Table of Content

16 June 2009 Volume 23 Issue 3

  

Articles

Erectile function in patients with obstructive sleep apnea hypopnea syndrome after operation

WANG De-Sheng, HUANG Jian-Min, LAI Hai-Chun, LI Chen, LIN Shu-Chun, XU Xiang-Na, HONG Yan-Ling

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  1-3. 

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ObjectiveTo explore the role of endothelin(ET)  and nitric oxide (NO) in the pathogenesis of erectile dysfunction (ED) in obstructive sleep apneahypopnea syndrome (OSAHS).   MethodsThe International index oferectile function （IIEF-5）, plasma ET, serum NO and polysomnographic (PSG) parameters in 30 OSAHS patients with accompanied erectile dysfunction and 32 normal erectile OSAHS patients were determined before and after operation.  10 normal subjects served as controls.  Results1. Compared with normal people, the apnea hypopnea index (AHI ) and ET were increased in OSAHS patients with or without ED, while the lowest SaO₂ and NO were decreased （P＜0.01）.  The lowest SaO₂ and NO inOSAHS patients with ED were lower than those in OSAHS patients without ED, AHI in OSAHS patients with ED was higher than that in OSAHS patients without ED （P＜0.05）. There was no significant difference in ET in the two groups（P＞0.05）.2. In OSAHS patients, IIEF-5 positively correlated with the lowest SaO2 and NO and negatively correlated with AHI and  ET （P＜0.05）.  3. In OSAHS patients with ED, AHI and ET were decreased after the operation, while IIEF-5, the lowest SaO₂ and NO were increased after the operation（P＜0.01）. Conclusion   Operation is effective for OSAHSpatients with accompanied erectile dysfunction.  NO may play a role in the pathogenesis of OSAHS-induced erectile dysfunction.

Indole-3-Acetic acids and horseradish peroxidase: the novel Prodrug/Enzyme combination for human nasopharyngeal carcinoma

MIAO Bei-ping, ZHANG Rui-shi, MENG Qing-guo, WANG Xiao-bin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  9-14. 

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Objective To study the ability of the recombinant replication-defective adenovirus vector adv5.oriP.HRP to target the Horseradish Peroxidase (HRP) gene into EBV-positive nasopharyngeal carcinoma cells to confer sensitivity to Indole-3-Acetic Acids (IAA) to the cells, and to investigate the killing ability of HRP/IAA to nasopharyngeal carcinoma cells under oxic and anoxic conditions and the bystander effect.  Methods  C666-1, KS1 and CNE-2Z were incubated with adv5.oriP.HRP, then IAA was added. MTT assay was used to evaluate the cytotoxicity of the suicide gene therapy whether in oxic or anoxic conditions.  Results   When being infected with a recombinant adenovirus carrying the HRP gene， high expression of HRP can be seen in C666-1 cells, which were killed by IAA. However, the infected KS1 and CNE-2Z cells remained resistant to IAA and no HRP protein were found. HRP/IAA can kill EBV-positive C666-1 cells in oxic and anoxic conditions. In addition, a bystander killing effect was demonstrated against C6661 cells when only 20% of the adv5.oriP.HRP-infected cells were mixed with the uninfected cells, and the eradication of cells can almost be achieved. Conclusion  These results demonstrate that the oriP sequence can achieve high levels of gene expression specifically targeted to EBV-positive NPC cells in the context of the adv vector. HRP/IAA is a novel Prodrug/Enzyme Combination for NPC. This has now provided the tumor-specific expression system from which additional interventions can be evaluated in future treatment strategies for patients with nasopharyngeal cancer.

Salpingocatheterism by endoscopy in treatment of secretory otitis media  following radiotherapy in patients with nasopharyngeal carcinoma

LI Jun-zheng,JIANG Dong-xin,CHEN Wei-nan, JIAO Wen-cheng, GAO Xiang　

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  15-16. 

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Objective  To estimate the curative effects of salpingocatheterism by endoscopy for secretory otitis media(SOM) following radiotherapy in patients with nasopharyngeal carcinoma(NPC)． Methods  45 SOM patients(58 ears) with NPC after radiotherapy were treated by salpingocatheterism under nasal endoscopy  and intratympanic application of medicine through the eustachian tubes． Results  In the 45 SOM patients(58 ears)， complete response was found in 42 ears (72.42％)，partial response in 13(22.41％)，and no response in 3(5.17％)． The total efficient rate was 94.83％． Conclusion   Salpingocatheterism is effective and practicable for SOM in patients with NPC after radiotherapy by supporting and enlarging the eustachian tube．

Abnormal expression of PI3Kp85 in nasopharyngeal carcinoma

HUANG Fang, KANG Rui

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  17-20. 

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Objective  To detect expression of PI3Kp85 in nasopharyngeal carcinoma(NPC) and chronic nasopharyngitis and to explore its role in the development of NPC. Methods  An immunohistochemical (streptavidin-perosidase SP) method was used to analyze protein expression of PI3Kp85 in paraffin embedded tissues from 57 cases of nasopharyngeal carcinoma and 20 cases of chronic nasopharyngitis. Average optical density (MOD) of the immunohistochemical Image was determined using ImageProPlus software. Results  The positive rates of PI3Kp85 protein in nasopharyngeal carcinoma tissues and chronic nasopharyngitis tissues were 78.95% and 45.00% (P＜0.05).  Expression of PI3Kp85 had no relation to lymph node metastasis, clinical pathological stage, size of primarily focus and sex and age of patients (P＞0.05). Conclusion   Expression of PI3Kp85 protein  may  relate to the occurrence of nasopharyngeal carcinoma.

Factors affecting pronunciation quality of the Blom-Singer pronunciation tube

ZHU Zhao-feng, WANG Yue-jian, LIANG Yu-yan, CHEN Wei-xiong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  21-22. 

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Objective  To explore relative factors affecting dysphonia of the Blom-Singer pronunciation tube.  Methods  The clinical data of 108 patients who had undergone Blom-Singer voice producing reconstruction following total laryngectomy were retrospectively analyzed. 96 cases received stage Ⅰ Blom-Singer voice producing reconstruction, and the other 12 cases underwent stage Ⅱ Blom-Singer voice producing reconstruction.  Results  22 of 96 cases who had undergone stage Ⅰ Blom-Singer voice producing reconstruction had less effective phonation(22/96, 23%), and 8 of 12 cases who had undergone stage Ⅱ Blom-Singer voice producing reconstruction did not get the expected voice(8/12, 67%), and the total failure rate of the two operative methods was 28%.  Conclusion   The successful rate of stage Ⅰ Blom-Singer voice producing reconstruction was higher than that of the stage Ⅱ Blom-Singer voice producing reconstruction. Effect of voicing quality after the operations was closely related to following factors, such as treatments to the cricopharyngeal muscle,  integrity of the tracheoesophagus wall,  size of the trachea stoma, pharyngeal fistula, stenosis of the esophagus hypo-pharyngeal cavity and pulmonary function of patients.

Nervous system hereditary disease patients combined with auditory neuropathy: a literature review of 4 cases

XUE Fei，JIANG Man-jie，CHENG You，WANG Jin-ling，ZHOU Mei，WANG Qiu-ping，LI Ze-qing

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  25-27. 

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Objective  To analyze the relationship between nervous system diseases and auditory neuropathy (AN). Methods  By a retrospective study, we summarized the clinical signs and results of audiometry and other electrophysiological examinations. ResultsOf the four patients, one was diagnosed as Charcot- Marie-Tooth disease, two as  Friedreich′s ataxia and one as Refsum′s disease. Audiometry of them indicated that they all had auditory neuropathy. Conclusion   Some nervous system diseases can combine with auditory neuropathy. An episode of AN can be early or late during the course of nervous system diseases. AN may be one symptom of other nervous system diseases.

Etiology of accessory auricles in embryos

CHEN Jin-Hua

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  28-29. 

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Objective  To investigate etiology of accessory auricles in the embryos. Method  The proportion of various accessory auricles was calculated. Results   97% of the deformities were near the ear screen,98% of the patients had no other deformities on the jaw,neck and face. 89% of the accessory auricles occurred only on the right or left side of the face. Conclusion  Accessory auricles come from the first gill bow of the human embryos. Most of the patients have no other deformities on the jaw, neck and face. Most of the accessory auricles occur only on the right or left side of the face.

Effects of Bidouqing Heji on morphological changes in maxillary sinus mucosa of rabbits with nasosinusitis

GU Zhen, NING Yun-Gong, LI Yan, LIU Feng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  39-42. 

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Objective  To observe the effects of Bidouqing Heji on the morphology of maxillary sinus mucosa of rabbits with nasosinusitis. Methods  Nasosinusitis models were established by a modified method of Hinni's. Fifty-four rabbits were randomly divided into nine groups: the normal, acute and chronic models, acute and chronic groups with Biyuanshu, and Bidouqing Heji of the low and high dosage groups. Transmission electron microscopy was used to observe morphological changes of maxillary sinus mucosa of each group. ResultsThere was no statistic difference between the Bidouqing Heji of the low dosage group and the normal control group, and between the acute groups and the chronic groups. ConclusionBidouqing Heji could improve the morphological changes of maxillary sinus mucosa of rabbits with nasosinusitis.

Effect of Ambroxol following functional endoscopic sinus surgery

CHEN Jing, QU Ling

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  43. 

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Objective   To investigate the curative effect of mucosolvan after functional endoscopic sinus surgery. Methods   192 patients with chronic sinusitis who had undergone endoscopic sinus surgery were randomly divided into 4 groups: the ambroxol group (ambroxol 30 mg tid, 5 days, after the operations, n=48), the nasal douche group using ambroxol after the operations (n=48), the union treatment group (n=48), and the control group without any treatment (n=48). All cases were followed up for 6 months. Results   Curative effect of the treatment groups was superior to that of the control group, and of the union treatment group was significantly higher than the other two treatment groups. Conclusion   Union treatment has good curative effect for chronic sinusitis and nasal polyps after endoscopic surgery.

Endoscopic surgery for frontal sinus diseases

YOU Jian-Jiang, CHAO Chang-Jiang, WANG Xiao-Ye, QIU Jian-He

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  45-47. 

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Objective   To assess the methods and efficacy of endoscopic surgery for frontal sinus diseases.  Methods   Thirtythree patients（56 cases）with frontal sinus diseases were involved in this study. With the foundation of HRCT, drainage passage and ostium of the frontal sinus were identified and opened through  the landmark of agger nasi cells, the superior attachment of the uncinate process and the anterosupterior basal lamella of the bulla. Results  The ostium of the frontal sinus was identified in all patients without serious complications. All patients were followed up by endoscopy for 3 to 18 months. Among them, 27 cases were cured,21 cases were effective and 8 cases were ineffective. Conclusion   HRCT scan is a  basic landmark for endoscopic surgery to identify the ostium of the frontal sinus. Removing the frontal recess lesions  and keeping  drainage passage of the frontal sinus are key points to cure frontal sinus diseases.

Nasolacrimal duct dilating with mitomycin C for nasolacrimal duct obstruction

QIN Min-An, FENG Mei-Yan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  48-49. 

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Objective   To investigate the efficacy and practicability of through nasolacrimal duct dilating with mitomycin C in treatment of nasolacrimal duct obstruction. Methods  60 patients  were randomly divided into two groups: Group A received mitomycin C and Group B received a silicone stent.After nasolacrimal duct dilating,   mitomycin C was used in Group A, and a silicone stent was retrogradely placed in Group B. Results   Followed up for 6 months, efficacy of the two groups was not significantly different through a Chi square test. Conclusion   Nasolacrimal duct dilating with mitomycin C has similar clinical efficacy with retrograde placement of a silicone stent.  It  has many advantages, such as simple operation, cheap charge, short treatmenttime, small trauma, and quick resumption.

Labiogingival groove approach in treatment of front dearticulation of the cartilage of the nasal septum

LIANG Li-Wei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  50-51. 

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Objective   To introduce a surgical approach to treat front dearticulation of the cartilage of the nasal septum. Methods   All patients with front dearticulation of the cartilage of the nasal septum were corrected through a labiogingival groove approach. A transverse incision of the ectolabium gingival mucous membrane was made, and two sides of the membrane of the septal cartilage were separated, and the dislocated nasal septum was fixed. Results   Nasal cavities of patients were unblocked, and symptoms of rhinocleisis and discharges disappeared. After a follow-up of half a year,  complications such as collapse of the nose tip and perforation of the nasal septum were not found. The curative rate was 100%. Conclusion  It is safe and effective to treat front dearticulation of the cartilage of the nasal septum through a labiogingival groove approach.

Treatment of intractable epistaxis

LI Chuang-Wei, LIN Xin-Qing, TAO Dan-Mian, YANG Chu, YANG Dong-Chao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  52-53. 

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Objective   To discuss  different therapeutic methods of intractable epistaxis.  Method  Among the 224 cases, 50 cases received ligation of the external carotid artery, 35 cases received ligation of the ethmoidal artery, 139 cases were treated under nasal endoscopy, and 3 cases recevied nasopharyngeal packing.  Results  During a followedup of 3 months after management, the recurrent rate of ligation of the external carotid artery was 22%, of ligation of the ethmoidal artery was 17.14%, and of nasal endoscopic surgery was 2.88%. Conclusion   Endoscopy is effective and safe in finding bleeding points and controlling intractable epistaxis.

Helicobacter pylori in throat swabs of patients with chronic pharyngitis under a multifunction microscopy

LI Li-Na, ZHANG Yan-Ping, LIU Jin-Wei, MA Lei, ZHANG Zong-Lin, DENG Hui-Yan, LUO Xiao-Pei, WANG Ya-Ying, ZHOU Feng-Shu

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  60-62. 

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Objective   To explore the helicobacter pylori（HP） distributions by  multifunction microscopy in pharyngeal secretion of patients with chronic pharyngitis. Methods   From September 2005 to December 2007, 295 patients with chronic pharyngitis and 30 controls were subjected to throat swab tests by multifunctional microscopy with 20000 magnification. Assessment was conducted by one professional worker. A Chi-square test was used to explore the statistical significance in terms of the outcome in the two groups. Results   In the chronic pharyngitis group, HP was positive in 229 patients（77.63%，229/295）and negative in 66 ones（22.37%，66/295）. In the control group, HP was found in only 2 individuals（6.67%，2/30）and the rest were negative（93.33%，28/30）. The infective rate of HP was statistically significant between the chronic pharyntitis group and the control group (χ2=6.670，P＜0.05). Conclusions   Helicobacter pylori might be a pathogen of chronic pharyngitis that has been neglected by physicians for a long time. Multifunction microscopy may provide a new method to screen HP in patients with chronic pharyngitis.

Tracheobronchial foreign bodies in 846 children

CUI Yan, LIU Ji-Xiang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  63. 

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Objective  To investigate the  best therapeutic method for removal of foreign bodies in the respiratory tract. Methods   846 cases of foreign body in the respiratory tract were retrospectively analyzed. 827 cases had foreign bodies taken out by bronchoscopy under total intravenous anesthesia, and 19 cases who had severe infections or had pneumothorax or endermic emphysema used antibiotics before the operation. Result  In 842 cases foreign bodies  were successfully taken out by one operation and in 4 cases by two operations.  None had a tracheotomy, thoracotomy or died. Conclusion   Tracheobronchial foreign bodies in children are  more frequent in otolaryngological diseases and should be diagnosed in an early stage.

Postoperative parageusia following self-retaining laryngoscopic operations

LI De-Sheng, LI Gong-Xia

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  65. 

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Objective   To explore causes and prevention of parageusia under self-retaining laryngoscopic operations. Methods   112 cases of self-retaining laryngoscopy in the past  6 years were retrospectively reviewed. Causes, prevention and treatment of 5 cases were analyzed. Results  Compression of the corpora linguae and radices linguae by a self-retaining laryngoscope might be the main cause of post-operative parageusia, 4 cases of tongue numbness were cured within 2 weeks, and 1 case of tongue deviation recovered in 5 weeks after prompt treatments. Conclusion   Improvement of operative skills， careful protection during the operations and avoidance of unnecessary injuries may reduce postoperative parageusia． Once parageusia has occurred， prompt and rational treatments can reverse parageusia without consequences.

Minimized retinal surgery for primary rhegmatogenous retinal detachment

SUN Xian-Yong, HUANG Xu-Dong, HUANG Jing, XU Xin-Yan, LOU Hua-Dong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  72-74. 

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Objective  To evaluate the clinical effect of the minimized retinal surgery: buckling and cryocoagulation with nondrainage. Methods  145 patients with rhegmatogenous retinal detachment accepted buckling and cryocoagulation surgery. Results  138 eyes got reattachment of the retina at the first time, and the achievement ratio was 95.2%. In 7 eyes of failure，6 got reattachment of the retina by minimized retinal surgery, and 1 by vitrectomy. Subretinal fluid of 102 eyes was completely absorbed on the first day of postoperation, 30 eyes in 2 to 3 days, 4 eyes in 3 to 7 days, and 2 eyes in more than 15 days. Followedup for 3 months, all the patients got a better visual acuity and none got serious complications such as superchoroid hemorrhage and infection. Conclusion   Minimized retinal surgery is a better way to treat most rhegmatogenous retinal detachments because of short operation time, low cost, light reaction and better visual function recovery.

Model establishment of optic nerve decompression surgery in cats

DING Jian, YANG Hua, ZHANG Nian-Kai

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  75. 

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Objective   To establish an experimental cat model of optic nerve damage and optic nerve decompression similar to traumatic optic neuropathy by a transnasal endoscopic approach. Methods  The sphenoidal sinus was opened and then fracture of the optic canal was made by transnasal endoscopy with a hammer in 20 domestic cats, and optic nerve decompression was made 8 hours later.  Photo-visual evoked potential (P-VEP) was made at anterior and posterior optic nerve injuries. Results   Fracture of the optic canal was observed by transnasal endoscopy while being damaged. P-VEP showed that the incubation period was lengthened after optic nerve damage,  and the amplitude was reduced. Incubation and amplitude of P-VEP after optic nerve decompression recovered in various degrees in 70% of the domestic cats.  Conclusions   The animal model has close biological characteristics to traumatic optic neuropathy of humans, and it is an ideal model to study optic nerve damage and decompression.

Prognosis of vitrectomy for advanced stage proliferative diabetic retinopathy

ZHANG Chen-Ming, WANG Yu, WANG Jian-Rong, GUO Bai-Ling, HU Chao-Xian

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2009, 23(3):  77-79. 

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Objective   To evaluate vitreoretinal surgery in the treatment of advanced stage diabetic retinopathy (PDR) from related clinical results. Methods   The clinical data of 60 cases, 72 eyes of 6 (out of the whole retina) PDR who had undergone vitreoretinal surgery were retrospectively analyzed. All eyes underwent vitrectomy surgery in combination with or without removal of the crystal and were injected with inert gas or silicone oil. OCT macular surgery was performed in all during a one-year follow-up. Results   42 eyes  successfully had the retina reset  by one operation, and 30 were failures. Vision that lost its sense was found in 3 eyes post-operatively and none pre-operatively, light perception was in 18 eyes post-operatively and 42 pre-operatively, manual was in 26 eyes post-operatively and 21 pre-operatively, number / 10cm～ 0.1 was in 20 eyes post-operatively and 9 pre-operatively, and ≥ 0.1 in 5 eyes post-operatively and none pre-operatively. Conclusion  Vitreoretinal surgery is difficult to  perform with a high rate of anatomic reduction, but a poor functional recovery rate for late PDR with a macular area.