Table of Content

20 May 2024 Volume 38 Issue 3

  

Original Article

Single cell sequencing analysis of RPN2 expression pattern in laryngeal squamous cell carcinoma cells

WU Bin, ZHOU Jingchun

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  1-11.  doi:10.6040/j.issn.1673-3770.0.2023.497

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Objective This study aims to explore the expression pattern of RPN2 in the microenvironment of laryngeal squamous cell carcinoma at the single-cell level. Methods By acquiring and preprocessing the GSE150321 dataset of laryngeal squamous cell carcinoma single-cell data, dimensionality reduction and clustering algorithms were applied to classify and define cell types, followed by an overview and analysis of RPN2 expression in each cell type. Differential expression genes between RPN2-positive and RPN2-negative tumor cells were screened and subjected to functional enrichment analysis. A cell-cell interaction network was constructed for RPN2-positive and RPN2-negative tumor cells. Results After single-cell sequencing of laryngeal squamous cell carcinoma cells, cells were classified into subgroups such as tumor cells, immune cells, fibroblasts, endothelial cells, and epithelial cells based on cell marker molecules. RPN2 showed relatively higher expression levels in tumor cells and immune cells, while lower expression levels were observed in endothelial cells, fibroblasts, and epithelial cells. Differential expression analysis identified genes associated with RPN2 expression, and functional enrichment analysis revealed that highly expressed genes in RPN2-positive tumor cells were mainly enriched in biological processes such as ribonucleoprotein complex biogenesis and cytoplasmic translation signaling pathways. The constructed cell-cell interaction network demonstrated strong interactions between RPN2-positive tumor cells and fibroblasts, endothelial cells, and immune cells. Conclusion This study reveals the expression pattern of RPN2 in the microenvironment of laryngeal squamous cell carcinoma and the characteristics of RPN2-positive and RPN2-negative tumor cells, as well as their associations with tumor occurrence, development, and prognosis. These findings provide a theoretical basis for the treatment and further research of laryngeal squamous cell carcinoma.

Expression and clinical significance of KRT4 in laryngeal carcinoma and adjacent normal mucosal tissues

WANG Jingsong, YU Can, ZHANG Xi, DENG Qicheng, XIE Zhuoliang, ZHAO Rui, WEN Bei, LIU Hai

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  12-17.  doi:10.6040/j.issn.1673-3770.0.2023.097

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Objective To investigate the relationship between the expression level of keratin 4(KRT4)in laryngeal cancer patients and the clinicopathological characteristics and prognosis of the patients. Methods 70 specimens of laryngeal cancer tissue, 70 specimens of normal mucosa tissue adjacent to cancer, and 40 specimens of vocal cord polyp tissue were collected. Immunohistochemical SP method was used, and the relationship between KRT4 expression and clinical pathological characteristics and prognosis of laryngeal cancer was analyzed statistically. Results The immunohistochemical SP method showed that the expression level of KRT4 in laryngeal cancer tissue was significantly lower than that in adjacent normal mucosal tissue and vocal cord polyp tissue, and the difference was statistically significant(χ2=51.511,P<0.001). There were significant correlationbetween the expression level of KRT4 and the clinical stage(χ2=5.741,P=0.017), degree of differentiation(χ2=6.713,P=0.010), and cervical lymph node metastasis of patients(χ2=4.639,P=0.031). Single factor Log rank test analysis showed that KRT4 expression(χ2=23.962,P<0.001), clinical stage(χ2=4.621,P=0.032), cervical lymph node metastasis(χ2=7.549,P=0.006), and prognosis of laryngeal cancer were correlated. The Kaplan Meier survival curve showed that the survival rate of the KRT4 positive expression group was significantly higher than that of the KRT4 negative expression group. Further research using Cox regression models revealed that KRT4 expression is an independent risk factor affecting the prognosis of laryngeal cancer. Conclusion The expression level of KRT4 in laryngeal cancer tissue is significantly lower than that in normal mucosa tissue and vocal cord polyp tissue adjacent to the cancer, and the expression of KRT4 is related to the clinical stage, differentiation degree, and cervical lymph node metastasis of patients. Laryngeal cancer patients with positive expression of KRT4 have a better prognosis. Therefore, KRT4 is expected to become an important biological indicator to guide the diagnosis, treatment, and prognosis evaluation of laryngeal cancer.

Expression of abnormal spindle-like microcephaly associated protein in nasopharyngeal carcinoma and its clinical significance

YANG Kaiyan, TANG Fengzhu, QIN Qicai, LI Xuxiang, FENG Dayi, NONG Fengjing, YANG Qiuyun

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  18-25.  doi:10.6040/j.issn.1673-3770.0.2022.219

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Objective This paper investigated the expression of abnormal spindle-like microcephaly associated protein(ASPM)in nasopharyngeal carcinoma tissue samples using immunohistochemical staining, and further analyzed the relationship between ASPM protein expression and clinicopathological parameters and the prognosis of patients with nasopharyngeal carcinoma, and then discussed the expression of ASPM mRNA in nasopharyngeal carcinoma. Methods The microarray dataset of nasopharyngeal carcinoma was downloaded from the GEO database, and the differential expression of the nasopharyngeal carcinoma microarray dataset was analyzed using R language. The differential expression of ASPM protein in nasopharyngeal carcinoma was analyzed using immunohistochemical staining, the correlation between ASPM expression and clinicopathological parameters of patients with nasopharyngeal carcinoma was analyzed using the chi-square test, the relationship between ASPM expression and prognosis of patients with nasopharyngeal carcinoma was analyzed by survival curves, the risk factors affecting prognosis of patients with nasopharyngeal carcinoma were analyzed using the Cox regression model, and the receiver operator characteristic(ROC)curve was used to evaluate the performance of various prognostic parameters in predicting the prognosis of patients with nasopharyngeal carcinoma. Results ASPM mRNA was found to be highly expressed in nasopharyngeal carcinoma microarray data set through analysis of nasopharyngeal carcinoma microarray data(P<0.001). Immunohistochemical staining showed that expression of ASPM in nasopharyngeal carcinoma tissues was significantly higher than in nasopharyngitis tissues(P<0.001). ASPM expression correlated with T stage(P=0.048), N stage(P=0.050), and total clinical stage(P=0.029). The overall survival time of the high expression ASPM protein group was shorter than that of the low expression ASPM protein group(P<0.001). Multivariate Cox regression model analysis showed that ASPM expression level may be an independent risk factor affecting prognosis of patients with nasopharyngeal carcinoma(P=0.015). ROC curve analysis showed that total clinical stage combined with ASPM expression achieved a higher accuracy in predicting prognosis of patients with nasopharyngeal carcinoma(P<0.001). Conclusion ASPM is highly expressed in nasopharyngeal carcinoma tissue samples, and this high expression is related to malignancy, disease progression, and poor prognosis of nasopharyngeal carcinoma, and may become a valuable biomarker for predicting prognosis in nasopharyngeal carcinoma. Combining total clinical stage and ASPM expression may be a promising method for predicting prognosis of patients with nasopharyngeal carcinoma.

Graphene cured nasal mask combined with subcutaneous specific immunotherapy of dust mite in patients with dust mite allergic rhinitis application analysis

ZHANG Lijing, FENG Xiaoxing, LIU Nanxian, ZHAO Huiming, CHEN Yuehua

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  26-32.  doi:10.6040/j.issn.1673-3770.0.2023.360

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Objective To analyze the effect of graphene-cured nasal mask combined with subcutaneous specific immunotherapy of dust mite in patients with dust mite allergic rhinitis. Methods A total of 102 patients with dust mite allergic rhinitis were selected and divided into two groups according to the random number table method, namely the control group(51 cases)and the observation group(51 cases), the control group was treated with subcutaneous specific immunotherapy(dust mite allergen vaccine immunization)with dust mites alone, and the subcutaneous specific immunotherapy + graphene cured nasal mask treatment of dust mites in the observation group was compared to compare the clinical effects, adverse reactions, clinical symptom scores, immune function indexes, Inflammatory factor indexes, quality of life scores. Results The total effective rate of the observation group was higher than that of the control group(Z=5.005, P=0.025). Compared with the control group, the difference in clinical symptom scores, immune function indicators, inflammatory factors, and quality of life scores was higher in the observation group before and after treatment(all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(χ2=0.614, P=0.433). Conclusion Compared with dust mite allergen vaccine alone, graphene-cured nasal mask combined with dust mite allergen vaccine can alleviate the clinical symptoms and improve the treatment effect of dust mite allergic rhinitis patients.

Evaluation of different surgical methods in the treatment of maxillary cysts

LI Hongjin, WANG Jian, LAI Yubin, XU Min, XUE Tao, CHEN Fuquan, ZHA Dingjun, CHEN Xiaodong

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  33-37.  doi:10.6040/j.issn.1673-3770.0.2023.053

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Objective To explore the advantages and disadvantages of different surgical methods in the treatment of maxillary cysts and to provide a theoretical basis for clinical practice. Methods Forty-one cases of maxillary cysts were selected as research objects. Of these, seventeen patients underwent maxillary cyst resection through a traditional labial gingival approach, and 24 patients underwent maxillary cyst resection through a nasal endoscopic approach. All patients were followed up for >12 months, with an average of 18 months. Visual analog pain score and postoperative reaction, recurrence, and swelling and numbness were observed and compared between the two groups. Results No significant differences were observed in the postoperative reaction, recurrence, swelling and numbness, and visual analog pain scores between the two groups. Conclusion Endoscopic fenestration and labial gingival approaches in the treatment of maxillary cysts have unique advantages. Before the operation, the position relationship between the cyst and each wall of the maxillary sinus can be determined based on imaging and nasal endoscopy to select a more appropriate surgical approach that benefits patients.

Short-term clinical observation of drugsustained-release stent implantation in patients with refractory sinusitis

LI Hao, YANG Liyuan, ZHANG Shoukai

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  38-42.  doi:10.6040/j.issn.1673-3770.0.2023.375

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Objective To explore the short-term clinical effect of drug sustained-release stent implantation in functional endoscopic sinus surgery for refractory sinusitis. Methods Sixty patients with refractory sinusitis were randomized observation group and control group. Both groups of patients underwent functional endoscopic sinus surgery. The observation group received sinus drug sustained-release stent during surgery, while the control group received routine medication after surgery. Four weeks after surgery, all patients underwent the sino-nasal outcome test-20(SNOT-20)for subjective symptom scoring, and nasal endoscopy and CT scan were performed for objective evaluation of mucosal recovery based on the Lund-Kennedy and CT Lund-Mackay scores of the sinuses. The clinical efficacy, incidence of complications, and recurrence of the two groups were compared. Results Four weeks after surgery, the total clinical efficacy in the observation group(93.33%)was significantly higher than that of the control group(86.67%), while the SNOT-20 score in the observation group was lower(P=0.02). The Lund-Kennedy and Lund-Mackay scores in the observation group were lower(P=0.04,0.03); the recurrence rate was not statistically different between the two groups(P=0.27). Conclusion Implantation of drug sustained-release stent in the nasal sinus in functional endoscopic sinus surgery has a significant effect in the short-term for the treatment of refractory sinusitis, which can effectively improve the morphology of nasal mucosa, improve the quality of life, and result in fewer complications.

Twenty-six cases of tubal torus hyperplasia after adenoid tonsillectomy in children

ZHAO Yun, TENG Zhipan, LI Qi, SHEN Xiaofei

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  43-48.  doi:10.6040/j.issn.1673-3770.0.2023.080

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Objective To report the clinical phenomenon and characterisation of torus hyperplasia occurring after adenoidectomy and/or tonsillectomy in children. Methods This study included 26 pediatric patients diagnosed with torus hyperplasia. Clinical data(age, gender, time of first operation, way of operation and allergic rhinitis or not)were reviewed and analyzed. Results Twenty-six children who had underwent adenoidectomy and/or tonsillectomy had recurred snoring symptom, and were diagnosed with TTH. There were 20 males and 6 females, of whom 92.3% underwent first adenoidectomy and/or tonsillectomy before 5 years of age; the interval of diagnosis of torus hyperplasia after the operation ranged from 3 to 45 months. Eight children underwent partial resection of torus hyperplasia, the interval of two operations ranged from 3 to 48 months, and 10 exhibited definite signs and symptoms of allergic rhinitis. Twenty-one children underwent adenoidectomy or adenoidectomy with partial tonsillectomy, and 5 underwent adenoidectomy with total tonsillectomy. Conclusion TTH is a rare complication after adenoidectomy, and tended to occur in those who underwent adenoidectomy before 5 years of age. TTH was associated with allergic rhinitis, anti-allergic therapy has a certain clinical effect, and low-temperature plasma surgery is useful for torus hyperplasia. Torus hyperplasia was more common in children undergoing adenoidectomy without tonsillectomy than in those undergoing adenoidectomy with tonsillectomy.

Effects of H-UPPP combined with radiofrequency ablation of tongue root with low temperature plasma on oxygen saturation and arterial oxygen partial pressure in patients with OSAHS

WANG Guifang, LI Rengao, MA Qing

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  49-54.  doi:10.6040/j.issn.1673-3770.0.2023.488

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Objective To explore the effect of han-uvulopalatopharyngoplasty(H-UPPP)combined with radiofrequency ablation of tongue root at low temperature on oxygen saturation and arterial partial pressure of oxygen(PaO₂)in patients with obstructive sleep apnea hypopnea syndrome(OSAHS). Methods Seventy-two patients with OSAHS were selected. They were divided into H-UPPP operation group(treated with single H-UPPP)and combined operation group(treated with H-UPPP combined with low-temperature plasma radiofrequency ablation of tongue root)according to the operation methods. Two patients were lost to follow-up, and finally 70 patients were included in this study. There were 35 patients in H-UPPP operation group and 35 patients in combined operation group. The apnea hypopnea index(AHI), low est oxygen saturation(LSaO₂), PaO₂, arterial partial pressure of carbon dioxide(PaCO₂), forced vital capacity, forced expiratory volume in the first second, Epworth sleepiness scale(ESS)and visual analogue scale(VAS)were compared between the two groups before and 6 months after operation. The clinical efficacy and postoperative adverse reactions of the two groups were observed. Results Six months after operation, AHI and PaCO₂ in the combined operation group and H-UPPP operation group decreased compared with that before operation, while LSaO₂ and PaO₂ increased(all P<0.05). The AHI of combined operation group was lower than that of H-UPPP operation group, and LSaO₂, PaO₂ were higher than that of H-UPPP operation group(P=0.036, 0.030, 0.001). But there was no significant difference in PaCO₂ between the two groups at six months after operation(P=0.737). The forced vital capacity and forced expiratory volume in the first second in the combined operation group and H-UPPP operation group were higher than those before operation(all P<0.05). The forced vital capacity and forced expiratory volume in the combined operation group were higher than those in the H-UPPP operation group(all P<0.001).The ESS score decreased and the VAS score increased in both groups. The ESS score of combined operation group was lower than that of H-UPPP operation group, and the VAS score was higher than that of H-UPPP operation group. The total effective rate of the combined operation group was higher than that of the H-UPPP operation group(P=0.025). There was no significant difference in the total incidence of postoperative complications between the two groups(P=0.353). Conclusion H-UPPP combined with radiofrequency ablation of tongue root with low temperature plasma can effectively promote the recovery of lung function and improve LSaO₂, PaCO₂, and PaO₂ in patients with OSAHS, with good clinical efficacy and safety.

Clinical observation of compacept in the treatment of diabetes mellitus with CRVO-ME high reflex point

BAO Ying, LIU Zhigao, JANG Pengfei, CUI Wenxuan, ZHENG Xiaoxia, YANG Mengyao, SI Mingwei, WANG Yu, WANG Hong

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  55-60.  doi:10.6040/j.issn.1673-3770.0.2023.504

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Objective To observe the changes in hyperreflective dots(HRD)in the retina of patients with non-ischemic central retinal vein occlusion-macular edema(CRVO-ME)treated with conbercept. Methods Eighty cases and 80 eyes of non-ischemic CRVO-ME patients were selected and divided into 40 cases(40 eyes)in the diabetic group and 40 cases(40 eyes)in the non-diabetic group according to the presence or absence of diabetes mellitus. Best corrected visual acuity(BCVA), central macular thickness(CMT)and the number of HRDs in the inner and outer retinal layers were compared and analysed in the two groups before and 1, 3 and 6 months after intravitreal injection of conbercept(IVC)treatment. Results At 3 and 6 months after IVC, BCVA in the non-diabetic group was significantly higher than that in the diabetic group(F=4.106,P=0.046;F=10.474,P=0.002), and CMT was significantly lower at 6 months after IVC(F=10.688,P=0.002). There was no significant difference in the amount of HRD in the inner retina between the two groups before and after IVC(F=1.608,P=0.209), but there was a significant difference in the amount of HRD in the outer retina(F=4.290,P=0.042). Conclusion IVC is effective in the treatment of non-ischemic CRVO-ME. HRD in the outer layer of the retina can be used as an imaging marker to monitor the inflammatory response and assess prognosis. The long-term therapeutic effect of non-ischemic CRVO-ME in diabetic group is worse than in non-diabetic group. Therefore, more attention should be paid to the long-term follow-up of diabetic patients to avoid serious complications.

A survey of psychological conditions and factors influencing patients requesting single-lid repair after blepharoplasty

HU Jun, PENG Changfu

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  61-66.  doi:10.6040/j.issn.1673-3770.0.2023.094

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Objective To investigate the psychological state and other factors that influence patients who request single-lid repair after blepharoplasty. Methods Patients who requested single-lid repair after blepharoplasty were selected for the study. Basic information was collected, and some patients were surveyed using the self-rated body image scale and the Eysenck Personality Questionnaire. The data were statistically analyzed using SPSS 26.0 software. Results Of the 38 patients who requested single-lid repair after blepharoplasty, body image disorder was detected in 23.68%. The key psychological factors influencing body image in these patients were the number of previous surgeries(P=0.022)and chief complaints(P=0.008). The raw scores of the N and P scales in the Eysenck Personality Questionnaire were higher than the national norms, and the differences were statistically significant(P=0.011, P=0.025). Based on the Eysenck Personality Questionnaire, 31.58% of the patients were predominantly depressive in personality. Moreover, the body image psychology of patients who requested monolithic lid repair after blepharoplasty was positively correlated with the N scale(r=0.663, P<0.01)and negatively correlated with the L scale(r=-0.320, P<0.05). Conclusion The incidence of body image disturbance in patients who requested single-lid repair after blepharoplasty was relatively high at 23.68%. The number of previous surgeries and chief complaints were critical factors influencing body image psychology. Neuroticism and psychosis were higher in patients who requested single-lid repair after blepharoplasty than in the general population. The personality trait of these patients was predominantly depressive(introverted-unstable), and their body image psychology was positively correlated with neuroticism(N)and negatively correlated with maskedness(L).

A meta-analysis of the correlation between platelet-lymphocyte ratio and prognosis of laryngeal squamous cell carcinoma

WANG Kaijian, CHEN Xuesheng, WANG Wei

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  67-73.  doi:10.6040/j.issn.1673-3770.0.2023.013

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Objective To investigate the correlation between platelet-lymphocyte ratio(PLR)and the prognosis of patients with laryngeal squamous cell carcinoma(LSCC)by Meta-analysis, and to predict the prognosis of patients. To provide evidence-based evidence for optimizing treatment strategies. Methods PubMed, Web of Science, CNKI, VIP and Wan fang databases were searched for studies on the correlation between PLR and the prognosis of LSCC. The raw data of prognostic indicators were extracted, and Meta-analysis was performed using Stata12.0 statistical software. Results A total of 14 studies were included. The results of Meta-analysis showed that overall survival of patients with higher PLR(HR=1.46,95%CI:1.34-1.58,P<0.001), recurrence-free survival(HR=1.37, 95%CI: 1.25-1.50, P<0.001), progression-free survival(HR=1.52, 95%CI: 1.11-2.08, P<0.001), disease-free survival(HR=1.15, 95%CI: 1.04-1.27, P<0.001), and the worse(HR=1.24, 95%CI: 1.12-1.38, P<0.001). Conclusion The prognosis of patients is closely related to PLR value. The higher the PLR value, the worse the prognosis of patients, PLR value is an effective indicator to preliminarily judge the prognosis of patients.

Meta-analysis of the effect of red-light therapy on spherical equivalent, axial length, and choroidal thickness in myopic children

LI Yang, LIU Dong, CAO Wenjie

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  74-81.  doi:10.6040/j.issn.1673-3770.0.2023.177

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Objective To explore the effect of red-light therapy on equivalent sphere, axial length and choroidal thickness in myopic children. Methods We searched PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang, CBM, Vip, and Clinical trial registry on red-light therapy for myopia control published from the establishment of the database to October 28, 2022. The Cochrane Handbook was used for risk of bias and quality evaluation of the included literature, and Revman 5.3 software was used for Meta-analysis, and STATA 12.0 software was used to detect publication bias. Results A total of 1425 eyes from nine articles were included, of which five were randomized controlled trials and three were control studies. Meta-analysis showed that the inhibitory effect of red-light on the increase in spherical equivalent(SE)and axial length(AL)was better than that of the single-focus spectacles group(SE: WMD=0.41, 95%CI: 0.29-0.54, I2=65%, P<0.000 01; AL: WMD=-0.21, 95%CI: -026 - 0.15, I2=73%, P<0.000 01), the increase of choroidal thickness(CHT)in red-light therapy group was superior to that in single-focus spectacles group(WMD=26.05, 95%CI: 22.11-29.99, I2=45%, P<0.000 01). Conclusion The control effect of red-light therapy was better than that of the single-focus spectacles, but long-term use of adverse reations still need to be further observed.

Case report and literature review of cholesteatoma accompanied with a dehiscent high jugular bulb

GAO Xinyu, ZHOU Han, LIU Dingding, LU Ling, CHEN Jie, QIAN Xiaoyun

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  82-87.  doi:10.6040/j.issn.1673-3770.0.2023.189

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Objective This report delves into the clinical manifestation, diagnosis, and treatment of cholesteatoma accompanied by a dehiscent high jugular bulb. We conducted a retrospective study on a patient with this condition and supplemented our findings with a literature review. Methods Our patient exhibited signs of a dehiscent high jugular bulb reaching the mesotympanum, as observed through otoscopy and CT scans. To address the cholesteatoma, we utilized underwater otoscopy, successfully removing the cholesteatoma, rectifying the retraction pocket involving pars flaccida and the posterosuperior aspect of pars tensa, and extracting the partially eroded malleus and incus. The arches of stapes were absent, but the footplate functioned well. During tympanoplasty with ossiculoplasty, we carefully navigated around the protruding jugular bulb while raising the tympanomeatal flap. A 2.5 mm total ossicular replacement prosthesis and preserved tragal cartilage perichondrium were used. Results In addition to pre-operative assessments of the mastoid, antrum, and ossicular chain, evaluating the jugular bulb is crucial to prevent severe complications like profuse hemorrhage. The underwater otoscopy technique demonstrated unique advantages in managing acquired cholesteatoma with a dehiscent high jugular bulb. Conclusion This case highlights the importance of thorough evaluation, including the jugular bulb, in cholesteatoma cases. The underwater otoscopy technique proved effective in our management approach.

Acupuncture combined with western medicine for the treatment of total deafness in sudden sensorineural hearing loss: a case report and literature review

ZHANG Jiajia, SHI Anni, XING Yu, HONG Yuying, BAI Peng

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  88-92.  doi:10.6040/j.issn.1673-3770.0.2022.347

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Incidents of total deafness in sudden sensorineural hearing loss carry a very poor prognosis, and such patients are not rare in clinical practice. At present, there is no acknowledged targeted treatment plan for this condition, although acupuncture is helpful. This case illustrates an attack of total deafness, treated by a combination of acupuncture and western medicine. It involved an intravenous infusion by means of a dexamethasone sodium phosphate injection and an alprodil injection. Professor Bai Peng's “Seven lines in the neck method” of acupuncture was used to promote blood circulation and relieve collaterals in the ear orifices. After one week of acupuncture combined with Western medicine, the patient's hearing had significantly improved. The patient was treated with acupuncture for one more week to improve the curative effect. After the treatment, the patient's hearing had completely recovered and accompanying symptoms such as tinnitus and ear tightness had disappeared. There was no recurrence after one year of follow-up.

Two cases of odontogenic deep cervical multi-space and mediastinal abscess and literature review

SONG Panpan, ZHAO Yufeng, ZHANG Yaoyao, DING Detao, ZHANG Jiafu, ZHANG Hui, ZHANG Jin, WU Yungang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  93-96.  doi:10.6040/j.issn.1673-3770.0.2023.052

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Objective The objective of this study was to retrospectively analyze and summarize the clinical diagnosis and treatment experiences of patients with deep cervical multi-space abscess, mediastinal abscess, and empyema in order to improve the understanding and treatment levels of clinicians. Methods The clinical characteristics, related examination, treatment, and follow-up of two patients with odontogenic deep cervical multiple space and mediastinal abscess were retrospectively analyzed. A literature review was also conducted. Results Bacterial culture was performed on the pus of each patient. Klebsiella pneumoniae was cultured from the pus of Case 1. The patient was hospitalized for 65 days after retropharyngeal abscess drainage plus thoracoscopic mediastinal abscess incision, as well as drainage plus thoracoscopic empyema removal(bilateral)plustracheotomy under general anesthesia. In Case 2, the bacterial sensitivity test of the pus indicated intermediate streptococcal infection. Incision and drainage of oral abscess plus thoracoscopic incision and drainage of anterior mediastinal abscess plustracheotomy were performed under general anesthesia. The patient was hospitalized for 37 days. Conclusion Severe deep cervical multi-space and mediastinal abscess is rare in clinic, and its rapid development and high fatality rate deserves attention. Abscess incision and drainage and combined application of sensitive antibiotics are the main treatment methods. Tracheotomy is a necessary procedure to ensure postoperative safety, and also plays an important role in reducing complications and improving prognosis. Early diagnosis, rational application of sensitive antibiotics, timely incision and drainage, and multidisciplinary cooperation are the keys to diagnosis and treatment.

Stickler's syndrome in children without retinal detachment:a case report and literature review

LU Song, XIA Yifan, LI Ziye, WEI Jing

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  97-101.  doi:10.6040/j.issn.1673-3770.0.2023.050

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Objective To investigate the clinical presentation, diagnosis, treatment, and prognosis of children with Stickler syndrome to enable early diagnosis. Methods We retrospectively analyzed and summarized the medical records of a child with Stickler syndrome without retinal detachment and reviewed the relevant literature. He presented to our hospital with a complaint of decreased visual acuity in the left eye with visual distortion for 15 days, and was examined by optical coherence tomography and visual field and fundus fluorescein angiography in both eyes. Intraocular fluid examination and gene sequencing detected the COL2A1 variant c.1597C>T/ p.Arg533*(NM_001844.5), and he was diagnosed with Stickler syndrome type I. Retinal laser photocoagulation and intraocular pressure(IOP)lowering treatment were performed. Results After treatment, the child's visual acuity in the left eye returned to 0.5 and his IOP returned to normal. Conclusion Early treatment of Stickler syndrome in children is important. Genetic testing in any child for whom Stickler syndrome is suspected, as well as preventive treatment and regular multisystem follow-up, is recommended for patients who fit the relevant clinical picture, especially if they have high myopia before the age of 6 years.

Academic Discussion

Analysis of the association between the stomach and five orifices through gastroesophageal reflux disease

TANG Qiushuang, BAI Xinghua

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  102-108.  doi:10.6040/j.issn.1673-3770.0.2023.056

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Objective To use gastroesophageal reflux disease(GERD)to interpret the pathogenesis of the association between the stomach and the five orifices(mouth, tongue, nose, eyes, and ears)in traditional Chinese medicine(TCM). Methods To analyze the pathogenesis of gastroesophageal reflux-related conditions in the five orifices from the perspective of TCM, we examined modern medical literature for the disorders of the five orifices caused by gastroesophageal reflux, and ancient Chinese medical records and documents on the pathogenesis and association of GERD with the stomach and the five orifices. Results In modern medicine, the stomach is considered structurally connected to the five orifices; therefore, the regurgitation of its contents through the esophagus can cause diseases in these orifices. This pathogenesis is consistent with the abnormal flow of the spleen and stomach Qi in TCM. While TCM generally associates the five zang organs with the five orifices, it also associates the stomach with these orifices. Hence, an abnormal flow of the spleen and stomach Qi is the basic pathogenesis of GERD-related disorders of the five orifices. TCM considers the stomach Qi to be turbid and naturally flowing downward; the mouth, tongue, nose, eyes, and ears to be clean orifices; and an upward flow of the turbid Qi to be the primary cause of GERD-related diseases of the five orifices. Furthermore, it views the spleen Qi to be clean and naturally flowing upward, but if the clean Qi cannot flow upward or flows downward instead, the five orifices will fail to be nourished. Although ancient medical records described some cases of five orifice conditions associated with gastroesophageal reflux, practitioners might have misidentified their patterns influenced by the theory of the five zang organs corresponding to the five orifices. Conclusion An analysis of the relationship between the stomach and the five orifices through GERO will not only serve as a valuable addition to the theory of the five zang organs corresponding to the five orifices in TCM but will also provide a further interpretation of the concept of abnormal flow of the spleen and stomach Qi leading to disorders of the five orifices. Moreover, it will present novel insights for identifying disorders of the five orifices and avoiding their misdiagnosis and mistreatment.

Review

Application of cone-beam CT in otorhinolaryngology head and neck surgery

YANG Ying, WEI Wei, YANG Jun

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  109-115.  doi:10.6040/j.issn.1673-3770.0.2023.004

Abstract ( 216 )   PDF (489KB) ( 139 )   Save

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Cone-beam CT was developed in the 1990s and has been mainly used in the field of stomatology. With recent advances in imaging technology, cone-beam CT has been increasingly utilized in fields of Otorhinolaryngology Head and Neck Surgery. Its advantages, such as high imaging accuracy, fast scanning speed, and low radiation dose, make it a superior choice for clinical diagnosis and treatment planning. This article aimed to review the applications of cone-beam CT in the fields of ear diseases, nose diseases, pharynx diseases, laryngeal and neck diseases, trauma and skull base diseases in order to further promote its application in this field.

Effect of matrix metalloproteinase on tissue remodeling in chronic rhinosinusitis

ZHANG Shihan, LIU Hongbing

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  116-123.  doi:10.6040/j.issn.1673-3770.0.2023.338

Abstract ( 178 )   PDF (1194KB) ( 27 )   Save

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The pathogenesis of chronic rhinosinusitis, a highly heterogeneous inflammatory disease of the sinus mucosa, is not fully understood. Tissue remodeling, which is the main factor in the pathogenesis of chronic rhinosinusitis, is characterized by features such as epithelial mucosal damage, basement membrane thickening, neovascularization, and fibroblast proliferation, aiming toward the generation and degradation disorder of extracellular matrix. Matrix metalloproteinases are one of the important enzymes that degrade extracellular matrix. Matrix metalloproteinases and tissue metalloproteinase inhibitors influence tissue remodeling by influencing extracellular matrix metabolism. Inhibition of the effects of these matrix metalloproteinases on tissue remodeling is a potential therapeutic approach. This article reviews the research progress of the effects of inhibitors of matrix metalloproteinases and tissue metalloproteinases on tissue remodeling in chronic sinusitis.

Advances in the pathological study of artificial intelligence in the lymph node metastasis of head and neck squamous cell carcinoma

XIE Yulin, LEI Dapeng

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  124-129.  doi:10.6040/j.issn.1673-3770.0.2023.037

Abstract ( 246 )   PDF (1429KB) ( 151 )   Save

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Artificial intelligence(AI)has developed rapidly in the field of medicine and is widely used in the diagnosis and prognosis evaluation of diseases. Head and neck cancer is one of the most common malignant tumors in the world, most of which are squamous cell carcinoma. Cervical lymph node metastasis of head and neck squamous cell carcinoma(HNSCC)is an important prognostic factor. The accuracy of the assessment of cervical lymph node metastasis is highly dependent on clinical diagnosis and treatment. At present, many studies have been conducted to develop models that can be used to predict cervical lymph node metastasis of HNSCC, and different clinical and pathological parameters were used in these predictive models. In order to progress development, we need to determine the optimum method to analyze the clinical and pathological data of HNSCC patients in a more comprehensive manner, as well as establish a prediction model with better precision. In this paper, we describe the progress of AI in the field of pathology and discuss the current status of its use in HNSCC research. Additionally, we have conducted an in-depth consideration and prospect on building an accurate and efficient AI prediction model for HNSCC lymph node metastasis to continuously improve the diagnosis and treatment of HNSCC.

Research progress of diabetic macular ischaemia

CHANG Weiwei, JIAO Wanzhen, CUI Yanyan, ZHAO Jie, LIU Zhaoqiang, ZHAO Bojun

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  130-136.  doi:10.6040/j.issn.1673-3770.0.2022.538

Abstract ( 175 )   PDF (1271KB) ( 121 )   Save

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Diabetes can cause various eye complications, of which diabetic retinopathy(DR)is the most common cause of blindness, and diabetic macular ischemia(DMI)is one of the causes of vision loss in DR. The pathogenesis, mechanism, and treatment of DMI have not been fully elucidated yet, and research is still in its early stages. However, the impact of DMI on patients cannot be ignored, and clinicians need to understand the disease completely. Therefore, this article reviews the research progress including risk factors, pathogenesis, diagnosis and treatment of diabetes induced by macular ischemia.

Effect of different Glaucoma surgery on induced astigmatism

LI Yang, MA Ping, ZHANG Han

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  137-143.  doi:10.6040/j.issn.1673-3770.0.2023.075

Abstract ( 164 )   PDF (454KB) ( 37 )   Save

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Trabeculectomy is the most commonly performed glaucoma operation. Various surgical techniques such as glaucoma trabeculectomy with phacoemulsification, intraocular lens implantation, ultrasonic ciliary plasty, glaucoma drainage devices, and newer minimally invasive glaucoma surgery are also used to treat glaucoma. Despite the popularity of such procedures, the impact of glaucoma surgical techniques on astigmatism is still incompletely understood. Our review aimed to summarize the existing literature on the effect of glaucoma surgery on astigmatism.

Research progress on refractive status and ocular biometrics in preterm births

HU Yarou, ZHAO Xinyu, WU Zhenquan, FAN Zixin, YU Zhen, LIU Yaling, CHEN Tingyi, ZENG Jian, ZHANG Guoming

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  144-150.  doi:10.6040/j.issn.1673-3770.0.2023.402

Abstract ( 169 )   PDF (446KB) ( 69 )   Save

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People who were born prematurely, especially those with retinopathy of prematurity(ROP), usually have a higher incidence of refractive errors than those who were born at full term. The refractive status is closely related to the ocular morphology. The morphology of the ocular structures, such as the cornea, anterior chamber, and lens, changes in preterm infants. Additionally, some changes in ocular biometrics were considered to be related to the refractive status. With improvements in modern medical technology, the survival rate of preterm infants has increased, resulting in an increase in the number of people with refractive errors caused by preterm birth and ROP. Among these, the visual impairment and long-term complications caused by myopia are the most serious. Therefore, focusing on the long-term refractive prognosis and ensuring a lengthy quality of both life and learning are urgently required. In this article, we review recent research findings on refractive status and ocular biometrics in preterm births.

Research progress on pigment epithelial derived factor and dry eye

YE Qiang, LUOSONG Bazong, NAN Suting, WANG Hao, MA Jinhai, LYU Peng, ZHANG Wenfang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2024, 38(3):  151-156.  doi:10.6040/j.issn.1673-3770.0.2023.413

Abstract ( 136 )   PDF (1447KB) ( 25 )   Save

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Dry eye is one of the ocular surface diseases seriously endangering the quality of human vision. In recent years, its incidence rate has increased year by year. However, the specific pathogenesis has not been clarified yet. The effects of ocular surface inflammation, oxidative stress, apoptosis of ocular surface cells, and reduction of nutritional protective factors in the occurrence of it have attracted much attention. Pigment epithelial derived factor(PEDF)is a natural neovascular inhibitor, which has biological functions such as inhibiting inflammatory response, resisting stress response, anti apoptosis, nourishing nerves and protecting cells. The latest studies suggest that PEDF plays important roles in the pathogenesis of it. In this review, the mechanism and potential therapeutic effects of PEDF in the occurrence and development of dry eye are briefly summarized, so as to further study the role of PEDF in dry eye and provide new ideas for the treatment of it in the future.