Table of Content

20 March 2024 Volume 38 Issue 2

  

Original Article

Cytokine expression among patients with acute secretory otitis media after SARS-CoV-2 infection

FAN Yongjiang, HUANG Wei, HE Chengshan, SHEN Haitao, XU Zheng, HAO Yanan

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  1-6.  doi:10.6040/j.issn.1673-3770.0.2023.215

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Objective We investigated the role of middle ear effusion and serum cytokines in the pathogenesis of acute secretory otitis media caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection in adults. Methods Forty-five adult patients with acute secretory otitis media after SARS-CoV-2 infection were enrolled in this study. All patients had been infected with SARS-CoV-2 within the past 4 weeks. Blood samples were collected for cytokine analyses, and cytokines and SARS-CoV-2 nucleic acid were detected by ear effusion after tympanocentesis, to analyze changes in serum and middle ear effusion cytokines. Results The expression of cytokines IL-5, IL-6, IL-8, and IL-10 in middle ear effusions was significantly elevated relative to their levels in serum(P<0.05); IL-2, IFN-α, IFN-γ and TNF-α expression was not significantly different between serum and middle ear effusion(P>0.05). IL-5, IL-6, IL-8, and IL-10 expression level in middle ear effusion displayed no significant difference between SARS-CoV-2 positive individuals(including suspected positive individuals)and negative individuals(P>0.05). Individuals with mixed hearing loss exhibited significantly elevated IL-6 and IL-8 expression in middle ear effusion than individuals with conductive hearing loss(P<0.05). Conclusion SARS-CoV-2 can infect the middle ear through the eustachian tube and induce middle ear immune cells to produce high levels of cytokines, promoting secretory otitis media. IL-5, IL-6, IL-8, and IL-10 were the main inflammatory cytokines that promoted adult acute secretory otitis media caused by the novel coronavirus. IL-6 and IL-8 can be used as primary indicators to predict the severity of impairment of sensory nerve function in patients.

Expression and significance of CXCL10 and IFN-γ in antrochoanal polyp

ZHANG Yongcai, ZHANG Jiang, LU Hui, XING Kexin, WU Jingfang, XUE Gang, LI Yanping, LIU Yanbin

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  7-12.  doi:10.6040/j.issn.1673-3770.0.2023.233

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Objective To investigate the expression and significance of inflammatory cells,CXC chemokine ligand 10(CXCL10), and interferon-γ(IFN-γ)in the antrochoanal polyp(ACP). Methods A total of 58 samples were collected from the First Affiliated Hospital of Hebei North University between October 2015 and July 2020, including 40 cases of ACP and 18 case of maxillary sinus cysts. Preoperative serum and surgical samples were collected. Paraffin embedding and HE staining were performed on surgical specimens, and the number and percentage of various inflammatory cells were counted. The epithelial hyperplasia of patients with ACP was comprehensively scored. The expression of CXCL10 and IFN-γ in ACP and control groups was observed by immunohistochemical staining. The enzyme-linked immunosorbent assay detected the protein concentration of serum CXCL10 in two groups, and the correlation between protein concentration and inflammatory cells in peripheral blood of the two groups was analyzed. Results HE staining revealed obvious epithelial remodeling and heterogeneity with inflammatory cell infiltration, primarily neutrophils, lymphocytes, and plasma cells in group ACP. A positive correlation was found between ACP neutrophils and lymphocytes with the analysis by routine blood examination. Immunohistochemistry showed that CXCL10 and IFN-γ in the experimental group were strongly positive compared with those in the control group. The concentration of CXCL10 was(32.15±4.60)pg/mL vs(12.11± 3.54)pg/mL in ACP and control groups as determined by ELISA(P<0.05). Conclusion The expression of CXCL10 and IFN-γ were significantly upregulated in the ACP group, which may be related to non-type Ⅱ inflammation, especially Th1 inflammatory factors.

Analysis of clinical characteristics of vaccine-associated uveitis: a retrospective study based on American vaccine adverse event reporting system

HOU Ning, YANG Junxing, ZHANG Yupeng, LIN Zichun, DENG Aijun

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  13-17.  doi:10.6040/j.issn.1673-3770.0.2023.044

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Objective To investigate the clinical characteristics of vaccine-associated uveitis in order to provide a reference for vaccine safety monitoring, vaccination, and clinical diagnosis and treatment. Methods The vaccine-associated uveitis reports from 1990 to 2022 were collected from the American Vaccine Adverse Event Reporting System. Moreover, sex, age, type of vaccination, dose series, time of occurrence, and type of uveitis of vaccine-associated uveitis reports were retrospectively analyzed. Results Of the 317 cases of vaccine-associated uveitis, more than 10 types of vaccine were involved, mainly the COVID-19 vaccine, human papillomavirus vaccine, and hepatitis B vaccine. There were 86 males and 231 females, with a male-to-female ratio of 1:2.7. Patients aged 18-<60 years, accounted for the majority of the total cases(65.3%). Uveitis is common under 8 days after vaccination and after the first dose of vaccination, accounting for 56.8% and 47.0%, respectively. Iridocyclitis represented the highest proportion of 184(56.5%)cases of uveitis. Conclusion Fully understand and study this adverse reaction to vaccination in depth, continue to monitor vaccine safety, better vaccination, and clinical diagnosis and treatment.

Effect of 577 nm subthreshold micropulse laser photocoagulation combined with anti-VEGF on the treatment of refractory diabetic macular edema

ZHOU Jinglin, LI Jinxiang, ZENG Qi

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  18-25.  doi:10.6040/j.issn.1673-3770.0.2023.313

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Objective We compared the clinical efficacy of subthreshold micropulse laser photocoagulation(SMLP)with a threshold of 577 nm, combined with intravitreal injection of compacept(intravitreal conbercept, IVC), with that of IVC alone in the treatment of refractory diabetic macular edema(DME). Methods We designed and performed a non-randomized controlled study. Patients with refractory DME who were admitted to the Department of Ophthalmology, Hunan Provincial People's Hospital from January 2022 to December 2022 were selected and divided into an experimental group(10 cases, 16 eyes)and a control group(12 cases, 17 eyes). The experimental group received 577 nm SMLP combined with IVC treatment, and the control group received IVC alone. The changes in best corrected visual acuity(BCVA), central macular retinal thickness(CMT), hard exudates(HE)area, microangioma(MA), and the number of intravitreal injections were collected after 6 months of treatment in the two groups. The incidence of complications was recorded after treatment. Results After 6 months of treatment, the respective Log MAR BCVA values in the experimental and control groups were 0.300(0.100, 0.400)and 0.400(0.300, 0.600), respectively. The difference between these two groups was statistically significant(t=-2.575, P=0.015). The respective CMT values were 237.00(230.75, 254.75)μm and 263.00(237.00, 341.50)μm, and the difference was statistically significant(t=-2.252, P=0.035). No significant difference was observed between HE ［411.50(72.25, 8 757.50)pixels²］ vs. ［3 000.00(10.00, 6 604.00)pixels²］ and MA ［1.00(0.00, 7.25)vs.(4.55±4.78)］(t=0.766, P=0.452; t=-0.861, P=0.400). The numbers of injections in the experimental and control groups were(4.6±0.2)and(5.3±0.2), respectively. This difference was statistically significant(t=-2.182, P=0.039). After 6 months of treatment, no obvious pigment deposition or sign of laser scar was observed in the fundus examination of the affected eyes in the experimental group. No obvious complications were observed in the experimental group or the control group after 6 months of treatment. Conclusion SMLP at 577 nm demonstrated good safety. Compared with simple IVC treatment, 577 nm SMLP combined with IVC treatment improves HE area, number of bleeding points, and MA with the same efficacy in patients with refractory DME. However, combined treatment can better reduce macular edema in some patients in the short term, improve BCVA, prolong the interval of intravitreal injection, and reduce the frequency of intravitreal injection, offering promising prospects for clinical application.

Epidemiological characteristics and prognostic factors associated with 4 526 cases of open globe injuries: a retrospective study

FU Qingyu, LIU Tiantian, WANG Pingping, LIU Longqian

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  26-33.  doi:10.6040/j.issn.1673-3770.0.2023.085

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Objective To study the epidemiological features and prognostic factors of open globe injuries(OGI). Methods A retrospective study was conducted, focusing on OGI treated at West China Hospital, Sichuan University, between January 2009 and December 2020. Univariate analysis was used to determine the impact of various factors, including general patient information, causes of injury, complications, and the interval between injury and presentation to the hospital, on the visual outcomes at discharge. Factors that showed statistically significant differences were further analyzed using a multivariate binary Logistic regression model. Results Multivariate binary Logistic regression analysis revealed that, ethnic minorities, age groups of(45, 60)years, age groups of(60, 75)years, blunt object resulting in injury, falls resulting in injury, rehospitalization, prolonged hospital stay, complications included intraocular hemorrhage, dislocated lens, and orbital fractures are risk factors for discharge visual acuity <0.05(OR=1.355, 1.380, 2.387, 1.716, 1.601, 2.013, 1.889, 1.983, 1.857, 3.311; 95%CI=1.050-1.748, 1.140-1.670, 1.632-3.490, 1.290-2.282, 1.066-2.403, 1.668-2.429, 1.581-2.258, 1.627-2.417, 1.351-2.553, 2.109-5.198; all P<0.05). Conclusion OGI predominantly affect young and middle-aged males, with many injuries related to the workplace. Visual prognosis of OGI is generally poor, emphasizing the need for targeted preventive interventions.

Association of glycosylated hemoglobin variation index with diabetic retinopathy severity

HE Jing, LEI Chunyan, ZHANG Meixia

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  34-40.  doi:10.6040/j.issn.1673-3770.0.2023.376

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Objective This study investigated the correlation between hemoglobin variation index(HGI)and the severity of retinopathy and macular edema in patients with type 2 diabetes mellitus(T2DM). Methods A total of 294 T2DM patients were enrolled. Based on the 2022 International Academy of Ophthalmology diagnostic criteria for diabetic retinopathy(DR), patients were classified into: proliferative DR(PDR), non-PDR(NPDR), and no microangiopathy(NC). DR severity was further categorized as mild NPDR, moderate NPDR, severe NPDR, and PDR. According to the international grading standards for diabetic macular edema(DME), patients were categorized as: central involved DME(CI-DME), non-central involved DME(NCI-DME), and no central involved DME(NDME). DME severity: NCI-DME <CI-DME. General clinical data were collected, and HGI differences between groups were analyzed. Results Patients with NPDR and PDR group had significantly higher HGI than those with NC. PDR patients had higher HGI than NPDR patients. Similarly, NCI-DME and CI-DME patients had significantly higher HGI than NDME patients, with CI-DME having the highest HGI. Univariate Logistic regression analysis revealed significant correlations between the presence of DR and T2DM, course of diabetes(P<0.01), body mass index(P=0.01), diastolic blood pressure(P=0.04), HGI(P=0.01), fasting plasma glucose(P=0.04), and HbA1c(P=0.01). Additionally, a significant correlation(P<0.001)was found between HGI and DR severity. Conclusion HGI is closely associated with the severity of both DR And DME in T2DM patients.

Elucidation of the Mongolian medicine Huricha-6 mechanism in treating allergic rhinitis via network pharmacology and animal experiments

SU Riguge, LI Hua, WU Richaifu, HAN Eerdemutu, MENG Yongmei

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  41-51.  doi:10.6040/j.issn.1673-3770.0.2023.217

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Objective To explore the possible mechanism of Mongolian medicine Huricha-6 in treating allergic rhinitis,based on network pharmacology and animal experiments. Methods Compounds and targets of Huricha-6 were obtained from the TCMSP database and literature. Allergic rhinitis(AR)-related targets were identified via searches of the OMIM, TTD, Disgenet, and GeneCards databases. Then, the Huricha-6 target and AR target intersection was identified by constructing a "compound-intersection target" network and selecting key compounds. The STRING database was used to draw the protein interaction network to screen core targets, and R language was used to conduct gene ontology(GO)and kyto encyclopedia of genes and genomes(KEGG)pathway analysis on intersection targets. AutoDockVina software was used to verify key compounds and targets by molecular docking. An AR guinea pig model was constructed for Huricha-6 testing. Guinea pigs were treated with Huricha-6 for 6 weeks, then their nasal symptoms were evaluated by behavioral assessment. Nasal mucosa tissue was taken for HE staining to observe lesions, and IL-4 and IFN-γ levels were detected by ELISA. Results Network pharmacology analysis identified 107 possible targets for Huricha-6 relevant to AR treatment, and 30 compounds related to Huricha-6 in the treatment of AR. Quercetin, luteolin, kaolin, isorhamnetin and quinine were the key compounds, and the key target include VEGFA, STAT3, IL-1B, IL-6 and ALB. KEGG pathway enrichment revealed involvement of TNF, IL-17, Toll and HIF-1 pathways. Molecular docking supports the premise that key compounds will exhibit strong binding to core targets. Animal experiments demonstrate that Huricha-6 can effectively reduce nasal symptoms, improve pathological changes in the nasal mucosa, significantly reduce serum IL-4 levels, and increase IFN-γ levels. Conclusion Huricha -6 can ameliorate AR symptoms via interactions with multiple targets that act in multiple pathways, may alleviate inflammatory cell infiltration of nasal mucosal tissue, and alleviate AR symptoms by modulating the inflammatory response.

Bibliometric analysis based on Web of Science for nasal irrigation for nasal diseases in the last decade

LI Xia, HOU Ran, WANG Liping

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  52-60.  doi:10.6040/j.issn.1673-3770.0.2022.540

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Objective To analyze the nasal irrigation treatment in the field of nasal disease at home and abroad in the last decade, analyze the research hotspots and trends, in order to provide a reference for the development of nasal flushing research in China. Methods The literature of nasal irrigation treatment from 2011 to 2021 was searched from the Web of Science citation database, and statistical and visual analysis was performed based on Citespace software. Results A total of 413 publications were included, and the overall number of publications on nasal rinse treatment diseases has been on the rise in the past decade, with the most publications in the United States and China. The research content mainly focused on saline nasal rinse, quality of life, efficacy and spray. The research frontiers focused on the study of rinse solution components, the advantages and disadvantages of the tools used for irrigation. Conclusion The use of nasal rinses for the treatment of diseases has gained clinical recognition and is attracting more and more attention of scholars, and there are more literature in this field in China, but it is still need to improve the quality of research and the impact of publications.

A global study on quality of life related to dry eye in the last ten years: bibliometrics and visualization analysis through VOSviewer and CiteSpace

WANG Jiahui, LIU Xueqin

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  61-72.  doi:10.6040/j.issn.1673-3770.0.2023.035

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Objective To explore the current status, hot spots and developmental trends of research on the quality of life related to dry eye in the past ten years, and to provide a basis for subsequent research. Methods Existing literature on the quality of life related to dry eye in the Web of Science(core collection)database from 2012 to 2022 was retrieved. VOSviewer software was used for the visual analysis of authors, journals, countries, institutions, keyword co-occurrence and clustering and co-citation. The CiteSpace software was used to analyze the number of publications, publication time, and burst keywords. Results In the last ten years, the number of papers published in this field has increased,the current research focuses on the management and treatment of dry eye-related quality of life, the influence of dry eye on quality of life, pathogenesis, pathophysiology, and definition and classification of dry eye. The current research frontiers are: investigation of quality of life related to dry eye disease, management and treatment of quality of life related to dry eye disease, exploration of dry eye treatment with modern characteristics, relationship between common psychological problems and quality of life in patients with dry eye disease, prevention and management of dry eye complications. Conclusion In this study, bibliometric analysis of dry eye-related quality of life articles in the Web of Science database over the past ten years was conducted using VOSviewer and CiteSpace software to visualize the research status, hotspots and frontiers in this research field and provide a reference and basis for future research on dry eye.

A case report of a new pathogenic gene mutation in neurofibromatosis type I and literature review

ZHANG Jin, QI Zhiling, WANG Shaohua, ZHAO Yufeng, MA Xu, WU Yungang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  73-78.  doi:10.6040/j.issn.1673-3770.0.2023.030

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Objective To summarize the clinical data of a patient with neurofibromatosis type Ⅰ(NFⅠ)and a new pathogenic gene mutation, so as to improve the understanding of the diagnosis and treatment of NFⅠ. Methods One case of a 15-year-old patient with NFⅠ was analyzed retrospectively and the relevant literature was summarized. Results NFⅠ patient had bilateral ear swelling, scattered skin plaques of variable size throughout the body, soft tissue swelling in the bilateral maxillofacial, cervical, and subchin areas, and scoliosis, his father had a similar history. Genetic testing revealed one new mutant locus. The patient recovered well after ear mass resection. Conclusion For NFⅠ patients, it is necessary to trace their family history, conduct detailed consultation and general physical examination and check whether patients are complicated with malignant tumors. At the same time, the mental health of patients should not be ignored. Although there is no cure for NFⅠ, surgery may be recommended for cases with significant symptoms that affect the patient's life as well as for malignant changes. For NFⅠ patients, we should follow up regularly, care about their mental health, and conduct genetic counseling and education.

Treatment of complex steel-sharps-based ear puncture wound: a case report and literature review

SUO Anqi, SUN Juxing, NIU Hongyan, ZHOU Yanqiu, NIU Penghao, MAO Wenwei, LI Xiaoyu, YANG Xinxin

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  79-83.  doi:10.6040/j.issn.1673-3770.0.2023.199

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Objective To investigate the emergency management of complex sharps-based ear injuries and the management of complications. Methods This report describes the treatment and prognosis of a patient with an ear sharpshooter injury. Results After treatment, the patient's hearing partially improved and the facial palsy improved significantly. Conclusion There are many important blood vessels and nerves in the vicinity of the ear. Therefore, serious sharps injuries to the ear can lead to not only serious complications but also life-threatening injuries. Injuries to the external auditory canal by sharp instruments are inevitable, and multiple injuries greatly increase the difficulty of the surgical intervention, related postoperative care, and management of postoperative complications. This case report describes a personalized treatment plan that was used to improve the patient's prognosis and quality of life.

Endoscopic transnasal fenestration for maxillary bone cysts: a report of nine cases and a review of the literature

LIU Jiaxin, JIANG Ye, SONG Daoliang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  84-88.  doi:10.6040/j.issn.1673-3770.0.2022.382

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Objective To investigate the feasibility of endoscopic transnasal fenestration in the treatment of maxillary bone cysts. Methods Nine patients with maxillary bone cysts, including eight adults and one child, were retrospectively analyzed. The corresponding surgical approach of endoscopic transnasal fenestration for maxillary bone cysts was selected based on the location of the cyst and the relationship between the cyst and the maxillary sinus and nasal cavity. The related literature on jaw cysts from China and abroad was retrieved through the China National Knowledge Infrastructure, Wanfang medical network, and foreign medical information resource retrieval platforms. Results Among the nine cases, only one 1-year-old patient had recurrence after surgery, while the other patients were successfully operated. The cyst cavity had unobstructed drainage and was epithelialized during a follow-up period of 6-24 months. The related literature showed that the transnasal endoscopic fenestration of maxillary bone cysts has the following advantages: it is highly minimally invasive, causing less nerve damage, and can effectively improve the quality of life of patients. It has become the first choice of treatment in rhinology. Conclusion Endoscopic transnasal fenestration for maxillary bone cysts has clinical application value; however, its indications and contraindications need to be further studied.

Adolescent oropharyngeal teratoma:a case report and literature review

MA Jing, ZHANG Min, ZHU Xinjie

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  89-97.  doi:10.6040/j.issn.1673-3770.0.2023.521

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Objective To explore the clinical characteristics, diagnosis and treatment of oropharyngeal teratoma. Methods A retrospective analysis was conducted on the clinical data of a teenage patient with oropharyngeal teratoma, and relevant literature published in Chinese and English was analyzed and discussed. Results A total of 45 articles published domestically and internationally from 1980 to 2023 were retrieved, and a total of 56 cases of oropharyngeal teratomas were retrieved, including this case. Most of the 56 cases of oropharyngeal teratomas were discovered at birth, mainly in the soft palate and tonsils, with more females than males. Some patients had deformities in other areas, with cleft palate being more common. The pathological classification was mainly mature teratomas, most of which could be removed through the mouth, and the prognosis was good. Conclusion Most oropharyngeal teratomas are benign lesions, which are more common in newborns and infants. High resolution CT combined with MRI can help clarify the diagnosis and lesion range, and serum AFP testing can help determine whether it is benign or malignant before surgery, and can be used for efficacy observation and prognosis assessment after surgery. Surgery is the preferred treatment method for removing oropharyngeal teratomas. Early resection has a good prognosis, and regular follow-up is required after surgery.

Congenital midline cervical cleft: a case report and literature review

PENG Yaqi, CHEN Liangsi, XU Mimi, HUNAG Yunye, SHENG Xiaoli

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  98-102.  doi:10.6040/j.issn.1673-3770.0.2022.505

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Objective To explore the characteristics, therapy, and embryological etiology of congenital midline cervical cleft(CMCC). Methods After pathological diagnosis revealed a skin fistula, the patient underwent surgical treatment: resection of a contractile, longitudinal neck sinus, skin tag, skin lesion and followed by double Z-plasty. And the clinical data of a case of CMCC was retrospectively reviewed along with a review of related literature. Results The postoperative neck incision of the patient healed in one stage. No evidence of recurrence was found during the 1-year follow-up. Conclusion CMCC is a rare congenital abnormality of the neck. CMCC is thought to occur through a failure of the first or second branchial arch fusion. Double Z-plasty is a common technique for the prevention of contracture and restoration of the anterior contour of the neck.

Fungal endophthalmitis in a patient with no history of vegetative trauma: a case report and literature review

LI Shuting, ZHAO Hui, SI Mingwei, CUI Wenxuan, YANG Mengyao, WANG Hong

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  103-108.  doi:10.6040/j.issn.1673-3770.0.2023.024

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Objective This report describes the pathogenesis in a patient with no history of vegetative trauma who was diagnosed with fungal endophthalmitis combined with diabetes mellitus. Methods A 53-year-old male patient with sharply decreased visual acuity in the left eye did not significantly improve after receiving glucocorticoid treatment for shock in an outside hospital. Fifteen d later, intraocular fluids analysis was performed in the Ophthalmology Department of Qilu Hospital of Shandong University to identify the causative organism. Moreover, ultrasonic emulsification for cataract, vitrectomy, intraocular laser, silicone oil filling, and intravitreal injection(voriconazole, 0.02 mg)were performed in the left eye. Results Postoperative vitreous fluid was submitted for staining: fungus(-). Corrected visual acuity: 0.1 in the right eye and HM/5 cm in the left eye and stable condition of the posterior anterior segment of the eye were found. Conclusion Fusarium is a rare but recognized cause of endogenous endophthalmitis in immunocompromised patients via various routes of infection. Diabetes mellitus and steroid hormone application could reduce the stability of the patient's immune system. Timely diagnosis and antifungal treatment were very important for improving the patient's prognosis.

Traumatic dislocation of the eyeball with optic nerve transection: a case report and literature review

ZHANG Yiran, HUANG Jingyi, LIN Tao, LIU Hui, DENG Ling, PAN Yingzhe

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  109-112.  doi:10.6040/j.issn.1673-3770.0.2023.076

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Objective To report the clinical characteristics and diagnosis and treatment of a patient with traumatic total dislocation of the eyeball combined with optic nerve rupture and to explore the treatment options for dislocation of the eyeball. Methods A patient with total dislocation of the right eye and complete disconnection of the optic nerve due to trauma was treated in the emergency department. The patient's right eye was treated with repayment of total dislocation, lateral canthus incision, eye exploration, extraocular muscle suture, debridement, and eyelid laceration suture to restore the eyeball. The patient's right eye was then further treated with amniotic membrane covering, corneal debridement, and eyelid laceration to promote corneal repair. Results After surgery, the eyeball was repositioned, and the cornea healed well. There were no complications in the follow-up 6 months after surgery. The patient was satisfied with the treatment results. Conclusion Patients with dislocation of the eyeball should be treated in time, and the surgical plan should be formulated according to the specific situation. Although patients with complete dislocation do not have the possibility of vision recovery, retaining the eyeball may be a better option considering the psychological burden of the patients.

Review

Progress in metabolomics research in sensorineural hearing loss

YANG Min, ZHU Xiaoyan, WANG Xu

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  113-121.  doi:10.6040/j.issn.1673-3770.0.2023.263

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Sensorineural hearing loss is a common clinical disease in otology, which is hearing loss or hearing loss caused by cochlea, auditory nerve or auditory center organic lesions, and its incidence is related to genetics, age, noise exposure, ototoxic drugs and other factors, and the current incidence is increasing year by year and showing a younger trend. Metabolomics is a life science research that uses high-throughput omics technology to identify and quantify all metabolites, and has been applied to the pathophysiological mechanism of the inner ear in recent years, metabolomics provides new ideas for etiological exploration from the perspective of metabolic changes, and its research problems include analyzing the association between metabolites and sensorineural hearing loss, discovering new metabolic markers, and finding new strategies for preventing and treating sensorineural hearing loss. The application of metabolomics in sensorineural hearing loss contributes to the early diagnosis, individualized treatment and prediction of sensorineural hearing loss. In this paper, the research progress of metabolomics of sensorineural hearing loss is reviewed at home and abroad, and the experimental methods and results of clinical trials and animal experiments are integrated and analyzed, in order to provide a basis for the research and clinical application of metabolomics of sensorineural hearing loss, and put forward a prospect.

Expression and clinical significance of IL-29 and TLR4 in eosinophil infiltrated nasal polyps

YAN Huijuan, XIAO Xuping, ZHONG Yu

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  122-127.  doi:10.6040/j.issn.1673-3770.0.2022.516

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Nasal polyp is a chronic inflammatory disease of the nasal cavity and the nasal sinus mucosal epithelium. It is a common condition in otorhinolaryngology. Nasal polyp result from inflammation and fibrin deposition and are related to epithelial barrier dysfunction. Although endoscopic sinus surgery is relatively mature, some nasal polyps are difficult to treat and the condition has a high recurrence rate. Previous studies reported a 50% recurrence in patients with. Interleukin-29(IL-29), a newly discovered member of type Ⅲ interferon, mediates signal transduction by binding to its receptor complex, activates downstream signalling pathways, and induces the generation of inflammatory components. Toll-like receptor 4(TLR4), a member of the Toll-like receptor family, is involved in innate immunity and mediates inflammatory responses by recognizing lipopolysaccharide or bacterial endotoxins. Studies have shown that the expression of TLR4 in patients with nasal polyps is significantly increased. Although IL-29 and TLR4 are important in regulating inflammatory responses, their relationship and their correlation with eosinophil infiltration in patients with nasal polyps are unclear. An exploration of the clinical indicators related to eosinophil infiltration in nasal polyps may provide new ideas for the diagnosis and treatment of nasal polyps.

Application and progress of three-dimensional-printing technology in rhinology

CHENG Xiqiao, QU Shenhong

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  128-136.  doi:10.6040/j.issn.1673-3770.0.2023.270

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Three-dimensional(3D)-printing technology is based on a digital model and 3D-printed structures from powdered metal or other materials printed layer by layer. The application of 3D-printing-technology in the medical field, combined with advanced imaging technology and artificial intelligence, facilitates clinical teaching, preoperative planning, and doctor-patient communication, and enhances tissue and organ repair and reconstruction. The nasal anatomy is fine, the adjacent structure is complex, the individual differences are evident, and the operation is difficult. With the improvement of quality of life, the demand for defect repair caused by rhinoplasty and other diseases have increased gradually, and conventional surgery cannot fully satisfy various needs. The combination of 3D-printing and various technologies is consistent with this trend and has become a hot topic in rhinology and other disciplines in recent years. Therefore, this review summarizes the 3D-printing technology methods in this research direction, and presents recent progress in rhinology in nasal reconstruction and plastic surgery, 3D-printing nasal bones, postoperative tissue reconstruction, improvement of nasal ventilation function, assisted surgery, teaching and anatomical training, and drug delivery. Furthermore, future research directions and prospects for practical applications are highlighted.

Clinical and anatomical features of upside-down reversal of vision

YE Qiang, LUO Song Bazong, WANG Hao, LIU Xiaoyan, MA Jinghai, NAN Suting, WANG Jing, YANG Yi, LYU Peng, WANG Degui, ZHANG Wenfang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  137-143.  doi:10.6040/j.issn.1673-3770.0.2023.111

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Upside-down reversal of vision(UDRV)is a rare clinica symptom of visual distortion or visual illusion that can distort the size, shape, or tilt of an object. Its characteristic is that the patient's visual image undergoes an instantaneous 180° inversion in the coronal position. So far, UDRV has not been reported in China, but in foreign literature, it seriously affects patients' vision and life, bringing unprecedented psychological impact to patients. Here, we discuss the potential etiology and clinical features of UDRV to further improve the understanding of this condition by clinicians, scientifically diagnose and treat the condition, and reduce the psychological distress of patients. Although existing studies on UDRV help us understand the mechanisms of vision formation and possible regulatory mechanisms of vision, the specific etiology and mechanisms are not yet clear. Therefore we propose a hypothesis of visual regulation: "visual-independent regulation center" to explain it.

Application of optical tomography angiography and artificial intelligence in choroidal neovascularization secondary to pathologic myopia

WU Lili, QU Yi

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  144-149.  doi:10.6040/j.issn.1673-3770.0.2022.042

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In recent years, the incidence of pathological myopia (PM) has increased. PM is a global eyeblinding problem and a heavy social burden. Choroidal neovascularization (CNV) is a severe complication of PM that can cause macular disorders. This may lead to central scotoma, metamorphopsia, visual field loss, and eventually blindness if left treated. Optical coherence tomography angiography (OCTA) provides an automatic and accurate visualization of the layers of the retina and choroid, which allows a qualitative and quantitative description of the microvascular areas of the retina and choroid. OCTA can be used to detect the pathogenesis of high myopia, at the microvascular level of the retina. OCTA helps diagnose CNV secondary to PM due to its ability to show the position and size of the CNV. As management, photodynamic and antivascular endothelial growth factor therapies have been used. OCTA can be used to evaluate the therapeutic effect of PMCNV. This article provides an overview of the current research options on the diagnosis and treatment of CNV and discusses the problems and prospects when they are combined with artificial intelligence for choroidal imaging, to provide reference for clinical work.

Research progress on the preferred retinal locus in patients with central vision loss

DENG Yu, WANG Jianwei, LIU Ziqiang, LI Yuanyuan, HOU Xiaoyu, JIE Chuanhong

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  150-155.  doi:10.6040/j.issn.1673-3770.0.2022.442

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Low central visual acuity is mainly caused by decreases or deficiencies in contrast sensitivity, color vision, and other visual functions in patients with age-related macular degeneration. Studies have found that patients with central visual acuity loss can form a new visual task area, called the preferred retinal locus, at a relatively good position outside the foveal retina. In this paper, relevant articles about the optimal fixation point location and the training of the preferred retinal locus using microvisual field instruments are reviewed, and the current research status and shortcomings are summarized. The purpose of this paper is to review the progress of research on the visual condition of patients with central vision loss and to provide information that will aid the selection of visual rehabilitation programs for such patients.

Related retinal manifestations in Parkinson's disease

WANG Xinyu, GAO Lifen, LU Hui, SONG Wenqi, YANG Yu

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  156-162.  doi:10.6040/j.issn.1673-3770.0.2023.409

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Parkinson's disease is a neurodegenerative disorder characterized by bradykinesia, resting tremor, and other symptoms caused by abnormal α-synuclein deposition in the nervous system and dopaminergic nerve damage. As visual impairments can be detected during the early stages, functional and structural changes in the retina can play an important role in diagnosis and treatment strategies for Parkinson's disease. This review examines the retinal changes associated with Parkinson's disease, such as a decreased number of retinal dopaminergic neurons, thinning of the retinal nerve fiber layer and macula(measured by using optical coherence tomography), and a decrease in amplitude and shortening of the latency period in electroretinograms, to explain the effects of Parkinson's disease on the retina. This paper concludes that retinal abnormalities in patients with Parkinson's can be used as a potential marker for early assessment of Parkinson's disease onset and can help to stage the disease, which is important for diagnosis and therapeutic strategies.

Role of Toll-like receptor 4/nuclear transcription factor-κB channels in diabetic retinopathy

LUN Yingjun, CHEN Chen, GAO Hongcheng, FAN Qinglin, TAI Renqing

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(2):  163-168.  doi:10.6040/j.issn.1673-3770.0.2023.333

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Diabetic retinopathy(DR)is a microvascular complication caused by diabetes mellitus and is the primary cause of blindness in patients. Its pathogenesis is influenced by various factors,such as immune inflammation, oxidative stress, and polyol pathways. Currently, immune-inflammatory responses are considered to play important roles in the development of DR. The Toll-like receptor 4(TLR4)/nuclear transcription factor-κB(NF-κB)pathway mediates the release of inflammatory factors and plays a key role in inflammatory mechanisms. Several studies have demonstrated that inhibition of the TLR4/NF-κB signaling pathway can effectively treat DR.This review addresses the role of TLR4/NF-κB channels in DR, which may provide novel treatment targets for this disease.