Table of Content

24 April 2007 Volume 21 Issue 2

  

Articles

Electromagnetic image-guidance system in endoscopic sinus and skull base surgery

WANG Gang,CHEN Lei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  97-99 . 

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To evaluate the advantages and disadvantages of the electromagnetic image-guidance system in endoscopic sinus and skull base surgery. Methods: Of twelve patients, five had chronic sinusitis with or without nasal polyps, two cerebrospinal fluid rhinorrhea, one chronic sinusitis with cerebrospinal fluid rhinorrhea, one foreign body in the ethmoid sinus, one pituitary tumor, one invasive plexiform neurofibromatosis in frontal and ethmoid sinus and one Wegener granulomatosis in nasopharynx and clivus. All of them received endoscopic surgery with the Insta Trak image-guidance system. Result： All the patients were successfully operated on and no complications occurred. The preoperative preparation needed fifteen minutes on average. Conclusion： The electromagnetic imageguidance system could help surgeons identify critical anatomical structures and reduce surgical complications, especially in patients whose normal anatomic landmarks have been distorted by a prior surgery or disease process.

Effect of Pulmicort respule on rehabilitation after functional endosocopic sinus surgery

YU Chen-jie,CHEN Feng,DAI Yan-hong,WANG Jun-guo,GU Ya-jun,GAO Xia

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  100-102 . 

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Objective: To investigate the effect of Pulmicort respule on rehabilitation of patients subjected to functional endoscopic sinus surgery(FESS). Methods: Twenty-seven patients suffering from chronic rhinosinusitis of polyposis type Ⅱ stage Ⅲ or type Ⅲ were enrolled in this selfcontrolled study. The left nostril was subjected to Pulmicort respule using a swell sponge just before the end of the surgery, the right, however, was not. The swell sponges were kept in the nostril for 1 week, and absorbable gelatin sponges with Pulmicort respule were given into the same nostril each time when the patients came in the following stage. The transitionary process of the mucosa was determined. Results: The excretions were decreased, the mucosa intumescence was diminished, and epithelization was established in a shorter time in the experimental group than in the control group. The cure rate was 92.6% in the experimental group and 85.2% in the control group （P＞0.05）. There were no significant differences between the two groups. Conclusion: Using Pulmicort respule locally is a benefit for relieving mucosa inflammation, shortening the stage of epithelization, and accelerating the recovery of mucosa after FESS.

Qinglisai nasal irrigetion after endoscopic sinus surgery

LU Biao-qing,SUN Yi-fan,ZHOU Xiao-jun,XU Qing-wen,GUO Yi-lian,PENG Hong-bin,LING Ya-ya,FAN Zhi-jun,FENG Bing-yi

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  103-106 . 

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Objective: To explore the effect of Qinglisai nasal irrigation locally used after endoscopic sinus surgery. Method: Eighty-five patients were randomly divided into two groups: the Qinglisai nasal irrigation group and the Gentamicin plus Decadron group. Result: The clearing time and mucous epithelization time were significantly different between the two groups(P＜0.000?5，0.01＜P＜0.025), but the time to the postoperative mucous disease was not significantly different(P＞0.05). Conclusion: Qinglisai nasal irrigation after endoscopic sinus surgery is excellent on the mucous and is of value to be popularized in clinics.

Endoscopy for maxillary sinus hemorrhagic and necrotic polyps in teenagers

CHEN Yan-lin,LI Qin,FU Yu-gui

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  107-108 . 

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Objective: To study the advantages of nasal endoscopy for maxillar sinus hermorrhagic and necrotic polyps. Method: The clinical data of sixteen teenagers with maxillar sinus hermorrhagic and necrotic polyps were retrospectively analyzed. Result: During a follow-up of 6 months to 3 years, all were cured without recurrence and complications. Conclusion: Nasal endoscopy is a suitable surgical approach to remove maxillar sinus hermorrhagic and necrotic polyps in teenagers.

Management of the ostium of the maxillary sinus in endoscopic sinus surgery

SHEN Fan,LI Chao-qing,HUANG Ai-lan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  109-110 . 

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Objective: To investigate the clinical role of the management of the maxillary sinus ostium on the prognosis in endoscopic sinus surgery (ESS). Methods: A total of 682 cases of chronic sinusitis or nasal polyp had been subjected to ESS since 2001. In the operation, the ostium was enlarged or not based on the shape and size of the ostium or ostium maxillary sinus diseases. Results: Followed up for 6 months, maxillary ostia was found in 84.22%(574/682) of the patients and maxillary ostia closure was found in 16.88%（106/682 ）of the patients. Conclusion: Patency of the maxillary ostia is one of the important criterions to evaluate ESS. Suitable management of the ostium and regular follow-up are the key points to regain the long-term patency of the ostia.

Effect of hypertonic saline on mucociliary clearance in patients with chronic rhinosinusitis

WANG De-hui,SUN Qiong,WANG Feng,YU Hua-peng,HU Li,ZANG Chao-ping

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  111-112 . 

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Objective: To explore the effect of hypertonic saline on nasal mucociliary clearance in patients with chronic rhinosinusitis. Methods: The saccharin test was used to determine the mucociliary clearance before irrigation and after normal saline or hypertonic saline irrigation. On the following days, an alternative solution was used to repeat the treatment and retest the mucociliary clearance time. Results: The normal saccharin clearance time of patients with chronic rhinosinusitis was 19.62 minutes, and it changed to 17.74 and 13.22 minutes after the normal saline and hypertonic saline irrigation, respectively. Compared with the normal group, the mucociliary clearance was not significantly changed in the normal saline group (P＞0.05), but significantly decreased in the hypertonic saline group (P＜0.01). Conclusion: Hypertonic saline can significantly improve the nasal mucociliary clearance time, while normal saline has no such effect.

The Foley catheter in maxillary sinus surgery

LU Xing,QIU Ming-sheng,TAO Yuan,ZHANG Fan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  113-114 . 

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Objective: To search for a suitable hemostasis method in maxillary sinus surgery. Method: The Foley catheter was used to control blood loss. Result： Hemostasis was good when using the Foley catheter. Conclusion: The foley catheter is worthy to be popularized with its advantages of good effect and little pain.

Alar cartilage-muscle rings in repairing the unilateral severe cleft lip

WANG Guo-yi,YAN Jun-xin,ZHANG Xiu-ying,ZHOU Xuan-yan,ZOU Jian-ping

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  115-117 . 

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Objective: To discuss an effective method of cheiloplasty for postoperative nasal deformity after unilateral severe cleft lip. Methods: Seventy-six patients with secondary cleft lip nasal deformity were repaired with alar cartilage-muscle rings by remov al of the points of theattachment of the nasal columella basement through a “V-Y” incision andimplant ation of an autologous rib cartilage tissue around the piriform aperture The short-and long-term responses were observed. Results: All got primary healings. Followed up for 12-38 months, the apex of nose, nasal ala, nostrils and nasal columella produced satisfied outlines. Conclusions: Alar cartilage-muscle ring is hypoplastic, which results in nasal myosthenic disequilibrium. Reconstruction of the alar cartilage-muscle ring plays a key role in the correction of nasal deformities for cleft lip patients.

Coronal CT imaging of anatomic variations of patients with chronic rhinosinusitis with or without polyps

GU Lin-tao,WANG Qi-rong,HAN Fei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  118-121 . 

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Objective: To explore the relationship between anatomic variations of the nasal cavity and chronic rhinosinusitis with or without polyps. Methods： Four hundred and eleven coronal plane CT scans of the paranasal sinuses were divided into three groups: the control group(A), the chronic rhinosinusitis group(B), and the deviation of middle turbinate group(C). The prevalence of anatomic variations in groups A, B and C was determined and analyzed by SPSS V.12.0 for windows. Results： The prevalence of concha bullosa, paradoxical middle turbinate and straight middle tubinate in group A was 23.39%, 8.06% and 3.23%, respectively, in group B was 38.52%, 18.58% and 12.84%, respectively and in group C was 37.45%, 21.70% and 17.02%, respectively. The prevalence of anatomic variations in the MT between groups A and B or C was statistically significant（P＜0.01）. The prevalence of pneumatization of the UP, superior divarication of the UP and paradoxical curvature of the UP in group A was 4.03%, 4.83% and 0.00%, respectively, in group B was 7.10%, 2.73% and 2.18%, respectively and in group C was 8.51%, 3.83% and 7.23%, respectively. Differences of paradoxical curvature of the UP were statistically significant between groups A and C（P＜0.01）and also statistically significant between groups B and C（P＜0.01）. Conclusions： Anatomic variations of the MT may be one of the reasons for chronic rhinosinusitis with or without polyps. The paradoxical curvature of the UP,superior divarication of the UP,nasal septal deviation and infraorbital ethmoid cells.

Expression and significance of Skp2 and P27kip1 protein in nasopharyngeal carcinoma

WANG Li,LU Yong-hui

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  122-126 . 

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Objective: The F-box protein Skp2 is required for the ubiquitin-mediated proteolysis of the cyclin-dependent kinase inhibitor P27kip1. Overexpression of Skp2 has been reported in many cancers including breast carcinoma, gastric carcinoma and prostate cancer. The purpose of this study is to investigate the correlation of Skp2 and P27kip1 expression with the clinical pathological features of nasopharyngeal carcinoma, and the correlation between expression of Skp2 and P27kip1 in nasopharyngeal carcinoma.　Methods: Thirty-nine cases of nasopharyngeal carcinoma and twenty-four cases of chronic nasopharyngitis were enrolled in this experiment. All specimens were proved by formallin-fixed paraffin-embedded slides with the hematoxylin eosin staining. Expression of Skp2 and P27kip1 was determined by using an immunohistochemical staining (PV-9000 two-step kit). Result: The Skp2 labeling frequency (71.79%) in nasopharyngeal carcinoma was significantly higher than that (41.67%) in chronic nasopharyngitis(P＜0.05). The positive rate of P27kip1 expression in nasopharyngeal carcinoma was 35.90%, which was remarkably lower than that (79.17%) in chronic nasopharyngitis (P＜0.01). Expression of Skp2 and P27kip1 protein in nasopharyngeal carcinoma was correlated with the clinical stage and cranial nerve encroachment (P＜0.05), but not correlated with the patient age, sex, histological grade, or lymph node metastases (P＞0.05). Skp2 expression was inversely correlated with P27kip1 in nasopharyngeal carcinoma（rs=-0.373, P=0.019）. Conclusion: Expression of Skp2 protein may decrease the P27kip1 level in human nasopharyngeal carcinoma, indicating it is involved in the development of human nasopharyngeal carcinoma. Skp2 and P27kip1 may be used as hopeful markers for predicting the clinical pathological features and the prognosis of these patients.

Radio-sensitization of Oridonin on nasopharyngeal carcinoma cell line CNE-2

XIAO Da-jiang,ZHU Guo-chen,WANG Xiao-lan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  127-129 . 

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Objective: To observe the radio-sensitization of Oridonin and its mechanism on nasopharyngeal carcinoma cell line CNE-2. Methods： The radiation sensitization enhancement ratio（SER） was determined by clonogenic assay. Cell cycle distribution was assessed by flow cytometry. Results： The SER was 1.227. The rate of G2/M phase block related to the Oridonin group, the radiotherapy group and the combination treatment group was 17.8%, 24.7% and 45.2%, respectively. Conclusion： Oridonin can enhance radiosensitition for CNE-2 cells, which maybe relate a to changes of the cell cycle.

Resistance of methicillin-resistant staphylococcus to antibiotics for chronic nasosinusitis

CHEN Jun, FU Ai-qing,ZHU Qiu-ping, LOU Zheng-cai

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  130-132 . 

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To investigate the infective rate of methicillin-resistant staphylococcus(MRS) and its resistance characteristics so as to provide a basis for the clinically rational use of anti-microbial agents and an effective control of MRS infections. Methods:　Strains of staphylococcus from clinical samples were determined by a disc agar diffusion method and MRS agar plate screening. At the same time their resistance to 20 different anti-microbial agents and the presence of β-lactamase in the strains were determined. Results： Twenty-seven strains of MRSA and thirty-three strains of MRSCoN were identified. The proportion of MRSA and MRSCoN was 37.6% and 38.3%, respectively. The incidence of MRSA and MRSCoN producing βlactamase was 77.8% and 72.7% ,respectively. The resistance rate showed a significant difference between the MRS and the MSS(P<0.05).The multi-resistance ranged from 6 to 17 and 5 to 15 antibiotics in MRSA and MRSCoN. Conclusions: Vancomycin, Rifampin and Amikacin have effective antibacterial activity against MRS. Vancomycin is the first choice for MRS infections. Wide attention should be paid to the multi-resistance of MRS, and the use of antibiotics should be better managed and the resistance of MRS to antibiotics should be further monitored.

Correlation between the thresholds acquired with ASSR and pure tone audiometry

MU Hong,LIU Jun-jie,LI Xiao-mei,ZHANG Jian-ji,ZHANG Qiu-gui,SUN Yan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  133-135 . 

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Objective: To determine the threshhold of multiple auditory steady-state responses (ASSR) and pure tone audiometry in children aged five to ten with normal hearing, and to explore the correlation between them. Methods: Thirty children with normal hearing had the ASSR and pure tone audiometry determined at 0.25, 0.5, 1, 2, 4 and 8 kHz. The coherence and correlation between the two groups were determined by the t test and the correlated modulus t test. Results: The different average threshholds of ASSR and pure tone audiometry at all tested frequencies ranged from 11 to 16.50 dBHL. There was a statistical difference between the result obtained by ASSR and pure tone audiometry at all tested frequencies (P＜0.05), especially at 0.25kHz and 0.5kHz (P＜0.01).　The correlation was significant between the results by ASSR and pure tone audiometry at all tested frequencies (P＜0.05) by using the correlated modulus t test,Conclusion: In the middle or high frequencies, there are good correlations between ASSR and pure tone audiometry. However, there is a numerical value between them. It is feasible to confer the pure tone hearing threshhold of children aged from five to ten by determining the threshhold of ASSR and by using the numerical value.

Human amnia in myringoplasty

OU Zhao-xi,LIU Jian-jun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  136-137 . 

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Objective: To study the feasibility of human amnia in myringoplasty. Methods: Thirty-five cases of minor tympanic membrane perforation were subjected to repaire by transplantation using human amnia. Result: All were healed except one inducing by epiphyte infection. Conclusion: Human amnion, a new transplantation material for myringoplasty, is worthy to be popularized for it is easy to obtain and operate and regains great success.

Expression of TRAIL and Survivin proteins in the carcinogenesis and development of laryngeal carcinoma

WU Kai, MA Mao-qiang, WANG Chun-hai,ZHANG Yong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  138-140 . 

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Objective: To explore the correlation between the expressions of TRAIL and Survivin proteins and the pathologic features of laryngeal epithelial lesions. Methods: Immunohistochemistry was used to determine the expressions of TRAIL and Survivin proteins in normal mucosa and displasia and invasive carcinoma tissues of 48 cases of laryngeal carcinoma. Results: The expression of Survivin protein progressively increased, whereas that of TRAIL protein gradually decreased in a route of normal mucosa and displasia and invasive carcinoma tissues. The expression of TRAIL protein in laryngeal invasive carcinoma was negatively correlated with that of Survivin protein (r=-0.510, P<0.01). Conclusions: The expressions of TRAIL and Survivin proteins are significantly related to the genesis and progression of laryngeal carcinoma.

A quantitative analysis of NF-kB in laryngeal carcinoma

SUN Yu-cai,HU Guo-hua,ZHU Jiang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  141-143 . 

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Objective: To explore the significance of the quantitative analysis of NF-kB in laryngeal carcinoma tissues. Methods: The quantitative analysis of the protein content and the DNA binding activity of NF-kB was examined by the Western blot method and electrophoretic mobility shift assay (EMSA) method in 20 cases of laryngeal carcinoma tissues and 10 cases of normal pericarcinoma tissues. Results: The protein content and the DNA binding activity of NF-kB in laryngeal carcinoma tissues were higher than those in pericarcinoma normal tissues（P<0.05）. Conclusion: The NF-kB might play an important role in the occurrence and development of laryngeal carcinoma and offers a new target of laryngeal carcinoma treatment.

Expression of Jab1 in laryngeal squamous cell carcinoma

ZHANG Feng,CAO Hua

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  144-146 . 

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Objective: To study the expression of Jab1(c-Jun activation domain-binding protein 1) in laryngeal squamous cell carcinoma (LSCC) and its correlation with clinicopathologic variables and prognosis. Methods: Expression of Jab1 protein was determined by SP immunohistochemistry in 23 cases of normal laryngeal tissues and 72 cases of LSCC. Results: Jab1 over-expression was produced in 54.17% of LSCC and was significantly positively associated with clinicopathologic variables and lymph node metastasis. Survival analysis revealed that Jab1 over-expression was significantly negatively associated with the overall survival (P<0.05). Conclusions: Jab1 protein may contribute to the development and progression of LSCC by facilitating the degradation of p27kip1 and represents a novel prognostic indicator for LSCC.

Diagnosis and treatment of temporal giant cell tumor:one case report

WANG Yan-sheng,LI Xue-chang,ZHANG Xiao-yan,ZHANG Yu-li,LIU Qing-ming

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  147-148 . 

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Objective: To explore the clinical manifestation, diagnosis, differential diagnosis and treatment of giant cell tumor of the temporal bone (GCTTB). Method: The symptom, objective sign, imaging and pathology of one case of GCTTB was retrospectively analyzed. Result: The patient, pathologically diagnosed as grade Ⅱ～Ⅲ received tumor resection and radiotherapy. Conclusion: The diagnosis of GCTTB should be based on the clinical manifestation, imaging and pathology. Once diagnosed, total resection is necessary and radiotherapy should follow if necessary.

An emergency management of severe laryngeal obstruction induced by acute epiglottitis

HOU Cheng-jie,ZHANG Qing-quan,WANG Qiang,WANG You-fu

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  149-150 . 

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［ABSTRACT］Objective: To study the experience and lessons of the emergency management of severe laryngeal obstruction caused by acute epiglottitis. Methods: The diagnosis, first aid, development of pathogenic condition and consequences of treatment of 7 patients with acute epiglottitis were retrospectively analyzed. Results: Four patients suffering from sudden dyspnea were subjected to emergency tracheotomy: of them, one patient died, one suffering from coma secondary to cerebral hernia and edema resumed sensation but regained hemiparalysis, and 2 were fully healed. The other three suffering from dyspnea of 2 to 3 degrees recovered after an intensive monitoring and a large dosage of steroid. Conclusion: After a prompt diagnosis, patients with acute epiglottitis should be subjected to a large dosage of steroid and proper measurement.

Application of bipolar coagulation forceps in tonsillectomy

CUI Xin-hua,WANG Qi-rong,HAN Fei,JIANG Shan-shan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  151-152 . 

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Objective: To explore the effect of bipolar coagulation forceps in tonsillectomy. Methods: One hundred patients were prospectively randomly divided into two groups: the tonsillectomy with bipolar coagulation forceps (TE-bcf) group and the traditional blunt dissection tonsillectomy (TE-trad) group. The surgical duration and intraoperative blood loss were determined. The postoperative pain scale, time of returning to a normal diet, and postoperative complications were also determined. Result: Surgical time was significantly shorter in the TE-bcf group than in the TE-trad group. Intra-operative blood loss was statistically less in the TE-bcf group than in the TE-trad group. The daily pain score was not statistically different between the two groups. Conclusion: TE-bcf offers a better effect than TE-trad does.

Holmium laser in the treatment of laryngeal and tracheal stenosis

WANG Li-yi,HUANG Wei-ning

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  153-154 . 

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Objective： To evaluate the efficacy and feasibility of the holmium laser in the treatment of laryngeal and tracheal stenosis. Methods： Fifteen patients with laryngeal or tracheal stenosis were treated by the holmium laser under a fibrolarygoscope or a self-retaining laryngoscope. Result： Followed up for 2 months to 3 years, all the patients were better. Conclusion： The holmium laser is effective in the treatment of laryngeal and tracheal stenosis.

Polysomnography of obstructive sleep apnea-hypopnea syndrome in different age persons

WANG Wei-zhi,MA Jian-ling,LIU Jie,ZHANG Dai-jie

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  155-157 . 

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Objective: To analyze the characteristics of polysomnography in different age persons with obstructive sleep apnea-hypopnea syndrome. Methods: 32-guide polysomnography was monitored in 72 young, 219 middle-aged and 28 elderly patients with obstructive sleep apnea-hypopnea syndrome, and the results were analyzed by polysmith. Results: Although the apnea hypopnea index (AHI) of the young was highest, of middle-aged patients was second, and of elderly patients was lowest, the sleep constructs of all three groups were similar. Apnea hypopnea inducing arousal index (ArI) and total ArI of the three groups were significantly different（P＜0.05）. Conclusions： Excluding the similar sleep structure disorder, sleep disorder and low blood oxygen are most serious in young patients.

Surgical treatment on pediatric obstruction sleep apnea hypopnea syndrome

CHEN Guan-gui,ZHANG Jian-guo,YAN Xiao-ling,HUANG Min-qi,ZHAN Yi-si

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  158-160 . 

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Objective: To study the clinical features and surgical curative effect of pediatric obstruction sleep apnea hypopnea syndrome(OSAHS). Methods: Thirty-two cases of pediatric OSAHS, diagnosed by overnight polysomnograph (PSG) were given trans-oral endoscopy-assisted adenoidectomy and/or tonsillectomy. Correlation between the relative sizes of adenoid (AN ratio), tonsils （TP ratio ）and apnea hypopnea index(AHI) were analyzed respectively, and parameters in PSG were compared between pre-and post-operation. Results: AN ratio and TP ratio were positively correlated to AHI. There were no acute obstructions in the airway and no post-operative bleeding and infections in any of the cases during peri-operation. Followingup for 12 to 24 months postoperatively, snoring and open-mouth breathing released, and no nasopharyngeal adherence, residual adenoid or eustachian tube dysfunction were found. AI, AHI, the lowest oxygen saturation and the longest time of apnea and hypopnea were improved significantly after the operation. Conclusion: Adenoids and tonsil hypertrophy are major contributions to pediatric OSAHS, and adenoidectomy and/or tonsillectomy are the effective treatments. Trans-oral endoscopy-assisted adenoidectomy has the advantages as good visualization, complete removal and minimal damage.

Microwave treatment on immune in children with tonsillitis

CHEN Zhao-quan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  161-162 . 

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Objective: To investigate the effect of microwave treatment on immune in children with tonsillitis. Method: From March 2002 to November 2004, 23 boys and 17 girls，aged 4 to 6 years, were enrolled in this study. 2ml venous blood was drawn from the ulnar vein before and one month after the treatment. Serum IgA, IgG, and IgMa were determined by immunoturbidimetry. Result: No significant difference was produced between a week before treatment and a month after treatment. Conclusion: Microwave treatment is safe, convenient, and available for children with tonsillitis.

Complications of tracheotomy in children

WU Liu-qing,LIANG Zheng-zhong,TANG Xiang-rong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  163-165 . 

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Objective: To explore the characteristics, reasons for complications and prevention measurement of tracheotomy in children. Method: The clinical data of 136 cases of tracheotomy from 1986 to 2001 were retrospectively analyzed. Results: Complications happened in 19 cases, including bleeding in 6 cases, emphysema in 6 cases, asphyxia during the operations in 2 cases, esophagus injuries in 2 cases, and drops of the tubes during the operations in 3 cases. The frequency was 26.67% in children below 3 years. The frequency was 26.8% for emergent tracheotomy and 26.47% for tracheotomy with a local anaesthesia. Conclusion: Complications in tracheotomy in children are closely related to the age, operative occasion, operative method and nursing.

Re-operation for thyroid cancer

ZHANG Hu,AI Qin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  166-167 . 

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Objective： To explore the factors of reoperation for thyroid carcinoma and to select a proper operative procedure. Methods: Fifteen cases with differentiated thyroid cancer subjected to reoperation were retrospectively analyzed. Results: Of the 15 patients, 12 were operated on twice, and 3 were operated on three times. The residual cancer was found in 60%(9/15) of the patients, that located at the primary site was found in 46.67%(7/15) of them, that transferred to the lymph node was found in 40% (6/15) of them. Conclusion: It is necessary to have a standard to deal with the neck nodular and tumor. Standard lobectomy shoule be done for thyroid tumor, and radical neck dissection should be done for those suspected of having lymph node metastasis.

High negative pressure drainage for chylous fistula after neck dissection

HUANG Yong-jiu,BAO Xue-li,KONG Xu-hui,WU Jiang,MAO Ming-rong,CHU Jiu-sheng,WANG Yu,DONG Pin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  168-170 . 

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Objective: To investigate the therapeutic effect of high negative pressure drainage for chylous fistula after neck dissection. Methods: A total of 245 cases were subjected to neck dissection. Among them, 4 cases produced chylous fistula. Then they were subjected to high negative pressure drainage and local pressure dressing. The maximal production of chylous fistula was about 600 ml/d. Results: The occurrence rate of chylous fistula after neck dissection was 1. 63 %(4/245). After high negative pressure drainage and local pressure dressing, all were cured in two weeks. Conclusion: Early diagnosis and high negative pressure drainage and local pressure dressing for chylous fistula is effective and safe .

High negative pressure drainage for chylous fistula after neck dissection

HUANG Yong-jiu,BAO Xue-li,KONG Xu-hui,WU Jiang,MAO Ming-rong,CHU Jiu-sheng,WANG Yu,DONG Pin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  168-170 . 

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Objective: To investigate the therapeutic effect of high negative pressure drainage for chylous fistula after neck dissection. Methods: A total of 245 cases were subjected to neck dissection. Among them, 4 cases produced chylous fistula. Then they were subjected to high negative pressure drainage and local pressure dressing. The maximal production of chylous fistula was about 600 ml/d. Results: The occurrence rate of chylous fistula after neck dissection was 1. 63 %(4/245). After high negative pressure drainage and local pressure dressing, all were cured in two weeks. Conclusion: Early diagnosis and high negative pressure drainage and local pressure dressing for chylous fistula is effective and safe .

Effect of rigid gas permeable contact lens on keratoconus

HU Ming,LI Zhao-na,LI Yun-jie ,TAO Xiang-chen

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  171-173 . 

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Objective: To evaluate the safety and the orthokeratic effect of longterm wearing of rigid gas permeable contact lens (RGPCL). Methods: A total of 366 eyes with keratoconus were subjected to wear proper RGPCL. Keratometer and corneal topography were used to determine the central cornea astigmatism, apex K value, apex decenteation distance, SRI and SAI before, 12 and 18 months after wearing RGPCL. Results: Of the slight keratoconus group: the above indexes significantly decreased(P＜0.05). Of the moderate group: the above indexes, except for the apex decentration distance significantly decreased at 12 months and more evidently at 18 months. Of the severe group, the K value significantly decreased at 12 months and other figures remained unchanged. However, all the indexes significantly decreased except that the apex decentration distance remained unchanged at 18 months. No corneal complications were found. Conclusion: Long-term wearing of RGPCL is safe and effect for keratoconus.

Secondary suspended intraocular lens implantation after ocular trauma with lens-vitrectomy

ZHANG Jie,XIU Fang-wei,ZHANG Hai-xia

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(2):  174-176 . 

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Objective: To evaluate the effect of secondary suspended intraocular lens implantation after ocular trauma with lens-vitrectomy. Method: Twentyone cases (21eyes) of ocular trauma were subjected to lensvitrectomy, those whose corrected vision was 0.2 or more and intraocular pressure and eyeground were normal were subjected to the secondary suspended intraocular lens implantation 3 to 6 months later. Results: During a followed-up of 1 to 6 months (average 4.5 months), the corrected vision of 6 cases (6 eyes) was up to 0.6 or more, of 10 cases (10 eyes) was up to 0.3 to 0.5, of 4 cases (4 eyes) was between 0.1 to 0.2, and of 1 case was less than 0.1. The postoperative uncorrected vision was significantly higher than the preoperative, but the postoperative corrected vision was not significantly different from the preoperative. Conclusions: Secondary suspended intraocular lens implantation is a reasonable surgery for ocular trauma 3 to 6 months after lens-vitrectomy, but this needs experienced skill and proper cases.