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    16 December 2011 Volume 25 Issue 6
      
    Articles
    Causes and treatment of secondary hemorrhage after Uvulopalatopharyngoplasty  
    ZHAO Xin, ZHANG Qing-quan, WANG Qiang, LIU Zhong-lu
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  1-3. 
    Abstract ( 1763 )   PDF (364KB) ( 1538 )   Save
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    Objective   To discuss the causes and preventive methods of secondary hemorrhage after Uvulopalatopharyngoplasty(UPPP). Methods   476 UPPP procedures ,performed from August 2002 to December 2010, were reviewed according to the Windfuhr J bleeding classification system. Results   26 patients suffered from postoperative bleeding, including 17 cases of secondary bleeding.We found that grade 1 bleeding occurred in 5 cases(1%), grade 2 in 7 cases(1.47%), grade 3 in 2 cases(0.42%), grade 4 in 3 cases(0.63%) and there was no grade 5 bleeding. The causes of secondary hemorrhage included failed suture in the operation, poorly controlled blood pressure, postoperative cough, and wound infection. All patients were cured with proper treatment. Conclusion   According to our findings, it is important to decide surgical hemostatic intervention in time. Preventing secondary postoperative hemorrhage  can be achieved by proper measures.

    Influence of single-staged nasal surgery on postoperative hemorrhage of tonsillectomy and Uvulopalatopharyngoplasty
    WANG Guang-zhi
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  4. 
    Abstract ( 1077 )   PDF (338KB) ( 1389 )   Save
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    Objiective   To evaluate the effects of single-staged nasal surgery on the occurrence of postoperative hemorrhage after tonsillectomy or uvulopalatopharyngoplasty. Methods   Patients admitted in our hospital, from May10, 2005, to October31, 2010, who had undergone single-staged  tonsillectomy/ uvulopalatopharyngoplasty with nasal surgery, were reviewed. Results   In a total of 1012 patients,  the rate of postoperative hemorrhage was 5.5%.  Among the patients, 204 underwent nasal surgery at the same time. No significant difference was found in the hemorrhage rate between the patients with nasal surgery or without nasal surgery(6.0% and 3.9%, respectively; P=0.30). Conclusion   Single-staged nasal surgery does not appear to increase the rate of postoperative hemorrhage in patients undergoing tonsillectomy or UPPPT. This suggests that surgeons can perform single-staged procedures under one-time anesthesia without the risk of increased postoperative hemorrhage.

    Voice acoustic parameters of pre-and post-operation for treating obstructive sleep apnea-hypopnea syndrome in males
    CHEN Xing1, YU Hai-an2, FENG Yong-gang2, ZHU Juan-fen2
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  9. 
    Abstract ( 971 )   PDF (313KB) ( 1150 )   Save
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    Objective    To explore the changes of voice parameters after surgery for  obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods   Voice acoustic parameters of 52 patients with OSAHS who had received surgery were measured by Dr. Speech software. Results   The post-operative F0 and Jitter were not significantly differently(P>0.05), but the post-operative NNE and Shimmer of  “Ji” were significantly differently(P<0.05). Conclusion   Surgery  is no distinctive handicap to the voice function of  patients for  obstructive sleep apnea-hypopnea syndrome (OSAHS). 

    Role of expressions of STAT3,VEGF and micro-vessel density in recurrence and invasiveness of juvenile
    LI Li-hua, REN Ji-hao, YIN Tuan-fang, LIU Wei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  11. 
    Abstract ( 785 )   PDF (1139KB) ( 1106 )   Save
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    Objective   To explore the role of transducer and activator of transcription 3(STAT3) and vascular endothelial growth factor(VEGF) and microvessel density in recurrence and invasiveness of juvenile onset recurrent respiratory papillomatosis (JORRP) and the relationships between them. Methods   Expressions of STAT3 protein and VEGF protein were both detected with immunohistochemical methods in 26 specimens of the invasive group of JORRP and 68 specimens of the non-invasive group of JORRP. CD34 protein was used to mark vessel endothelium cell. Microvessel density was compared according to CD34 protein expression. Results   The positive expression rate of STAT3 protein and VEGF protein were higher in the invasive group than the non-invasive group(P<0.05) and the MVD was also higher(P<0.01).  CD34-MVD of JORRP of positive expression of STAT3 and VEGF were higher than the negative expression group (P<0.01). There were significant positive correlations between STAT3 protein ,VEGF protein and CD34-MVD expression(r=0.747, P< 0.01; r=0.666, P<0.01); expression of STAT3 protein also had a positive correlation with expression of VEGF protein(r=0.464, P<0.01). Conclusions   Higher expressions of STAT3 protein, VEGF protein and higher MVD in the invasive group indicate that STAT3 may play a critical role in invasion andrecurrence of JORRP by promoting angiogenesis.

    Correlation between maspin and p53 proteins in laryngeal carcinoma
    ZOU Ji-dong, XU Wei, L Zheng-hua, CAO Hong-yuan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  16-18. 
    Abstract ( 912 )   PDF (317KB) ( 1162 )   Save
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     Objective   To detect expression of maspin protein and to explore the correlation between maspin and p53 proteins in laryngeal carcinoma, and explore their roles in the development of cancer. Method   Maspin and p53 protein expressions were evaluated in 78 patients with laryngeal squamous cell carcinoma(LSCC) by immunohistochemical staining. Results   LSCC expressed maspin protein in 43/78(55.1%) cases. The depression of maspin protein was related to low cell differentiation and lymph node metastasis. The gross positive expression rate of p53 was 58.9%(46/78). In the maspin-positive LSCC, p53 expression was found in 34/43 cases(79.1%), while among the maspin-negative cases, the p53 expression rate was 34.3%. There was significant difference between the two groups. Spearman rank correlation analysis showed a strong inverse correlation between maspin expression and p53(P<0.05).  Conclusions   Expression of maspin inhibits the development of LSCC. It is inversely correlated with p53, suggesting that maspin is an effector of mutanttype p53.

    Sinonasal neoplasms in children and elderly
    WANG Xiao-ting, SHI Guang-gang, LIU Yi-qing, JI Hong-zhi, HE Ming-qiang, LI Jian-feng, WANG Hai-bo
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  19-22. 
    Abstract ( 1076 )   PDF (342KB) ( 1042 )   Save
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    Objective   To study the clinical and pathological characteristics of sinonasal neoplasms in children and elderly. Methods   A cohort of hospitalized children and old patients confirmed by surgical pathology with sinonasal tumors were enrolled in this study. The characteristics, in terms of gender, origin, disease component ratio and therapeutic methods were reviewed. Results   ① In this series of children, there were 15 males and 15 females and the ratio of benign to malignant tumors was 2.3∶1. 15 neoplasms arose from the nasal cavity and 15 tumors arose from sinus. In the series of elderly patients, there were 53 males and 29 females and the ratio of benign to malignant tumors was 1∶1.2. 49 tumors arose from the nasal cavity, while, 33 neoplasms derived from sinus. ② The disease component ratio of children decreased in order of softtissue, lymphohematopoietic tissue, bone and cartilaginous tissue, ectopic intracranial tumors, and epithelial tissue. The disease component ratio of the elderly decreased in order of epithelial tissue, softtissue, bone and cartilaginous tissue, lymphohematopoietic tissue, and ectopic intracranial tumors. ③ Surgery is the main method for these benign tumors. And comprehensive treatment, in combination with other therapeutic methods, is the main strategy for malignant tumors.  Conclusions   Tumors in children and elderly from different parts of the nasal cavity and paranasal sinus have specific clinical and pathological characteristics. Comprehensive treatment is the main therapeutic method for these tumors.

    Clinical analysis on 37 cases of squamous cell carcinoma of the base of the tongue
    WEI Dong-min, LEI Da-peng, JIN Tong, LIU Da-yu, XU Feng-lei, PAN Xin-liang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  23. 
    Abstract ( 1309 )   PDF (372KB) ( 1395 )   Save
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    Objective   To make a retrospective analysis on 37 cases of squamous cell carcinoma of the base of the tongue, and to explore the surgery operation of squamous cell carcinoma of the base of the tongue, the applied extent of different approaches and functional reconstruction. Methods   From March 1994 to March 2006, a retrospective analysis was performed on 37 cases of tongue root carcinoma in Qilu Hospital of Shandong University.  Results   Neck dissection was performed on 37 cases with a metastasis rate of 64.9%(24/37). 59.5%(22/37)was operated by the latero-pharynx approach. The sternohyoideus fascia muscularis flap and pectoralis major myocutaneous flap were used for functional reconstruction. Post-operative complications occurred in 8 patients. All patients′ swallow function was successfully recovered after postoperative training, and all patients′ linguistic function was successfully recovered expect for 4 cases of trachea cannula. The 3-year and 5-year survival rate was 62.2%(23/37) and 51.4%(19/37) respectively.  Conclusion   Pre-operative examination and the exact assessment of the tumor extent is important, the exact surgical approaches and repair methods can be used to totally remove the tumor, successfully reconstruct the function, and efficiently improve the life quality.

    Therapeutic effects of retroaurcular injection of lidocaine in pure nerve tinnitus
    HONG Yan-li, XU Hai-bo, HUANG Cui-lian
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  30. 
    Abstract ( 2892 )   PDF (325KB) ( 1562 )   Save
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    Objective   To explore the clinical effectiveness in the treatment of pure nerve tinnitus with retroaurcular injection of lidocaine. Methods   64 patients were randomly and evenly divided into the treatment group or the control group. In addition to oral medication, the patients in the treatment group were administered with an retroaurcular injection of 2% lidocaine. Results   The effective rate was 87.50%(28/32) in the treatment group, but 56.25%(18/32) in the control group(P<0.05). Conclusion   Retroaurcular injection of 2% lidocaine can help alleviate nerve tinnitus.

    Mutation analysis of GJB2 in patients with sporadic hearing impairment
    LI Jian-rui1, LIU Tao1, YAN Jiang-wei2, YANG Ya-ran2, WANG Li-wei3
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  33-36. 
    Abstract ( 1233 )   PDF (678KB) ( 1258 )   Save
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    Objective   To investigate the molecular etiology of sporadic hearing impairment by analyzing 235delC  the mutation of the GJB2 in congenital deaf patients in Erdos and Hohhot,Inner Mongolia. Methods   The medical histories of 131 patients with sporadic hearing impairment were collected by a questionnaire survey. The audiological examination was conducted with pure-tone audiometry and acoustic admittance measurement. GJB2 235delC mutation was identified by both  PCR and restriction enzyme ApaI digestion,then the positive samples were tested with direct sequencing. 50 cases of normal Chinese people and 100 cases of normal Canadian people were used for cross reference. Results   131 patients with sporadic hearing impairment were all diagnosed with sensorineural hearing impairment. 4 cases had homozygous deletion C at position 235 (Han 3 cases,Mongoloid 1 case)and 3 cases (Han 2 cases,Mongoloid 1 case) had heterozygous mutation  in 131 patients.  One carrier with the GJB2 235delC mutation was found in 50 cases of normal Chinese people,no 235delC mutation in 100 cases of normal Canadian people. Conclusions   GJB2 235delC mutation is one of the molecular etiologies in sporadic patients with sensorineural hearing loss. GJB2 235delC allelic frequency between Mongoloid and Han ethnic deaf group in Inner Mongolia does not have great diversity. Screening the mutationsof GJB2 235delC gene can identify pathogenesis in sporadic patients with sensorineural hearing loss, and plays an important part in early diagnosis, genetic counseling, prevention and treatment of deafness in sporadic hearing impairment caused by genetic mutation.

    Rabbit′s middle ear approach and its anatomic structure
    WANG Xiao-yan1, YE Qing1, SHEN Fan1, XIE Shu-sen2, ZHANG Xian-zeng2, ZHAN Zhen-lin2
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  37-40. 
    Abstract ( 1422 )   PDF (1253KB) ( 1108 )   Save
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    Objective   To study the surgical approach to middle ears and middle ear structure in rabbits and to provide experimental data for a rabbit model used in otological study. Methods   Eight healthy New Zealand rabbits (sixteen ears) were used in this study. The middle ear surgical approach and the landmarks were studied.  Middle ears of the rabbit were anatomized and observed under a microscope. Results   The retroauricular surgical approach was a fast and better way into a rabbit′s middle ears, but it was important to have a suitable position of the rabbit during the experiment. Some anatomical landmarks such as the facial nerve were useful for fast and correct approaching into middle ears. The rabbit′s middle ear anatomical structures are complex and similar to human′s. Conclusions   The retroauricular surgical approach is the choice of way to a rabbit′s middle ears,and the rabbit has similar anatomic structures with human′s in middle ear, so the rabbit model can be used in otological experiments.

    The therapeutic effect of ganciclovir combined with compound betamethason on herpes zoster oticus and Ramsy-Hunt syndrome(35 cases report)
    QU Tong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  41. 
    Abstract ( 1258 )   PDF (322KB) ( 1698 )   Save
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    Objective   To observe the clinical effect and safety of gahnciclovir combined with compound betamethason in the treatment of herpes zoster oticus and Ramsy-Hunt syndrome. Methods   35 patients with herpes zoster oticus were divided into 2 groups randomly, in which group 1 was treated with intravenously guttae of ganciclovir, oral vitamin B1, injection of mecobalamine and external use of acyclovir, while the group 2 was treated with extra injection of  another 1ml compound betamethason. Results   The therapeutic efficacy of group 2 was better than group 1, without any significant difference in the adverse reactions between the two groups.  Conclusion   Ganciclovir combined with compound betamethason is an effective and safe therapy for herpes zoster oticus.

    Clinical application of negative pressure drainage in ear reconstruction
    BO Lin, SU Fa-ren, DING Jing-hua
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  43. 
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    Objective   To investigate the application method and value of negative pressure drainage in ear reconstruction. Methods   Negative pressure drainage was used in ear reconstruction of 215 cases(225 ears)by soft tissue expander. After operation the amount of fluid from the negative pressure drainage was recorded everyday. All cases were followed-up for three months to two years, and the shape of the reconstructed ears was observed. Results   After expander implantation, hematoma occurred in 8 cases. After the ear reconstruction, hematoma occurred in 11 cases in various degrees. Although 11 cases had different degrees of deformation in constructed ears during follow-up period, the constructed ears in the other 204 cases showed similar size and shape to healthy ones, and the structure of the ear cavity and triangular fossa was clear. Conclusions   Negative pressure drainage is significant to decrease the incidence rate of hematoma and shape the reconstructed ears in ear reconstruction.

    Maxilla surgery by a modified midfacial degloving approach
    LUAN Shao-min1,2, LI Yong-tuan2, WANG Ning-ning2
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  46-48. 
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    Objective   To explore the clinical experience in treating nasal and sinus tumor involved maxilla. Methods   Extirpation of 28 cases of tumors of the maxillary sinus by a modified midfacial degloving approach was studied during the period from 2001 to 2010 at our department. Intra-operative exposure, bleeding and surgical difficulty were observed and post-operative local appearance, functional impairment and prognosis, including the exposure for adequate tumor resection and the preservation of as much as possible functional tissue integrity were compared. Results   28 patients successfully underwent the planned procedures through the midfacial degloving approach for the treatment of the maxilla lesions without significant complications. The patients had immediate post-operative face edema and no infection occurred, but the post-operative deformity was not obvious within 3 to 5 months. Late complications, such as persistent palatal fistula occurred in 3 patients. Nasal crusting in the operative cavity were found with recent surgery effect as clean cut in all patients. About six months after the surgery, a depressed deformity in the face or the nasolabial fold were found. Rhinolalia aperta was also observed among patients with palate removal. Conclusions    The midfacial degloving approach offers good exposure for removal of extended or partial maxilla with excellent cosmetic results. Other advantages such as less operative time, less damnification, quicker recovery, and more function remaining are obvious. The mid-facial degloving technique can be considered as a valuable procedure with low mortality and excellent cosmetic outcome.

    Expression of nerve growth factor and its receptors in human nasal polyps 
    WANG Li-juan1, ZUO Min2, GAO Guo-feng1, ZENG Shao-ming1, ZHANG Wei1, LIU Ming1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  49. 
    Abstract ( 841 )   PDF (1604KB) ( 981 )   Save
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    Objective   To confirm expression of nerve growth factor (NGF) and its receptors in human nasal polyps.  Methods   Expressions of nerve growth factor and its receptors were detected in 20 specimens of nasal polyps and 6 samples of normal inferior turbinates by the ABC immunohistochemical technique.Results   Normal inferior turbinates had no expression of nerve growth factor and its receptors. Expressions of nerve growth factor, which were TrKA in the mucosa and submucosa of nasal polyps were 90%(18/20) and 95%(19/20), and expression of TrKA in the same tissue were also high, but were P75 in cilium cells and in the glands. Conclusion   Nerve growth factor is mainly distributed in the human nasal polyps. High expression of nerve growth factor indicates it may be involved in the development of nasal polyps.

    Endonasal endoscopic orbital decompression: Primary experience of the orbital sling technique
    ZHANG We-tian, CHENG Fu-wei, ZHANG Yu-jun, ZHU Hua-ming, GUO Jin-bao, YIN Shan-kai
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  52. 
    Abstract ( 1261 )   PDF (560KB) ( 1163 )   Save
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    Objective   To evaluate the method and effect of the orbital sling technique in reducing the incidence of diplopia following endoscopic orbital decompression. Methods   Endoscopic orbital decompression was performed on 11 orbits in 5 patients with proptosis from Graves disease and 1 patient from a traumatic case. The orbital sling technique, which tailors a horizontal strip of orbital periosteum, was used to prevent prolapse of the medial rectus muscle. Results   No patients developed new-onset diplopia following the surgery. Of the 2 patients with pre-existing diplopia from the orbitopathy, double vision was improved in both patients and unchanged in the remaining four patients. The mean reduction in proptosis was 3.2mm. Conclusions   The preservation of a periosteum sling overlying the medial rectus muscle during endoscopic orbital decompression may reduce the incidence of post-operative diplopia, while still allowing for a satisfactory reduction in proptosis.

    Rhino-endoscopic secondary surgery after failure
    ZHOU Lu-sheng1, JIANG Shao-hong2, SONG Xi-cheng2, WANG Qiang2, ZHANG Tian-zhen2
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  56. 
    Abstract ( 1317 )   PDF (333KB) ( 1080 )   Save
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    Objective    To discuss the reason of failure of traditional darcryocystorhinostomy and the feasibility of secondary rhino-endoscopic darcryocystorhinostomy surgery. Methods   Fifteen patients (15 eyes) who underwent traditional darcryocystorhinostomy which ended up in failure underwent secondary rhinoendoscopic darcryocystorhinostomy surgery for chronic dacrocystitis, simultaneously deflection of the nasal septum, nasal polyps and sinusitis were treated, and the reasons of the previous failures were analyzed. Results   Out of 15 patients(15 eyes), 10 (eyes) were cured and 5 (eyes) improved, and  dacrocystmucosal accretion of the cavity and too small bone windows were the reason of previous failure. Conclusions   Rhino-endoscopic darcryocystorhinostomy surgery is feasible in case of failure of traditional darcryocystorhinostomy, and mitomycin administration in the operation cavity can help increase the success rate of the surgery.

    Three kinds of medicine in dacryocystorhinostomy
    LIU Cheng, WEI Ping-cun, HU Jin-wang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  58. 
    Abstract ( 877 )   PDF (367KB) ( 1346 )   Save
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    Objective   To assess the efficacy of mitomycin C (MMC), 5-Fluorouracil and sodium hyaluronate in dacryosystorhinostomy (DCR) for chronicity dacryocystisis.Methods   One hundred and fifty-five cases (one hundred and sixty-six eyes) of chronicity dacryocystisis were randomly divided into the mitomycin C group, the 5-Fluorouracil group, the sodium hyaluronate group and the control group. The surgical procedures were exactly the same except that 0.4mg/mL mitomycin C, 50mg/mL 5-Fluorouracil, 10mg/m sodium hyaluronate were used in the three groups, and in the control group, the dacryosystorhinostomy procedures were employed . All the cases were followed up for 12 months. The condition of lacrimal passages was observed, area of orificium fistulae was measured by endoscopes, and the recovery of the nasal cavity was monitored. Results   (1) In the four groups: the recovery rate in test team (43/44 eyes(97.7%) in the mitomycin C group, 35/38 eyes ( 92.1%) in the 5-Fluorouracil group, 40/44 eyes (90.9%) in the sodium hyaluronate group) was obviously higher than that in the control group(35/40 eyes ( 87.5%)) with a statistically significant difference between the test groups and the control group(χ2=5.62, P=0.019; χ2=7.84,P=0.029; χ2=5.78, P=0.016). (2) The difference of area of the orificium fistulae between the test groups and the control group showed statistical significance in 6 months after the operation(F=6.096, P=0.006), but showed no statistical significance in the three test groups(P=0.564). The area of the orificium fistulae between the test groups and the control group showed statistical significance (F=6.162, P=0.002). The area of the orificium fistulae in the mitomycin C group was bigger than that in the 5-Fluorouracil group, and the difference had statistical significance (P=0.022). The area of the orificium fistulae in the mitomycin C group was bigger than the sodium hyaluronate group, and the difference was statistical significance (P=0.034). There was no statistical significance(P=0.719) between the 5-Fluorouracil group and the sodium hyaluronate group. Conclusion   Drugs used in dacryocystorhinostomy can increase the recovery rate, and mitomycin C is better than 5-Fluorouracil and sodium hyaluronate.

    Relationship between size of adenoids and nasal obstruction under a 30°nasal endoscope
    LIANG Hui, WANG Qi-rong, HAN Fei, CUI Zhao-yang, GU Lin-tao
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  62. 
    Abstract ( 1274 )   PDF (432KB) ( 1394 )   Save
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    Objective   To explore the relationship between size of adenoids under a 30° nasal endoscope and degree of the nasal obstruction. Methods   A sample of 197 children undergoing adenoidectomy alone or simultaneously with tonsillectomy was studied. Nasal endoscopy was performed on all cases. According to the new grading system, the relationship between size of adenoids and degree of nasal obstruction was studied. Results   The difference of degree of adenoid hypertrophy in child-patient with different degree nasal obstruction showed statistical significance. Conclusion   The new grade system is reliable and simple.

    Intratympanic Gentamicin through an inserted catheter for Meniere′s disease
    YU Hai-yang, SUN Feng-lin, ZHANG Zeng, WANG Wei-guo
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  64. 
    Abstract ( 1048 )   PDF (327KB) ( 1296 )   Save
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    Objective   To treat meniere′s disease by intratympanic gentamicin through an inserted catheter and to explore its effect. Methods   A catheter was put into the tympanum through an eustachina tube under nasal endoscopic visualization and it was kept for almost one week. Gentamicin was injected after insertion of catheters into the tympanum and oral steroid hormone was used to protect audition. Patients were observed on the first day, the third day, the seventh day and in three months. Results   After injection of gentamicin, vertigo was relieved the next day, and completely relieved within a week while the recurrence rate was extremely low. Conclusion   Most of retrospective experiments have focused on research about the damage effect of gentamicin to the inner ear cells without paying attention to its therapeutic effect. It was found that it is effective to cure meniere′s disease by intratympanic aminoglycosides antibiotics.

    A comparison of two nasal packing materials used in post-operative functional endoscopic sinus surgery
    HE Shou-huan1, SHEN Zhi-hao1, JIN Xiao-jie1,2
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  67. 
    Abstract ( 1065 )   PDF (422KB) ( 1187 )   Save
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    Objective   To compare the effect of digital gauze and calcium alginate used as nasal packing materials in post-operative functional endoscopic sinus surgery (FESS). Methods   60 patients with chronic sinusitis/nasal polyps were randomly divided into two groups, those who had digital gauze or calcium alginate as nasal packing material postoperative FESS, and self-examination questionnaire surveys were applied to all the patients before and after surgery. The questionnaire included pre-operative nasal ventilation score, nasal ventilation score, nasal pain score, headache score, dental pain score, nasal bleeding stopped time, blood loss and body temperature on the day of surgery and one day after the surgery (the day of stuffing removal). By the survey, the effect of digital gauze and calcium alginate was analyzed and compared. Results   There was no significant difference in pre-operative nasal ventilation score between the two groups. On the day of surgery, the nasal ventilation score was significantly different between the two groups; however, nasal pain score, headache score, tooth pain score, nasal bleeding stopped time were not statistically different between the two groups; and nasal bleeding and fever were not found in either of the two groups. One day after the surgery, nasal ventilation score, nasal pain score, headache score, dental pain score, nasal bleeding stopped time had no statistical difference between the two groups; and nasal bleeding and fever were also not found in either of the two groups. Conclusion   As a new nasal packing material used in chronic sinusitis/nasal polyps patients who accepted FESS, digital gauze has the advantage of better nasal ventilation score compared to calcium alginate, and it should be widely used in clinical practice.

    Subjective and objective assessment on chronic rhinosinusitis following adjuvant therapy of nasal inhalation with
     Chinese medicine after endoscopic sinus surgery
    ZHANG Tao, ZHANG Zhi-jun, JIANG Meng-sui,YUAN Bo, LI Chun-fang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  70. 
    Abstract ( 1031 )   PDF (438KB) ( 1368 )   Save
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    Objective   To evaluate the efficacy of nasal inhalation with Chinese medicine in chronic rhinosinusitis(CRS) after endoscopic sinus surgery (ESS). Methods   63 cases of CRS were randomly divided into the treatment group (33 cases) and the control group (30 cases),and all had nasal inhalation following endoscopic sinus surgery(ESS). Bidouyan-oral was used for the treatment group, twice a day, at 8mL, for five consecutive days, and then changed to once a week for 3 months. The control group used saline nasal inhalation, in the same way. Before inhalation, 5 days and 3 months later,  the two groups were assessed in visual analogue scale, Lund-Kennedy score system and Lund-Mackay score system. Results   On subjective symptoms, nasal endoscopy and sinus CT scan to check assessment, the difference between the treatment and control groups were significant. Before and after the spray the difference was also significant in each groups. Conclusion   CRS patients after ESS for adjuvant use of traditional Chinese medicine treatment of inhalation, can significantly improve the surgical effect.

    Clinical analysis of allergic factors and their impact on 165 cases of patients suffering from chronic sinusitis with or without nasal polyps
    LIU Yi-qing, LI Hong, JI Hong-zhi, HE Ming-qiang, SHI Guang-gang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  74. 
    Abstract ( 990 )   PDF (339KB) ( 1366 )   Save
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    Objective   To analyze the clinical significance of allergic factors  in patients suffering from chronic sinusitis with or without nasal polyps. Methods   A cohort of 165 patients suffering from chronic sinusitis was randomly selected in this study, in which 98 belonged to CRSwNP, while the other 67  belonged to CRSsNP. All patients were subjected to skin prick test(SPT), and the positive allergens and their distribution features were compared within the CRS groups with 53 patients complaining of allergic rhinitis symptoms. Also, the infiltrating degrees of eosinophil cells in nasal polyp specimens from CRSwNP were analyzed for allergic history, SPT results and past operation history. Results   There was no statistical significance between CRSwNP and CRSsNP for the rate of positive allergen, whereas,  there existed a significant difference between the CRS and AR′s. On the other hand, the differences of the distribution feature in these three were not significant. The higher the degree of eosinophil infiltration in the local polyps, the higher the positive rate of SPT and the allergic factor history, but with no relationship to patients′ past operation history. Conclusion   Allergicfactors have great impacts on both CRSsNP and CRSwNP. It is necessary  to test their allergic conditions in patients with CRSsNP and CRSwNP, which is helpful for early evaluation, therapy and prognosis of these patients.

    Causes of blindness after vitreoretinal surgery for proliferative diabetic retinopathy
    WANG Shu-ya, HUA Ning, LI Xiao-rong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  77-79. 
    Abstract ( 940 )   PDF (344KB) ( 1059 )   Save
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    Objective   To analyze the risk factors of blindness after vitreoretinal surgery for proliferative diabetic retinopathy (PDR). Methods   A total of 142 eyes of 110 patients undergoing vitrectomy for PDR were followed up. Results   In the 142 eyes with diabetic blindness, 91(64.1%) were improved in visual acuity and postoperative blindness occured in 51(35.9%) . The chief causes of blindness were traction retinal detachment, severe retinal vascular occlusion, optic neuropathy, diffuse macular edema and neovascular glaucoma. Conclusion   The incidence of blindness after vitreoretinal surgery for PDR is high, and early prevention and treatment is important to avoid diabetic blindness.

    Surgical treatment for 5 cases of abnormal lens zonule or lens subluxation caused by refractory glaucoma
    LI Mei, WU Yu-bo, YANG Hai-yan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  83-84. 
    Abstract ( 946 )   PDF (327KB) ( 1192 )   Save
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    Objective   To evaluate the method and timing of surgery for abnormal lens zonule or lens subluxation caused by refractory glaucoma. Methods   The clinical data and treatment were analyzed in 5 cases of abnormal lens zonule or lens subluxation caused by refractory glaucoma. Results   Glaucoma surgery or glaucoma surgery combined with phacoemulsification+intraocular lens +capsular tension ring in the normal quadrant of lens zonule were performed on 5 cases of high intraocular pressure. The intraocular pressure was normal after operation. Correction of visual acuity was improved in all the cases. Conclusions   Primary acute angle-closure glaucoma can lead to abnormal lens subluxation and intraocular pressure; carefully checking lens zonule and choosing the best site and timing are important for prognosis.

    Lower eyelid retractor muscle aponeurosis repair combined with skin and orbicularis muscle excision for senile entropion
    CHEN Jian-hua1,2, CHEN Wei2
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  85. 
    Abstract ( 979 )   PDF (303KB) ( 1427 )   Save
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    Objective   To evaluate the effect of lower eyelid retractor muscle aponeurosis repair combined with skin and orbicularis muscle excision for senile entropion. Methods   64 patients (84 eyes) with senile entropion were divided into two groups. 24 patients (30 eyes) in group A were treated with simple excision of skin and orbicularis muscle, and 40 patients(54 eyes) in group B were treated with lower eyelid retractor muscle aponeurosis repair combined with skin and orbicularis muscle excision. The effect of the two surgical techniques was compared during a 1-2 years follow-up period. Results   All cases were well corrected after stitches were removed 7 days later. Recurrence happened in six cases of group A and one case of group B. Conclusion   Lower eyelid retractor muscle aponeurosis repair combined with skin and orbicularis muscle excision is a good safe method with low recurrent rate in treatment of senile entropion. 

    Clinical analysis of re-operation of 46 children with tracheo-bronchial foreign bodies
    YU De-xian, PI Shi-jun, MA Qing, ZHANG Wen-shan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(6):  89-91. 
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    Objective   To discuss the causes and ways of reoperation for foreign bodies in the trachea and bronchus, and to explore measures to avoid reoperation. Methods   Data of 46 cases, who had been bronchoscopied 2 times for trachea-bronchial foreign body, were reviewed. The causes and ways of reoperations were analyzed, and measures to avoid reoperation were explored. Results   In 46 cases, 16 cases were diagnosed within 24 hours, 9 cases in 1 week, and 21 cases after one week. 12 cases were bonchoscopied immediately they visited doctors because of  difficult respiration,  while 26 cases were bronchoscopied within days, and the other 8 cases were bronchoscopied at a designated time. In 27 cases, foreign bodies were discovered in the trachea and/or bronchus, which were removed during the first operation. However, in 6 cases, foreign bodies failed to be retrieved. Operations were aborted in 3 patients because of the bleeding in the bronchus. There were 10 cases with no foreign body discovered during the first operation. All the first operations were performed by doctors with a Negus bronchoscope. But for the second operations, three methods, including a Negus bronchoscope, fibro-bronchoscope and thoracotomies, were applied. During the second operations, foreign bodies were rediscovered in 36 cases, but not in the other 10 cases. Conclusions   For the cases with foreign body in trachea and/or bronchus, whether the foreign body had been found or not during the first operation, reoperation should be recommended if the foreign body remains suspected. Sufficient preparations can reduce the possibility of reoperation.