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    16 April 2013 Volume 27 Issue 2
      
    Articles
    The application of modified hyoid suspension surgery for the obstructive sleep apnea-hypopnea syndrome
    ZHAO Wei1, ZHOU Yan1, GU Zhao-hui1, HU Yan1, LU Hong2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  5-7.  doi:10.6040/j.issn.1673-3770.0.2012.341
    Abstract ( 1624 )   PDF (1286KB) ( 693 )   Save
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    Objective   To discuss the method and therapeutic effects of modified hyoid suspension surgery for obstructive sleep apnea-hypopnea syndrome. Methods   Modified hyoid suspension was performed in 68 OSAHS patients in one or consecutive stages. All the patients underwent polysomnography(PSG) and multislice CT (MSCT) before and six months after the operation. Results   In all the cases, PSG indexes showed significant improvement after the operation. According to the assessment guidelines, the efficiency is 100% six months after. The anteroposterior dimensions of retroglossal were decreased and transverse dimensions were increased after the surgery. The shape of airway tended to be normal. Conclusion   Modified hyoid suspension is effective for OSAHS patients with oropharyngeal obstruction.

    Hearing screenings  in 11894 infants
    LIU Zhi-qi1,2, LIU Li-si1, YANG Kun3
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  8-12.  doi:10.6040/j.issn.1673-3770.0.2012.297
    Abstract ( 1943 )   PDF (967KB) ( 1745 )   Save
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    Objective    To obtain the pass rate of hearing screening, the incidence and cause of hearing loss in the newborns. Methods   11894 cases were screened by a two-stage program of transient evoked oto-acoustic emissions test(TEOAE). The failed were re-examined with DPOAE,1000Hz probe tone tympanometry, auditory brainstem response(ABR) 3 months later. The results were analyzed. Results  The primary screening pass rate was  82.64%, while the secondary pass rate was 78.71%. The pass rates were 84.63% and 78.00% in the obstetric ward and NICU ward,respectively (ANOVA, P<0.05). 68 cases (including 106 ears) were diagnosed as hearing loss with the incidence rate at 0.57%. Among them, there were 31 conductive hearing loss, 16 sensorineural hearing loss, and 21 mixed hearing loss. In the groups with the tests failed bilaterally or unilaterally , the corresponding prevalence rate was 12.92% (38/294) or 5.00% (30/600). The proportions of moderate and severe hearing were 3.33% (1/30) and 18.42% (14/76) (ANOVA, P<0.05). The possible causes of hearing loss consisted of jaundice (24.56%, 14/57), infection (24.56%, 14/57), asphyxia (19.30%, 11/57), low birth weight (17.54%, 10/57), and other factors (14.04%, 8/57). Conclusion   Hearing screening is a basic project for early detection of neonatal hearing loss. Binaurally failed cases are more likely to develop into hearing loss than the unilateral, and the degree of hearing loss might also be more severe. Jaundice, infection, asphyxia, and low birth weight are major causes for neonatal hearing loss.

    Expression and significance of CyclinD1 in middle ear cholesteatoma
    L Feng, LI Yong-tuan
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  13-15.  doi:10.6040/j.issn.1673-3770.0.2013.008
    Abstract ( 1758 )   PDF (1091KB) ( 881 )   Save
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    Objective   To investigate the expression of CyclinD1 protein and its role in the occurrence and development of middle ear cholesteatoma. Methods   Immunohistochemical technology(PV-6000) was applied to examine the expression of CyclinD1 in 30 cases of cholesteatoma tissues and 15 cases of normal auricle skin. Result   The positive expression rate of CyclinD1 protein in the middle ear cholesteatoma tissues was 70.0% and 26.7% in normal auricle skin(χ2=5.951,P<0.05). Conclusion   The overexpression of CyclinD1 suggested the hyperproliferative nature of cholesteatoma epithelium. CyclinD1 may play an important role in the formation and development of middle ear cholesteatoma.

    ELP enteric soft capsule and grommet insertion for chronic secretory otitis media
    WANG Gang, WU Chang-song, LIU Cheng, CHEN Shi-qin, HU Jin-wang
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  16-17.  doi:10.6040/j.issn.1673-3770.0.2012.309
    Abstract ( 2787 )   PDF (924KB) ( 1479 )   Save
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    Objective   To assess the efficacy of ELP enteric soft capsule and grommet insertion for chronic secretory otitis media with simple grommet insertion. Methods   60 cases(72 ears) chronic secretory otitis media were randomly divided into experimental group 30 cases(38 ears) and control group 30 cases(34 ears). Control group patients for simple grommet insertion by ear endoscopy, Experimental group patients for grommet insertion and ELP enteric soft capsule, assess the efficacy of tow groups after 6-month follow-up. Results   Experimental group 21cases(26 ears) cure, 6 cases(8 ears) improve, 3 cases(4 ears) invalid, Total efficiency 34/38. Control group 16 cases(16ears) cure, 7 cases(8 ears) improve, 7 cases(10 ears) invalid, Total efficiency 24/38. Efficacy of experimental group is better than control group(P=0.043). Conclusion   The efficacy of ELP enteric soft capsule and grommet insertion for chronic secretory otitis media is better than simple grommet insertion, can improve cure rate.

    Audiological analysis before and after artificial auditory ossicle implantation
    WANG Xia, WANG Pei-cheng, SONG Jian-jing, YU Xiao-wei, ZHANG Yu, WANG Ai-chu, LIU Xiu-ling, WANG Xue-hai
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  18-20.  doi:10.6040/j.issn.1673-3770.0.2012.251
    Abstract ( 2195 )   PDF (971KB) ( 837 )   Save
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    Objective   To compare the hearing changes in the patients with conductive deafness before and after ossicular chain reconstruction using artificial auditory ossicle, and analyze related factors affecting the improvement of hearing. Methods   The efficacy of ossicular reconstruction with ossicular replacement prosthesis or Titanium artificial auditory ossicle was reviewed in 46 patients. Prosthetic height was the distance between capitulum stapedis and malleus handle. Tympanic membrane was repaired by sandwich method, overlay method or underlay method with autologous antilobium perichondrium or temporalis fascia. Results   During the 6-to 67-month follow-up, tympanic membrane healed well in all the patients. The efficiency of hearing improvement was 78.7% and there was no rejection or recurrence. Conclusion   The application of ossicular chain reconstruction using ossicular replacement prosthesis in the patients with conductive deafness is safe and effective. The postoperative hearing improvement is significant and the inconvenience of  hearing aids is avoided.

    Cotton patch and  external auditory canal packing in the treatment of dry tympanic membrane perforation (54 cases report)
    DENG Bing-hui, LIN Yun-yan, WU Hua-fei, ZHONG Wen-ying
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  21-23.  doi:10.6040/j.issn.1673-3770.0.2012.275
    Abstract ( 2118 )   PDF (933KB) ( 797 )   Save
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     Objective   To explore the way to shorten the healing time of dry tympanic membrane perforation treatment with cotton patch. Methods   108 patients with dry tympanic membrane perforation were selected. They were randomly divided into two groups.In the test group(n=54), cotton patch and external auditory canal packing were applied . In the control group(n=54), only the cotton patch was applied. Healing time of both  groups was observed. Results   The healing time in the test group was (54.9±13.7) days, while the healing time in the control group was (65.2±16.0) days(t=-3.562, P=0.001). Conclusion   Cotton patch with concurrent  external auditory canal packing can significantly shorten the healing time in the treatment of dry tympanic membrane perforations.

    Expression of squamous cell carcinoma antigen and its clinical significance in the patients with sinonosal squamous carcinoma
    TANG Zhi, WANG Ji-qun, LI Yu-lan, CHEN Yong-ming, TU Zhi-feng
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  24-25.  doi:10.6040/j.issn.1673-3770.0.2012.358
    Abstract ( 1511 )   PDF (928KB) ( 906 )   Save
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    Objective   To determine the expression of squamous cell carcinoma antigen (SCC) and to explore its clinical significance in the patients with sinonosal  squamous carcinoma. Methods   Serum SCC of  35   patients with sinonosal  squamous carcinoma was detected by MEIA, and the clinical characters and the clinical significance of SCC were analyzed. Results   It showed that the positive rate of SCC expression was 54.29% in the sinonosal squamous carcinoma group, 35.0% in the nasal inverted papilloma group, and 6.67% in the nasal polyps group (P<0.05). The content of SCC was closely related to the clinical stage and pathological grade of sinonosal carcinoma (P<0.05). Conclusion   SCC-Ag is useful in diagnosis and clinical monitoring for sinonasal squamous carcinoma.

    Fluticasone propionate and loratadine granules improve the quality of life in patients with allergic rhinitis in childhood: A clinical observation
    LIU Ji-rong, YANG Ai-ping, YU Jia-rui, LI Yuan-ming, SU Chuan
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  26-28.  doi:10.6040/j.issn.1673-3770.0.2012.256
    Abstract ( 2186 )   PDF (979KB) ( 983 )   Save
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    Objective   To evaluate the therapeutic effect of fluticasone propionate and loratadine granules on quality of life(QOL) in patients with allergic rhinitis in childhood. Methods   77 patients with allergic rhinitis in childhood were randomly in this study. They were compared with self-controlled and healthcontrolled groups.QOL was measured by using rhinoconjunctivitis quality of life questionnaire(RQLQ). Patients were investigated 2 and 4 weeks after using fluticasone and Loratadine respectively. Symptoms were evaluated by the patients, and signs were evaluated by the investigators using scores under self-controlled models. RQLQ was administered at the start of treatment and 2 and 4 weeks after the treatment. Results   Fluticasone and loratadine improved the symptoms and signs. The 4-week scores which reached that of the health group were significantly less than the pre-treatment scores and the 2- week scores.  Conclusion   Fluticasone and loratadine play an extremely important role in the treatment and improve the QOL in patients with allergic rhinitis in childhood.

    Experimental study on regulatory T cells and IgE, IL-4 and IL-5 in a mouse model of allergic rhinitis and in administration of nasal corticosteroid
    PANG Wen-hui1, SHI Guang-gang1, SHI Lei1, WANG He-feng2, WANG Xiao-ting1, HAN Jie1, LI Jian-feng1, WANG Hai-bo1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  29-33.  doi:10.6040/j.issn.1673-3770.0.2012.389
    Abstract ( 1458 )   PDF (1911KB) ( 821 )   Save
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    Objective   To elucidate the expression and efficacy of CD4+CD25+FOXP3+ regulatory T cells(Tregs)as well as IgE, IL-4 and IL-5 in a stable experimental allergic rhinitis (AR) mouse model and in administration of nasal corticosteroid. Methods   Female Balb/c mice of 4-5 weeks were randomly divided into three groups: the normal group, the AR group and the nasal corticosteroid treatment group (n=10). The normal group was without any intervention; The AR group was sensitized by intraperitoneal injection and then challenged by atomization and intranasal instillation of ovalbumin (OVA) to induce allergic airway inflammation; The nasal corticosteroid treatment group was administrated by aerosol inhalation of fluticasone propionate for 10min after mice were successfully challenged. After 24h of the final challenge, all mice were sacrificed to collect samples. Nasal mucosa was stained with HemateinEosin (HE). Flow cytometry was applied for analyzing number of Tregs in paratracheal draining lymph nodes and the spleen. ELISA was used to assay serum OVA-specific IgE, IL-4 and IL-5 levels in nasal lavage fluid. Results   Compared to the normal group, mice in the AR group exhibited a significantly increased number of eosinophils in nasal mucosa, up-regulated expression of Tregs in paratracheal draining lymph nodes, and elevated OVA-specific IgE levels in serum and IL-4 and IL-5 levels in NALF. However, mice administrated with nasal corticosteroid were detected more significantly up-regulated Tregs in both paratracheal draining lymph nodes and the spleen, along with significantly decreased IgE, IL-4 and IL-5 levels. Conclusion   Tregs not only play an immunomodulatory role in the development of AR mediated by IgE, IL-4 and IL-5, but also in the administration of nasal corticosteroid.

    An investigation on treatment for chronic rhinosinusitis in 118 cases
    ZHAO Shu-min, LI Xue-zhong, LIU Di
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  34-36.  doi:10.6040/j.issn.1673-3770.0.2013.053
    Abstract ( 1192 )   PDF (973KB) ( 771 )   Save
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    Objective   To investigate the treatment condition of different groups of chronic rhinosinusitis(CRS) in our hospital. Methods   The questionnaires were given to 118 CRS patients who were divided into different groups, according to age, VAS score and education levels. Results   Education degree and VAS score factors influence the choice of the ways of treatment manner. Age and VAS score two factors influence choice of the most effective treatment manner. Age, VAS score and education degree three factors influence post-operative choice of the duration. Education degree influences post-operative choice of the most basic treatment manner. Conclusion   Due to personal situation, CRS patients is better in understanding pre-operative treatment knowledge than understanding post-operative treatment knowledge. 

    Inferior nasal concha flipping for treatment of inverted papilloma of the maxillary sinus by endoscopy
    CHEN Xiu-mei, SONG Xi-cheng
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  37-39.  doi:10.6040/j.issn.1673-3770.0.2012.315
    Abstract ( 1575 )   PDF (927KB) ( 681 )   Save
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    Objective   To explore the treatment method of inverted papilloma of the maxillary sinus. Methods   29 cases were treated by an inferiornasal concha flipping pathway from January 2006 to June 2011. All the cases were in stage Ⅲ according to the Clinical grading standard of Krouse. 4 cases originated in the maxillary sinus, the other 25 cases invaded in the maxillary sinus. All the patients were performed the operations by the inferior nasal concha flipping approach. Results   Followed up in 12 to 36 months, only 3 cases recurred. Among these recurrence cases, 2 were extensive lesion for all the sinuses and 1 originated in the frontal sinus. Conclusion   Inferior nasal concha flipping is helpful in reducing trauma and providing an expansive field of view and is an effective method of treatment of inverted papilloma of the maxillary sinus.

    Diagnostic of the origin on CT to sinonasal inverted papilloma
    LI Jing-yu, HE Fu-qin, ZHANG Nian-kai
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  40-42.  doi:10.6040/j.issn.1673-3770.0.2012.335
    Abstract ( 2324 )   PDF (1199KB) ( 880 )   Save
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    Objective   To precisely localize the origin of sinonasal inverted papilloma(SIP) by preoperative CT imaging so that the tumor can be thoroughly excised and result in low tumor recurrence. Methods   Sinonasal CT imagines of 25 patients were retrospectively reviewed to contract with the true origin, and the CT values of tumor origin and non-original tissue were calculated and the CT imagines were observed. Results   CT values were(36.87±10.21)HU at tumor origin, which demonstrated a higher density on CT imagines and appeared grey-white, and were (25.32±10.69)HU at the non-original tissue of the tumor, which showed a low density shadow and appeared grey-black. Using paired samples test, there were statistical differences between the two groups(P<0.05); 6 in 20 initial cases presented focal hyperostosis,4 of these cases coincided with the origin of tumor, the Consistency was up to 66.7%, 6 cases had air sign(24%),10 cases had bone displacement(40%) and 10 cases had bone destruction. Conclusion   CT values at the origin of SIP are higher than those at the non-original tissues, associated with bone changes. Air sign is helpful in detecting the tumor origin and making operation plans.

    Symptom characters of mucosa contact point headache
    LIN Jia-feng, CHEN Jian-qiu, WANG Bao-dong
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  43-45.  doi:10.6040/j.issn.1673-3770.0.2013.021
    Abstract ( 2000 )   PDF (1157KB) ( 649 )   Save
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    Objective   To study the symptom characters of mucosa contact point headache. Methods   A retrospective view was performed for  symptoms of mucosa contact point headache in sixty-eight cases. Results   Swelling pain on the forehead is the main symptom for mucosa contact point headache. Dizzy, not sober in the head, oscitancy and memory power difference are common accompanying symptoms. In some cases, accompanying symptoms other than headache are the chief clinic manifestation. Conclusion   Headache is not the only symptom of mucosa contact. It’s diagnosis should be based on comprehensive analysis of symptoms, the nasal cavity examination and CT scanning, not only relied on existence of headache and mucosa contact.

    Clinical analysis of palatine tumor in 61cases
    SHI Chun-sheng1, GE Chang-yi1, ZHANG Qing-quan2, SUN Yan2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  46-48.  doi:10.6040/j.issn.1673-3770.0.2012.375
    Abstract ( 2227 )   PDF (989KB) ( 661 )   Save
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    Objective   To discuss the clinical features and treatment principle of palatine tumors. Methods   61 patients with palatine tumors including 44 benign tumor and 17 malignant tumor cases were enrolled. All the benign tumors underwent local resection, while all the malignant tumors underwent extended resections. Topical/neck flap and acellular dermal matrix were applied to repair the defect. Two patients of squamous carcinoma received radiotherapy after the operation. Results   No recurrence was found in 44 benign tumors after the operation. Among the malignant tumors, one malignant transformation of mixed tumor was noted with in the 11 patients and was in progression after two years of local recurrence,and one squamous carcinoma resulted in lung metastases in 1 year after the operation. Conclusion   Palatine tumors with benign tumor is given priority to. Malignant tumors should undergo radiotherapy according to the situation and restoration of the soft palate function.

    Etiology and treatment of inspiratory laryngeal stridor in infants
    ZHAO Li-min, NI Kun, WU Jia-li, CHEN Shu-mei, LI Xiao-yan
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  49-51.  doi:10.6040/j.issn.1673-3770.0.2013.043
    Abstract ( 1984 )   PDF (972KB) ( 975 )   Save
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    Objective   To summarize the cause of inspiratory laryngeal stridor in infants in order to make accurate diagnosis and treatment of the disease. Methods   The medical records of 256 cases of patients 1ess than 2 years with presenting symptoms of stridor initially evaluated in the outpatient setting of otorhinolaryngological department from July 2009 to July 2012 were reviewed. The causes of stridor were clarified by examinations of flexible laryngoscopy in awake, throat three-dimensional CT (MRI)and bronchoscopy in all cases. Results   162 cases(63.3%, 162/256) were diagnosed as congenital airway abnomalities for cause of stridor including 153(59.8%, 153/256)congenital laryngeal abnormalities and 9 (3.5%, 9/256)congenital tracheal abnormalities. The most congenital laryngeal anomaly was laryngomalacia(151, 60.0%, 151/256) .The most congenital tracheal abnormalities was tracheomalacia(7, 2.7%, 7/256). Another 50 cases(19.5%, 50/256)were diagnosed as spaceoccupying lesions for cause of stridor. 11 cases(4.3%,11/256) were diagnosed as neurological diseasevocal cord paralysis.7 cases(2.7%, 7/256)were diagnosed as foreign body in airway and 26 cases(10.2%, 26/256)were respiratory infection.  Conclusion   Congenital airway strucunal abnormality is a major cause of infant laryngeal tridor. Laryngomalacia is still a major cause of infant inspiratory stridor which is spontaneously resolved. Other throat lesions are also important and should be diagnosed and treated in time. The principle of treatment is relief of symptoms by different therapeutic protocols according to different etiological factors.

    Hemorrhage following coblation-assisted tonsillectomy and adenoidectomy in children
    HOU Jin, WANG Bo-tao, YAN Jing, REN Xiao-yong, KANG Quan-qing, XU Min
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  52-55.  doi:10.6040/j.issn.1673-3770.0.2012.260
    Abstract ( 2077 )   PDF (950KB) ( 908 )   Save
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    Objective   To investigate the postoperative bleeding of coblation-assisted and traditional operation in children’s tonsillectomy and/or adenoidectomy. Methods   Data of 1597 children with tonsillitis and adenoid hypertrophy, who underwent traditional(804 cases) or coblation-assisted (793 cases) operation between January 1,2007 and December 30,2011, were reviewed.Incidence of hemorrhage, severity and location between the two groups were compared. Results   Postoperative hemorrhage occurred in 25 patients with coblation assisted operation (3.2%) and 19 patients with traditional operation (2.4%) (χ2=3.34, P>0.05). There was no difference in the site (χ2=0.736, P=0.085) or incidence (Z=0.392, P=0.614) . Significant difference was found in the interval of hemorrhage after surgery between the two surgical techniques(χ2=9.45, P<0.01). Conclusion   There is no difference in the postoperative hemorrhage for coblationassisted or traditional tonsillectomy and adenoidectomy in children.

    Low small incision in  total thyroidectomy and selective neck lymphnode dissection
    CAO Lei, HE Qing-qing, ZHUANG Da-yong, ZHENG Lu-ming, FAN Zi-yi, ZHOU Peng, ZHU Jian
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  56-59.  doi:10.6040/j.issn.1673-3770.0.2013.054
    Abstract ( 1632 )   PDF (1311KB) ( 716 )   Save
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    Objective   To explore the feasibility of harmonic focus scalpel combined with Frankfurt automatic retractor auxiliary low collar small incision in total thyroidectomy and selective neck lymphnode dissection. Methods   124 patients with thyroid cancer were randomly divided into two groups: the experimental group of 62 patients with harmonic focus scalpel combined with a low collar small incision assisted with a Frankfurt automatic retractor, and the control group of 62 patients with a low collar incision. Two groups were compared by hospitalization time, tumor size, incision length, operative time, blood loss, number of operators, post-operative drainage, post-operative drainage time, pre-operative and post-operative parathyroid hormone, serum calcium, serum phosphorusvalue, the number of resected lymph nodes and post-operative complications. Results   Compared to the control group, it was statistically decreased in operative time, number of operators, incision length and blood loss in the operation in the experimental group (P<0.05). However, other clinical indicators were not significantly different between the two groups(P>0.05). Conclusion   Utility of Harmonic focus scalpel combined with Frankfurt automatic retractor auxiliary low collar small incision underwent total thyroidectomy and selective neck lymph node dissection is feasible, and it has the advantages of shorter operative time, smaller number of operators, less blood loss  and smaller incision.

    Digitalized skullbase surgery: an anatomical and medical imageology study
    Mandulegeqi, LIU Yu-guang, ZHU Shu-gan, YANG Hong-an, YANG Yang
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  60-63.  doi:10.6040/j.issn.1673-3770.0.2013.017
    Abstract ( 1666 )   PDF (945KB) ( 479 )   Save
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    Objective   To quantitatively evaluated the feasibility of digitalized skull base surgery by comparing the corresponding accuracy of anatomical, imageology and neuronavigator based measurements. Methods   Distance between the anterior semicircular canal and the oval foramen of 25 cadaver skull bases (50 sides) were measured with caliper (an anatomical measurement), CT (an imageology base measurement) and neuronavigator (a neuronavigator based measurement), respectively. The data were documented and the accuracy of three different methods of measurement was statistically analyzed with Spss19.0 software. Results   ① The mean deviation of anatomical measurement was larger than that of the imageology based measurement from the corresponding mean of anatomical measurement(P<0.01); ② The mean deviation of the neuronavigator based measurement was larger than that of the imageology based measurement from the mean of anatomical measurement (P<0.01); ③ The mean deviation of the neuronavigator based measurement from the mean of anatomical measurement was a little bit larger than that of the anatomical measurement, whereas the P value (90%) was larger than 0.8. Conclusion   ① The data from imageology based measurement are more accurate than those from group-based anatomical measurement in evaluating individual anatomical characteristics; ② Errors occurred during registration and application will compromise the accuracy of a neuronavigator to a more or less extent; ③ Statistically equivalent accuracy is undeniable(the power of the test was as high as 90%)between the anatomical and neuronavigator based measurements, even if deviations from the latter are inevitable.

    Clinical characteristics and treatment of 11 patients with Behcet’s disease
    LIU Shou-li, HAN Feng-qin
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  64-65.  doi:10.6040/j.issn.1673-3770.0.2013.015
    Abstract ( 1568 )   PDF (1118KB) ( 704 )   Save
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    Objective   To investigate the clinical characteristics and treatment measures of Behcet’s disease. Methods   We retrospectively studied clinical data of 11 patients (22 eyes) with Behcet’s disease. Five patients were treated with glucocorticoids, and six patients were treated with glucocorticoid and immunosuppressants. Results   Visual acuity decreased in 8 eyes and unchanged in 2 eyes in glucocorticoid therapy group. Visual acuity decreased in 2 eyes, unchanged in 6 eyes, and improved by 1 line in 3 eyes and by 2 lines in 1 eye in combination therapy group. Conclusion   Uveitis in Behcet’s disease is a severe blind disease. The combination therapy of early, sufficient and systemic application of glucocorticoid and immunosuppressants might avoid serious consequences.

    Effect of prior laser and triamcinolone acetonide on vitrectomy of proliferative diabetic retinopathy
    LIU Bei1, ZHU Zhong-qiao1, DU Shan-shuang1, WANG Li-li2, YANG Xin-guang1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  66-68.  doi:10.6040/j.issn.1673-3770.0.2012.353
    Abstract ( 1567 )   PDF (936KB) ( 676 )   Save
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    Objective   To observe the effect of prior laser and triamcinolone acetonide  on vitrectomy of proliferative diabetic retinopathy. Methods   The study included 110 patients (132 eyes) with proliferative diabetic retinopathy who underwent vitrectomy. The 65 patients (72 eyes) who underwent prior and standard laser treatment accepted vitrectomy and triamcinolone acetonide (4mg/0.1mL) was injected into the vitreous. The 45 patients (60 eyes) who never underwent standard laser treatment accepted vitrectomy and triamcinolone acetonide (4mg/0.1mL) was injected into the vitreous one week before the vitrectomy. All the patients were followed up for 3 months, and the clinical curative effect was summarized. Results   The natural visual acuity and best corrected vision acuity had significant differences 1 month after operation than before operation. The postoperative inflammatory reaction of anterior chamber was mild in the most patients. Postoperative intraocular press increased in 41eyes(31.1%), and turned normal after the patients used medicine. Conclusion   The early standard laser treatment combined with triamcinolone acetonide before and during operation is helpful to decrease the hemorrhage and other serious complications.

    Effects of psychological intervention on botulinum toxin for  Belepharospasm and Hemifacial spasm
    BO Ming-xiang1, ZHANG Ying-ying2, ZHANG Li-gui2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  69-70.  doi:10.6040/j.issn.1673-3770.0.2012.379
    Abstract ( 1607 )   PDF (1022KB) ( 476 )   Save
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    Objective   To explore the effects of psychological intervention on botulinum toxin injections for Belepharospasm and Hemifacial spasm. Methods   Fifty-six patients with Belepharospasm and Hemifacial spasm who accepted botulinum toxin injection were randomly divided into experimental group(n=30) and control group(n=26). Conventional care was given to the two groups. In addition, the experimental group accepted psychological intervention. Self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were used to evaluate the treatment efficacy. We contrasted the improvement of sleep quality and the grade point variation of SDS and SAS between the two groups. Results   The sleep quality in the experimental group was significantly better than that in the control group(P<0.01). The scores of SDS and SAS in the two groups were better after treatment than before treatment, and the difference was more obvious in the experimental group. Conclusion   There is a significant clinical effect of psychological intervention for Belepharospasm and Hemifacial spasm.

    Comparison of corneal nerve regeneration of femtosecond laser and keratotome for laser in situ keratomileusis using confocal  microscope
    HAN Shi-chao1, CUI Chuan-bo2, LI Yan1, HAO Fa-xiang1, SHEN Hong-jing1, XIAO Jun-jie1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  71-74.  doi:10.6040/j.issn.1673-3770.0.2012.374
    Abstract ( 1857 )   PDF (1292KB) ( 748 )   Save
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    Objective   To observe and compare the short-term change of morphology of regenerated subbasal nerve fiber after the femtosecond laser and keratotome for laser in situ keratomileusis (LASIK) using confocal microscope.  Methods   In this study, 40 patients (80 eyes) with refractive error were randomly divided into 2 groups: femtosecond laser was used for LASIK myopic surgery in 20 patients (40 eyes), and keratotome was used in the other 20 patients (40 eyes). The morphology of corneal subbasal nerves was observed with confocal microscope 1 week, 1 month and 3 months after surgery. Results   Only short (<50μm), curved and independent subbasal nerve fibers were observed in a small number of eyes in the two groups 1 week after surgery. The subbasal nerve fibers were longer 1 month after surgery than 1 week after surgery, but no branch connection was found between the nerve fibers. The length of subbasal nerve fibers at central corneal was more than 200μm in 18 eyes(45.0%) in femtosecond group and in 25 eyes(62.5%) in keratotome group, and there were intercommunicating branches and class beaded structures between subbasal nerve fibers at central cornea 3 months after surgery. Conclusion   The postoperative nerve morphology in femtosecond laser group and keratotome group was close to preoperative nerve morphology with time. The regenerated subbasal nerve in keratotome group was better than in femtosecond laser group 3 months after surgery, but there was still difference compared with preoperative morphology.

    Early laser photocoagulation combined with triamcinolone acetonide in treating macular edema secondary to temparal branch retinal vein occlusion
    YAN Xiao-teng, KANG Jian-fang, FENG Jun
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  75-76.  doi:10.6040/j.issn.1673-3770.0.2012.298
    Abstract ( 2016 )   PDF (963KB) ( 745 )   Save
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    Objective   To evaluate the effect of early laser photocoagulation combined with triamcinolone acetonide(TA) in treating macular edema secondary to temparal branch retinal vein occlusion. Methods   A total of 42 patients (42 eyes) with macular edema secondary to temparal branch retinal vein occlusion diagnosed by fundus fluorescein angiography(FFA) and optical coherence tomography (OCT) were treated by TA and early laser photocoagulation. The changes were observed including the visual acuity, intraocular pressure, FFA and CMT in the first, third and sixth months after treatment. Results   The visual acuity 6 months after treatment was improved in 37 eyes, remained the same in 4 eyes, and declined in 1 eye. The best corrected visual acuity was more than 0.3 in 11 eyes before treatment and 23 eyes after treatment. The CMT was (561±104) μm before treatment, and(349±93) μm 6 months after treatment (P<0.01). The introaocular pressure increased in 2, 6 and 1 eyes 1, 3 and 6 months after treatment respectively, and became normal after eye drops administration for a short time. Conclusions   Early laser photocoagulation combined with retrobulbar injection of TA is safety and effective in treating macular edema secondary to temparal branch retinal vein occlusion.

    Standardization of diagnosis and treatment of otitis media with effusion in children
    JING Shang-lin, LIN Nan, CHEN Ji-chang
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  77-80.  doi:10.6040/j.issn.1673-3770.0.2012.284
    Abstract ( 1761 )   PDF (939KB) ( 538 )   Save
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    Otitis media with effusion (OME) is a non-suppurative disease of the middle ear which is mainly characterized as the tympanic effusion and conductive deafness. It is one common childhood diseases, and the younger the children are, the higher the incidence will be. Children’s OME has its own characteristics in terms of etiology, course and clinical manifestations. If improperly treated, it will deteriorate into adhesive otitis media, tympanosclerosis, cholesterol granuloma etc., which can cause the permanent hearing loss. In severe cases, it may affect the normal development of language and intelligence, resulting in serious adverse consequences. Based on the current progress in the reserch, we conducted a deep investigation on the pathogen, pathogenesis and clinical features of the OME  in children to provide the clinical information by recommending the individualized and standardized therapeutic strategy.

    Treatment progress of diabetic macular edema
    XIE Li, WEI wei
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  81-85.  doi:10.6040/j.issn.1673-3770.0.2012.301
    Abstract ( 2502 )   PDF (958KB) ( 945 )   Save
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    Diabetic macular edema in diabetic patients is one of the main causes of vision loss, and its pathogenesis is speculated to be related to blood retinal barrier breakdown and cytokine interaction. More effective treatment in clinic has been explored, and in this paper, the treatment of diabetic macular edema and the development trend are reviewed.

    Application of flaps in the reconstruction of soft palate defects
    SHI Chun-sheng1, ZHANG Qing-quan2, WANG Qiang2, SUN Yan2, GE Chang-yi1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  86-88.  doi:10.6040/j.issn.1673-3770.0.2013.010
    Abstract ( 1500 )   PDF (963KB) ( 1268 )   Save
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    Soft palate deformities and velopharyngeal dysfunctions caused by soft palate defects are very significant. Scholars and clinicians have done a lot of research and published many papers about the repairing methods. In our essay, we summarize clinical experience of our work, combined with academic reports of other experts and scholars, to come up with an overview of current clinical methods and characteristics of different flaps, as well as a overlook to the future development.

    Suture following correction of deviation of the nasal septum
    LI Chang-qing, ZHANG You-ji, ZHANG Ming-xin, SUN Da-wei, MA Ke
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  89-90.  doi:10.6040/j.issn.1673-3770.0.2012.307
    Abstract ( 1821 )   PDF (1061KB) ( 1486 )   Save
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    Epiglottic cyst treatment by electric coagulation under an endoscope and an anesthetic laryngoscope
    YANG Jie-chao, ZOU Jia-ping, ZHANG Lei
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  91-92.  doi:10.6040/j.issn.1673-3770.0.2012.299
    Abstract ( 2093 )   PDF (912KB) ( 841 )   Save
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    1 case of petrous apex cholesteatoma deafness patients
    ZHANG Ling1, SUN Chuan-yi1, XU An-ting2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(2):  93-94.  doi:10.6040/j.issn.1673-3770.0.2012.329
    Abstract ( 1489 )   PDF (1303KB) ( 845 )   Save
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