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    16 June 2013 Volume 27 Issue 3
      
    Articles
    Partial radiofrequency ablation tonsillectomy for children with OSAHS
    CHEN Xi, LI Jin-rang
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  1-3.  doi:10.6040/j.issn.1673-3770.0.2012.339
    Abstract ( 1398 )   PDF (1136KB) ( 547 )   Save
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    Objective   To investigate the efficacy and feasibility of partial radiofrequency ablation tonsillotomy children with OSAHS. Methods   239 OSAHS children were divided into two groups. Except for adenoid ablation, complete radiofrequency ablation tonsillectomy was performed in group A (183 cases ), but partial tonsillectomy was performed in group B(56 cases). The operation time,postoperative pain, and days-before-returning-to-normal-diet between  the two groups were evaluated. Results   The operation time,postoperative pain, days-before-returning-to-normal-diet were significantly less (U=2.685, 582.00, 84.00, 2519.00, 306.00,  P<0.05, respectively) in group A  than in group B. During the 6-to 12-month followed-up,symptoms of snoring and mouth breathing all disappeared. Conclusion   Partial radiofrequency ablation tonsillectomy is an effective method for children with OSAHS.

    Therapeutic effects of multiplanar operation for the obstructive sleep apnea hypoventilation syndrome
    ZHAO Wei1, GU Zhao-hui1, ZHOU Yan1, HU Yan1, HE Jing2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  4-6.  doi:10.6040/j.issn.1673-3770.0.2013.011
    Abstract ( 1456 )   PDF (953KB) ( 528 )   Save
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    Objective   To investigate the effect of  one stage multiplanar operation for the obstructive sleep apnea hypoventilation syndrome(OSAHS). Mehods   68 cases with nasal、 palatopharyngeal and oropharyngeal obstruction received H-uvulopalatopharyngoplasty(H-UPPP), nasal reconstruction and hyoid suspension. Before the operation, some severe cases underwent continuous positive airway pressure(CPAP) therapy or tracheotomy. Results   In 68 cases, all the  operations were performed successfully. No death or  severe complications occurred during the operation and follow-up. According to  polysomnography(PSG), the effectiveness was 100%  6 months later and 95.55% after one year. 6 months and one year after the operation, the changes of AHI and SaO2 were  significant (P<0.05) compared with those  preoperative. On CT scanning, the anteroposter dimensions of retroglossal areas were decreased, and retropalatal areas were increased after surgery (P<0.05). The shape of airway was improved  significantly. Conclusion   The one stage multiplanar operation is safe and effective for OSAHS. The shape of airway tends to be normal . CPAP before the operation can  effectively  prevent postoperative severe complications.

    Effects of monopolar electrocautery and traditional tonsillectomy in treatment of OSAHS
    TENG Yi-shu, LI Lan, LIANG Zhen-jiang, XIAN Zhi-xiong, HAN Sai-hong, ZHANG De-lun
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  7-9.  doi:10.6040/j.issn.1673-3770.0.2012.333
    Abstract ( 1606 )   PDF (1021KB) ( 716 )   Save
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    Objective   To compare the efficiency, advantages and disadvantages of monopolar electrocautery and traditional tonsillectomy. Methods   Eighty patients with hypertrophic tonsil, which led to obstructive sleep apnea hypopnea syndrome or chronic tonsillitis, underwent tonsillectomy. Among them, 40 cases were treated with traditional tonsillectomy(group A) and the other 40 cases were treated with monopolar electrocautery (group B). Differences in operation time, blood loss and postoperative pain between the two groups were compared. Result   There were significant differences in operative time and blood loss(P<0.05), but not in postoperative pain between the two groups. No postoperative bleeding occurred in all the patients. Conclusion   The monopolar electrocautery tonsillectomy is safe for children, and can reduce the  intraoperative blood loss and improve the efficiency of the operation.

    Clinical observation of continuous positive airway pressure  combined with captopril and nifedipine in the treatment of patients with severe OSAHS accompanied with hypertension
    YANG Rong, ZONG Tao, SUN Ya-nan, LU Jin-fa
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  10-12.  doi:10.6040/j.issn.1673-3770.0.2013.082
    Abstract ( 1217 )   PDF (1105KB) ( 505 )   Save
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    Objective To investigate the effect of continuous positive airway pressure (CPAP) combined with captopril and nifedipine on severe obstructive sleep apnea hypopnea syndrome (OSAHS) patients with hypertension. Methods Sixty-six patients with severe OSAHS accompanied with hypertension were randomly divided into control group and CPAP group. In control group, the patients underwent captopril and nifedipine treatment for 8 weeks, while in CPAP group, extra CPAP treatment was applied concurrently for 4 weeks. Systolic and diastolic blood pressures were measured at 22:00, 2:00, 6:00 respectively. Effective rate and blood pressure changes before and after the treatment between the two groups were compared. Results The effective rates in both groups showed no significant differences at 22:00 (Ctrl 78.8%; CPAP 75.6%) and 2:00 (Ctrl 63.6%; CPAP 60.6%) (P>0.1, P>0.1). However, effective rate in CPAP group was significantly higher (75.6%) than that of control group (51.5%) at 6:00 (0.025<P<0.05). Total effective rate in CPAP group (76.7%) was higher than that of control group (52.1%) (P<0.05). Conclusion CPAP combined with Captopril and nifedipine can effectively control hypertension in severe OSAHS patients and the total effective rate is higher than oral medication alone.

    Application of double islands pectoralis major myocutaneous flap in reconstruction of head and neck tumor surgery
    LIU Chuang-ming1,2, LU Yong-tian1, WANG Xiao-bin1, MIAO Bei-ping1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  13-15.  doi:10.6040/j.issn.1673-3770.0.2013.018
    Abstract ( 1185 )   PDF (1333KB) ( 732 )   Save
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    Objective   To evaluate the effectiveness and advantages of double islands pectoralis major myocutaneous flap in the reconstruction of defects after head and neck tumors’ excision. Methods   8 patients underwent  double islands pectoralis major myocutaneous flap reconstruction  after head and neck tumors were  removed.  Results   All  the reconstructed hypopharyngeal cavity were not narrow, and the neck skin were survived.  7 flaps were well survived, except one patient who suffered from  mild necrosis in the skin edge which was cured after treatment. The mean resumption of oral intake was 10 days (8-12) after surgery. Mean hospital stay was 16 days (14-20). Conclusion   Because of  excellent blood supply and abundant tissue, double islands pectoralis major myocutaneous flap is a preferred one-stage method to reconstrut the double defects, including  skin and mucosa, in head and neck tumor surgery.

    Clinical analysis of adenoid cystic carcinoma of larynx and trachea (10 case report)
    HE Fa-yao, WANG Yue-jian, CHEN Wei-xiong, ZENG Yong, ZHU Zhao-feng, ZHANG Jian-li, TANG Su-cheng
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  16-18.  doi:10.6040/j.issn.1673-3770.0.2013.112
    Abstract ( 1805 )   PDF (916KB) ( 1139 )   Save
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    Objective   To explore the clinical characteristics, treatment and outcome of adenoid cystic carcinoma(ACC) of the larynx and trachea. Methods   Clinical data of 10 patients with ACC in larynx and trachea was reviewed. Among theses cases, there were 1 T1N0M0,1 T2N0M0,3 T3N0M0 of laryngeal ACC (UICC2002 TNM staging), and 1 T1N0M0, 3 T2N0M0 , 1 T3N0M0 of tracheal ACC (Bhattacharwa staging). Laryngalgia, hoarseness, cough and progressive dyspnea accompanied with stridor were the main complaints. Surgery plus postoperative radiotherapy was applied to all the cases. Total/partial laryngectomy or sleeve resection of trachea followed by anastomosis were performed for ACC of larynx and trachea. The dose of intensity modulated radiotherapy varied from 60-70Gy. Results    10 patients recovered well without complications. Neither local recurrence nor metastasis was noted during the followup from 2 months to 7 years. Conclusion   With progressive dyspnea accompanied with stridor, cough and hoarseness, ACC of the larynx and trachea features low cervical lymph node metastasis and good prognosis. It can be detected early by laryngoscope. Surgery combined with postoperative radiotherapy is the best treatment for this disease.

    A preliminary study to establish the tumor bank for head and neck carcinoma
    TIAN Shen-zhi, ZHAI Jin-ming, YUAN Xu-ping, ZHANG Jian-guo, HUANG Min-qi, GUO Zhen-ping
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  19-21.  doi:10.6040/j.issn.1673-3770.0.2012.336
    Abstract ( 1427 )   PDF (1058KB) ( 677 )   Save
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    Objective  To explore the methods to establish a tumor bank for head and neck carcinoma by collecting and preserving the tumor tissue specimens with an information-based database. Methods   The tumor tissues, tumor-adjacent tissues, normal tissues were collected from surgery or biopsy, as well as peripheral blood samples, including serum, plasma, lymphocyte or stem cells, etc, from head and neck carcinoma patients and healthy subjects.  All the specimens were stored in liquid nitrogen or -80℃ refrigerator. Meanwhile, an information-based database was established.  Results   Specimens from 220 cases were collected, including 120 cases of carcinoma (tumor and tumor-adjacent tissues) and 100 cases of tissues without tumor. Samples of peripheral blood from 476 cases were collected, including 316 cases of carcinoma and 160 healthy subjects. Conclusion   The tissue bank of head and neck carcinoma can be established large-scalely and intensively,  which  can greatly enhance the efficiency of specimen usage.

    Result of skin prick tests in patients with allergic rhinitis in Shandong province
    ZHAO Li1, YANG Yan2, SHI Li2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  22-24.  doi:10.6040/j.issn.1673-3770.0.2013.079
    Abstract ( 1513 )   PDF (919KB) ( 998 )   Save
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    Objective   To estimate common allergic antigens and analyze its epidemiologic data in Shandong province. Methods   Skin prick tests of 30 types of allergopharma allergens were made on 2218 patients with suspected allergic rhinitis. Results   1619 patients (73%) had positive reactions, 486 of which had single positive allergen and 1133 had over two positive allergens. Dust mites were the most common in 1164 cases(71.9%) , house dust mites were the second in 1125 cases (69.5%). Conclusion   Dust mites and house dust mites are the most common allergic antigens in patients with allergic rhinitis in Shandong province, and pollens and molds follow them.

    Allergens in patients with allergic rhinitis in Jinan area
    HE Zhen, CHEN Jian-qiu, ZHU Chun-sheng, LIN Jia-feng, YE Ben, LI Gen-hong, ZHAO Xiu-juan, ZHANG Tian
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  25-26.  doi:10.6040/j.issn.1673-3770.0.2013.049
    Abstract ( 1675 )   PDF (948KB) ( 583 )   Save
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    Objective   To explore the allergens of allergic rhinitis(AR) patients living in Jinan area. Methods   The medical records of skin prick tests (SPT) performed in 1138 AR patients were retrospectively analyzed. The samples were divided into two groups based on age or on gender: the 2-18-year old group and the 19-70-year old group, or the male group and the female group. Sensitizing allergens were assessed and the positive rates of aeroallergens were compared between the groups. Results   There were 843 patients (74.08%) with positive prick test result. The  aeroallergens was as follows: mite in 745 cases(88.37%), cockroach in 363 cases(43.06%), farina in 301 cases(35.71%), freshwater fish in 207 cases(24.56%), dog hair in 139 cases(16.49%), cat hair in 74 cases(8.78%), scandent hop in 39 cases(4.63%), Felon herb in 18 cases(2.14%), albumen in 15 cases(1.78%), mutton in 12 cases(1.42%), milk in 4 cases(0.43%) and beans in 3 cases(0.36%). There was significant difference of distribution of cockroach and dog hair between the age groups (P<0.01). There was no significant difference between male and female patients neither in distribution of aeroallergens nor in single allergen and multiple allergens(P>0.05).  Conclusion   The most common allergen in patients with allergic rhinitis in Jinan seems to be mite, and the second is cockroach and farina. Mutton, milk and been are rate allergen of allergic rhinitis patients in Jinan. With the age growing, part allergens positive rate are changed. The distribution of aeroallergens has no correlation with gender.

    Clinical effect of operation for allergic rhinitis with septumdeviation.
    ZHANG Tian1, CHEN Jian-qiu1, LIN Jia-feng1, LI Gen-hong1, YE Ben1, HE Zhen1, ZHAO Xiu-juan1, WANG Hui-li2, ZHU Chun-sheng1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  27-29.  doi:10.6040/j.issn.1673-3770.0.2013.063
    Abstract ( 1898 )   PDF (920KB) ( 648 )   Save
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    Objective   To investigate the effect of nasal endoscopic operation on persistent allergic rhinitis with septum-deviation. Methods   According to the symptoms, sinus CT and examination result of the nasal cavity,132 patients with persistent allergic rhinitis with septum-deviation were randomly divided into A, B and C groups separately using drug-therapy, endoscopic nasal septal reconstruction and endoscopic nasal septal reconstruction and inferior turbinate angioplasty. Results   After a follow-up of 3 months, the total effect rates of the three groups respectively were 86.36%, 93.18% and 100%. After a follow-up of 6 months, they were 68.18%, 86.36% and 97.73%, respectively. After a follow-up of 1  year, they were 43.18%, 81.82% and 95.45%, respectively. Conclusion   Comparing with drug therapy, nasal endoscopic operation is better for persistent allergic rhinitis with septum deviation. Endoscopic nasal septal reconstruction and inferior-turbinate angioplasty or inferior turbinate lateral fracture can obtain a more satisfactory long-term curative effect.

    Analysis of treatment in chronic hypertrophic rhinitis of two different surgical methods
    TAN Guo-jie, YAN Yong-yi, LIN Ying
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  30-32.  doi:10.6040/j.issn.1673-3770.0.2013.020
    Abstract ( 1453 )   PDF (917KB) ( 707 )   Save
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    Objective   To analyze the effect of two different surgical methods for chronic hypertrophic rhinitis. Methods   124 patients were randomly divided into two groups with nasal endoscopy surgery. 64 patients underwent submucous resection of partial inferior-turbinate-bone via the front incision (Group A). 60 patients underwent submucous tissue resection of partial inferior-turbinate with a micro-suction cutter(Group B). Recovery and efficacy of the two groups after one, six and 12 months were compared between the two groups. Result   Group A had a superior one-year-efficacy to group B. Conclusion   Submucous resection of partial inferior-turbinate-bone via the front incision had better efficacy and function, which retained all the normal mucosa and normal functional sinus tissue of the inferior turbinate was worth appropriately making surgical indications widen.

    Effect of atrophic rhinitis treated with allograft bone powder
    HAN Nai-gang, LI Xiao-hong
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  33-35.  doi:10.6040/j.issn.1673-3770.0.2013.119
    Abstract ( 1849 )   PDF (914KB) ( 718 )   Save
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    Objective    To evaluate the effects for atrophic rhinitis by using allograft bone powder. Methods   46 patients with atrophic rhinitis were treated by padding allograft bone powder tissue under mucous-periosteum of nasal base. Results   During a follow-up of 1 to 10 years, the significant effect rate was 73.9%, the effect rate was 26.1% and the total effect rate was 100%. No serious complication happened. Conclusion   This surgical procedure presents an ideal effect.

    Diagnosis and endoscopic treatment of congenital nasal mass of infants
    HOU Dong-ming, CAO Rong-ping, MENG Guo-zhen, CHENG Lan
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  36-38.  doi:10.6040/j.issn.1673-3770.0.2012.320
    Abstract ( 2258 )   PDF (907KB) ( 556 )   Save
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    Objective   To explore the diagnosis and transnasal endoscopic surgical treatment of congenital nasal mass of infants. Methods   Clinical data including CT and MRI imaging of 12  infants with congenital nasal mass were retrospectively analyzed. Results   3 cases of meningocephaloceles, 1 glioma, 3 hamartoma, 1 teratoma and 3 hemagioma were diagnosed and removed under transnasal endoscopic approaches, and 1 case of rhabdomyosarcoma was diagnosed   only following chemical treatment. Conclusion   CT and MRI imaging both are helpful in characterizing the nasal mass and potential skull base defects. The transnasal endoscopic technique is helpful in completely removing the nasal masses in most cases and promptly repairing the skull base defects along with precise visualization and minimally invasiveness.

    Sphenoid sinus open surgeries for sphenoid sinus related diseases
    ZHONG Zhao-tang, LIANG Min-zhi, CHEN Ze
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  39-41.  doi:10.6040/j.issn.1673-3770.0.2012.376
    Abstract ( 1857 )   PDF (912KB) ( 963 )   Save
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    Objective   To improve the understanding of sphenoidotomy for sphenoid sinus and related diseases. Methods   The clinical data of 42 cases of sphenoidotomy treated in our department were retrospectively analyzed. There were type 1 sphenoidotomy for 18 cases of bacterial sphenoiditis, type 2 sphenoidotomy for 19 cases related of sphenoid sinus mycoses, submucosal cyst and papillary tumor, type 3 sphenoidotomy for 5 cases related for adjusting ethmoid sinus mucocele, pituitary tumor, rock peak cholesteatoma and rock peak cholesterol granulation cyst. Results   All patients were cured and did not relapse during a followup of six months to 3 years. One case of pituitary tumor had post-operative cerebrospinal fluid rhinorrhea was cured after conservative treatment. Conclusion   Different types of sphenoid sinus open surgery can be used to treat different sphenoid sinus diseases, also can be used as the nasal endoscopic skull base surgery approach.

    Cavemosum of the inferior turbinate be retained in the nasal cavity surgery expansion for obstructive sleep apnea hypopnea syndrome
    ZHANG Hao-liang, YU Feng, GONG Hui-cheng, ZHANG Qun-hui
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  42-44.  doi:10.6040/j.issn.1673-3770.0.2013.004
    Abstract ( 1746 )   PDF (1168KB) ( 999 )   Save
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    Objective   To investigate an improved surgical approach of nasal cavity surgery expansion for obstructive sleep apnea hypopnea syndrome (OSAHS). Methods   55 OSAHS patients with choking plane located in the nasal cavity were enrolled in the treatment group in which cavemosums of inferior turbinate had been retained in the nasal cavity surgery expansion and 26 patients were performed partial removal of the inferior turbinate submucosal the preoperative data and postoperative data results were compared. PSG data of AHI, AI, LSaO2 and  MSaO2 of the two groups were compared. Result   Followed up for 6 to 12 months, the latter had poor results. Conclusion   The operation of cavemosums of inferior turbinate had been retained in the nasal cavity is helpful in reserving nasal function and has good clinical effect for OSAHS typeⅠ. It is better than portion inferior turbinate submucosa excision. 

    Artificial lacrimal duct retrograde placement through the nasal cavity in treatment of chronic dacryocystitis
    YAN Xiao-teng, FENG Jun
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  45-46.  doi:10.6040/j.issn.1673-3770.0.2012.314
    Abstract ( 1621 )   PDF (904KB) ( 861 )   Save
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    Objective   To observe the clinical curative effect of artificial lacrimal duct retrograde placement through the nasal cavity. Methods   93 patients with chronic dacryocystitis were randomly divided into two groups: the observation group (50 patients) with artificial lacrimal duct retrograde placement through the nasal cavity and the control group (43 patients) using dacryocystorhinostomy. Results   During a post-operative follow-up of 3 months, artificial lacrimal duct retrograde placement through the nasal cavity had the same effect as  dacryocystorhinostomy did , but had statistically different VAS pain scores between 4h and 24h. Conclusion   Artificial lacrimal duct retrograde placement through the nasal cavity for chronic dacryocystitis is  good, and it is  effective in relieving postoperative pain.

    Causes and efficacy of vitrectomy for secondary epiretinal membrane
    RAN Li-li1,2, YUAN Gong-qiang2, DONG Xiao-guang2.
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  47-49.  doi:10.6040/j.issn.1673-3770.0.2013.014
    Abstract ( 2025 )   PDF (995KB) ( 631 )   Save
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    Objective   To observe morphological and functional changes in the macular in eyes with different kinds of secondary epiretinal membranes (SEM) and to explore the significance of surgical treatment. Methods   A retrospective, observational case series of 55 patients with SEM who underwent pars plana vitrectomy and membrane peeling during October 2008 and August 2012 were included. The causes of SEM were classified. Changes in macular morphology before and after the surgery were observed by optical coherence tomography. The thickness of neuroepithelium in the central macular area(CMT) and the integrity of its IS/OS layer were recorded, as well as best corrected visual acuity (BCVA, logMAR). Paired t test was used to compare pre-operative and post-operative BCVA. Independent sample t test was used to compare BCVA and CMT between group of IS/OS layer integrity and unintegrity. Results   Trauma, cataract surgery,laser photocoagulation,and retinal vein occlusion etc had relation with this disease.5 patients(9.09%) were lost for follow-up. In the other 50 patients, 40 eyes (80.00%) had their vision improved and 10 eyes (20.00%) had no changed. Postoperative BCVA was improved (t=-7.467, P<0.001).The eyes with intact IS/OS layer had better post-operative BCVA than the other eyes(t=-4.437, P<0.001),but CMT did not(t=-0.990, P=0.329). Conclusion   Secondary epiretinal membrane has significant influence on macular function. Surgical treatment can save or improve the patients’ visual quality.

    Effect of posterior vitreous detachment in high myopia eyes after Bigbag intraocular lens implantation
    TANG Dong-yong, TAN Shao-jian, LIANG Hao, HE Jian, LI Xia
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  50-53.  doi:10.6040/j.issn.1673-3770.0.2013.003
    Abstract ( 1561 )   PDF (936KB) ( 1122 )   Save
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    Objective   To evaluate the occurrence of posterior vitreous detachment (PVD) in high myopia patients’ cataract surgery with Bigbag intraocular lens implantation. Methods   Sixty-six eyes in 38 high myopia patients received phacoemulsification to remove cataract. Then Bigbag intraocular lens were implanted into capsular bag. Pre-operative and post-operative best uncorrected distance visual acuity (BUDVA), best corrected distance visual acuity(BCDVA), refractive status were collected. The axial length of the eyeballs and the distance from the central of posterior capsule to the retina were measured by A-mode ultrasound. Occurrence of PVD was evaluated by B-scan ultrasonography and Non-contact slit lamp lenses. Results   Six months after the operations, BUDVA and BCDVA were significantly improved compared with those pre-operatively, while the spherical diopter was significantly decreased. But the axial length had not significantly changed. The distance from the central of posterior capsule to retinal became longer than that before the operations, with the average margin for distance variation of (1.56±0.41)mm. Pre-operatively, PVD was detected in 45 eyes (68.18%). Of the 21 eyes without PVD before the operation, 14 eyes (66.67%) developed PVD post-operatively. No retinal detachment was detected. Conclusion   Bigbag intraocular lens implantation is safe and effective for high myopia eyes with cataract. The incidence of PVD in such patients is relatively low.

    Clinical analysis of combined therapy for 166 children with amblyopia
    CHEN Peng, WANG Hong, WANG Jing, ZHAO Xin
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  54-55.  doi:10.6040/j.issn.1673-3770.0.2013.027
    Abstract ( 2043 )   PDF (944KB) ( 875 )   Save
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    Objective   To explore the curative effect of combined therapy for children with amblyopia. Methods   166 cases (280 eyes) were treated by combined therapy of eyeglasses, occlusion, eyesight exercise, flicker pleoptics and vision stimulation. Results   The basical cure rate was 71.79% (201 eyes) and progress rate was 23.57% (66 eyes). The total effective rate was 95.36%. Conclusion   Combined therapy is an effective method in treating amblyopia. The curative effect of amblyopia is related with age, amblyopia type, degree, fixation pattern and treatment duration.

    Characteristics of 535 cases of glaucoma in outpatient department
    WANG Yin-yan, LI Lu-lu, TAO Yu, SHEN Jia-quan
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  56-59.  doi:10.6040/j.issn.1673-3770.0.2013.066
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    Objective   To investigate the proportion and distribution features of glaucoma patients in out-patient department. Methods   The clinical data of 535 cases of glaucoma in out-patient department in our hospital from January 2012 to December 2012 were analyzed, which were compared with the clinical data in Jiangxi Medical College Affiliated Hospital out-patient department in 1955. Results   Of the 535 cases, primary-angle-closure glaucoma(PACG), open-angle glaucoma(POAG), secondary glaucoma(SG), and congenital glaucoma (CG) accounted for 51.21%, 20.19%, 17.39% and 11.21% respectively; the male and female ratio of 4 types of glaucoma was 1∶1.88, 3.5∶1, 2.44∶1 and 1∶1.07 respectively. The blindness rate of open-angle glaucoma was the lowest, which was only 3.7%. The blindness rate of primary-angle-closure glaucoma was 6.20% and of the SG binocular blindness and monocular blindness was 34.40%. The age over 40 showed a high incidence of primary-angle-closure glaucoma and open-angle glaucoma. Gender and age were related to glaucoma. Conclusion   PACG is with high blindness rate and mostly seen in elderly females. The proportion of POAG and CG is rising.

    Value of Oculyzer anterior segment analysis system used before and after laser periphery iridectomy
    GAO Li-fen, LU Hui, LIU Zheng, GAO Dong-hong, ZHANG Dong-xiang
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  60-61.  doi:10.6040/j.issn.1673-3770.0.2012.377
    Abstract ( 1694 )   PDF (1290KB) ( 723 )   Save
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    Objective   To evaluate the anterior segment parameters in early primary angle-closure glaucoma eyes before and after YAG laser periphery iridectomy(LPR) by using Oculyzer system. Methods   Twenty seven eyes of twenty seven patients were recruited into this study. The images of the anterior segment of the eye were captured and the parameters were measured by the Oculyzer system pre-operatively and 1 week after laser treatment. Results  The Oculyzer system clearly showed the structure and parameter changes of the anterior segment after LPR. Conclusion   The changes of anterior chamber after LPR can be demonstrated by the Oculyzer qualitatively and quantitatively.

    Use of self made lingual frenum hemostat in short lingual frenum correction surgery
    DENG Bing-hui, LIN Yun-yan, ZHU Hao-biao, WU Hua-fei
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  62-65.  doi:10.6040/j.issn.1673-3770.0.2012.365
    Abstract ( 1486 )   PDF (1021KB) ( 902 )   Save
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    Objective   To explore the application and advantages of self made frenum hemostat in short frenum correction surgery. Methods   132 cases of children with thick and degree Ⅱ frenum or above were alternately divided into experimental and control groups according to the time sequence of  diagnosis. The self made frenum hemostat was used in the operations in the experimental group, but not  the control group. The operation time, the amount of surgical bleeding and treatment effectiveness  between the two groups were compared. Results   Compared with the control group, both the operation time and surgical bleeding in the experimental group were much less(P<0.05), however, the effectiveness was  better  but not significant(P>0.05 ). Conclusion   The self made frenum hemostat is easy to make, easy to use and can significantly shorten the operation time and reduce the amount of surgical bleeding.

    Effects of jejunal autograft with partially scraped mucosa on mucociliary clearance of trachea
    ZHENG Li-gang1, WANG Yue-jian1, TANG Su-cheng1, CHEN En-kuan2, CHEN Wei-xiong1, HE Fa-yao1, YU Qing-qing1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  66-68.  doi:10.6040/j.issn.1673-3770.0.2012.345
    Abstract ( 1194 )   PDF (953KB) ( 614 )   Save
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    Objective   To establish an animal model to study the changes of tracheal mucociliary transport before and after trachea reconstruction, in which a 6.5 cm segment of cervical trachea was replaced by jejunal autograft with partially scraped mucosa. Methods   Eight beagle dogs were included in the study. A 6.5 cm segment of cervical trachea was resected. Through a midline abdominal incision, 7 cm jejunum was resected and the graft was prepared by scraping partial mucosa off with surgical knife and dry gauze. Microvascular anastomoses were done between the mesenteric artery and the right common carotid artery, using a standard end-to-side technique. The mesenteric vein was anastomosed with the right common carotid vein, using a standard end-to-end technique. The silicone stent was placed in the lumen of the jejunal segment and  removed  four week later after the operation. A Ni-Ti alloy prothesis was placed over the jejunal segment, with the mesenteric vessels passing through the longitudinal opening of the mesh tube. In every canine model, the position of lower margin of resected trachea was marked in cervical skin  and 50% barium sulfate mucilage was injected as a tracer into the trachea lumen under fiberoptic bronchoscopy. The time between the injection and arrival of tracer to  glottis (mucociliary transit time, MTT) and corresponging length of travel  (mucociliary transport length, MTL) were recorded. Mucociliary transit rate (MTR), as MTL/MTT, was calculated. The same procedure was performed before operation and 7 days, 1 month and 3 months postoperatively. Statistical analysis was performed. Results   There was no difference in MTR before operation and 1 month, 3 months after operation, and there was also no difference in MTR between 1 month and 3 months postoperatively(P>0.05). Statistical significance in MTR were noted between all the neighboring two time points, from preoperative MTR, 1 week , 1 month and 3 months  postoperative(P<0.05). Conclusion   In the tracheal reconstruction by jejunal autograft with partially scraped mucosa, MTR is to be normal 1 month later after the operation. MRT at 3 months postoperative remains equally with the preoperative or 1 month postoperative.

    Transcranial approach with a coronal incision for orbit osteomas: Case report and literature review
    SHI Yu-hua1, XIA Yuan1, GUAN Jian2, SU Kai-ming2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  69-72.  doi:10.6040/j.issn.1673-3770.0.2013.030
    Abstract ( 1475 )   PDF (1208KB) ( 588 )   Save
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    Objective   To investigate the surgical management and clinical characters of patients with orbital osteomas. Methods   We reported a case with a large orbit osteoma removed via a transcranial approach with a coronal incision. We also performed a Pubmed search and reviewed all studies published from 2003 to 2013 on orbit osteomas from a minimal cohort of 3 patients Results   6 studies, including 67 patients, were reviewed.  Among all the cases, the frontal sinus was the most common location for osteoma, followed by ethmoid sinus. Total resection were performed in 55 cases (82.1%), while partial resection in were achieved in 12 patients (17.9%), Different tumor sizes, locations, and different surgeons yielded different surgical methods, such as  transcranial approache, endoscopic removal , transorbital approaches ,and so on. Conclusion   Surgical choice depends on the tumor size, location , and the experience of the surgeon. Transcranial approach is to be indicated if a large or deep osteoma locates in the orbit where it’s difficult or impossible to expose by a conventional orbitotomy.

    Comparison of 4 surgical methods of adenoidectomy
    CHEN Xiu-mei, ZHANG Qing-quan, LUAN Jian-gang, SONG Xi-cheng, ZHANG Tian-zhen, WANG Li, LIU Zhong-lu
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  73-76.  doi:10.6040/j.issn.1673-3770.0.2012.352
    Abstract ( 3918 )   PDF (927KB) ( 1870 )   Save
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    Objective   To evaluate four surgical methods of adenoidectomy. Method   Clinical data 138 cases of adenoid hypertrophy were reviewed. Four different surgical methods were applied, including conventional transoral adenoidectomy with a currete(group A, 20 cases),  conventional transoral adenoidectomy with a currete plus punch forceps (group B, 63 cases),  endoscopic adenoidectomy (group C, 25 cases), and plasma ablation(group D, 30 cases). The effects, residue, complication, operation time and blood loss were evaluated  among the methods. Result   The effective rate was 90% for group A, but 100% for the other three groups. The residual rates in descending order were 60% in group A,  6.67% in group D, and zero in both group B and C. Post-op hemorrhage occurred in 4 cases (1 in group A, 2 in group B,  and 1 in group C). 6 cases presented  nasal synechia (4 in group B, 2 in group C) . Operation time of group A and group D were longer than the other two groups. There was no significant difference in  blood loss between the group A and B. The maximal loss was noted in group C, however the minimal loss was in group D. Conclusion   The conventional transoral adenoidectomy with a currete should be abandoned because of the high rate of residue. Though plasma ablation shows the advantages, including short operation time and little blood loss,  cost of this method is one big concern. It can only be applied in the patients who can afford it and give much attention to the blood loss. For the majority of patients, conventional transoral adenoidectomy plus punch forceps or endoscopic adenoidectomy are desirable , which are relatively simple and affordable.

    Dissection combined with guillotine tonsillectomyin adults
    QIAN Feng, HUANG Peng, CHEN Jian, CHEN Chang-feng, NI Qin
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  77-78.  doi:10.6040/j.issn.1673-3770.0.2012.348
    Abstract ( 1895 )   PDF (945KB) ( 984 )   Save
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    Objective   To explore the clinical effectiveness of dissection combined with guillotine tonsillectomy in adults. Method   In 238 adult chronic tonsillitis patients, 130 (experimental group) were treated by dissection combined with guillotine tonsillectomy, while the other 108 (control group)  were treated by dissection tonsillectomy only. Result   The experimental group showed shorter operation time and less bleeding compared with the control group (both P<0.01). There was no case of primary bleeding in experimental group, however, two cases of primary hemorrhage were noted in the control group. No case of secondary bleeding in either group. Conclusion   Adult tonsillectomy with dissection combined with guillotine is easy to practice. It can minimize bleeding, shorten the operation time, and decrease the patient’s discomfort.

    Progress of molecular mechanisms of presbycusis
    WANG Xiang, LIU Qiang-he
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  79-82.  doi:10.6040/j.issn.1673-3770.0.2012.323
    Abstract ( 1286 )   PDF (922KB) ( 608 )   Save
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    The relations of mitochondrial mutations and oxidative damage with presbycusis and related genes were summarized in this article to illustrate the molecular mechanisms. Gene therapy is to prevent and cure agerelated deafness.

    Auditory brainstem implantation
    CHEN Yan-li, Huang Fang
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  83-86.  doi:10.6040/j.issn.1673-3770.0.2012.316
    Abstract ( 3433 )   PDF (958KB) ( 2365 )   Save
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    Auditory brainstem implant (ABI) is one of the developments in the cochlear implant technology. Its operating principle is similar to artificial cochlear implant. However, rather than stimulating the neural elements in cochlea as artificial cochlear implant, the auditory complex residing in brainstem is stimulated directly. The indications, contraindications, surgical approaches,  methods, complications and hearing improvement of ABI are summarized in this paper.

    Treatment of recurrent auricle pseudocyst with partial cyst wall excision
    ZHANG Zhi-jun, ZHANG Tao, YUAN Bo, TENG Lei, ZHANG Jin-ming, SHU Yan-fang, ZHANG Li
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  87-88.  doi:10.6040/j.issn.1673-3770.0.2012.311
    Abstract ( 1670 )   PDF (1018KB) ( 496 )   Save
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    Deep neek space infection, one cases were misdiagnosed as acute epiglottitis
    WANG Zhi-gang, L Rong-lin
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  89-89.  doi:10.6040/j.issn.1673-3770.0.2013.002
    Abstract ( 1347 )   PDF (887KB) ( 659 )   Save
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    One cases of right maxillary sinus myofibroblastic tumor
    RUAN Qing-ping1, WU Qing-yong1, OU Jian-hui1, LIN Chang2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  90-90.  doi:10.6040/j.issn.1673-3770.0.2012.387
    Abstract ( 1342 )   PDF (922KB) ( 823 )   Save
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    Doublepassage silicone tube implantation in canalicular laceration anastomosis
    FANG Xiu-ling, ZHANG Liao, WU Jian-xia, ZHAO Chang-tao, JIANG Hu-lin
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  91-92.  doi:10.6040/j.issn.1673-3770.0.2013.076
    Abstract ( 1267 )   PDF (893KB) ( 770 )   Save
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    Misdiagnosis analysis on 2 cases of adult advanced Coats disease
    SUN Ying, DONG Chang-xia
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(3):  93-94.  doi:10.6040/j.issn.1673-3770.0.2013.024
    Abstract ( 1083 )   PDF (899KB) ( 938 )   Save
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