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    16 February 2012 Volume 26 Issue 1
      
    Articles
    One-stage surgical approach on obstructive sleep apnea hypopnea syndrome with triple plane obstructions
    CAI Qian, ZOU Hua, GUAN Zhong, ZHENG Yi qing, LIU Xiang, HUANG Xiao ming
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  1-3. 
    Abstract ( 1043 )   PDF (1068KB) ( 1080 )   Save
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    Objective   To investigate the effectiveness of one-stage surgical approach on OSAHS (obstructive sleep apnea hypopnea syndrome) with triple plane obstructions. Methods   Thirty-five OSAHS patients (male 32, female 3; age range 39±7 ys; BMI 27.5±2.3kg/m2; moderate 9, severe 26) with stenosis in nasal cavity, oropharynx and lingual root were treated in the Second Affiliated Hospital of Sun Yat-sen University between Sept. 2006 and Jan. 2010. They underwent uvulopalatopharyngoplasty (UPPP), combined with radiofrequency ablation of inferior nasal concha and lingual root. Nasopharyngeal tube was planted postoperatively for 24 to 48 hs. Results   Among the 35 patients, 8 (22.9%) patients presented discomfortableness. Nasal  backflow appeared five days after the surgery in one (2.9%) patient, but recovered after the tissue edema eliminated by oropharyngeal atomization treatment. One (2.9%) patient suffered from hypogeusia and six (17.1%) presented slight pharyngeal dryness, foreign body sensation, or sore throat. No blurred speaking or difficult swallowing occurred.  No death or other serious complications appeared. Postoperative review showed the cure were achieved in 5 cases, excellent effect in 13, effect in 8, and no effect in 9. The total effective rate was 74.3% (26/35). Effective rate of short-term and longgerm followup were 81.3% and 68.4%, respectively. Conclusion   Radiofrequency ablation combined with UPPP is safe and effective in treating OSAHS with triple plane obstructions.

    Multilevel surgery of upper airway for adults with obstructive sleep apnea-hypopnea syndrome
    YAN Zhi-qiang1,2, SUN Jian-jun1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  4-8. 
    Abstract ( 1055 )   PDF (1008KB) ( 1049 )   Save
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    Hypoxemia and hypercapnia occur frequently in the adults with obstructive sleep apnea-hypopnea syndrome(OSAHS) during sleep, leading to progressive impairments of multiple systems and organs.In addition to nasal continuous positive airway pressure(nCPAP), surgical treatment for OSAHS is an important means so far. Nasal, nasopharyngeal, oropharyngeal and hypopharyngeal obstruction, acting alone or in combination,are frequently identified as the causes of OSAHS.To improve efficacy, it is vital to make a individual plan for every patient according to the sites of obstruction. This article reviews the history of surgical treatment, clinical classification and surgical efficacy on the basis of the sites of obstruction and surgical plans.

    Establishment of OSAHS peri-operative monitoring system
    SUN Yan-qing, ZHANG Qing-quan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  9-11. 
    Abstract ( 1190 )   PDF (1047KB) ( 1355 )   Save
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    Objective    To explore the significance of perioperative monitoring system in the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods    One hundred OSAHS patients were divided into group A and group B, in which the patients in group A did not receive the systematic perioperative treatment, while the patients in group B received the treatment. The perioperative monitoring system included mainly the following: physical examination before the surgery, doctors′ consultation from different departments, determination of the obstruction by imaging studies and PSG monitoring, 3-5 days positive airway pressure treatment, tracheastomy if necessary, deep anesthesia/intensified anesthetic care, ICU monitoring after the surgery, special care at the ward, and post-discharg healthy education. The incidence of the complications was retrospectively analyzed. Results   In group A, one patient died. The complictions consisted of ten postoperative primary pharyngeal hemorrhage, ten secondary hemorrhage, two tracheal obstruction, and two tracheastomy. In group B,  there was no complication in all the 50 patients. No severe cardiovascular complication ever occurred in either group. The incidence of complications in group B was significantly lower than that in group A (P<0.05). Conclusions   The perioperative monitoring system can obviously enhance patients′ tolerance to the operation/anesthesia, strengthen the treatment, and reduce the operative risks  in the patients with OSAHS.

    Complications and treatment of UPPP
    ZHANG Hua, ZHANG Qing-quan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  12-14. 
    Abstract ( 2123 )   PDF (983KB) ( 3488 )   Save
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    Determination and analyse of  serum osteocalcin and bone age in children with obstructive sleep apnea hypopnea syndrome
    LI Wen-li, FENG Hui-wei, ZHANG Hui, ZHANG Hai-ling, ZHANG Hong-ping, FAN Xian-liang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  15-18. 
    Abstract ( 1295 )   PDF (1003KB) ( 1217 )   Save
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    Objective   To study the influence of obstructive sleep apnea hypopnea syndrome on children′s growth, especially on their bone growth, by the determinations and analyses of  serum osteocalcin level and bone age,  including height, weight and other parameters. Methods   29 children,  diagnosed as OSAHS according to their history, physical examination and polysomnography, were enrolled in the experimental group and the other 13 children without sleeping snoring and dyspnoea were enrolled into the control group.  Anteroposterior (AP) Xray film was taken on the left wrist to assess the bone age, and the serum osteocalcin was measured in a fasting blood sample. Meanwhile, the height and weight data of children were measured. Results   The bone age in the experimental and control group were 6.31+1.12, and 6.45+1.57 years, respectively (t=0.15, P>0.05). The Dvalues in the bone age and the real age for the two groups showed a significant difference (t=8.07, P<0.05). The serum osteocalcin was 7.41+0.31μg/L in experimental group, and 10.22+0.50μg/L in the control group (t=10.17, P<0.05). Conclusion   Compared with the controls, the bone age of children with OSAHS was lower and the serum osteocalcin level was decreased, which indicates that OSAHS probably exerts influence on the bone growth.

    Correlation between blood trace element and obstructive sleep apnea hypopnea syndrome in children
    WANG Bo-tao, HOU Jin, ZHANG Xiang-hong, ZHU Kang, LIANG Jian-min
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  19-21. 
    Abstract ( 1043 )   PDF (995KB) ( 1231 )   Save
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    Objective   To determine the changes of blood trace element levels in children suffering obstructive sleep apnea hypopnea syndrome (OSAHS). Methods   65 children aged 3-14 years with OSAHS were selected as the OSAHS group, and 43 children of similar age without OSAHS (excluded any other diseases that could result growth retardation or hypoxemia) were chosen as the control group. The plasma concentration of copper,zinc,iron,calcium and magnesium were measured by flame atomic absorption spectrophotometry. Results   Statistical analysis was conducted and the results were as follows: the plasma concentration of copper in the OSAHS group were higher than in the control group(P<0.01), while the zinc and calcium levels in serum of the adenoid hypertrophy group were lower than the control group(P<0.01). No significant difference was found between the iron and magnesium level(P>0.05). Conclusion   In the children with OSAHS, the plasma concentrations of copper, zinc and calcium have changed, while iron and magnesium levels do not.

    Data collection and preservation of hereditary hearing impairment in pedigree populations
    WANG Li-wei1,3, CAO Shi-feng2, LI Ling-xiang1, LIU Tao3, FU Chun-hua3, LI Jian-rui1,3. 1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  22-25. 
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    Objectives   To offer experiences for  collection and storage of genetic information via analyzing the methods for hereditary hearing loss family pedigree. Methods   We collected the pedigrees of deafness from Disabled Federation at all levels, special school, outpatient department of  E.N.T.  and other channels. To the members of these families, we performed questionnaire survey,specialized examination,pedigree tree plotting. On the basis of informed consent, we collected peripheral blood samples, extracted the genomic DNA and established the digital management model for these data. Results   We collected 40 hereditary pedigrees and obtained their detailed clinical information, audiometry data,blood samples and genomic DNA. We also systemically sorted out and stored electronic and printed version of these data with digital management. Conclusion   Hereditary hearing loss is diverse and heterogeneous. However, there has been a decreasing tendency in pedigrees resources. It is of great urgency to coordinate and utilize multidisciplinary approaches for data collection and storage.

    Tregs and lymphocyte subpopulations in the acute secretory otitis media patients.
    LIU Zhen1, WANG Yue-Jian1, XIAO Ping2. 1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  26-28. 
    Abstract ( 1310 )   PDF (1357KB) ( 1726 )   Save
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    Objective   To investigate the changes of Tregs and lymphocyte subpopulations in the peripheral blood of the patients with SOM (secretory otitis media),  and explore the influence of immunological status on the development of SOM.  Methods   Peripheral blood samples of thirtynine patients and thirty healthy donors were prepared. The percent of CD4+CD25+、CD3+、CD4+、CD8+、NK、B lymphocyte and the ratio of CD4+/CD8+ were  analyzed by tricolour flow cytometry. Results   The percentage of CD3+CD8+、NK in the patients group was lower than that of the control group(P<0.05);The percentage of  CD4+/CD8+、B lymphocyte was  higher than that of the control group. The percentage of Tregs in the patient  and  control group were (12.82±4.56)% and (6.695±1.09)%, respectively(P<0.05). There were no significant differences in the number of  CD3+、CD3+CD4+、CD3+CD8+T lymphocyte and the percentage of  CD3+、CD4+ T lymphocyte. Conclusion   The ratio of CD4+/CD8+ in the SOM patients is significantly lower than that of the healthy and the ratio of Tregs is higher, which implies that immune imbalance existes in the acute secretory otitis media patients.

    Intratympanic dexamethasone injections through pharyngotympanic tube for sudden sensorineural hearing loss
    WU Yun-gang, LI Xiao-yu, PANG Tai-zhong, GAO Fu-ping, LI Shan, WANG Cai-hua, ZHANG Hui, HUANG Meng-meng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  29-30. 
    Abstract ( 1632 )   PDF (1930KB) ( 1447 )   Save
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    Objective   To investigate the efficacy of intratympanic dexamethasone injection through the  pharyngotympanic tube (PTIDI)for 20 patients with sudden sensorineural hearing loss(SSNHL). Methods   Deamethasone(5mg) was injected into the middle ear through the pharyngotympanic tube for 20 patients of SSNHL sensorneural hearing loss. The medication was repeated every day until a total of 7-10 doses(3550mg) was reached. Results   The 20 patients were followed up for two weeks. One (5%) recovered completely, Three (15%) demonstrated a 32dBHL improvement in PTA, and 11 (55%) showed no response. Conclusions   PTIDI is a simple and effective treatment for SSNHL. It can be applied to the patients who failed to respond to conventional treatment and can avoided the side effects followed  by highdosage systemic corticostemid treatment.

    Singlestage reconstruction of large alar full thickness defect with the combination of island forehead flap and nasolabial flaps
    ZHANG Wei-tian1, GUAN Jian1, CHENG Fu-wei1, ZHANG Yu-jun1, ZHU Hua-ming1, GUO Jin-bao2, YIN Shan-kai1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  31-34. 
    Abstract ( 1301 )   PDF (991KB) ( 1893 )   Save
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    Objective   To discuss the methods and effects of large alar full-thickness defects reconstruction with combined application of island forehead flap and nasolabial flaps. Methods   We retrospectively reviewed the clinical and followup data in 4 patients who underwent singlestage reconstruction of large alar full-thickness defects with combined application of island forehead flaps and 2 nasolabial flaps from January 2008 to January 2011. All patients were male and the patients′ age ranged from 62 to 76 years, the mean age was 64 years, of which 3 cases of defects resulted from resection of skin malignant tumor (basal cell carcinoma in 2 cases, and acanthoma canceration in 1 case) and traumatic defect in 1 case.  The average diameter of defects was 3.3 cm (2.5-4.5cm).  Defects involved two subunits (tip + alar) in one case, three subunits (alar + tip+ nasal lateral side) in one case and four subunits (tip + alar + lateral side + dorsal) in 2cases. All patients had been excluded the risk factors of peripheral vascular disease. The first step, a trapezoidal flap of the medial nasolabial sulcus based on piriform aperture was harvested and turned into the nasal cavity to reconstruct the lining. Then the triangle flap of the lateral nasolabial sulcus was raised on a subcutaneous pedicle and was medially moved and sutured around the alar region. The third step, an island forehead flap, based on the subcutaneous pedicle containing the supratrochlear artery and the parallel terminal angular artery, was harvested and inferiorly transferred through the glabella subcutaneous tunnel to cover the nasal skin defect. Results   All defects were successfully repaired. All tissue flaps survived and the scar was not conspicuous. One patient had nostril stenosis with mild nasal congestion complain after the postoperatively 6th month. There was no tumor recurrence during 6 months to 3 year follow-up.   Conclusions   In select cases, the paramedian island forehead flap in combination with two nasolabial flaps can be safely used and is an effectively method to repair the large alar full thickness defect.

    Endoscopic ligation of the sphenopalatine artery in posterior epistaxis
    NI Ling-da, ZHANG Yu-jun, ZHU Hua-ming,YU Dong-zhen, SU Kai-ming
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  35-37. 
    Abstract ( 1560 )   PDF (979KB) ( 1422 )   Save
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    Objective   To evaluate the efficacy of endoscopic ligation of the sphenopalatine artery in the treatment of severe posterior epistaxis. Method   25 patients were hospitalized for the treatment of severe posterior epistaxis, in whom posterior nasal packing was not effective. Endoscopic ligations of the sphenopalatine artery were performed under general anesthesia in 24 patients and local anesthesia in 1. Results   In the procedure, all the sphenopalatine arteries were successfully identified and ligated as the artery leaves the sphenopalatine foramen. After surgery, 22 patients were successfully controlled without any bleeding. Recurrent epistaxis occurred in one patient after 6 hours after surgery and was successfully treated with posterior nasal packing and discharged after two days. Two patients suffered minor late epistaxis only requiring medical treatment. There were no further bleedings in all patients after 3 to 6 months followup. No complications were found except slight intranasal adhesion in 2 patients. Conclusion   Endoscopic ligation of the sphenopalatine artery is a safe and an effective surgical treatment for patients with severe posterior epistaxis.

    Influence of controlled-release formulations in maxillary sinus for chronic sinusitis
    CHEN Zhi-peng1, WANG Qi-rong1, CUI Zhao-yang1, CHEN Hai-xia3
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  38-40. 
    Abstract ( 873 )   PDF (1169KB) ( 1293 )   Save
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    Objective   To study the implantation of controlled release formulations of erythromycin treatment of maxillary sinusitis in clinical efficacy. Methods    Controlledrelease formulations of erythromycin were implanted in the maxillary sinus by nasal antrostomy of inferior nasal meatus under endoscopy.  Result   48 sides were detected erythromycin from human nasal secretions after 21 days, and 45 sides reached standards of clinical cure. Conclusion   Clinical application of controlled-release formulations of erythromycin can reduce or stop oral or intravenous drug use, reduce the frequency of postoperative dressing, also reduces the suffering of patients.

    Expression and significance of Tiam1 and MTA1in human laryngeal squamous cell carcinoma
    WU Gui-qing1, TIAN Jun2, SUN Jing1, CHEN Qi1. 1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  41-43. 
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    Objective   To observe the expression of Tiam1 and MTA1 in human laryngeal squamous cell carcinoma and its relationships with clinical-pathological features. Methods   The expression of Tiam1 and MTA1 in 46 human laryngeal squamous cell carcinoma (group A) and 10 tumor-adjacent normal larynx tissue (group B) were detected by immunohistochemistry. Results   The expression of Tiam1 and MTA1 was higher in group A than that in group B (P<0.01). Expression of Tiam1 was correlated with clinical staging, lymph node metastasis, but not age, sex or pathologic staging. Expression of MTA1 was correlated with clinical staging, lymph node metastasis and pathologic staging, but not age or sex. The expression of Tiam1 was positively correlated to that of MTA1 in group A . Conclusions   Tiam1 and MTA1 may be correlated with invasion and metastasis of laryngeal carcinoma,  and it is useful for diagnosis, treatment and prognosis.

    Diagnosis and treatment of micro-thyroid cancer
    SUN Zhen-feng, ZHANG Jia, XU Hong-ming, WANG Guo, DONG Pin
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  44-45. 
    Abstract ( 1418 )   PDF (1979KB) ( 1408 )   Save
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    Objective   To explore the ways to determine the diagnose of  micro-thyroid cancer. Method   The clinic data of 136 cases, confirmed as  micro-thyroid cancer, were analysed .The related symptoms and highly sensitive examinations, as well as the treatmemt of micro-thyroid cancer,  were reviewd.  Results   There were 46 cases of Globus pharyngeus in 136 cases(46/136). All cases were examined by High-resolution thyroid ultrasound, in which the mass with small calcium bits were identified. All cases underwent  the surgery treatment and followed up for more than 1 year. No one recurred. Conclusion   Globus pharyngeus may be related with micro-thyroid cancer. High-resolution thyroid ultrasound is an important means to identify micro-thyroid cancer. Early surgeyy is the key for the successful treatment.

    Carbon dioxide laser to treat epiglottic cyst in patients
    WANG Jun, MA Li, GAO Gang, YANG Ju-fang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  46-47. 
    Abstract ( 1592 )   PDF (971KB) ( 1692 )   Save
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    Objective   To investigate the clinical value of carbon dioxide (CO2) laser in the treatment of epiglottic cyst in laryngeal micro-surgery. Methods   42 cases of epiglottic cysts were removed under microscope with CO2 laser. The  curative effects were evaluated by  electronic laryngoscopy 3 to 6 months after the surgery. Results   All 42 patients were cured, with the cure rate at 100%. Conclusion   CO2 laser-assisted microsurgery of  epiglottic cyst shows reliable curative effect, with no recurrence and few complications.

    Clinical analysis of 36 patients with laryngeal tuberculosis
    LIN Qing-qiang, CHEN Miao-an, CAI Zhi-liang, WEN Han-guang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  48-49. 
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    Objective   To explore the clinical symptoms of laryngeal tuberculosis and key points for the diagnosis. Method   Clinical data of 36 cases of laryngeal tuberculosis were reviewed. Result    In the total 36 patients, the chief symptoms consisted of hoarseness, sore throat, dryness, foreign body sensation, etc. Few accompanied with such symptoms as low-grade fever or night sweatand malnutrition. The primary misdiagnosis was very common. All patients were administered with anti-TB treatment once the diagnosis was confiremed and the treatment outcomes were satisfying. Conclusion   Compared with the similiar patients in the past, the local symptoms of 36 patients were apparent, however, the systemic symptoms were not typical, which could easily lead to the misdiagnosis. The diagnosis depends mainly on the history of illness, chest X-ray,PPD examination,sputum smears, laryngoscopy, etc. Pathological examination is much useful for hyperplastic laryngeal tuberculosis.

    Nasal packing with multi-material combinations following nasal septum surgery
    ZHANG Tao, ZHANG Zhi-jun, JIANG Meng-sui, ZHANG Jun-jun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  50-52. 
    Abstract ( 1190 )   PDF (1129KB) ( 1061 )   Save
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    Objective   To evaluate the clinical effectiveness of nasal packing with combination of multi-material for cases received nasal septum surgery. Methods   Retrospective analysis of 105 cases of multi-material nasal packing patients (the treatment group) and 124 patients with conventional packing patients (the control group) was taken effect. Subjective symptoms, complications and pathophysiological changes in nasal packing periods after nasal septum surgery were compared. Results   Multi-material nasal packing significantly eliminated or reduced the adverse reactions of nasal packing. Conclusion   Multi-material nasal packing is an ideal method following nasal septum surgery.

    Absorbable hemostatic gauze in treating child epistaxis of the anterior nasal septum
    LI Da-jian, LIU Yan, ZHANG En-dong, LIU Xin-yi
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  53-54. 
    Abstract ( 1591 )   PDF (979KB) ( 1833 )   Save
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    Objective   To evaluate the curative effect of absorbable hemostatic gauze in treating the child epistaxis of anterior nasal septum. Methods   261 cases of child epistaxis in anterior nasal septum were treated and analyzed, of which 127 cases were treated with 30% silver nitrate from March 2006 to September 2007 and 134 cases were treated with absorbable hemostatic gauze from September 2007 to March 2010. Results   124 cases were effective in the absorbable hemostatic gauze group with an effective rate 92.5%; 110 cases were effective in the 30% silver nitrate group with an effective rate 86.6%; there was no significant difference between the two groups(P>0.05). The most children in the silver nitrate group showed symptoms of rhinodynia, rhinocnesmus and/or sneezing while few children showed the above symptoms in the absorbable hemostatic gauze group. There was significant difference between the two groups(P<0.05). There was no serious compliance such as perforation of nasal septum in the both groups. Conclusion   Absorbable hemostatic gauze is effective, safe, simple, and convenient For child epistaxis of anterior nasal septum.

    Follicular Dendritic Cell Sarcoma of Tonsil: a case report and review
    CAI Zhi, ZHENG Shi-xin, GAO Chong-yang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  55-57. 
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    Objective   To investigate the clinical and pathologic characteristics of follicular dendritic cell sarcoma (FDCS) of tonsil to improve the diagnosis and treatment. Methods   The histopathological, immunohistochemical, clinical characteristics and treatment of a tonsil FDCS case was reviewed. One year after the extended tonsillectomy, the FDCS recurred and were further treated with radical neck dissection and postoperative radiotherapy. Related literature were reviewed. Results   The patient were followed up for 5 years without recurrence and lost function. Conclusions   The FDCS of tonsil is rare and often misdiagnosed  The diagnosis is based on the histopathology and immunohistochemistry. Recurrence were reported after the surgery. We recommend the primary treatment of FDCS of tonsil is surgery. Postoperative radiotherapy can be performed depending on the tumor extension and size.

    Comparison of different methods in the treatment of adult secretory otitis media (86 cases report)
    SUN Li-hua2, ZHAO Xin-tao2.
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  58-59. 
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    Objective   To explore and evaluate the efficacy of different treatments in adult secretory otitis media (SOM). Method   The 86 adult SOM patients(92 ears)were divided into two groups randomly. We used an integrated approach for 46 patietns in the experiment group, including oral cefetamet pivoxil hydrchloride tablets, glucocorticoids, Myrtol Standardized, 1% ephedrine furacilline solution nasal drops, tympanic drainning with the injection of dexamethasone plus ɑ-chymotrypsin, and eustachian tube insufflation. The control group,in which 40 patients (43ears) enrolled, was treated with conventional therapy, such as oral cephalexin,glucocorticoids,Myrtol Standardized, 1% ephedrine furacilline solution nasal drops, paracentesis treatment of tympanum. Results   Total efficiency of the experiment group was 98%, while that of the control was 81.4%  (P<0.05). There was no adverse reaction in both groups. Conclusion   Comprehensive treatment of adult SOM effect is significant, which is worth promotion.

    Clinical application of canal Wall reconstruction with homograft cortical bone plate in canal wall down tympanoplasty
    MA Zhe, XI Gu-ping, ZHANG She-jiang, CAI AI-jun, HAO Yan-fang, LIANG Bao-lian
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  60-62. 
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    Objectives   To evaluate the therapy of canal wall down tympanoplasty and canal reconstruction with homograft cortical bone plate.  Methods   Retrospective case review. All 49 patients were divided into 2 groups. The experimental group included25 ears underwent canal wall down tympanoplasty and canal reconstruction with homograft cortical bone plate, while the control group included 24 ears underwent regular canal wall down tympanoplasty with canal reconstruction. Follow up lasted 6~36 months and postoperative hearing and dry ear rate were evaluated.  Results   The criteria for success were defined as AB gap closure over 15 dB HL or air conduction threshold less than 40 dB HL (using the mean of 0.5-, 1-, and 2-KHz threshold values). The experimental group's effective rate was 68%(17/25)and the control group′s 62.5%(15/24). No significant difference was found between two groups(χ2=0.1635, P>0.05). The dry ear rate of experimental group was significantly higher than that of the control group(92% vs 58.33%, χ2=4.3636, P<0.05) Patients of experimental group showed normal postoperative external auditory canal  without closure or stenosis.  Conclusion   Canal wall down tympanoplasty and canal reconstruction with homograft cortical bone plate has advantage in retaining physical structure of external auditory canal and middle ear, with complete removal of lesions and is more efficient in improving hearing and obtaining dry ear.

    Placement of tympanostomy microtube to treat middie ear atelectasis in 32 cases
    WANG Zhi-qiang1, DU Ji-liang1, MA Xiu-fang2, SONG Li1, WANG Xi1, KONG Qing-dong1, JIANG Hai-hua1, WANG Ren-wen1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  63-65. 
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     Objective   To investigate the medical efficacy of tympanostomy microtube placement in the treatment of middle ear atelectasis. Methods   32 cases (34ears) of middle ear atelectasis underwent tympanostomy microtube placement under general or local anesthesia. Operations and clinic data were all reviewed. Prior to the treatments, all patients presented fullness or pressure in the ear. Otoscope, hearing and tympanogram examination were perormed and follow-ups were 2 to 6 months after the operation. Results   All cases were operated successfully. Before the treatments,acoustic immittance tests showed type “C” tympanogram in all 34ears. After the treatment, the fullness disappeared in 30 ears and types “A” tympanograms were found in all the ears. The pure-tone average (PTA)of hearing thresholds were improved significantly with an aveage elevation at 5 to 15dB. No  complication, such as middle ear infection, tympanosclerosis, and  permanent perforation, was found. Conclusions   The placement of tympanostomy microtube, which is minimal invasive without myringotomy, proves to be a simple, effective way to treat middle ear atelectasis.

    Benign Symmetric Lipomatosis (4 cases report)
    WU Wen-yuan, CHEN Yi-min, LIN Rong-zhi, HONG Yu-ming, QIU Lian-sheng, HANG Fang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  66-67. 
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    Objective   To investigate the diagnosis and treatment of  benign symmetric lipomatosis(BSL). Method   All 4 patients were treated by surgery. The retrospective analysis were done on each case.  The literature of the diagnostic procedure and  diagnostic/therapeutic characteristics of BSL were reviewed. Result   The postoperative pathology in all patients revealed that no coated adipose tissue was found. All the patients recovered well with satisfactory appearance and without any complications. Conclusion   BSL is a benign disease caused by fat metabolism disorder,  characterized by symmetry adipose tissue deposition in the neck and subcutaneous shallow fascia clearance and (or) the deep fascia. It usually occurs in middle-aged males. Alcoholism, hyperuricemia, hypercholesterolemia and other metabolic diseases were risk factors for BSL. CT scanning is useful in the diagnosis of BSL. The patients can recover well with satisfactory appearance and function after the surgical excision.

    cases of tonsillectomy with ultrasonic harmonic scalpel
    HOU Yan-peng, XU Zhen-ming, GUO Yin, CUI Xiao-feng, GU Quan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  68-69. 
    Abstract ( 1463 )   PDF (1037KB) ( 1630 )   Save
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    Objective   To evaluate the advantages  of tonsillectomy with ultrasonic harmonic scalpel. Methods   167 cases of tonsillectomy with ultrasonic harmonic scalpel and 45 cases of tonsillectomy with HF elctrotome were analyzed retrospectively.   The operation time,anesthesia time, intraoperative bleeding, and postoperative pain between the two groups were reviewed. Results   The operation time ,intraoperative bleeding, anesthesia time and postoperative pain in the ultrasonic  harmonic scalpel group were much better than those in the HF electrotome group. Conclusion   It is of great value to perform the tonsillectomy with ultrasonic harmonic scalpel.

    Application of hyperbaric oxygen therapy  on sudden deafness
    LIU Yang-yun, JIANG Wen, MAO Kun-hua, CHEN Qiong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  70-72. 
    Abstract ( 1658 )   PDF (993KB) ( 1197 )   Save
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    ObjectiveIn    order to increase the curative effect, the effects of different hyperbaric oxygen therapy plans and the courses of treatment on sudden deafness were explored. Methods   80 cases of sudden deafness were divided into two groups respectively( each group with 40 cases). Hyperbaric oxygen treatment was given before (group A) or after the drug treatment(group B) on every day morning.  Drug treatment lasted for 23 weeks, while The hyperbaric oxygen treatment was repeated for 13 courses.One course of the treatment was 10 days. Results   Total effective rates were significantly different between group A(77.5%, 31/40) and B(55.00%, 22/40) (χ2=4.528,P=0.033). There was no difference between the first course of hyperbaric oxygen treatment and the second or 3rd course. Conclusions   For the patients with sudden deafness, it is better to apply the hyperbaric oxygen treatment after the drug treatment than the contrary.Because the first course of hyperbaric oxygen treatment has shown good curative effect, it is unnecessary to increase the courses.

    Perioperative nursing of patients with infratemporal fossa tumors
    ZHANG Jing, JIANG Wen-xia, MA Ling-guo, WANG Mu-qing, LIU Yuan-mei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  73-75. 
    Abstract ( 1265 )   PDF (1037KB) ( 1257 )   Save
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    Objective   To explore the keys of perioperative nursing and the prevention of postoperative complications for infratemporal fossa tumor. Methods   The common complications of 1 infratemporal fossa tumor case after the operation was summarized and the corresponding nursing measures were discussed. Results   This patient recovered smoothly, without  perioperative complication. Conclusion   The scientific and effective nursing is the key for the successful operation of infratemporal fossa tumor

    Recent developments in audiology of demyelinating diseases
    WANG Bin, CAO Ke-li
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  76-79. 
    Abstract ( 1051 )   PDF (1947KB) ( 1366 )   Save
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    Demyelinating disease is a large class of disease with similar characteristics, but with different causes, varying clinical manifestations. The common feature is demyelination of nerve fibers, but nerve cells are relatively intact. Scholars have reported some patients with varying degrees of auditory nerve damage, but so far there have not been pathologically confirmed, and it is not clear and specific lesions. This review discusses characteristics of audiology of demyelinating disease in recent years.

    Cytoskeleton-associated protein in the inner ear and gene mutations cause hereditary deafness
    YANG Xia, GAO Xia
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  80-84. 
    Abstract ( 1170 )   PDF (1006KB) ( 1494 )   Save
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    The correlated hereditary deafness-associated genes include cytoskeletal proteins, extracellular matrix proteins, channels and gap junction proteins, transcription factor genes, mitochondrial genes and other unknown function genes. Most of the cloned genes are cytoskeletal molecules.This paper makes a summary about major structural protein associated with hair cells and the pathogenesis of gene mutations lead to hereditary deafness.

    Surgery advance of congenital ear malformation
    HAN Hao-lun, WU Wei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  85-88. 
    Abstract ( 1142 )   PDF (986KB) ( 1193 )   Save
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    Congenital ear malformation is caused by developmental abnormalities of the first and second branchial arch. Congenital ear malformation is performance ear hypoplasia and smaller than normal, often accompanied by external auditory canal atresia and middle ear deformities. Surgery is the main treatment for congenital microtia. This article mainly overview the progress on auricle reconstruction, auditory rehabilitation and other surgical treatment.

    Research status of isolated sphenoid sinus disease
    QIU Jin-mei, QIU Lian-sheng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  89-91. 
    Abstract ( 1271 )   PDF (1929KB) ( 1175 )   Save
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    Isolated sphenoid sinus disease derives from and confines to the sphenoid sinus, not involving the adjacent structure. Its incidence is 1. 0% ~ 2. 7%. The early symptoms of sphenoid sinus diseases are often nonspecific. According to the recent literatures, this paper presents a review of the anatomy, clinical symptoms, composition, imaging manifestations, diagnosis and treatment of isolated sphenoid sinus disease.

    An irrigator used in endoscopy
    LI Jian-fang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2012, 26(1):  92-92. 
    Abstract ( 1009 )   PDF (953KB) ( 1149 )   Save
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