of complications of group A was significantly lower than that of group B(P＜0.05). Conclusion: Pedicle buccinator flap transplantation is great for atrophic rhinitis.

Effect of the hole-key technique for sinusitis

MU Xun-ye,SU Shi-zheng,ZHANG Jun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  214-215 . 

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Objective： To explore the effect of the hole-key technique in treating sinusitis. Methods： The hole-key technique was performed on 252 cases of sinusitis. The result was compared with that of the routine method. Result： Differences of the two groups were significant, and responses in atresia of aperture of the maxillary sinus, apertura sinus frontalis, aperture of the sphenoid sinus and in complete epithelium of ethmoidal cell mucous membrane of the hole-key group were superior to those of the routing group. Conclusion： The micro-hurt concept should be applied in endoscopic surgery.

Clinical features of oltactory cleft bleeding

ZHAO Shen-lin,ZHAO Yu-feng,SONG Dao-liang,ZHANG Min

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  216-217 . 

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Objective: To investigate the clinical features and management for olfactory cleft bleeding. Method: The clinical features and management for twenty-two patients with olfactory cleft bleeding were retrospectively analyzed. Results: Olfactory cleft bleeding was found in 22 cases, was uncertain in 8, and was induced by internal carotid artery pseudoaneurysm in 2. Under an endoscope, burnt and package were performed on 21 cases, ligation of the anterior ethmoid artery on 6, and DSA on 1. Four cases were healed under a conservative condition. Conclusion： Olfactory cleft bleeding is difficult to be found and treated. Nasal endoscopic surgery provides an effective and safe method for it.

Esoinophil infiltration on the regeneration of nasal mucosa following nasal endoscopic sinus surgery

LI Shu-jie,YIN Huai-sheng,LV Ling-yan,WU Yu-mei,MENG Ling-qiu,ZHANG Feng,GAO Zhen-feng,CHEN Bing

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  218-220 . 

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Objective: To explore the eosinophil infiltration on the transitionary process of nasal mucosa following nasal endoscopic surgery. Methods: Eosinophil was quantitatively determined in polyps and recurrent polyps and edema tissues around the maxillary sinus by Chromotrope 2R staining. Results: Eosinophil was higher in polyps than in the middle turbinate (P＜0.01). The recurrence rate was highly correlated with the eosinophil infiltration in the tissues. Conclusion: Eosinophil infitration is directly related to the recurrence of polyps, which can be regarded as a prognostic indicator for polyps.

Endoscopic adenoidectomy for hypertrophic adenoid with micro-stryker instruments

SHI Bao-yuan,SHI Li,YIN Feng-fang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  221-223 . 

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Objective： To explore the efficacy of endoscopic adenoidectomy using micro-stryker instruments in children． Method： A retrospective analysis was conducted on 80 cases of adenoidal　hypertrophy subjected to endoscopic adenoidectomy． Result： Hypertrophic adenoids were completely removed without complication and recurrence． Conclusion： The powered-assisted adenoidectomy has the advantages of a short surgical time and less hemorrhage and its effect is satisfactory．

Upper respiratory tract endoscopy in the diagnosis and treatment of chronic cough

XUE Ling-jun,SUN Wen-hai,LI Da-jian,LIU Xin-yi,ZHANG En-dong,LIU Yan,SUN Cai-bo

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  224-226 . 

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Objective: To investigate the etiological factors of chronic cough and the effect of endoscopic examination of the upper respiratory tract. Method: Endoscopic examination of the upper respiratory tract and the assistance inspection were performed on 120 cases of chronic cough to explore the etiology. Results: In the 120 cases, posterior nasal drip syndrome was found in 47 cases, acidophile bronchitis and cough variability asthma in 32 cases, gastroesophageal reflux diseases in 35 cases, hysteria in 2 cases and unknown cause in 4 cases. After treatment, 98 cases were greatly improved in 3-7days, 106 patients felt obviously improved in 2 weeks, and 106 cases stopped taking medicine 1 week after the symptoms vanished. The other 14 cases were transferred to departments of paediatrics or psychology. Conclusion: Chronic cough is caused by many factors. Endoscopic examination is helpful in observing the slight pathological changes of the upper respiratory tract.

Clinical analysis of 32 cases of Charlin'syndrome

LIU Chun-qing,LIU Hai-cheng,WANG Fu-juan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  227-228 . 

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Objective: To investigate clinical features of Charlin′ syndrome and an effective treatment method. Methods: Rhinoscopy and CT examination were performed on 32 cases of Charlin′ syndrome. Specific surgical therapy was taken to correct such abnormalities of the nasal cavity. Result: Followed up over 6 months, 27 cases were cured and 5 cases had some effect. Conclusion: Nasal endoscopy combined with CT scanning can significantly improve the diagnostic efficacy. Surgical intervention for Charlin′ syndrome should be selected according to the etiology of diseases.

Temperature-controlled radio-frequency ablation in treatment of obstrustive sleep apnea hypopnea syndrome

WAN Han-feng,JIN Jian-xin,GAO Jin-jian,FAN Qi-jun,LIU Xue-jun,HUANG Jia-yun,CHEN bo-bei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  229-231 . 

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Objective: To determine the efficacy of temperature－controlled radio-frequency ablation (TCFR) for obstructive sleep apnea hypopnea syndrome (OSAHS) in adult. Methods: Some objective and subjective indexes of fifty patients with OSAHS were determined before and after TCRF treatment. A full-night polysomnography examination was performed on all patients. The Epworth sleepiness scale (ESS) and the Calgary sleep apnea quality of life index (SAQLI) were assessed before and six months after operation. Results: Of them, 19 cases were cured, 18 cases were significantly improved, 16 cases were improved, and 7 cases were not improved. The mean apnea hypopnea index （AHI） decreased from（45.2+20.5）/h to (26.5+30.2)/h and the mean lowest arterial oxygen saturation (LSaO2) increased from(0.7+0.1) to (0.8+0.1). The ESS decreased from (9.4+5.2) to (4.0+3.3) and the SAQLI increased from(3.8+1.0) to (4.8+1.1). All the above differences were significant (P＜0.05). Conclusion: TCFR is an effective treatment for OSAHS and can improve the health-related quality of life.

Surgery for scarring laryngeal stenosis involved with respiratorium scleroma

WANG Yan,SUN Yan,SUN Wen-hai,CHEN Zhi-jun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  232-233 . 

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Objective: To study the clinical manifestation and treatment of laryngeal stenosis. Method: The clinical data of seven patients with cicatricial laryngeal stenosis involved with respiratorium scleroma were retrospectively reviewed. Results: Of them, 6 cases had laryngeal obstruction in the first degree and 1 case in the second degree. Four cases of simple cicatricial laryngeal stenosis had no relapse after surgery for 7 to 14 years; 2 cases of cicatricial stenosis mainly in the larynx and neck were subjected to enlargement of the laryngeal cavity and reconstruction surgery of the tongue bone flap also had no relapse for 6 to 8 years; 1 case of subglottic stenosis had hypolarynx atresia at 3 months after surgery. Conclusions： Cicatricial laryngeal stenosis should be operated on. In operation, mucous membrane must not be greatly injured and the mucous membrane flap or bone flap may be used to relieve laryngeal stenosis in serious patients.

Emergency tracheotomy for patients with severe head injury

KANG Hong-jian,LI Xiao-hong,WANG Bao-an,ZHOU Tao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  234-236 . 

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Objective: To explore the significance, indications and complications of emergency tracheotomy for patients with severe head injury. Method: The clinical data of 147 patients with severe head injury treated in 2003 to 2006 were retrospectively analyzed. Result: Of them, 116 were basically cured (78.9%), 25 had improvement (17%), 7 were released from the hospital (4.8%), 4 survived(2.7%) in a vegetative state, and 5 died (3.4%). Conclusion: Emergent tracheotomy should be performed on patients with severe brain injury to resolve respiratory tract obstruction, prevent stifling, improve air current, prevent cerebral anoxia， and promote brain function recovery.

Endoscopic surgery for chronic cough owing to adenoid hypertrophy in children

FENG Yong-gang,ZHU Juan-fen,YU Hai-an

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  237-238 . 

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Objective： To explore the effect and security of endoscopic adenoidectomy in treatment of chronic cough in children. Method： Thirtynine patients who presented chronic cough were subsequently found by nasal endoscopy to have adenoid hypertrophy and they were subjected to endoscopic adenoidectomy. Result： Followed up for 624 months, 29 cases were cured, 8 had improvement, and 2 had not significantly changed. Conclusion： Endoscopic adenoidectomy is effective and reliable for chronic cough of children induced by adenoid hypertrophy combined with infection.

A comparision between the enameloplasty sealant technique and the conventional saelant technique

ZHENG Han,LUO Xian-feng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  239-240 . 

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Objective： To compare the clinical effect and preservation rate of the sealant between the enameloplasty sealant technique(EST) group and the conventional sealant technique(CST)group. Methods： One hundred and sixty cases of the first permanent molars in the mandibula were sealed by EST and CST. The preservation rate of the sealant was produced after a follow-up of 2 years. Result： The preservation rate of the sealant was 87.3% in the EST group and 63.7% in the CST group. Conclusion： EST is superior to CST in clinical effect.

Early definitive surgery in the treatment of serious naso-orbital-ethmoid fractures

SHAO Shan,XU Xin,MA Yue,LAN Jing,HUANG Hai-yun,

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  241-242 . 

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Objective： To explore the clinical effect of early definitive surgery for naso-orbital-ethmoid fractures. Methods： Ddefinitive surgeries in early stage such as reduction of the fracture, rigid internal fixation (RIF), reconstruction, reattachment of the medial canthal ligament were performed on 23 cases of naso-orbital-ethmoid fractures based on the conditions of physical examination, fracture and malformation. Results： In the 23 cases, the complexions, occlusive relation and open reduction were resumed or nearly resumed. Conclusion： Early definitive surgery is a reliable and effective technique for naso-orbital-ethmoid fractures patients.

Early definitive surgery in the treatment of serious naso-orbital-ethmoid fractures

SHAO Shan,XU Xin,MA Yue,LAN Jing,HUANG Hai-yun,

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  241-242 . 

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Objective： To explore the clinical effect of early definitive surgery for naso-orbital-ethmoid fractures. Methods： Ddefinitive surgeries in early stage such as reduction of the fracture, rigid internal fixation (RIF), reconstruction, reattachment of the medial canthal ligament were performed on 23 cases of naso-orbital-ethmoid fractures based on the conditions of physical examination, fracture and malformation. Results： In the 23 cases, the complexions, occlusive relation and open reduction were resumed or nearly resumed. Conclusion： Early definitive surgery is a reliable and effective technique for naso-orbital-ethmoid fractures patients.

Transplantation of limbal autograft following microsurgery for pterygium

YAN Rui,ZHU Lin-jie

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  243-244 . 

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Objective: To investigate the effect of transplantation of limbal autograft following microsurgery for pterygium. Method: Fifty-seven eyes with pterygium were treated by transplantation of limbal autograft combined with modification of ocular reconstruction. Results: During a follow-up of 12 to 24 months, no recurrence and no sub-epithelial fibro-vascular proliferation were found and all achieved a radical cure. Conclusion: Transplantation of limbal autograft is an effective microsurgical treatment for pterygium.

A comparison of intra-operative mitomycin C and post-operative heparin in trabeculectomy

LIU Zhen,YU Dong-zhen,CHEN Wei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  245-247 . 

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Objective： To explore the effect of intra-operative mitomycin C and post-operative heparin in trabeculectomy for glaucoma. Methods: One hundred and fifty eyes of ninety patients were randomly divided into the mitomycin C group and the heparin group. Mitomycin C at 0.2-0.4 mg/ml was subjected to patients of the former group for 2-4min, and 5% heparin was used in patients of the later group. Results: During a follow-up of 6 months, the success rate of the two groups was both higher than that of the standard trabeculectomy group. The difference between the two groups was not significant（P>0.05）.　Conclusion： Both intra-operative mitomycin C and post-operative heparin can improve the success rate and regain the functional bleb for a long time.

Extracapsular cataract extraction combined with goniosynechialysis for acute angle closure glaucoma

LIU Yong-mei,TIAN Xu,ZHANG Shuang,ZHANG Lin-na

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(3):  248-250 . 

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Objective: To investigate the clinical effect of extracapsular cataract extraction combined with goniosynechialysis in treatment of acute angle closure glaucoma with cataract. Methods: Thirty-four patients (37 eyes) were subjected to this management. The anterior chamber depth, visual acuity, configuration of chamber anger, and intraocular pressure were determined. Results: After a mean postoperative follow-up of 180 days, the best corrected visual acuity was improved in 28 cases (30 eyes). The mean anterior chamber depth was 1.674±0.478 mm pre-operatively and 3.412±0.169 mm at post-operative 30 days (t=6.743, P＜0.001). The intraocular pressure was decreased from a pre-operative of 28.436±3.325 mmHg to a postoperative 7-day of 13.983±5.196 mmHg (t=5.263, P＜0.001). Angles of the anterior chamber were opened at post-operative 30 days in all 34 patients. The visual field was not significantly changed in 15 patients at six months after operation. Conclusion: Extracapsular cataract extraction combined with lysis of the synechiae is safe and effective for acute angle closure glaucoma.