Table of Content

20 March 2025 Volume 39 Issue 2

  

Expert Consensus

Expert consensus on AI-assisted diagnosis and treatment of retinopathy of prematurity(2025)

ZHANG Guoming, WEI Wenbin, LIN Haotian, CHI Wei, ZHANG Shaochong, ZHAO Peiquan, LEI Baiying, CHEN Youxin, WANG Yusheng, HE Mingguang, LIANG Jianhong, LU Hai, LU Fang, HUANG Xin, LIANG Xiaoling, ZHAO Xinyu, WU Zhenquan, YU Zhen, CUI Kaixuan, LIU Yaling, XIANG Daoman, CHEN Changzheng, ZHANG Zifeng, LIN Duoru, YU Shanshan, SUN Yue, TAN Tao, CHEN Yanxian, PENG Jie, DONG Li, CHENG Yong, ZHU Xuemei, YANG Peng, CHEN Shaobin

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  1-5.  doi:10.6040/j.issn.1673-3770.0.2024.381

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Retinopathy of prematurity(ROP)is a proliferative blinding retinal disease that occurs in premature infants and those with low birth weight. Timely screening and treatment are critical for the prevention and management of ROP. With the ongoing exploration of artificial intelligence(AI)in ophthalmology, AI has shown potential in areas such as automated screening, diagnosis, and treatment guidance for ROP. However, there is currently no unified standard for AI applications in this field. To better standardize and promote the application of AI in ROP diagnosis and management, enhance the accuracy of AI models in diagnosing ROP, encourage interdisciplinary collaboration, and improve training and education-ultimately contributing to the eye health of infants-we formulated this expert consensus. It serves as a valuable reference for ophthalmologists and researchers in the development and application of AI technologies for ROP.

Original Article

Protective effect of Chinese herbal medicine on sudden sensorineural hearing loss: a retrospective analysis and network pharmacology

WANG Xin, YUAN Jingjing, HAO Pengpeng, YAN Zhanfeng, LIU Jianhua, ZHONG Liqun, LIU Siming, WU Wei, ZHAO Xiaoyang, ZHANG Ying

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  6-17.  doi:10.6040/j.issn.1673-3770.0.2023.304

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Objective To explore the curative effect and possible mechanism of traditional Chinese medicine(TCM)in the treatment of sudden sensorineural hearing loss(SSNHL), and to provide reference for clinical application and further research. Methods The basic information of patients with SSNHL was summarized through retrospective study, and the frequency of TCM treatment of SSNHL was obtained, and the curative effect was analyzed by symptoms and pure tone audiometry. The effective ingredients and targets of the top 20 TCMs were obtained from TCMSP and BATMAN-TCM platforms using network pharmacology technology, and disease targets were obtained from GeneCards and OMIM data platforms. After taking intersection targets, protein-protein interactions, core targets, and pathways were analyzed based on String and Metascape platforms. Results The mean age of SSNHL patients was 51 years 59.05% of the affected ears were left ear, 39.05% were right ear, and 1.9% were binaural hearing loss. The total effective rate of treating SSNHL was 72.90%, among which symptoms of aural fullness, tinnitus, and vertigo were different after treatment. Network pharmacological study show that the treatment of SSNHL by the top 20 TCM involves multiple targets, pathways and mechanisms, among which the core targets include MAPK1, AKT1, JUN, TP53, EGFR, etc. The key pathways are pathways in cancer, lipid and atherosclerosis, proteoglycans in cancer, MAPK signaling pathway, human cytomegalovirus infection, and other aspects. Conclusion Application of CHM in the cases of SSNHL provides positive therapy and some contributions to improving hearing loss, tinnitus, aural fullness, and vertigo. Moreover, CHMs produce glucocorticoid-like effects and act on the cochlea, vestibular organ, and auditory nerve through an anti-inflammatory and anti-apoptotic mechanism, which can protect the auditory function of inner ear.

Analysis of anxiety and depression states in the treatment of chronic subjective tinnitus with masking sound therapy

DONG Xuelin, ZHANG Zhijun

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  18-24.  doi:10.6040/j.issn.1673-3770.0.2023.291

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Objective To explore the improvement of anxiety and depression status in patients with chronic subjective tinnitus after masked sound therapy and its influencing factors. Methods 256 patients with chronic subjective tinnitus were divided into observation group and control group according to the duration of masked sound therapy. The Tinnitus handicap inventory(THI), Hamilton depression scale(HAMD), and Hamilton anxiety scale(HAMA)scores of the two groups were collected before and after treatment. The changes of tinnitus degree, anxiety and depression status before and after treatment were compared, and the factors affecting anxiety and depression status were analysed. Results The efficacy rates of THI, HAMA, and HAMD scores in the observation group were significantly higher than those in the control group(P<0.001, P<0.001, P<0.001). In the observation group, multivariate binary logistic regression analysis showed that tinnitus loudness(OR=31.57, P=0.003)and pre-treatment THI level(OR=0.11, P=0.002)were independent factors for effective improvement of HAMA score, while residual inhibition result(OR=0.12, P=0.003)and pre-treatment THI level(OR=0.20, P=0.016)were independent factors for effective improvement of HAMD score. Conclusion This study found that masked sound therapy can reduce the severity of tinnitus and improve anxiety and depression. Pre-treatment THI level, tinnitus loudness, and residual inhibition results have significant effects on the effective improvement of anxiety and depression in patients with chronic subjective tinnitus.

Clinical value of highly expressed p-mTOR and p-S6K in sinonasal inverted papilloma

BI Heng, XIE Jia, GONG Huicheng

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  25-34.  doi:10.6040/j.issn.1673-3770.0.2024.393

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Objective In order to provide directions for screening molecular markers that can help identify nasal polyps and sinonasal inverted papilloma(SNIP), and to provide a theoretical basis for exploring the application of mTOR pathway inhibitors in the treatment of SNIP. Methods The differences in the expression of phosphorylated mammalian target of rapamycin(p-mTOR)and phosphorylated ribosomal protein S6 kinase(p-S6K)in SNIP compared with that of the middle turbinate mucosa were analyzed experimentally, which provided an experimental basis for verifying that the mTOR pathway mediates the pathogenesis of SNIP. Immunohistochemical staining was used to detect the expression of p-mTOR and p-S6K in the experimental group and the control group, and the differences in expression were analyzed using SPSS23.0 progressive statistics, and the results were verified by Western blotting(WB)experiments using fresh SNIP specimens and paraneoplastic specimens. Results The positive expression rates of p-mTOR and p-S6K in paraffin-embedded tissue specimens of 64 cases of SNIP were 85.94% and 81.25%, respectively, and those of p-mTOR and p-S6K in the mucosa of 32 cases of middle turbinate in the control group were 34.38% and 40.63%, respectively, and the differences were statistically significant after the statistical analysis process(χ2=26.400, P<0.01; χ2=16.103, P<0.01); WB experiments also confirmed that there were significant differences in the expression of p-mTOR and p-S6K between the SNIP experimental group and the paraneoplastic control group. Conclusion p-mTOR and p-S6K play an important role in the pathogenesis of SNIP, and the over-activation of mTOR pathway is an important mechanism to promote the pathogenesis of SNIP.

The expression and function of Tespa1 in chronic rhinosinusitis with nasal polyps

ZHANG Guangling, CHEN Xingxue, WU Tianyi, SUN Zhanwei, WANG Weiwei, LI Shichao,WANG Guangke

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  35-42.  doi:10.6040/j.issn.1673-3770.0.2024.108

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Objective To determine the expression and expression differences of thymocyte-expressed, positive selection associated 1(Tespa1)in nasal polyps and nasal mucosa and to investigate the role of Tespa1 in CRSwNP and its relationship with mast cells. Methods Twenty-nine patients with chronic rhinosinusitis with nasal polyps(CRSwNP)and 20 patients with chronic rhinosinusitis without nasal polyps(CRSsNP)were included in the study, 18 cases of controls. Quantitative real-time PCR(qPCR), immunohistochemistry(IHC), enzyme-linked immunosorbent assay(ELISA), and hematoxylin-eosin(H&E)staining were used to detect the expression and distribution of Tespa1 in nasal mucosa and nasal polyps, and its correlation with mast cells, IgE, IL-4, and IL-13 was analyzed. Results The qPCR results showed that the expression level of Tespa1 mRNA in CRSwNP was significantly lower than that in both control and CRSsNP groups(Z=2.42, P=0.046; Z=-3.38, P=0.002). The IHC results showed that Tespa1 was lowly expressed in the epithelium and mesenchyme of nasal polyps compared with the control group, and the expression of tryptase-positive mast cells was upregulated in nasal polyps(t=10.14, P<0.001). The number of Tespa1-positive cells in nasal polyps was negatively correlated with the number of trypsin-positive mast cells(r=-0.710, P=0.006).The ELISA results showed that the tissue Tespa1 level was much higher than its level in serum, and the tissue Tespa1 level was negatively correlated with the levels of IgE, IL-4, and IL-13(r=-0.682, P=0.002; r=-0.682, P=0.002; r=-0.691, P=0.002; r=-0.539, P=0.021). Conclusions Tespa1 is low expressed in nasal polyp tissues of CRSwNP patients, negatively correlated with the expression levels of IgE, IL-4 and IL-13, and may act through mast cells. This study provides a new perspective for understanding the pathomechanism of CRSwNP and may provide new molecular targets for future diagnosis and treatment.

Comparison of the safety and efficacy of short-course postoperative topical glucocorticoid adjuvant therapy for eCRSwNP combined with asthma

CAO Zhengyong, LI Xiaobo

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  43-50.  doi:10.6040/j.issn.1673-3770.0.2024.357

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Objective To compare and analyze the safety and efficacy of short-course postoperative topical glucocorticoid(budesonide, nasal drops or spray)adjunctive mometasone furoate therapy for eosinophilic chronic rhinosinusitis with nasal polyps(eCRSwNP)combined with asthma. Methods 87 postoperative patients with eCRSwNP combined with asthma were randomly divided into 3 groups and treated with budesonide nasal drops(group A, n=29)and budesonide nasal rinse(group B, n=29)in combination with mometasone furoate nasal spray, versus mometasone furoate nasal spray alone(group C, n=29). The rates of symptom reduction, quality of life improvement, and glucocorticoid treatment sensitivity rate were compared among the 3 groups 1 w after treatment. The total nasal symptom scale(TNSS), endoscopic nasal polyp(NP)score, and Chinese version of sinonasal outcome test-22(SNOT-22)were used on the 1st of treatment(D1), the 7th d of treatment(D7), 1 and 3 months after treatment to evaluated the symptoms and quality of life of patients. The occurrence of adverse reactions in the three groups was observed and compared. Results The symptom reduction rate, quality of life improvement rate and glucocorticoid treatment sensitivity rate in group A and group B were higher than that in group C at 1 w after treatment(P<0.05), but the difference between group A and group B was not statistically significant(P>0.05). After 1 w of treatment, the TNSS, endoscopic NP and SNOT-22 scores were significantly reduced in all 3 groups, and there was a decreasing trend at 1 and 3 months after treatment(P<0.05). The scores of group A and group B were significantly lower than those in group C(P<0.05), but the difference between group A and group B was not statistically significant(P>0.05). There were no serious adverse reactions in any of the 3 groups. Conclusion Short-course topical glucocorticoid can be used to treat eCRSwNP combined with asthma with a favorable safety profile. Budesonide nasal drops in combination with mometasone nasal spray improved clinical symptoms and the quality of life of patients better than mometasone furoate nasal spray alone.The efficacy of two modes of administration, budesonide nasal drops or nasal rinse in the treatment of patients with eCRSwNP combind with asthma was comparable.

Analysis of allergen detection results in children with allergic rhinitis in the Changchun area

LIU Chang, YANG Jingpu, GAO Yu, WANG Wenjia

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  51-58.  doi:10.6040/j.issn.1673-3770.0.2024.312

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Objective To analyse the serum specific immunoglobulin E(IgE)detection results of children with allergic rhinitis(AR)in the Changchun area. The study will provide insights into the common allergens and their distribution characteristics in children with AR. The findings of this study will serve as a valuable basis for the diagnosis, treatment and prevention of children with AR. Methods A total of 478 children with AR who visited the Department of Otorhinolaryngology, Head and Neck Surgery of the Second Hospital of Jilin University and underwent serum specific IgE detection from January 1 to December 31, 2023 were selected for this study. The common allergens and their distribution were analysed, and the differences in allergens between different age,gender groups and monosensitisation and multisensitisation were compared. Results The top four positive rates of inhaled allergens in children with allergic rhinitis in Changchun were Artemisia(38.3%), dust mite/house mite(35.6%), cat dander(34.9%), and Candida/Penicillium nodularis/Cladophorium/Alternaria spp./Aspergillus niger(34.9%). The four main food allergens were milk(63.6%), egg white(12.1%), peach/apple/mango/lychee/strawberry(8.4%), and shrimp/crab(6.9%). The highest number of visits by children with AR was observed in August(135 cases)and September(109 cases). The positivity rate for Artemisia and dwarf ragweed reached its highest point in September(57.8%,47.7%), while the positivity rate for Candida/Penicillium nodularis/Cladophorium/Alternaria spp./Aspergillus niger reached its highest point in July(56.8%), and for dust mites/house mites in December(100%). The positive rate of peach/apple/mango/lychee/strawberry was higher in males than those in females(χ2=5.473,P=0.019), while the positive rate of shrimp/crab was higher in females than those in males(χ2=6.440,P=0.011). Statistically significant differences were identified among the different age groups for the following allergens: inhalant allergens, Artemisia, dust mite /house mite, Candida/Penicillium nodularis/Cladophorium/Alternaria spp./Aspergillus niger, cat dander, and food allergens, milk, egg white, shrimp/crab, peanuts/soybeans showed statistically significant differences among the different age groups(all P<0.05). The positive rate of inhalant allergens increased with age(P<0.001), while the positive rate of food allergens showed an opposite trend(P<0.05). Pearson correlation analysis(r=0.692,P=0.009)revealed a positive correlation between polysensitisation and age in all children with AR. Conclusion The primary allergens identified in children with AR in Changchun are milk, Artemisia, and dust/house dust mite. The study revealed gender and age-related differences in the prevalence of positive reactions. The positive rate of inhalant allergens increased with age, while the positive rate of food allergens decreased. Furthermore, the number of children with multiple sensitisation also increased with age. This comprehensive understanding provides a solid foundation for the diagnosis, treatment and prevention of children with AR in this local area.

Analysis of patterns of variation in nasal and ocular symptoms before and after delivery in pregnant women

YANG Juanjuan, LANG Yongyao, ZHOU Wencheng

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  59-64.  doi:10.6040/j.issn.1673-3770.0.2024.328

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Endoscopic-assisted individualized surgical approach for the treatment of nasal dermoid and sinus cysts in children

FU Shengyao, CHEN Min, PANG Wenhui, LI Na

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  65-71.  doi:10.6040/j.issn.1673-3770.0.2024.022

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Objective To explore the surgical effect and treatment experience of resection of nasal dermoid and sinus cysts(NDSC)in children. Methods The clinical data of eight children with NDSC were retrospectively analyzed, including five boys and three girls. All children underwent CT of the nasal sinus and those with large lesions involving the skull base underwent MRI of the nasal sinus at the same time. All patients underwent endoscopy-assisted surgery. Different surgical approaches were designed according to lesion location and nasal aesthetic subunit with reference to imaging. Medical history, clinical manifestations, imaging, incision, lesion characteristics, surgical methods and follow-up were analyzed. Results Among the eight cases, five cases were associated with nasal bone absorption or nasal septal cartilage absorption, two cases were deep to the anterior skull base, two cases had two fistula orifices, one case had two branches in the deep part of the fistula, all children were operated smoothly, and one case underwent surgery again due to local scar hyperplasia. Patients were followed for 3-60 months without recurrence. Conclusion Children with NDSC should be operated on as soon as possible after discovery. The surgical approach should be individualized. The use of endoscopic-assisted surgery can completely remove the lesion and reduce the damage, taking into account the need for cosmesis.

Effectiveness of transnasal and transoral fenestration in the treatment of maxillary bone cysts

LI Xiaoyu, WANG Binchen, XU Dapeng, WANG Yanhua, DU Pinggong, ZHANG Qingquan

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  72-78.  doi:10.6040/j.issn.1673-3770.0.2023.437

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Objective To analyse the volume and three-dimensional direction changes of maxillary bone cyst treated by endoscopic and transnasal fenestration through three-dimensional modelling and model registration, and to explore the difference in volume reduction and three-dimensional contraction of maxillary cyst treated by endoscopic and transnasal fenestration. Methods The data of patients with maxillary bone cyst diagnosed in Yantai Stomatological Hospital Affiliated to Binzhou Medical College from June 2019 to June 2022 were collected. The operation was divided into two methods: transoral fenestration, transnasal endoscopy intranasal fenestration with nasal base and inferior nasal canal fenestration. Materialise Mimics 21 and 3-matic software were used for 3D reconstruction to measure changes in volume, proximal and distal diameter, buccolingual diameter and height. Results The regression models of volume percentage and time of the two groups were obtained: V₁=-0.007×t3+0.462×t2-10.175×t+99.481(P<0.001, R=0.956, adjusted R²=0.904); V₂=-0.018×t3+0.872 t2-13.834×t+99.978(P <0.001, R=0.964, adjusted R²=0.919), the volume contraction rate of the endoscopic intranasal fenestration group was higher than that of the transoral fenestration group in the first 6 months. The capsule volume in the transoral window group remained stable at 22 months. The volume of the two groups was similar after stabilisation of the changes in the cystic cavity. The percentage change of the three-dimensional direction in the transoral fenestration group was adjusted by a regression model: X₁=-2.23×10^-4×t3+0.074×t2-3.652×t+98.979(P<0.001, R=0.91, adjusted R²=0.811); Y₁=-0.005×t3+0.288×t2-5.638×t+100. 028(P< 0.001, R=0871, adjusted R2=0.734); Z₁=0.079×t2-3.880×t+97.633(P<0.001, R=0.917, adjusted R2=0. 830); The regression model of percentage and time of 3D direction change of the nasal window group was as follows: X₂=0.072×t2-3.346×t+98.80(P<0.001, R=0.945, adjusted R²=0.883); Y₂=-0.001×t3+0.127×t2-4.036×t+99.138(P<0.001, R=0.892, adjusted R2=0.766); Z₂=0.074×t2-3.758×t+99.209(P<0.001, R=0.961, adjusted R²=0.916). The maxillary cyst changed mainly in height after intranasal fenestration under nasal endoscope. Maxillary cyst after transoral fenestration mainly changed in proximal and distal diameter and height. Conclusion Transoral fenestration for maxillary bone cyst and intranasal fenestration under nasal endoscope for maxillary apical cyst have similar clinical effects in terms of volume contraction, and intranasal fenestration under nasal endoscope will shrink the volume faster. Accurate prediction of morphological changes of maxillary apical cyst can provide some reference for clinical work.

Clinicopathologic and survival analysis of laryngeal neuroendocrine neoplasm in 26 cases

XIE Feng, XU Zhenju, WU Ce, LIU Jie, ZANG Chuanshan, ZHANG Longxiao, HAN Min

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  79-86.  doi:10.6040/j.issn.1673-3770.0.2024.369

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Objective The objective of this study was to investigate the clinicopathologic characteristics of laryngeal neuroendocrine neoplasm and to conduct a survival analysis, with the aim of providing a valuable reference for clinical diagnosis and treatment. Methods A retrospective study of clinical data was conducted for a total of 26 patients diagnosed laryngeal neuroendocrine neoplasm. The clinical data was then grouped for the purpose of comparison. Survival analysis was perfoemed using both Kaplan-Meier analysis and Cox proportional-hazards regression models. Results Laryngeal neuroendocrine neoplasm(LNN)was most prevalent in the well-differentiated cases, and significant disparities were observed between the two groups with respect to the body mass index(BMI), tumour size, and Ki-67 labeling index. The 5-year overall survival rate for LNN was 43.2%, signifying a poor prognosis. Multifactorial analysis showed that lymph node metastasis, high Ki-67 labeling index and distant metastasis were independent risk factors affecting patients' overall survival rate. Conclusion Laryngeal neuroendocrine neoplasms manifesting diverse differentiation patterns exhibit distinct characteristics. The most significant factors affecting the overall survival rate are the Ki-67 labeling index, the presence of distant metastasis, and lymph node metastasis.

Safety of bedside percutaneous dilational tracheotomy for elderly patients with mandibular lift in the supine position

LI Hui, ZHAO Yongqiang, HE Zhen, YANG Huimin, ZHAO Ye, TIAN Xiujuan, CHEN Jianqiu

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  87-93.  doi:10.6040/j.issn.1673-3770.0.2024.254

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Objective To study the feasibility and safety of percutaneous dilatational tracheotomy(PDT)at the bedside in elderly patients with mandibular lift in the horizontal position. Methods We retrospectively compared different tracheotomy methods with regard to the surgical incision length, procedure duration and safety of the procedure and complications. A total of 244 elderly patients in the wards underwent PDT, with mandibular lift in the horizontal position(ML-PDT)or with shoulder cushion in supine shoulder cushion position(SC-PDT)and conventional open surgical tracheotomy with supine shoulder cushion position(surgical tracheotomy, ST). The demographic characteristics and outcomes were recorded. Results There were more male patients than females, with a mean age of(82.8±7.2)years, and all patients successfully completed tracheostomy. The mean value of surgical incision length(P=0.002)and procedure duration(P=0.002)in the ML-PDT group and in SC-PDT group was significantly lower than those in the ST group, with a statistically significant difference(P<0.05). There was no difference(P>0.05)between ML-PDT and SC-PDT groups(P_{surgical incision length}=0.140, P_{procedure duration}=0.162). Bleeding(P=0.007)and subcutaneous emphysema(P<0.001)and morbidity of complications(P<0.001)were significantly reduced significantly lower in ML-PDT group and SC-PDT group compared with in ST group, the difference was statistically significant(P<0.05). There were no differences(P>0.05)between ML-PDT and SC-PDT groups(P_bleeding=1.000、P_{subcutaneous emphysema}=1.000、P_{general complications}=0.701、P_{total complications}=0.605). Accidental decannulation(P=0.447), accidental destubes air leak from the fistula(P=0.623), incision infection(P=0.156)and granulation(P=0.156)were also lower in ML-PDT group and SC-PDT group, however, there was no significant difference statistically among the three groups(P>0.05). Conclusion PDT with mandibular lift in the horizontal position can be performed on the bedside in elderly patients without shoulder cushion to tilt the head position change. The operation is rapid and simple, intraoperative and postoperative complications are few, which is safe and feasible.

Clinical and prognostic analysis of spindle cell squamous carcinoma of pharynx

HUANG Jiali, LIU Ziqi, XU Juan, CHEN Xi, ZHANG Liqing, ZHOU Han

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  94-100.  doi:10.6040/j.issn.1673-3770.0.2023.216

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Objective To investigate the clinicopathological features, diagnosis, treatment and prognosis of patients with spindle cell squamous carcinoma, in order to improve the level of diagnosis and treatment of this tumor. Methods Between 2014-2021, patients from the First Affiliated Hospital of Nanjing Medical University with spindle cell squamous cell carcinoma were analyzed alongside patient data from the SEER database of America retrospectively. The propensity score matching(PSM)analysis was performed between patients with spindle cell squamous cell carcinoma and those with squamous cell carcinoma in the SEER database, and Kaplan-Meier survival analysis was performed to analyze the difference in overall survival between the two groups. Chi-square test and Cox risk model were used to analyze the relationship between clinical risk factors and prognosis. Results All patients were male with an average age of 60, including 5 cases of hypopharynx and 2 cases of nasopharynx. The main treatment is surgery, accompanied by chemoradiotherapy. Survival analysis after PSM showed that the survival rate of spindle cell squamous carcinoma of pharynx was significantly worse than common squamous cell carcinoma(χ2=61.84, P<0.001). Univariate analysis showed that race, TNM stage, T stage and M stage were related to overall survival(P<0.05). Multivariate regression analysis showed that race and M stage were independent prognostic factors for patients with spindle cell squamous carcinoma of pharynx(P<0.05). Conclusion Spindle cell squamous carcinoma of pharynx is rarer than common squamous cell carcinoma with poor prognosis. Race and distant metastasis are important prognostic indicators. And comprehensive treatment mode, regular review and lifelong follow-up should be adopted for these patients.

The effect of orofacial muscle functional training on snoring indicators and sleep quality in patients with snoring

WANG Xiaoqing, WANG Yuyu, QIU Jinwei, XU Jinxia, ZHU Mei

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  101-107.  doi:10.6040/j.issn.1673-3770.0.2024.226

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Objective Exploring the effects of snoring indicators and sleep quality in snoring patients through orofacial muscle functional training. Methods The study subjects were 80 patients diagnosed with simple snoring, upper airway resistance syndrome and obstructive sleep apnoea(OSA)admitted to Beijing Friendship Hospital, Capital Medical University. These patients were randomly divided into a control group(n=40)and an observation group(n=40). The control group received conventional interventions, while the observation group received training in oral and facial muscle function. The study compared the two groups on parameters related to snoring, sleep quality, daytime sleepiness, and anxiety and depression levels to assess the effectiveness of oral and facial muscle function training in reducing snoring. Results After 4 and 8 weeks of intervention, the snoring index(t=-2.353, -3.806; P=0.021, P<0.001), snoring loudness(t=-1.045, -2.602; P=0.299, 0.011)and total number of snores(t=-0.868, -2.545; P=0.388, 0.013)in the observation group were lower than those in the control group; the ESS score(t=-3.229,-6.925; P=0.002, P<0.001), PSQI score(t=-2.067, -4.446; P=0.042, P<0.001), SAS score(t=-2.366, -4.580; P=0.021, P<0.001), and SDS score(t=-5.103, -7.069; all P<0.001)in the observation group were lower than those in the control group. Conclusion In patients with snoring who underwent functional orofacial muscle training as an intervention, there was a significant decrease in snoring index, snoring loudness, and total number of snoring events with prolonged intervention. In addition, sleep quality and daytime sleepiness improved, and anxiety and depression were reduced. This method could be considered for wider promotion in the intervention of patients with snoring.

Visualization analysis of herpes simplex virus keratitis based on CiteSpace in the past decade

WANG Ziyan, WANG Fang

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  108-115.  doi:10.6040/j.issn.1673-3770.0.2023.495

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Objective To reveal the research overview of herpes simplex virus keratitis(HSK)in the past decade through visual analysis and to analyze the research hotspots and trends in this field. Methods Retrieve HSK related Chinese literature collected from CNKI, Wanfang, and VIP databases from January 2013 to December 2022. Use CiteSpace software to analyze the volume of annual publication, authors, institutions, and keywords from the relevant literature. Draw and interpret various graphs to reveal research hotspots and trends in this field. Results 608 articles were finally included, with a decreasing trend in the volume of publications. The author with the highest number of publications was Yu Ying(7 articles); the Chinese Academy of Traditional Chinese Medicine Ophthalmology Hospital as a high-yield institution(11 articles); From the keyword analysis, it can be concluded that research focuses mainly on the pathogenesis and symptoms of herpes simplex virus and herpes simplex keratitis, clinical treatment options, disease recurrence and prognosis. Conclusion The study identified influential authors and institutions in the field of herpes simplex keratitis in China, summarized existing research hotspots; Novel ways of detecting and diagnosing the disease, exploring more effective treatment methods and more valuable drug formulations, rationalizing the use of medication, and avoiding adverse reactions may be future research directions.

Trousseau's syndrome in tonsil carcinoma complicated by multiple acute cerebral infarctions: a case report and literature review

PENG Xin, WEI Xianfeng, LIANG Yibo, QIAO Jie, WANG Wei, LIN Peng, LI Li

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  116-120.  doi:10.6040/j.issn.1673-3770.0.2023.392

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Patients with malignant tumors face a higher risk of developing thrombosis compared to those without tumors. The relationship between the occurrence of thrombus and tumor is called Trousseau's syndrome(TS). This thrombotic event is unpredictable, potentially occurring before or concurrently with the detection of an underlying malignancy. TS is relatively rare, presenting clinically as multiple lesions causing infarction in multiple vascular territories, and its prognosis is poor. Herein, we report a case of TS and review the literature. We aimed to assist head and neck surgeons in recognizing and improving the prognosis of this condition.

Hypopharyngeal fibrovascular polyp:a case report and literature review

WANG Tan, WANG Jing, LI Yanzi, BU Lingnan, YANG Sujuan

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  121-125.  doi:10.6040/j.issn.1673-3770.0.2023.400

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Objective To discuss the clinical manifestations and difficulties in the diagnosis and treatment of hypopharyngeal fibrovascular polyps, to summarise experience, to reduce misdiagnosis and missed diagnosis, and to select surgical methods accurately. Methods The literature was reviewed and the diagnosis and management of a patient with a hypopharyngeal fibrovascular polyp was summarised. The clinical manifestations, the course of the disease, the results of accessory examinations and the difficulties of treatment were analysed. Results Hypopharyngeal fibrovascular polyps can migrate in the larynx and esophagus, and the surface is covered with normal epithelial tissue, which is prone to misdiagnosis and missed diagnosis in the clinic. A comprehensive diagnosis should be made on the basis of clinical symptoms supported by endoscopy, imaging and other investigations. Anesthesia is safe when polyps are located in the esophagus, and endoscopic surgical resection is the preferred method of treatment. Conclusion Hypopharyngeal fibrovascular polyps are rare and prone to misdiagnosis and missed diagnosis. It is very important to perform a complete preoperative evaluation, establish a clear diagnosis, and choose an appropriate surgical approach based on the location, width, size and composition of the root base.

Review

Research advances on the etiology and pathogenesis of acute low-frequency sensorineural hearing loss

PAN Jiayu, ZHANG Chunlin

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  126-131.  doi:10.6040/j.issn.1673-3770.0.2023.275

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Acute low-frequency sensorineural hearing loss(ALHL)is one of the common diseases in otology, and its incidence has been gradually increasing in recent years; the population with ALHL is getting younger and younger. ALHL is characterized by a good clinical prognosis, a high recurrence rate, and even the progression of Meniere's disease. The specific etiology and pathogenesis of ALHL have not been fully clarified till now. The specific etiology and pathogenesis of acute low-frequency sensorineural hearing loss have not been completely clarified, and the possible etiology and pathogenesis include endolymphatic fluid, immunological factors, viral infections, vascular circulatory and hematologic disorders, and metabolic diseases. In this article, we would like to summarize the progress of research on the etiology and pathogenesis of ALHL in recent years, to improve the clinical understanding of this disease, so as to make a reliable diagnosis in a timely and effective manner.

Advances in the mechanisms of nervous system plasticity in vestibular compensation

WANG Xuezhi, YANG Ling, HUANG Yingxi, LYU Ping

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  132-139.  doi:10.6040/j.issn.1673-3770.0.2023.279

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Vestibular disorders may cause vertigo, balance disturbance, nausea, vomiting, and other symptoms that can adversely affect an individual's quality of life and health. When peripheral vestibular inputs are partially or completely lost, a phenomenon known as vestibular compensation occurs in the hours and days following the injury. Vestibular compensation is a neuroplastic process divided into a rapid, complete, static compensation and a longer-term, incomplete, dynamic compensation. Static compensation primarily occurs through electrophysiological rebalancing of the bilateral vestibular nuclei, whereas dynamic compensation involves three mechanisms: vestibular adaptation, substitution, and acculturation, all of which participate in the overall reorganization of systems throughout the brain. In recent decades, studies have investigated the mechanisms of neuroplasticity in vestibular compensation. Static compensation is attributed to a series of changes in the vestibular nuclei, including molecular alterations, cell proliferation and excitability, synaptic plasticity and transmission, and neural circuit projections. In contrast, dynamic compensation involves reorganization throughout the whole brain. In this paper, we briefly summarize the research progress into neuroplasticity mechanisms in vestibular compensation, providing a basis for improvement of treatment strategies in patients with vestibular disorders in China.

Current status and advances in magnetic resonance imaging in sudden deafness

GUO Xiang, MA Yongqiang, YI Haijin

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  140-144.  doi:10.6040/j.issn.1673-3770.0.2023.301

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Idiopathic sudden sensorineural hearing loss is a common disease in Otology. Recently, its incidence rate has been increasing, and the age of onset appears to have become younger. The quick determination of the cause of idiopathic sudden sensorineural hearing loss, and the provision of reasonable and effective treatment in a timely manner has, accordingly, become a matter of focus. With the continuous development and progress of imaging technology, scholars have gradually improved the detection rate of the cause of sudden deafness and the accuracy of prognosis by conducting internal auditory canal magnetic resonance imaging(MRI)examinations. The T₁WI, T₂WI, 3D-T2Fair, DTI, DSI and other sequences in the MRI examination of the internal auditory canal play a crucial role in assisting clinicians in diagnosing the causes of sudden deafness. These may include internal auditory canal tumors, posterior cranial fossa infarctions, internal ear bleeds, labyrinthitis, loss of nerve fiber integrity, and the course of the anterior inferior cerebellar artery blood vessels. This article provides a comprehensive review of the current status and recent advancements in determining the etiology and prognosis of sudden deafness through MRI examinations of the above aspects,. Thus, this review provide valuable insights for the timely selection of optimal treatment plan.

Research progress of machine learning prediction model in clinical application of sudden deafness

LI Peipei, LU Yanqing, HOU Nan

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  145-151.  doi:10.6040/j.issn.1673-3770.0.2024.036

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Due to the unclear aetiology and pathogenesis of sudden deafness, there is still no uniform treatment plan at home and abroad. In the face of different sudden deafness patients, it is not possible to directly estimate the effective prognosis of patients and formulate the most suitable treatment plan for patients. With the development of big data and the computer information age, the application of artificial intelligence represented by machine learning(ML)can help transform patient education and joint decision-making between doctors and patients from an abstract concept into a concrete operable form, so as to evaluate the prognosis and effectiveness of diseases and formulate treatment plans for diseases. The purpose of this paper is to review the whole process of ML prediction model construction and its application to sudden deafness, with the aim of providing relevant reference information for clinical staff to evaluate the curative effect of sudden deafness and make plans, so as to better realise joint decision-making between doctors and patients and improve the curative effect of sudden deafness.

Molecular mechanisms of programmed cell death and its role in nasopharyngeal carcinoma

WU Min, LI Zhengyang, MENG Jie, YE Huiping

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  152-157.  doi:10.6040/j.issn.1673-3770.0.2023.295

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About 3/4 of patients with nasopharyngeal cancer are diagnosed at an intermediate to advanced stage. Radiation and chemotherapy are the main therapies for NPC. However, the treatment efficacy is not always ideal. The molecular mechanism of NPC remains unclear. Regulated death comprises a variety of active and orderly modes of cell death, and is vital in the balance of life activities. Recent studies have associated regulatory death with NPC. Various modalities of programmed cell death, such as cuproposis, ferroptosis, pyroptosis, autophagy, necroptosis, and apoptosis, play important roles in different NPC stages. This article provides an overview of the molecular mechanisms of cupropopsis, ferroptosis, pyroptosis, autophagy, necroptosis, and apoptosis in cells and their roles in NPC development. The information could provide a new perspective for studies exploring the pathogenesis and potential therapeutic targets of NPC.

Research progress of animal models of olfactory disorders

LI Zhicheng, YAN Ya, DAI Liangping, YING Junjie, WANG Renzhong

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  158-167.  doi:10.6040/j.issn.1673-3770.0.2023.299

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Olfactory disorders have a complex aetiology and a prolonged course. Animal models are essential for the further study of the pathophysiology of olfactory disorders, the mechanism of therapeutic response and drug development. However, a systematic and comprehensive review of olfactory modelling methods is lacking. Currently, the most commonly used animal models include mouse and rat models. This review will start with the aetiology. The animal model of olfactory dysfunction was divided into the model of olfactory dysfunction associated with exposure to toxins/drugs, the model of olfactory dysfunction secondary to nasal and sinus diseases, the model of olfactory dysfunction after infection, the model of olfactory dysfunction associated with congenital olfactory dysfunction and normal ageing, the model of olfactory dysfunction after trauma, and the model of olfactory dysfunction associated with the nervous system. This paper summarises the construction methods and pathological changes of these models to provide a reference for the selection of modelling methods for animal models of olfactory dysfunction.

Research progress on biomarkers of traditional Chinese medicine in the treatment of allergic rhinitis

ZHOU Heqing, SHEN Qi

Journal of Otolaryngology and Ophthalmology of Shandong University. 2025, 39(2):  168-176.  doi:10.6040/j.issn.1673-3770.0.2023.020

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Allergic rhinitis(AR)is a common disease in otolaryngology. It is characterized by nasal itching, paroxysmal sneezing, runny nose, and nasal congestion. The incidence rate has been gradually increasing and it has become a major chronic inflammatory disease of the respiratory tract. Traditional Chinese medicine(TCM)treatment can not only effectively control the symptoms of patients with AR, but also has preventive and long-term effects. At present, the evaluation of efficacy is still based on the symptom, which are subjective. Therefore, biological indicators that can objectively evaluate the efficacy are needed with urgency. This paper reviews the relevant recent literature on the biological markers of the efficacy of TCM in the treatment of AR. We show that the changes in various cytokines and immune cells in nasal secretions and serum immunological indexes are related to the mechanism of TCM in the treatment of AR. Therefore, they can be used as potential biomarker to evaluate the efficacy of TCM, and provide evidence-base for the treatment of allergic rhinitis with TCM.