Table of Content

16 June 2008 Volume 22 Issue 3

  

Articles

DNA analysis of the cell cycle in sino-nasal neoplasm

GONG Lei,SUN Jie,XUE Zi-chao,LI Jing-hua,XUE Wei-guo

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  193-195 . 

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To explore the significance of the cell cycle in sino-nasal neoplasm by flow cytometry (FCM). Methods30 cases of paraffin-embedded malignant tumors in nasal cavities or sinuses served as the experimental group and 30 cases of normal mucosa of deflection of the nasal septum as the control group. The DNA index(DI) value and the S-phase fraction(SPF) values were determined by FCM and their correlation was analyzed. ResultsThe DI and SPF values of the experimental group were significantly higher than those of the control group. ConclusionFlow cytometric analysis of DI and SPF plays an important role in diagnosis of sino-nasal neoplasm.

Association of killer cell immunoglobulin-like receptor gene polymorphisms with nasopharyngeal carcinoma

MENG Qing-guo,LU Yong-tian,FAN Xian-liang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  196-199 . 

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To investigate whether the killer cell immunoglobulin-ike receptor (KIR) gene polymorphisms are associated with nasopharyngeal carcinoma(NPC)． Methods43 NPC patients in the Guangdong Han population and 53 randomly ethnically matched healthy controls were enrolled to determine the KIR genotypes by using PCR/SSP． Results 16 KIR genes were identified. Frequencies of KIR 3DL3, 3DL2 and 2DL4 were all 100%． The 2DL2, 2DS1, 2DS3 and 2DS4 gene frequencies were significantly higher in the patient group (P=0.035, 0.002, 0.007 and 0.001) than those in the control group, and the remaining KIR gene frequencies were not statistically different between the two groups． Conclusion There may be an association between pathogenesis of NPC and 2DL2, 2DS1, 2DS3 and 2DS4 genes．

Effect of H-uvulopalatopharyngoplasty on obstructive sleep apnea
hypopnea syndrome

WAN Li-jia,LU Hai-tao,JIANG Yi-dao,LIU Hui,LI Qin,SHE La-zhi

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  204-205 . 

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To investigate the curative effect of peri-operative treatment and H-uvulopalatopharyngoplasty(H-UPPP) on obstructive sleep apnea hypopnea syndrome. Methods41 patients were treated by continuous positive airway pressure for 1 week. Then tonsillectomy and H-UPPP were performed. ResultPSG showed the total response rate was 82.9% on the 6th month post-operatively. All signs were improved or disappeared. ConclusionH-UPPP can effectively improve the symptoms of OSAHS and keeps the physical function of uvula and the basic construction of pharynx and prevents velopharyngeal insufficiency.

Effect of H-UPPP and nasal operations on obstructive sleep apnea syndrome in 38 cases


QIAO Yi,NI Guan-sen,CHEN Wen-wen

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  206-208 . 

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To explore the effect of H-uvulopalatopharyngoplasty (H-UPPP) and nasal cavity aerated and volume extension(NCAVE) in treatment of medium and severe obstructive sleep apnea hypopnea syndrome (OSAHS). Methods38 cases (male 28 and female 10), aging from 24 to 76 years old (average 46.18) were diagnosed by polysomnography (PSG) as medium or severe OSAHS from Jan. 2005 to Sep. 2006 in our hospital. They were semi-randomly divided into groups A and B. BMI, Friedman degree, nasal acoustic reflection and nasal airway resistance were all not statistically different between the two groups. Group A was first treated by H-UPPP and then NCAVE including inferior turbinate bone resection and nasal septal reconstruction, and group B was first treated by NCAVE and then H-UPPP. The tests were rechecked at the end of the 1st or the 6th month after the operations. All parameters were analyzed by software SPSS 10.0. ResultsClinical manifestations such as snoring, suffocating, headache, drowsiness, etc. were apparently mitigated or eliminated in 6 months after the operations. Based on the Hangzhou standard, 7 cases were cured, 27 cases had an effect, and the total response rate was 97.37%. Pre-operative levels of AHI, LSaO2 and AHTI were statistically different from post-operative levels. Nasal acoustic reflection was increased from 10.14±3.54 cm3 to 15.03±3.29 cm3 and nasal airway resistance was decreased from 0.64±0.53 Pa·s/cm3 to 0.20±0.14 Pa·s/cm3 (P＜0.01). Velopharyngeal close insufficiency or atresia was not found.　ConclusionsH-UPPP enlarges pharyngeal left-right and anterior-posterior diameters. Either H-UPPP or NCAVE could improve the AHI, LSaO2 and AHTI levels, however, combined together they can give a better effect.

Expression of ABAD in inner ears and its clinical significance in different age mice

WANG Xiao-feng,LIN Chang,CHENG Jin-mei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  207-211 . 

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To investigate the variance of the ABAD expression in the inner ears of different age mice. MethodsKuming mice were divided into three groups based on the age: two weeks, five months and one year. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to determine the expression of ABAD in different groups. ResultsThe ABAD expression was statistically different in each group. With an increase of age, the expression of ABAD was increased. ConclusionsABAD may take part in the aging of inner ears, and it may have some relation to presbycusis.

Expression of the heat shock protein 27 in rat cochlea induced by sodium salicylate injection by the FQ-PCR technique

FAN Qi-jun,HUANG Zhi-wu,MEI Ling,XIAO Bo-kui

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  212-214 . 

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To investigate the gene expression of HSP27 in the cochlea of rats induced by sodium salicylate injection and to explore its role in sodium salicylate ototoxity. MethodsThe HSP27 gene expression in specimens was determined by using real time RT-PCR with SYBR GREEN I, and β-actin served as the internalcontrol. ResultsThe gene expression of HSP27 in the cochlea of rats induced by sodium salicylate injection was significantly increased compared with normal rats(P＜0.01). ConclusionQuantitative PCR with SYBR GREEN I fluorescence is a reliable method to determine the gene expression of rarely available tissues. Sodium salicylate has an effect on inducing the gene expression of HSP27 in the cochlea of rats.

Age-related spiral ganglion neuron damages and hearing loss in senescence accelerated mice

LIU Qiang-he,LUO Xiang-lin,GENG Wan-ping,CHEN Chen,LEI Xun,LIU Fang-xian,DENG Ming

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  215-217 . 

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To determine age-related spiral ganglion neuron damages and hearing loss in the senescence accelerated mice. MethodsThe auditory thresholds and the morphological changes of the spiral ganglion neurons were studied in senescence accelerated mouse/prone 1 (SAMP 1) mice of 1, 3, 5, 7 and 9 months. Normal aging senescence accelerated mouse/resistance 1 (SAMR 1) mice served as the control group. 8?kHz threshold of auditory brain-stem response was determined, transmission electron microscopy and terminal deoxynucleotidyl transferase(TdT) dUTP nick end labeling(TUNEL) were used to observe the auditory function changes, the morphological changes and the immunohistochemical changes. ResultsAuditory function: Compared with the SAMR 1 mice, SAMP 1 mice of 7 or 9 months developed a progressive hearing loss at 8kHz，which showed an age-related significant increase(P＜0.05). Morphological observation: The SAMR 1 mice had no apoptosis in the spiral ganglion neurons (SGNs), while the SAMP 1 mice of 7 or 9 months developed a significant apoptosis in the SGNs. TUNEL observation: Negative immunohistochemical reaction for TUNEL staining was found in the SGNs in the SAMR 1 mice of 7 months, and a positive reaction was found in the nucleolus of the part of the SGNs of the SAMP 1 mice of 7 months. The image analysis showed that the percentage of positive SGNs of the SAMP 1 mice of 7 months was significantly higher than that of the SAMR 1 mice of 7 months. ConclusionsSAMP 1 mice can be used for investigating mechanism of auditory-function-aging and as a pertinent animal model of presbyacousis.

Measurement of the posterior tympanum and its clinical significance

LIU Yan,LIU Xin-yi,WANG Jin-ping,LI Da-jian

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  218-221 . 

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To measure structures of the posterior tympanum and thus to provide theoretical reference for operation approach related to the middle ear. Methods60 sides of 30 dry temporal bone specimens had their mastoids outlined by an electric drill, and then the related structure of the posterior tympanum was exposed. Distances of the related anatomic structures were determined under surgical microscopy. ResultsDistances between pyramidal eminence and chordal eminence and the facial canal were 3.22±0.41mm and 3.59±0.48mm, and length of the tympanic chorda posterior tubules was 9.44±1.65mm. Distances between pyramid segment of the facial canal and chordal eminence, lateral semicircular canal and posterior semicircular canal were 3.34mm±0.42mm, 1.54±0.25mm and 2.15±0.29mm, respectively. The vertical segment of the facial nerve went down on the convex arc and vertically went down only in 2 cases (3.3±3%). The musculus stapedius all passed through the front wall of the facial nerve. The tympanic chorda nerve came from the facial nerve, outside the canal in 9 cases(15%), from the inferior one-third in 49 cases (81.67%), and from the middle one-third in 2 cases (3.33%). ConclusionWhen the facial recess is opened, distance from the chordal eminence to the pyramid segment and the pyramidal eminence can be regarded as the width of the facial recess. The pyramidal eminence and the facial canal are regarded as the basis for searching for each other. Pyramidal eminence and chordal eminence should not be lowly abraded in order to avoid damaging the musculus stapedius and chorda tympani nerve when dealing with a facial recess lesion.

Blood histamine in guinea pigs with allergic rhinitis

JI Xiao-bin,DENG Jia-de,ZANG Lin-quan,WANG Lei,XIE Jun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  228-230 . 

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To investigate the role of blood histamine in the pathogenesis of allergic rhinitis. MethodsToluene 2,4-diisocyanate was mixed with Florence oil in a concentration of 10%, and then this solution was dropped into the nostrils of animals to induce sensitization. 8 guinea pig models were prepared as allergic rhinitis and 8 normal animals served as the blank controls. The content of blood histamine was determined by the ELASA method after the model was successfully established. ResultsThe content of blood histamine of the model group was statistically higher than that of the control group ［（9.59±1.11）ng/mL vs（7.62±0.96）ng/mL, P＜0.01］. ConclusionAllergic rhinitis was successfully established in guinea pigs by Toluene 2,4-diisocyanate combined with Florence oil. Blood histamine may play an important role in the pathogenesis of allergic inflammation.

Classification and surgical treatment for nasal inverted papilloma

LIN Feng,LIANG Yong,LU Yong-tian,WAN Li-xia

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  231-233 . 

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To investigate the clinical classification of nasal inverted papilloma (NIP) and its role in planning surgery. MethodsFortyseven cases of NIP underwent curative surgeries, and clinical classification was identified by preoperative endoscopy and CT or MRI imaging. All cases were routinely followed up from 1 to 8 years. ResultsRecurrence occurred in 4 patients (4/47, 8.5%). The recurrence rate in type I and type II patients were 7.1% (2/28) and 10.5% (2/19). Recurrence rate in the two times operation group was higher than that in the one time group (27.3% vs 2.8%). ConclusionReda Kamel's classification system based on NIP origin is helpful in planning surgery.

Endoscopic repair for cerebrospinal fluid rhinorrhea in 19 cases and a literature review

XIANG Deng,LU Yong-tian,SUN Huan-ji

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  234-236 . 

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To investigate the leak location, the repair material and method for cerebrospinal fluid rhinorrhea. MethodsThe clinical data of 19 cases were retrospectively analyzed. The fracture occurred in the ethmoid plate in 14 cases, in the ethmoid plate and the contralateral frontal sinus postwall in 1 and in the sphenoid sinus in 4. The leak was 0.8-2.5cm. After packing with a mixture of muscle and biological glue, the fascia was covered and iodoform pledget was filled into the nasal cavity. Results19 cases were successfully operated on, 1 case was subsequent with topical meningitis and 1 with local fungal infection. ConclusionEndoscopic repair for cerebrospinal fluid rhinorrhea is simple and less injurous, has a high success rate and few complications.

Septum corrective treatment for allergic rhinitis

PANG Tai-zhong,LIU Bing, CHENG Liang-jun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  237-238 . 

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To explore the curative effect of nasal septum deviation correction for allergic rhinitis(AR) with septum deviation and to explore its mechanism．Method54 cases in the treatment group were treated with nasal septum deviation correction and 50 cases in the control group were treated by antihistaminic or glucocorticosteroids． ResultFollowed up for one year，the curative response rate in the treatment and control groups was 92.6％ and 84％ (P<0.01). ConclusionSeptum correction is one of the effective methods for AR with septum deviation．

Effects of controlled hypotension at different levels on definition of surgical field and cerebral blood flow

WANG Zong-feng,ZHANG Zhi-li,LI Jian-dong,LI Jian-ge

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  239-241 . 

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To explore the effects of deliberate hypotension at different levels on cerebral blood flow and definition of surgical fields. Methods240 ASA Grade patients were randomly divided into four groups( 60 in each group ): group 1 whose mean arterial pressure(MAP) was 64% of the former, group 2 whose MAP was 70% of the former, group 3 whose MAP was 80% of the former and the control group. Cerebral blood flow during hypotension was determined by transcranial Doppler ultrasonography, meanwhile surgical field quality (SSFQ) scores were assessed based on the Fromme surgical field quality list. ResultHypotesion caused a light decrease in cerebral blood flow velocity (CBFV) but was not significantly different either among three groups or during the procedure. Conclusion64% MAP maintained for 1 hour has no significant effect on cerebral blood flow but gives the best definition of the surgical field.

Endscopic surgery for chronic nasosinusitis and nasal polyps in 180 cases

BAI Guang-ping,LI Jun,DONG Pin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  242-243 . 

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To study the curative effect of endscopic sinus surgery(ESS) in treatment of chronic nasosinusitis and nasal polyps. MethodsThe clinical data of 180 cases subjected to ESS from 2003 to 2005 were retrospectively analyzed. Of them, 12 cases were I type grade 1, 15 were Ⅰ type grade 2, 44 were Ⅰ type grade 3, 30 were Ⅱ type grade 1, 43 were Ⅱ type grade 2, 14 were Ⅱ type grade 3 and 22 were Ⅲ type. ResultsThe curative rate was 94.4% for type I, 74.7% for type Ⅱ and 63.6% for type Ⅲ（P<0.01）. ConclusionsThe curative effect of ESS was successful. ESS is an effective method in the cure of chronic sinusitis and nasal polyps. The curative result is directly related to the type of diseases. Experienced technique is most important for a perfect operation, and after the operations, normative treatment can improve the cure rate.

Sphenoid sinus and trans-sphenoid surgery under nasal endoscopy and microscopy

ZHAO Min,WANG Shou-sen,ZHEN Ze-nian,CHEN Xian-ming,WANG Mao-xin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  244-245 . 

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To explore the method of sphenoid sinus and trans-sphenoid surgery by a direct hemi-nasal approach. MethodsWith nasal endoscopy and microscopy, the middle conchas were moved outside by Hardy′s stretcher, the nasal cavities were broadened, the frontal walls of sphenoid sinus were opened, and the lesions were removed. Results12 cases of simple sphenoid sinusitis had the aperture well opened and then symptoms disappeared. 9 cases had the sphenoid sinus cyst and meningoma removed. 1 case of sphenoid sinus osteoma recovered well. 1 case of traumatic ablepsia received decompression of the optic canal but no recovery was found after the operation. In 33 cases of pituitary adenoma, 18 tumor were totally removed, 12 were sub-totally removed, and 3 were fully removed, and they were all further treated by post-operative X-knife. During a postoperative follow-up of half to 3.5 years, there were no recurrences in cases of sphenoid sinusitis, sphenoid sinus cyst, meningoma or phenoid sinus osteoma. Pituitary adenoma recurred in 3 cases. All cases had no intracranial and nasal complications. ConclusionSphenoid sinus and trans-sphenoid surgeries by a direct hemi-nasal approach with nasal endoscopy and microscopy have advantages of minimal invasion, less time and bleeding, few complications and good effect.

Expression of NSE,S100 and GFAP in retinoblastoma and its clinical significance

WANG Hong-xia,WANG Peng-cheng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  263-264 . 

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To explore the expression of neuron specific enolaes (NSE), S protein(S100) and glial fibrillary acidic protein(GFAP) in retinoblastoma(Rb) and its clinical significance. MethodThe NSE, S100 and GFAP levels were determined in 32 cases of eyeball excision by immunohistochemistry, and the relation between their expressions and tumor differentiation and clinical stage were analyzed. ResultsThe Rb pathological stage was not identical to the clinical stage. The immunohistochemistry results showed that NSE was positive in both differentiated and undifferentiated Rb, S100 and GFAP were negative in undifferentiated Rb, but S100 and GFAP were positive in nerve fibers and nerve glial cells among the high differentiated Rb. ConclusionsCalcification is one of the features of Rb. Tumor necrosis is associated with its differentiation degree. There are positive NSE neuron cells in Rb, and S100 and GFAP double positive nerve glial cells in the high differentiated Rb.

Quality of tear film of adolescence during internet terminal use

WANG Xu,ZHANG Hua,LV Li-ping,CUI Lei,LI Miao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  265-268 . 

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To investigate internet-related factors on quality of tear film in adolescence. MethodsEpidemiological questionnaires were used by 533 young people in 7 net bars in Jinan City. The Schirmer1 test and break -up time (BUT) were determined. Multiple linear regression and stepwise regression were used to analyze the data. Results1. 40% of the males had abnormal Schirmer test results and 21.33% of them occurred in both eyes. 96% of the males had abnormal BUT and 84% of them occurred in both eyes. 57.12% of the females had abnormal Schirmer test results and 85.71% had abnormal BUT, and all occurred on binoculus. 2. 52.81% of them had visual fatigue. 3. The greatest risk factor is time of using the internet. The Schirmer test result was 0.19 and the BUT 0.20. Conclusions1. A long internet terminal use history and long time on net are key reasons for the decrease of tear secretion. 2. Abnormal BUT is common in adolescence during internet terminal use. 3. Internet games and monitors are important factors influencing quality of the tear film. 4. Most female net users have poor quality of tear film on binoculus.

Etiological analysis of paraesthesia pharynx in 405 cases

LOU Zheng-cai,LOU Fang-yi,JIN Zhong-hai

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  271-275 . 

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To explore a method for clinical diagnosis of paraesthesia pharynx. MethodThe clinical data of 405 cases of paraesthesia pharynx were retrospectively analyzed. ResultsOf them, 232 cases had paraesthesia pharynx in a constant site and 173 cases did not; 201 cases had insomnia or multi-dreams, 71 had menstrual disorder, 97 had chest distress,and 129 had digestive tract diseases. After personalized treatment, 270 cases were cured, 101 had an effect and 34 had no effect. The total effective rate was 91.60%. ConclusionDiagnosis of paraesthesia pharynx according to age, location and accompanying symptoms is possible, but the definite pathogeny is still difficult to prove.

Bronchoscopic video supervision system in infant bronchial foreign bodies

HUANG Fang,HUANG Hai-qiong,HUANG Jian-qiang,HE He-fan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  276-277 . 

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To investigate the advantages and feasibility of a bronchoscopic video supervision system in the removal of bronchial foreign bodies in children. Methods3 cases aged from 11 months to 6 years were operated on. Foreign bodies were located in the bronchus in 1 case and in the trachea in 2 cases, and a peanut kernel was found in 2 cases and the plastic cap of a pen was found in 1 case. ResultsAll foreign bodies were successfully taken out. ConclusionsBronchoscopic video supervision system is safe and effective for infant bronchial foreign bodies, and can be used for other diseases of the airway.

Excision of huge epiglottis cysts under MedtrnicXPS3000 in 23 cases

YU Zhi-liang,WANG Wei-wei,WANG Ming-hua

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  278-279 . 

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To explore the effect of MedtrnicXPS3000 in the excision of huge Epiglottis Cysts. Method23 cases, of which 14 cases were suffering from dyspnes in degree I-Ⅱ had their huge epiglottis cysts removed by MedtrnicXPS3000 under local anesthesia. Results23 cases were cured by one operation. No complications were found, and no relapse was found during a followup of 6 months. ConclusionMedtrnicXPS3000 is feasible for the excision of huge epiglottis cysts.

Long-term effect of laser reduction on lingua adenoids



YIN Guo-hua,ZHONG Xiao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  280-282 . 

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To evaluate the long-term effect, surgical complications and safety of semiconductor laser sub-mucosal tunnel tissue reduction in treatment of lingua adenoids. Methods56 patients with lingua adenoids were treated by semiconductor laser sub-mucosal tunnel tissue reduction under local or general anaesthesia. In the operations, 3 to 5 tunnels on lingua hypertrophy were gasified from front to rear by the fiber needle of a semiconductor laser and adenoids surrounding the tunnels were also gasified and curdled to reduce lingua adenoids volume. All patients were followed up from 12 to 50 months (average 23 months). Results Post-operative one month, foreign body sensation at the laryngopharynx and/or obstructive feeling disappeared, and other concomitant symptoms improved. After three months, the lingua tonsil was reduced to the basic tongue level except in 2 cases. By re-operation, the lingua tonsil returned to the size at the third month after 6 to 12 months. In the operations, hemorrhage was less than 5mL. Except for 1 patient who had hypopharynx dryness feeling, all patients had no taste influence, hemorrhage, edema and laryngopharynx obstruction after the operations. ConclusionThe semiconductor laser has advantages of high efficiency and safety in the treatment of lingua adenoids.

Clinical analysis of 21 cases of neck cut injury

LIU Lian-he

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(3):  283-284 . 

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To investigate the treatment method and effect for neck injury. MethodsThe clinical data of 21 cases of neck cut injury from June 2000 to April 2007 were retrospective analyzed. ResultsAll were successfully treated. Followed up for 6 months to 2 years, 3 cases were hoarse, and others had normal pronunciation and swallowing. ConclusionIn the treatment of cut neck injury, if the vital signs are normal, the molding repair surgeries on the throat should be done as soon as possible.