Table of Content

16 February 2013 Volume 27 Issue 1

  

Articles

Sexual behavior and HPV infection in squamous cell carcinoma of the oropharynx

Guojun Li1,2, MD, PhD, Xinliang Pan3, MD, PhD, Dapeng Lei3, MD, PhD et al

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  1-7.  doi:10.6040/j.issn.1673-3770.1.2012.015

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High risk human papillomavirus (HR HPV) infection is associated with a significant portion of squamous carcinoma of the head and neck, particularly for the oropharynx and for those lacking the other risk factors of tobacco and alcohol.  The link between HR HPV and carcionoma of the oropharynx have been suggested based on the identification of HR HPV in oropharyngeal tumors and association of HR HPV with the risk of oropharyngeal cancer from casecontrol epidemiologic studies. This review highlights the roles of sexual behavior characteristics in patients with oropharyngeal cancer compared with patients with non-oropharyngeal cancers at sites of oral cavity, larynx, and hypopharynx. Determining the behavioral risk factors for head and neck cancer is imperative for future cancer prevention efforts and for understanding the potential role of the HPV vaccine currently available.  This review also expands our understanding of the roles of sexual behavior as a risk factor for oropharyngeal cancer and its role as a marker of HPV exposure and emphasizes that HR HPV is sexually transmitted to the upper aerodigestive tract and that certain sexual behaviors increase the risk for HPV-associated oropharyngeal cancer.

Endoscopy assited nasal septum rhinoplasty

LI Na

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  8-9.  doi:10.6040/j.issn.1673-3770.1.2012.016

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Surgery for pediatric obstructive sleep apnea hypopnea  syndrome- A report of 80 cases

WAN Jing-ming

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  10-11.  doi:10.6040/j.issn.1673-3770.0.2012.120

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Objective   To investigate the effect of adenoidectomy and/or tonsillectomy in the treatment of pediatric obstructive sleep apnea hypopnea syndrome. Methods   Clinical data of 80 children with obstructive sleep apnea hypopnea syndrome were analyzed retrospectively. Results   3 months after the operation, there were 73 cured cases, 5 effective cases, and 2 moderately effective cases. 6 months after the operation, there were 2 cured cases, 3 effective cases, 2 moderately effective cases, and 3 recurrence cases, including 2 obesity cases  and 1 cerebral palsy case. The latter 3 cases got improved after weight reduction and ventilation treatment. Conclusion   Adenoidectomy and/or tonsillectomy are mainstays in the treatment of pediatric obstructive sleep apnea hypopnea syndrome. Individualized treatment according to the etiology can improve the therapeutic effects.

Effectiveness of nasal surgery on sleep in patients with obstructive sleep apnea hypopnea syndrome and nasal obstruction

CAO E-hong1, ZHU Mei-ying1, SHI Yi1, SONG Yong1, CHEN Jian-qiu2.

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  12-15.  doi:10.6040/j.issn.1673-3770.0.2012.218

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Objective   To evaluate the effectiveness of nasal surgery  on sleep quality, architecture, position, and sleep-disordered breathing (SDB) in the patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and nasal obstruction. Methods   30 patients with OSAHS and nasal obstruction, who underwent the nasal surgery, were enrolled in the study. Polysomnographic(PSG) data and Epworth Sleepiness Scale(ESS) evaluation were performed, and the relationship  with sleep quality (sleep efficiency ［SE］ and arousal index ［ArI］), sleep architecture, the distribution of sleep positions, and SDB (apnea-hypopnea index ［AHI］, minimum arterial oxygen saturation ［LSaO2］, and snoring) before and after nasal surgery were analyzed. Results   After the nasal surgery, sleep efficiency ［from (86.4±6.4)% to (89.4±6.8)%, P＝0.043］, ESS evaluation (from 10.08±3.3 to 8.1±3.3, P=0.001) and stage R ［from (15.5±4.0)% to (18.8±4.7)%, P＝0.006］ were significantly changed, however, there was no significant change in ArI, other sleep stages, the proportion of sleep time spent in the supine position, AHI, LSaO2 or snoring. Conclusion   Nasal surgery alone is partially effective in improving sleep quality and architecture, but it shows no effect on the distribution of sleep positions, snoring and obstructive apnea in patients with OSAHS and nasal obstruction.

Initial observation of micromovement sensitive mattress sleep monitoring system in auto-pressure titration

ZHOU Shi-tong1, HOU Qun1, LIU Jun3, CUI Zhen-ying1, ZHOU Bo1, WANG Ling1, HU Li-bo1

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  16-18.  doi:10.6040/j.issn.1673-3770.0.2012.184

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Objective   To explore the clinical value of the micro-movement sensitive mattress sleep monitoring system (MSMSMS)in auto-pressure titration for patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods   71 OSAHS patients treated by respirator with auto-pressure titration were simultaneously monitored by MSMSMS and the results were compared with that of pre-therapy, as well as the automatic pressure titration results between MSMSMS and respirator. Results   59 patients (83.1%) completed the whole night pressure titration while 12 patients (16.9%) didn’t. Compared with the pre-therapy data, MSMSMS showed that the sleep apnea-hypopnea index(AHI) of the 59 patients was reduced 88.1%±6.6% on average at titration night and the blood oxygen saturation was also significantly improved. The titration results showed that AHI monitored by MSMSMS was greater than that by the respirator(P＜0.001). Conclusion   MSMSMS shows many advantages, such as convenience and no interference. As a simultaneous monitoring method, MSMSMS could be adopted to ensure the quality of sleep of OSAHS patients during the auto-pressure titration. With the titration results from respirator, it could be better to evaluate the initial treatment effect and compliance of patients with OSAHS and guide the treatment.

Effects of crush injury to the facial nerve on the expressions of CNTF in motoneurons of facial nucleus in rats

LIU Yue1,4, LI Pei-hua2， LIU Wen2， SHEN Ping2， XU Xue-gu2， SUN Guang-ming2， SUN Hai-qing3

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  19-23.  doi:10.6040/j.issn.1673-3770.0.2012.131

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Objective   To observe the behavioral difference after the crush injury of facial nerve in rats and determine the expression of CNTF in motoneurons of facial nucleus. Methods   In 30 healthy adult rats, the trunk of right facial nerve were crushed while that of the left nerve was control. The rats were divided into 5 subgroups according to the days after the operation, including 1d, 7d, 14d, 21d and 35d subgroup. During the experiment, the behavioral changes were monitored, while the pathological differences of motoneurons were observed by HE staining and the number of cells was counted. CNTF protein in facial nucleus were detected by immunohistochemical method and analyzed by optical density. Results   The rats showed right facial palsy immediately after the crush injury. The number of neurons in the right side decreased significantly compared with the left side (P<0.01) on the 7th, 14th and 21st day. Some morphological changes were observed, such as deranged cellular structure, cytoplasm vacuolization, or nucleolar margination. The expressions of CNTF increased obviously in the right side on the day of  7th, 14th and 21st day (P<0.01). Conslusion   Nerve crush is a simple, easy and stable way to establish animal model for the reversible facial paralysis. The expression of CNTF protein increases in the motoneurons of facial nucleus after the facial nerve is crushed.

Treatment of sudden hearing loss by monosialotetrahexosylganlioside

SHEN Feng

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  24-25.  doi:10.6040/j.issn.1673-3770.0.2012.163

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Objective   To investigate the efficacy of monosialotetrahexosylganlioside in the treatment of sudden hearing lossl. Methods   80 cases suffered from sudden hearing loss were randomly divided into 2 groups. Except for glucocorticoid plus vasodilators and hyperbaric oxygen therapy, 40 cases in the treatment group were administrated with monosialotetrahexosylganlioside, while the other 40 cases in the control group were given mecobalamin injection. One course lasted for 10 days. Results   The total effective rates of hearing improvement between the treatment group and control group were 85% and 62.5%, while the cure rates of both groups were 52.5% and 27.5%(P<0.05).  Meanwhile, the total effective rate of tinnitus in the treatment and control group were 80% and 51.7%(P<0.05). Conclusion   Monosialotetrahexosylganlioside plays a positive role in the treatment of sudden hearing loss.

Short-term effectiveness of intratympanic plus intravenous Dexamethasone injection and conventional regimen for sudden sensorineural hearing loss

LIU Dong-mei1, XU Kai-lun1, LUO Xiao1, et al

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  26-30.  doi:10.6040/j.issn.1673-3770.0.2012.213

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Objective   To observe the the short-term effectiveness of intratympanic dexamethasone(ITD) plus intravenous dexamethasone injection and conventional regimen for sudden sensorineural hearing loss(SSNHL).  Methods   The SSNHL cases were divided into treatment group A (11cases,11ears), treatment group B (11cases,13ears), control group A(11cases,11ears), and control group B(11cases,13ears) based on the admitted time. With informed consent signed, the patients in control group A and B were given intravenous injection of dexamethasone, highly oxygenized liquid(group A) or hyperbaric oxygen treatment (group B), accompanied by circulation booster/stasis elimination agents, vitamin and so on. Besides the above, ITD was performed in the treatment group A and B. Assessment of hearing function was carried out on the exact day or next day after one 10-day course. The results of pure tone average（PTA）were recorded and calculated at 500Hz, 1kHz, 2kHz, 4kHz, respectively. Meanwhile, the results at 250Hz and 8kHz were compared. Hearing improvement was defined as a 15 dB HL decrease. Results   The treatment group A showed an average increase of (25.73±6.07)dB HL(P<0.01). The treatment group B showed an average increase of (24.15±4.86)dB HL(P<0.01). The control group A showed average increase of (16.36±3.36) dB HL(P<0.01). The control group B showed an average increase of (19.46±6.01)dB HL(P<0.01). The PTA of four groups before and after the treatment all demonstrated statistical significance. Except for the treatment group A, the pure tone threshold at 250 Hz of all the three other groups before and after treatment showed statistical significance. Except for the treatment group B, the pure tone threshold at 8kHz of all the other three groups before and after treatment showed no statistical significance. No significant difference at 250 Hz was noted between the treatment group A and the control group B, while the same result was found at 8kHz between the treatment group A and control group B (P>0.01). Overall improvement was observed in 9 ears (81.8%) in the treatment group A and 4 ears (36.4%) in the control group A (P<0.05). Overall improvement were observed in 8 ears(61.5%) in the treatment group B and 5 ears(38.5%) in the control group B (P>0.05).There were no middle ear infection. The treatment was invalid for 1 case, but her hearing level stopped falling. In the process of injection, vertigo happened in 5 cases, temporary mild edema in 2 cases, while the rest 20 patients did not show any adverse reaction. Conclusion   Four kinds of treatments are effective for sudden sensorineural hearing loss. However, intratympanic joint intravenous dexamethasone plus conventional regimen is more effective, safer and simpler. Curative effect is better for low frequency than the high. Two treatment strategies have no obvious difference in the improvement of low frequency.

Transmastoid approach treatment for facial paralysis complicated by otitis media cholesteatoma（75 cases report）

LIU Jun1, ZHAO Yu2, ZOU Jian2, QIN Xue-ling2.

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  31-32.  doi:10.6040/j.issn.1673-3770.0.2012.217

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Objective   To investigate the effect and method of transmastoid approach treatment for facial nerve paralysis complicated by otitis media cholesteatoma. Methods   Clinical data of 75 peripheral facial paralysis patients caused by middle ear cholesteatoma were reviewed, including 13 cases involving the vertical segment, 36 cases involving the horizontal segment and cone segment, 22 cases involving the geniculate ganglion, and 4 cases involving the geniculate ganglion and labyrinth segment. Facial decompression surgery was performed through transmastoid apporach. Results   In a 1 to 6-month follow-up, facial nerve function rehabilitated to Ⅰ~Ⅴ level based on House - Beckmann facial grading system score. Conclusion   Transmastoid approach is a reliable method for facial nerve decompression in the treatment of peripheral facial paralysis caused by middle ear cholesteatoma.

Repair of traumatic auricle defect

SU Fa-ren， BO Lin, DING Jing-hua， LIU Xin-gang

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  33-35.  doi:10.6040/j.issn.1673-3770.0.2012.178

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Objective   To investigate the therapy for auricle defect after trauma.  Methods   With expanded local skin and cartilaginous skeleton based on the digital flipped photo of health ear，auricle defect was repaired by the flap from mastoid area covering autologous rib cartilage. Results   All cases were followed-up from one year to nine years. The results of 36 cases (36 ears) were satisfying，with the similar ear size, location, and skull-ear angle as the healthy ear. Reconstructed ear showed normal in skin color and feeling，without deformation and absorption. Conclusion   With expanded local skin and digital technology， Auricle reconstruction by autologous rib cartilage is satisfying with few complications. It is a good therapy for auricle defect after trauma.

Endoscopic microvascular decompression in the treatment of idiopathic trigeminal neuralgia (36 cases report)

ZHENG Xi-qi， XU Jun， WANG Min, LIANG Na, WU Yan-hong, JING Hui

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  36-37.  doi:10.6040/j.issn.1673-3770.0.2012.166

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Objective   To explore the method and effectiveness of endoscopic microvascular decompression in the treatment of idiopathic trigeminal neuralgia(ITN).  Methods   36 ITN cases underwent microvascular decompression under nasal endoscope by retrosigmoidal approach. In the operation, the corresponding vessel was identified and padded with Tfelon patch.   Results   The efficiency of postoperative pain relief was 97.2%. The responsiblele vessels were anterior cerebellar artery in 14 (38.9%), 10 anterior inferior cerebellar artery(27.8%), 7 posterior inferior cerebellar artery (19.4%), 2 basilar artery (5.5%), and 3 anterior cerebellar artery plus petrosal vein (8.4%). Conclusion   Microvascular decompression under nasal endoscopy is an effective method to treat idiopathic trigeminal neuralgia.

Brain cotton technique in endoscopic middle meatus antrostomy for removing maxillary fungus ball

LIU Xiang, CHEN Qiu-jian, ZOU Hua, DING Jian-hui

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  38-40.  doi:10.6040/j.issn.1673-3770.0.2012.226

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Objective   To investigate the effect of brain cotton technique in endoscopic middle meatus antrostomy for removing maxillary fungus ball. Methods   16 cases of maxillary fungusl balls were randomly divided into two groups: the brain cotton technique group and the nonbrain cotton technique group. The surgical time, post-operative complications and recurrence were compared between the two groups. Results   6 patients were enrolled in the brain cotton group and were performed operations from 40min to 60min with an average of 51min. Followed up by endoscopy in 12 months, no one had postoperative complications or recurrence. 10 patients were enrolled in the nonbrain cotton technique group, 5 of whom had inferior meatus antrostomy and were performed operations from 30min to 100min with an average of 74min. Followed up by endoscopy for 6 months to 20 months, no one had recurrence. 2 patients had nasal adhesion and were cured by endoscopy in outpatient. Conclusion   Maxillary fungus ball can be cured just through endoscopic middle meatus antrostomy assisted by the brain cotton technique. It is simple and convenient with little damage and good result and can be widely applied in clinic.

Nasal endoscopic dacryocystorhinostomy with type“V”mucous flaps in 60 patients

LIU Xiao-feng, LI Li, WANG Xia, ZHAO Yi-hua, MENG Yuan-tong

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  41-42.  doi:10.6040/j.issn.1673-3770.0.2012.248

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Objective   To investigate the clinical effect of nasal endoscopic dacryocystorhinostomy using type“V” mucous flaps. Methods   From June 2011 to March 2012, 60 patients(72eyes)were performed transnasal endoscopic dacryocystorhinostomy using the type“V” mucous flaps. Results   67 eyes (93%) were cured, 3 eyes (4%) were improved, and 2 eyes were invalid. The total effective rate was 97%. Conclusion   Nasal endoscopic dacryocystorhinostomy using type“V” mucous flaps is effect for dacryocystitis. It covers the exposed bone, speeds epithelization, and reduces hyperostosis and scar formation.

Clinical analysis of 237 epistaxis inpatients

MIU Jian-liang, GUO Jian-lin, WU Jian, YU Hong-lei, LU Jia, HUO Zhi-qiang, WANG Chun-xu

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  43-44.  doi:10.6040/j.issn.1673-3770.0.2012.220

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 Objective   To investigate etiology, bleeding points, treatment methods, and curative effect of epistaxis inpatients. Methods   The clinical data of 237 epistaxis inpatients were retrospectively analyzed. Results   There were 176 males, 61 females, aging from 14 to 86 years (mean 55 years). 232 were unilateral and 5 were bilateral. The bleeding points were more often in the following sites: anterior and inferior side of the septum (n=47), inferior nasal meatus (n=42), and olfactory cleft area (n=31). Vaseline gauze or iodoform gauze nasal packing were used in 102 patients in which 68 patients were cured and 34 followed by endoscopy and electrocoagulation. Merocel or Gelfoam nasal packing were used in 134 patients in which 40 patients were cured and 94 followed by endoscopy and electrocoagulation. 1 patient was cured by drugs without nasal packing. 128 patients were treated by nasal endoscopy and electrocoagulation and 122 of them were cured. Conclusion    Epistaxis inpatients are mainly old man and are almost unilateral. The most effective treatment for epistaxis inpatients is electrocoagulation by nasal endoscopy.

Treatment for aging patients with intractable epistaxis by nasal endoscopy under general anesthesia

ZHAO Chun-hong, LI Yu-jie

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  45-46.  doi:10.6040/j.issn.1673-3770.0.2012.234

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Objective   To investigate the curative effect of the treatment by electric coagulation and nasal packing by nasal endoscopy under general anesthesia for aging intractable epistaxis. Methods   135 patients were divided into two groups. The treatment group(89 patients) were treated by electric coagulation and nasal packing by nasal endoscopy under general anesthesia and the control group(46 patients) were treated by routine nasal packing. Results   In the treatment group, 86 patients were cured by one time treatment, 3 by twice, and the total effective rate was 100%. In the control group, 24 patients were cured by one time treatment, 17 by twice, and the total effective rate was 89.1%. Conclusion   Nasal endoscopy under general anesthesia for aging intractable epistaxis is safe and effective, and it is worthy to be extended on clinical.

Efficacy of endoscopic sinus surgery for necrotizing nasal polyps

HE Li-yong1, ZENG Shao-hua1, LIU Wen-tong1, YAO Min1, ZHEN Ze-nian2

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  48-50.  doi:10.6040/j.issn.1673-3770.0.2012.036

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 Objective   To evaluate the feasibility and efficacy of endoscopic surgery for nasal polyps and sinus necrotizing.  Methods   The clinical data of 23 cases of hemorrhage and necrosis of nasal and sinus polyp treated from January in 2002 to January in 2010 were retrospectively analyzed. They were all pathologically diagnosed, performed endoscopy sinus, CT and MRI before the surgery. Under general or local anesthesia, the nasal and paranasal sinuses lesions were completely and thoroughly removed.  Results   22 patients (95.7%)were cured and 1 patient (4.3%)were improved by endoscopic sinus surgery with less blood loss. 22 patients had no recurrence in a follow-up of 2 to 6 years, and 1 patient relapsed after 1 year and was re-operated through Ke-Lu endoscopic approach.  Conclusion   Endoscopic sinus surgery is a preferred treatment for nasal polyps and sinus necrotizing, which is simple, safe and effective.

Effect rate of radiofrequency ablation on chronic hypertrophic rhinitis： A  meta-analysis

HOU Sen1， YANG Hai-zhen2

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  51-53.  doi:10.6040/j.issn.1673-3770.0.2012.232

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Objective   To evaluate the effect of low-temperature plasma radiofrequency in chronic hypertrophic. Methods   Pubmed, CNKI and Wanfang electronic databases were searched by the terms  “radiofrequency ablation” and “chronic hypertrophic rhinitis”, to extract the pertinent literature about the lowtemperature plasma radiofrequency in treatment of chronic hypertrophic rhinitis. Meta analysis was used to analyze the overall effect. Results   Metaanalysis results showed that the total efficiency and 95% CI was 0.963 (0.942,0.977),   the  three-month overall efficiency and 95% CI was 0.966 (0.934,0.982), and of the 6-month overall efficiency and 95% CI was 0.936 (0.901,0.969). Conclusion   Low temperature plasma radiofrequency surgery in treatment of chronic hypertrophic rhinitis has a high effective rate in short-term and long-term and is worthy of clinical application.

Prognostic factors of local recurrence after endoscopic laser cordectomy for early glottic carcinoma

GUO Hong-guang, LI Jin-rang, SUN Jian-jun

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  54-57.  doi:10.6040/j.issn.1673-3770.0.2012.168

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Objective   To assess the prognostic factors of local recurrence after endoscopic laser cordectomy for early glottic carcinoma. Methods   Data of 76 patients with early glottic carcinoma (T1a,T1b,T2), who were treated with endoscopic laser cordectomy between January 2000 to February 2012 at single institution, were retrospectively analyzed. Surgical margins were set at about 2mm  and marked. Surgical specimens were fixed in 10% buffered formalin and embedded with paraffin. Sections were stained using hematoxylin-eosin for pathologic examination. Overall survival and disease-free survival were estimated using the Kaplan-meier method. The univariate analyses of prognosis factors with impact on disease-free survival were assessed with the log-rank test. Results   The 5 year overall survival, disease-free survival, and laryngeal preservation were 92.0%, 81.9%, and 96.1% respectively. Univariate analysis revealed that anterior commissure involvement and thyroarytenoid muscle invasion exerted a significant impact on disease-free survival. There was no significant difference in disease-free survival according to the status of surgical margin. Conclusion   The anterior commissure involvement and thyroarytenoid muscle invasion increase the risk of local recurrence for endoscopic laser cordectomy. The positive margin does not show any influence on 5 year disease-free survival, however,  close surveillance is required to avoid over-treatment.

Diagnosis and treatment of reflux throat pharyngitis with helicobacter pylori infection

CAO Zhong-liang1, XU Xing-xing2

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  58-60.  doi:10.6040/j.issn.1673-3770.0.2012.209

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Objective   To investigate the diagnosis and treatment in reflux throat pharyngitis(RTP) with helicobacter pylori(HP) infection. Methods   545 patients with chronic throat pharyngitis(CTP) were selected. All the patients underwent １４ＣUBT screening for grouping. HP positive patients were treated and assessed through HP conversion rate and clinical presentation. Results   ① For the RTP patients, HP -positive rate was higher than that in normal CTP patients (P<0.05). ② Clinical symptoms and signs of two groups of HP-positive patients  were significantly improved, or disappeared, after a standard triple sterilization process in a 2-week treatment. No difference in  efficiency was found between the two groups(P>0.05). Conclusion   As a common pathogen for  CTP, HP is related to the occurrence, development of gastroesophageal reflux disease(GRED) or RTP． Therefore, it is  effective  to screen HP to improve the diagnosis and treatment of CTP.

Preferable treatment for nonspecific granuloma of larynx

ZHONG Zhao-tang, LIANG Min-zhi, CHEN Ze

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  61-63.  doi:10.6040/j.issn.1673-3770.0.2012.246

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Objective   To explore the efficiency and effectiveness of comprehensive treatment for laryngeal nonspecific granuloma. Methods   20 patients with laryngeal nonspecific granuloma were enrolled. Among them, 8 patients with endotracheal intubation history were performed with self-retaining laryngoscope operation and 2-week corticosteroid inhalation without any other conservative treatment. 12 cases, without endotracheal intubation history, were administered chiefly with acid inhibitors combined with self-retaining laryngoscope operation, corticosteroids inhalation and phonological treatment. Results   All the patients were followed up for 6 months after the treatments. Among the patients with endotracheal intubation history, one case recurred and was cured by surgery and corticosteroid inhalation. 10 cases of patients with Non-endotracheal intubation history were cured by acid suppression therapy only.  2 cases were cured by self-retaining laryngoscope operation combined with corticosteroid inhalation and phonological therapy. Conclusion   The reason of laryngeal nonspecific granuloma is complicated and the treatment methods are various.  For those with endotracheal intubation history, surgery and postoperative corticosteroids inhalation is preferable. For those without endotracheal intubation history, acid suppression therapy combined with comprehensive treatment is the first choice.

Seven cases of styloid syndrome after tonsillectomy

CHEN Wu-na, GAO Xing-qiang, SHANGGUAN Han-jing

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  64-65.  doi:10.6040/j.issn.1673-3770.0.2012.258

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Objective   To explore the reason of styloid syndrome after tonsillectomy and the clinical effect of styloidectomy. Methods   Seven patients with styloid syndrome after tonsillectomy received styloidectomy. The clinical effect was evaluated. Results   One side styloid was removed in six patients, while  both sides styloid were removed in one patient. All patients were followed-up for 3 months to 3 years after operation. Among them, 5 patients were cured and the others showed considerable alleviation. Conclusion   The mechanism of styloid syndrome after tonsillectomy might be related to the stimulation of scar formation in the tonsillar fossa. Styloidectomy is an effective treatment.

Meta-analysis of limbal stem cell transplantation and amniotic membrane transplantation for pterygium

YU Xiao-ming, WU Xin-yi

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  66-71.  doi:10.6040/j.issn.1673-3770.0.2012.331

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Objective   To evaluate the clinical effect of limbal stem cell transplantation and amniotic membrane transplantation in the treatment of pterygium by evidence based medicine.  Methods   Clinical data of effect in limbal stem cell transplantation and amniotic membrane transplantation were collected from computer literature searching, which was carried out in PubMed,  EMBASE, Wanfang and VIP database etc, also performed searching based on www.baidu.com and www.google.com. Meta analysis that recommended by Cochrane Collaboration was done for the data obtained that 3126 eyes that met with the eleven criteria of enrollment were included in this study. Publication bias was assessed by using a funnel plot.  Results   The results of metaanalysis showed that 35 RCTs evaluated the pterygium recurrent rate after grafting including 3126 eyes, the incidence rate including 1108 eyes, and the mean time of corneal epithelium wound healing including 900 eyes. In comparison with the amniotic membrane transplantation group, the recurrent rates of pterygium (P＜0.00001)and the total complication rate (P=0.01)were lower in the limbal stem cell transplantation group. Moreover, the mean time of corneal epithelium wound healing was shorter in the limbal stem cell transplantation group.  Conclusion   Corneal limbal stem cell autograft is an effective way to reduce the recurrent rate of pterygium and the incidence of symblepharon and to accelerate the healing of corneal wound comparing with amniotic membrane transplantation．

Diagnosis of Acanthamoeba keratitis by laser scanning confocal microscopy

LI Ying-chao, SUN Zhong-hua, WU Xin-yi

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  72-75.  doi:10.6040/j.issn.1673-3770.0.2012.350

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 Objective   To evaluate the role of laser scanning confocal microscopy (LSCM) in rapid diagnosis and followup examination for Acanthamoeba keratitis. Methods   The clinical manifestation, corneal scraping and culture, and LSCM examination in 4 cases of Acanthamoeba keratitis were retrospectively studied. Results   Corneal opacity, infiltration, stroma mist edema， elastic layer folds, and corneal ulceration were observed in 2 cases by slitlamp microscopy. Typical corneal stromal ring infiltration was observed in 2 cases. Corneal fungal scraping and culture showed negative results in all cases. Amebic cysts were observed under corneal epithelium or within 150μm of shallow stroma by LSCM. Several cysts were observed in 1 case, and 1 cyst was observed in every other case. Cysts assumed round or oval hyperechogenicity with double capsule wall, 25-150μm long, and the core is round. Cysts disappeared and stroma inflammation relieved in 2 cases after treatment. Cysts became smaller, and the structure of double capsule wall was not clear in 2 cases. Trophozoite was observed only in 1 case. Conclusion   The traditional methods to detect Acanthamoeba keratitis, such as corneal scraping and culture, are restricted by corneal material, and positive rate is low. LSCM can be used for rapid noninvasive living inspection of corneal infection, and has advantages of high resolution, accurate depth positioning, dynamic observation, and longitudinal scanning, so it is an important method for rapid etiology diagnosis and followup of Acanthamoeba keratitis.

Anesthesia in cataract surgery for patients with psychosis

LIU Huai-gang1， GUO Ying-xia2， LEI Yu-lin2， LI Jian-jun3， DANG Guang-fu4， LI Xiao-jing1

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  76-77.  doi:10.6040/j.issn.1673-3770.1.2012.017

Abstract ( 1896 )   PDF (965KB) ( 616 )   Save

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Objective   To evaluate the effect of propofol in cataract surgery anesthesia for mental illness. Methods   We investigate 15 psychiatric patients who underwent cataract surgery from June 2006 to July 2012. In operating room, oxygen inhalation was given through nasal catheter and intravenous access was established. ECG, HR, BP, SpO2, PetCO2 and BIS were continuously monitored. 1-2mg/kg propofol was injected and the BIS value was kept below 60 before operation. Anesthesia was maintained by 2-5mg/(kg·h) propofol microinjection, and additional 20-50μg fentanyl was given in case of body movement in response to pain. BIS value was maintained at 40 to 60 during the operation, and propfol pumping was stopped at the end of surgery. Results   All operations were successfully performed. Only two cases had transient respiratory depression, but their SpO2 was normal. The situation was improved after reducing the speed of propofol pumping, and no special treatment was given. No anesthesia-related complications happened in remaining cases. No anesthetic sequelae or psychotic exacerbations were found during postoperative follow-up. Conclusion   Propofol can be used in psychiatric patients’ anesthesia for cataract surgery. At the same time, preoperative visit, intraoperative monitoring, and postoperative management and nursing should be enhanced in order to ensure safety of psychosis patients during perioperative period.

Relationship between photoreceptor cell layer and best corrected visual acuity (BCVA) in patients with retinal vein occlusion

WANG Yong-bo， SHI An-na， SHI Xun， JIN Yu， LIU Wei-feng

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  78-80.  doi:10.6040/j.issn.1673-3770.0.2012.225

Abstract ( 1939 )   PDF (1691KB) ( 566 )   Save

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Objective   To evaluate the relationship between photoreceptor cell layer and best corrected visual acuity (BCVA) in patients with retinal vein occlusion(RVO). Methods   The data of 88 patients (88 eyes) with retinal vein occlusion were collected in our hospital from August 2008 to August 2011, including 28 patients (28 eyes) with central RVO and 60 patients (60 eyes) with branch RVO. The continuity of foveal photoreceptor cell layers was observed by 3D-OCT. According to the test result of photoreceptor cells’ IS/OS layers, the patients were divided into 3 groups: completely continuous group (36 eyes), partly continuous group (40 eyes), and completely losing group (12 eyes). Then the differences of BCVA were compared among them. Results   BCVA of the three groups was 0.65±0.32， 0.54±0.27 and 0.08±0.06 respectively. There were significant differences in BCVA between patients who was completely lack of IS/OS layers and the others whose IS/OS partly or completely existed(P<0.01). No significant difference was found between completely continuous group and partly continuous group (P>0.05). Central foveal thickness of the three groups was (176.00±42.00)， (165.00±34.00) and (152.00±33.00)μm respectively, and no significant difference was found between them(F=2.05,P>0.05). Conclusion   The BCVA of patients with RVO improves when the continuity of photoreceptor cells increases, and more attention should be paid to protect foveal photoreceptor. 

Modified oral caring in tongue cancer defects repaired with facial arterysubmental island mylcutaneous flap

CHEN Bi-ling， CHEN Lu-di， LIN Su-hua， SU Ya-nen

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  81-82.  doi:10.6040/j.issn.1673-3770.0.2012.186

Abstract ( 1710 )   PDF (924KB) ( 839 )   Save

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Objective   To discuss the clinical effect of modified oral caring in tongue defects repaired by facial artery-submental island mylcutaneous flap. Methods   Fifteen tongue cancer (T2N0M0) were radically removed and repaired with facial artery-submental island flap. During the different postoperative period, corresponding modified oral caring were carried on. Results   All the submental island flap survived after surgery. The modified oral caring enhanced the success rate of the operation, and improved the quality life of patients. Conclusion   The modified oral caring can reduce postoperative complications.

Median palatine cyst

WANG Yong-fu1， ZHANG Qing-quan2

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  83-84.  doi:10.6040/j.issn.1673-3770.0.2012.179

Abstract ( 2433 )   PDF (961KB) ( 821 )   Save

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The median palatine cyst is rare. The aim of this report was to review its pathogenesis, clinical manifestation, differential diagnosis, therapy and prognosis. We also reported our experience in the surgical treatment of  median palatine cyst.  Opercle surgery under a rhino-endoscope was simpler, easier and safer than palate and /or upper labiogingival groove approach surgery for median palatine syst.

Non-syndrome type unilateral auditory neuropathy: report of one case

XUE Fei, XU Li, YANG Hong-wei, HAN Yuan-chao, WANG Qiu-ping

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  85-86.  doi:10.6040/j.issn.1673-3770.0.2012.252

Abstract ( 1566 )   PDF (923KB) ( 502 )   Save

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Familial bell’s palsy in three siblings

WANG Na1, XU An-ting2

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  87-88.  doi:10.6040/j.issn.1673-3770.0.2012.194

Abstract ( 1804 )   PDF (1050KB) ( 712 )   Save

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PENG Hong-bin1, CHEN Wei-liang2

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  89-89.  doi:10.6040/j.issn.1673-3770.0.2012.254

Abstract ( 1727 )   PDF (1054KB) ( 922 )   Save

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Endoscopic excision of one case of ethmoidal osteoma

LIU Di, LI Xue-zhong, ZHAO Shu-min

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  90-90.  doi:10.6040/j.issn.1673-3770.0.2012.355

Abstract ( 1630 )   PDF (982KB) ( 649 )   Save

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Significance of sinus CT in nasal endoscopic operation

WANG Hai-ying1, YANG Mei-yan2

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  91-92.  doi:10.6040/j.issn.1673-3770.0.2012.236

Abstract ( 1706 )   PDF (919KB) ( 675 )   Save

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WENG Yong-cai, GU Dong-sheng, CHEN Yu-wu, ZENG Dong-qian, WANG Tian-sheng

J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(1):  93-94.  doi:10.6040/j.issn.1673-3770.0.2012.253

Abstract ( 1590 )   PDF (970KB) ( 910 )   Save

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