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    16 August 2013 Volume 27 Issue 4
      
    Articles
    Electric coagulation hemostasis under nasal endoscopy for 121 cases of intractable nosebleed
    YU Peng-ju1, XU Feng-lei2, JIANG Man-jie2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  4-5.  doi:10.6040/j.issn.1673-3770.0.2013.159
    Abstract ( 1386 )   PDF (905KB) ( 496 )   Save
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    Objective    To study the clinical effect of electric coagulation hemostasis under nasal endoscopy for treatment of intractable nosebleed. Methods    Clinical data of intractable nosebleed patients received treatment at our hospital from 2011 to 2012 were retrospectively analyzed. Patients were divided into two groups. Group A received nasal endoscopic treatment and group B received packing hemostasis treatment. Cure rate, complications, pain scale, recovery and rehaemorrhagia rate were compared between the two groups. Results    Group A had a higher cure rate than group B(97.2%, 69/71 vs 84.0%, 42/50; P=0.0095).The pain scales were lower in group A both peri-treatment and post-treatment than in group B (3.08±0.72 vs 4.72±0.49; P<0.001; 2.59±0.48 vs 4.21±0.58; P<0.001). The group A patients had a sooner recovery than group B patients (P<0.001). Group A patients had a lower rehaemorrhagia rate than group B patients(5.6%, 4/71 vs  46.0%, 23/50; P<0.001). Conclusion    Electric coagulation hemostasis under nasal endoscopy is a safe and effective treatment for intractable nosebleed.

    Endoscopic ligation of sphenopalatine artery using suction electric cautery for refractory epistaxis
    HOU Yan-peng1, CHANG De-long2, TAI Xu-hui1, XU Zhen-ming1, YANG Xin1, ZHU Bao-yu1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  6-7.  doi:10.6040/j.issn.1673-3770.0.2013.047
    Abstract ( 2584 )   PDF (855KB) ( 1305 )   Save
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    Objective    To investigate the effect and possibility of using suction electric cautery in refractory epistaxis. Method    The clinical data of 15 cases of refractory epistaxis were retrospectively analyzed. Results    14  patients′ sphenopalatine arteries were successfully exposed and ligated under endoscopy, and one patient′  sphenopalatine  artery was not found intraoperatively. Conclusion    Endoscopic ligation of sphenopalatine artery via lateral nasal wall incision is a convenient and effective method  for  patients with refractory epistaxis.

    Endoscopic electrocoagulation in 29 cases of epistaxis
    QI Jian-wei, XU Jin-jing, WU Yuan-qing
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  9-10.  doi:10.6040/j.issn.1673-3770.0.2013.128
    Abstract ( 1741 )   PDF (849KB) ( 1213 )   Save
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    Effects of H-UPPP on blood pressure and heart rhythm in OSAHS patients
    XU Wei-wei, LI Jian-dong, LIU Chun-ning, ZHANG Zhi-li
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  11-13.  doi:10.6040/j.issn.1673-3770.0.2012.347
    Abstract ( 1518 )   PDF (871KB) ( 603 )   Save
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    Objective    To observe the changes of  blood pressure and rates of arrhythmia after H-UPPP in the patients with OSAHS. Methods    72 patients,who had obvious obstructions in oropharyngeal cavity, were diagnosed as OSAHS with PSG. 24h ambulatory blood pressure and Holter testing were performed before H-UPPP, 10 days and six months after the operation. Data were analyzed by spss13.0. Results    Six months after H-UPPP, blood pressures and rates of arrhythmia were statistically different from the preoperative levels. But no difference was found between the preoperative and  10days after HUPPP. Conclusion    H-UPPP is effective for OSAHS patient′s blood pressure and arrhythmia control.

    Obstructive planes and therapeutic efficacy in severe obstructive sleeping hypopnea-apnea syndrome
    LI Ji-zhou, HAN Li, SONG Jian-jing
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  14-16.  doi:10.6040/j.issn.1673-3770.0.2012.371
    Abstract ( 1348 )   PDF (869KB) ( 772 )   Save
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    Objective    To explore the obstructive planes and treatment of severe obstructive sleeping hypopnea-apnea syndrome (OSAHS) by evaluating  the efficiacy of H-UPPP, Hyoid suspension plus nasal operation, and compliance of CPAP. Methods     60 cases of patients underwent PSG and were diagnosed as severe OSAHS.  And all the patients received PSG again after the operation or CPAP treatment. Results    60 patients were all multi-level obstructive.  HUPPP, hyoid suspension and nasal operation were performed in 24 cases, while 20 of them presented with hypertension or diabetes. Nasal operations consisted of  inferior turbinectomy, nasal septum reconstructomy or endoscopic surgery. CPAP treatment was applied in the rest 36 elderly patients.  Conclusion    For the severe OSAHS patients, suitable and feasible surgery should be done according to the obstructive planes. As for elderly patients,  CPAP is a good choice.  The good results can be achieved in all the severe OSAHS cases.

    Therapeutic effects of adenoidectomy and tonsillectomy in children with obstructive sleep apnea hypopnea syndrome
    LUO Hui-xiu, FAN Chun-tao, DENG Yan-hua
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  17-20.  doi:10.6040/j.issn.1673-3770.0.2013.061
    Abstract ( 1481 )   PDF (882KB) ( 783 )   Save
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    Objective    To investigate the clinical effectiveness of adenoidectomy and tonsillectomy in children with obstructive sleep apnea hypopnea syndrome(OSAHS). Methods    Clinical data of eighty children undergoing adenoidectomy and tonsillectomy were reviewed, including polysomnography(PSG) and OSA-18 scale three months preoperative and six months post-operative. Effects of operation, changes of PSG parameters and OSA-18 scores were analyzed. Results    Among eighty cases, there were seventy cured(87%), 8 markedly effective(10%), and 2 improved(3%). The total effective rate was 100%. In the latter ten cases, symptoms of allergic rhinitis  were significantly improved in eight cases, and obesity-associated symptoms were relieved in the other two cases. The clinical parameters, such as apnea hypopnea index(AHI), lowest oxygen saturation (LsaO2) and OSA-18 score, were significantly improved after the operation(P<0.05). Conclusion   Tonsillectomy and (or) adenoidectomy are effective procedures to treat OSAHS in children. PSG and OSA-18 scale are comprehensive tools to evaluate the clinical results.

    Obversation of cornea flaps′ characters created by Wavelight FS200 and Moria M2 110
    ZHAI Chang-bin1, HAO Ying-juan2, YI Sheng-ping2, YANG Qing-song1, ZHANG Jing1, ZHOU Yue-hua1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  21-25.  doi:10.6040/j.issn.1673-3770.0.2013.163
    Abstract ( 2293 )   PDF (1583KB) ( 1212 )   Save
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    Objective    To compare the features of corneal flaps created using the FS200 and Moria M2 microkeratome 110μm-knife. Methods    A pilot and prospective study was designed. Ninety eyes of forty five patients were enrolled in this clinical trial. The patients were divided into the FS200 group (50 eyes) and the M2 microkeratome 110μm-knife group (40 eyes) with matching demography. Fourier-domain optical coherence tomography (RTVue OCT) was used to measure flap thickness by 10 settings on 90 corneas at one month post-operatively. The features of the laser in situ keratomileusis (LASIK) flaps were analyzed on the basis of the outcomes. Written informed consent was obtained from each patient prior to LASIK. Results    The mean flap thickness of the FS200 group was considerably thinner than that of the Moria 110 group (112.2±3.2μm versus 151.1±14.9μm), and the same result could be found in the variable range of the two groups (18.3±4.1 of the FS200 versus 42.6±14.5 of the M110) simultaneously.  The corneal flaps in the FS200 groups showed a flat shape and in the Moria 110 group showed a meniscus shape. The central flap thickness of the FS200 group was not evidently different from that of peripheral(P>0.05), but in the Moria 110 group, the central flap thickness was obviously thinner than the peripheral thickness (P<0.05).  Conclusion    The shape of flaps created using the FS200 is more uniform and closer to the expected thickness of 110μm than the ones created using the Moria M2 110 microkeratome.

    Characteristics of thin corneal flaps created with Wavelight FS200 femtosecond laser
    HAO Ying-juan1, YANG Qing-song2, ZHOU Yue-hua2, YI Sheng-ping1, ZHAI Chang-bin2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  26-31.  doi:10.6040/j.issn.1673-3770.0.2013.193
    Abstract ( 2277 )   PDF (1234KB) ( 894 )   Save
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    Objective    To compare the features of corneal flaps created using the FS200 and Moria M2 microkeratome 90μm-knife. Methods    A pilot and prospective study was designed. Ninety eyes of 145 patients were enrolled in this clinical trial. The patients were divided into the FS200 group (50 eyes) and the M2 microkeratome 90μm-knife group (40 eyes), with matching demography. Fourier-domain optical coherence tomography (RTVue OCT) was used to measure flap thickness using 10 settings on the 90 corneas at one week post-operatively. The features of the LASIK flaps were analyzed on the basis of the outcomes. Written informed consent was obtained from each patient prior to LASIK. Results    The mean flap thickness of the FS200 group was considerably thinner than that of the Moria 90 group (112.2±3.2μm versus 128.2±11.2μm) (P<0.01). The corneal flaps in both the FS200 groups showed a flat shape and in the Moria 90 group showed a meniscus shape. The central flap thickness of the FS200 group was not evidently different from that of peripheral(P>0.05), but in the Moria 90 group, the central flap thickness was obviously thinner than the peripheral thickness (P<0.05). The mean deviation between the achieved and attempted flap thickness (110μm) was (2.99±4.34)μm in the FS200 group and (16.82±9.72)μm in the Moria 90 group (P<0.01).  Conclusion    The shape of flaps created using the FS200 is more uniform and closer to the expected thickness of 110μm than the ones created using the Moria M2 90 microkeratome.

    Correlation analysis of LDV femtosecond laser flap and corneal curvature
    DING Xin, YU Chen-ying, AI Feng-rong, CHEN Bing-jun, LI Ying
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  32-35.  doi:10.6040/j.issn.1673-3770.0.2013.185
    Abstract ( 1393 )   PDF (881KB) ( 939 )   Save
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    Objective    To evaluate the correlation between diameter of corneal flap created by LDV femtosecond laser and corneal curvature (K), so as to provide clinical evidence for the choice of suction ring to satisfy patients with different corneal curvature. Methods    Fifty myopic patients (100 eyes) who had femtosecond-assisted LASIK surgery from February to April 2013 in Peking Union Medical College Hospital were included in this study. Patients were divided into two groups based on the diameter of suction ring used in the creation of corneal flap. Thirteen patients (26 eyes) who used suction ring of 9.0mm were in Group Ⅰ, while the other thirty-seven patients (74 eyes) who used suction ring of 8.5mm were in Group Ⅱ. All the procedures were done by the same skillful surgeon who also measured the diameter of the cornea and the flap, and the corneal curvature during each procedure. An independent samples t test and bivariate correlation method were used to analyze the quantitative data. Results    There were eighteen males (36 eyes) and thirtytwo females (64 eyes) in this study aged 18 to 37 (average 24.6) years old. Patients all underwent binocular surgery and no intra-operative complication occurred. The average diameter of the cornea in each group was 10.7mm and 10.6mm respectively (t=0.04, P<0.05). The average diameter of the corneal flap in Group Ⅰ was 9.2mm, and for patients whose corneal curvature was greater than 44.0D, between 42.0D and 44.0D, or less than 42.0D, their average corneal flap diameter was 9.3mm, 9.1mm, and 8.6mm respectively, which showed a significant positive correlation between the corneal curvature and the corneal flap diameter (r=0.492, P=0.027). The average diameter of the corneal flap in Group Ⅰ was 8.3mm, and for patients whose corneal curvature was greater than 44.0D, between 42.0D and 44.0D, or less than 42.0D, their average corneal flap diameter was 8.4mm, 8.3mm, and 8.0mm respectively, which also showed a significant positive correlation between the corneal curvature and corneal flap diameter (r=0.513, P=0.001). Conclusion    The diameter of corneal flap created by LDV femtosecond laser is strongly correlated with corneal curvature, meaning patients with a high K Value tended to have a bigger corneal flap than patients with a relatively low K Value in femtosecond-assisted LASIK surgery. It suggest that surgeons should choose suction rings that are relatively bigger for patients with a low K Value in order to prevent creation of small or even free corneal flaps. And for patients with a high K Value, suction rings that are relatively smaller are recommended, in order to prevent creation of large corneal flaps, intraoperative bleeding, and post-LASIK dry eye.

    Characteristic analysis of corneal flap made by Ziemer FEMTO LDV femtosecond laser
    CAO Guang-yi, XUE Jin-song
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  36-39.  doi:10.6040/j.issn.1673-3770.0.2013.177
    Abstract ( 1569 )   PDF (1212KB) ( 868 )   Save
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    Objective    To discuss the characteristics of corneal flap made by Ziemer FEMTO LDV femtosecond laser. Methods    50 myopic patients ( 100 eyes) desired for refractive surgery were enrolled in this study. Corneal flaps were all made by Ziemer FEMTO LDV femtosecond laser. Pre-operative examinations included diopter, corneal topography, and corneal thickness etc. Anterior segment optical coherence tomography was used to measure corneal parameters on the horizontal direction at one week post-operatively. Then the centrality, stability and uniformity of corneal flaps were analyzed. Results   The central position of corneal flaps distanced the central position of cornea about (0.29±0.20)mm. Horizontal diameter of corneal flaps presupposed differed with the actual in the range of (1.04±0.49)mm. Average thickness of corneal flaps was (119.29±2.23)μm. Horizontal average thickness of corneal flaps made differences at the bitamporal side 1.5mm, 2.5mm, 3.5mm[(118.94±2.34)μm, (119.14±2.65)μm, (119.53±2.77)μm, respectively] and the nasal side 1.5mm, 2.5mm, 3.5mm[(118.98±2.55)μm, (119.38±2.47)μm, (119.77±2.64)μm, respectively] around the central position of corneal flaps. Conclusion    In LASIK, corneal flaps made by Ziemer FEMTO LDV femtosecond laser are in the neutral well, and there are no significant correlation between position offset and astigmatism. Corneal flaps are steady, uniform and predictable.

    Analysis of the common types of inner ear malformations and the surgical complications in deaf children with cochlear implants
    XU Xue-hai, YAN Xing, ZHONG Cui-ping, AN Fei, LIN Wen-kui
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  40-42.  doi:10.6040/j.issn.1673-3770.0.2013.113
    Abstract ( 2131 )   PDF (1431KB) ( 903 )   Save
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    Objective    To investigate common types of inner ear malformation and the surgical complicationsin deaf children with cochlear implants. Methods    The clinical data of 170 cases of cochlear implantation were retrospectively analyzed. The type of 32 patients with bilateral inner ear malformation and the surgical complications were analyzed. Results    ① The proportion of inner ear malformations is higher than other literature reports(32/170;18.8%); ② In the 32 cases of inner ear malformations, there were 23 cases of large vestibular aqueduct(71.3% of the total number of malformations), 5 cases of large vestibular aqueduct with other innerear deformity  (4 cases complicated by Mondini malformation and 1 case complicated by nondevelopment of lateral semicircular canal), 2 cases of Mondini deformity, and 1 case of mondini deformity complicated by lateral semicircular canal not developing and enlarged vestibular cavity, 1 case CT images of the cochlea was considered “trigeminal shape”; ③ 3 cases had cerebrospinal fluid(CSF)gusher during surgery. 1 case of the cochlea was considered “trigeminal shape” by CT imaging, 1 case of Mondini deformity complicated by lateral semicircular canal not developing and enlarged vestibular cavity, and 1 case of large vestibular aqueduct complicated by Mondini deformity; ④ The patient with cochlea imaging“trigeminalshape”occurred CSF gusher during surgery, and four pairs of electrodes could not be implanted. Hearing recovery was not ideal after surgery; ⑤The patient with Mondini deformity complicated by lateral semicircular canal not developing and enlarged vestibular cavity was followed cerebrospinal fluid leakage, repeated episodes after six months, and was cured after surgical exploration after 1 year. Conclusion    ① The common deformity of cochlear includes large vestibular aqueduct syndrome and the inner ear malformation accompanies. ② Cochlear implantation in these inner ear deformities is not absolutely contraindicate, but serious CSF gusher is common during surgery. And totally electrodes implantation is difficult, cerebrospinal fluid leakage complicated after surgery is often occurred in deformity cochlears. Detailed imaging examination before surgery can reduce the incidence of complications.

    Position and operation skill of boneanchored hearing aids implantation under microscopy
    CAI Xun-hua1, CHEN Wen-wen1, YANG Yu2, ZHANG Yu-hua1, TONG Jun1, DENG Ya-xin1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  43-46.  doi:10.6040/j.issn.1673-3770.0.2012.325
    Abstract ( 1646 )   PDF (1747KB) ( 656 )   Save
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    Objective    To explore bone-anchored hearing aids(BAHA) implant position and operation skill under local anaesthesia microscopy. Methods    Both 2 male patients were operated under microscopy and local anaesthesia. One was 62 years old. He had the mixed hearing loss at the left and sensorineural deafness at the right. The result of sound field examine was over 100dB in two ears, and the BAHA soft belt test was 45-100dB sharp decline type, over 4kHz was lost. In case 1, the BAHA pedestal was implanted in the conventional position on the skull, which was behind the ear groove 3cm and above the ear canal 3cm. The two was 16 years old. He had double three-auditory-ossicle malformed fixation and hearing loss, but the hearing was only a little improved after operation of two times. The result of sound field audiometry was 67.5dB, and the BAHA soft belt test was 40-50dB flat type. In case 2, the BAHA pedestal was implanted on the different position on the skull, which was in the level of the ear canal and behind the ear groove about 2cm. Results    Case 1 obtained the hearing improved about 35dB in the sound field examine post-operation. Case 2 hearing improved above 35dB. The post-operative CT revealed Case 1 pedestal had a little projecting skull bone into meninges. Case 2 pedestal was away from meninges about 2cm. Conclusion     BAHA can evidently improve hearing, and the pedestal can be implanted under local anaesthesia and microscopy in most cases. Bone is thicker at the position behind the ear canal than at the conventional position, so pedestal implantation at this position  has less probability of damage mininges than the conventional position.

    Diagnosis and treatment of glomus jugulare tumor: a report of 8 cases
    MIAO Bei-ping1, ZHANG Rui-shi2, GUO Zhi-hong3, XU Hua-jian4, SUN Yan-hua5, LEI Da-peng6, LU Yong-tian1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  47-50.  doi:10.6040/j.issn.1673-3770.0.2013.206
    Abstract ( 2070 )   PDF (1681KB) ( 1504 )   Save
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    Objective    To investigate the clinical feature, diagnosis and management of glomus jugulare tumors and operative methods for complex tumors. Method    The data of eight cases of glomus jugulare tumors were retrospectively analyzed. Results    Among 8 patients, 5 were females and 3 males with average age of 41 years(33-62 years). The tumors were located in the left ear in 2 cases and the right in 6 cases. Pulsatile tinnitus, hoarse voice, hearing loss and prosopoplegia wer  the main symptoms. Final diagnosis depended on clinical manifestation, CT and/or MRI. According to the Fisch classification, the tumor in 1 ear was type B, 1 was type C, 2 were type D1 and 2 were type D2. All the tumors were  completely removed; two had recurrence after 3 years; 4 patients with residual tumor had no changes after taking radiotherapy of 3 years. Conclusion    Surgical approaches allow complete resection of the tumor. And pre-operative embolization is able to reduce the operation time and blood loss.

    Management of 77 fungal otitis externa by otoendoscope
    LIU Chun-qing, LIU Hai-cheng, HOU Zheng
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  51-52.  doi:10.6040/j.issn.1673-3770.0.2012.362
    Abstract ( 1644 )   PDF (852KB) ( 782 )   Save
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    Objective    To evaluate the diagnosis and management of fungal otitis externa by otoendoscope.  Methods    77 patients (90 ears) with fungal otitis extema were cleaned and sprayed with Fluconazol by otoscope, once per four days for 2 or 5 weeks.  Resulths    Followed up for 6 months , among 77 cases (90 ears), there were 80 cured, 7 effective, and 3 ineffective ears. The total effective rate was 96.7%. Conclusion    Management of 77 fungal otitis extema with Fluconazol by otoendoscope can provide a good view. The procedure is safe and effective.

    A clinical study of the surgical treatment for early stage glottic carcinoma
    WANG Xiao-bin1, PAN Xin-liang2, LU Yong-tian1, WEI Ming-hui1, SUN Huan-ji1, MIAO Bei-ping1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  53-58.  doi:10.6040/j.issn.1673-3770.0.2013.108
    Abstract ( 1714 )   PDF (1550KB) ( 934 )   Save
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    Objective    To explore the surgery way for T1 and T2 glottic carcinoma. Methods    From 2003 to 2010, small partial laryngectomy was performed on 112 patients with T1 or T2 (80 with T1N0M0 and 32 with T2N0M0 ) glottic carcinoma. By a retrospective review of the surgery approach, the curative results and advantages of the surgery treatment,  dynamic follow-up of the movement of the arytenoid cartilage,  reconstruction of the glottis rimae and the changes of the voice were analyzed. The pre-operative and post-operative voice qualities were compared with the software of Dr. Speech system for windows. Results    All patients were healed in one stage about 6 or 7 days and took food with mouth post-operatively 2 or 3 days, and the mean time of all patients with cannula was 7.3 days. The removal rate of the trachea cannula was 100 %. The movement of the arytenoid cartilage of 47 cases 1 week after surgery was weakened, the reconstructed glottis rimae  was close to be normal 6 months  after operation. There was no significant difference in Shimmer and NNE before and 1 week after operation(P>0.05), but there was significant difference before and 2 months and half a year  after operation, and there was also significant difference 1 week, 2 months and 6 months  after operation(P<0.01). 76 cases survived during 3 years′ follow-up, 35 of 36 cases survived in 5 years′ follow-up post-operatively (1 case died without definite causes). Conclusion    Partial laryngectomy achieves satisfied curative results and provides a clear operative view to resect the tumor completely, reconstruct the function of the larynx and improve the voice quality of the patients post-operatively. Therefore, partial laryngectomy is effective for T1 or T2(T1N0M0, T2N0M0) glottic carcinoma.

    Anatomical study of submental artery island flap
    CHEN Xi1, ZHANG Yong-jie2, LU Mei-ping1, YIN Lin3, CHENG Lei1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  59-61.  doi:10.6040/j.issn.1673-3770.0.2013.187
    Abstract ( 1947 )   PDF (1078KB) ( 890 )   Save
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    Objective    To obtain the detailed anatomical data on submental artery island flap (SAIF) including the location, dimension and relationship of the submental artery with the submental vein. Methods    Fifteen cases of 30 sides of fresh adult wet cadaveric heads were examined for gross and microscopic anatomy. Artery perfusion system was mixed with red dye emulsion and intravenous with blue dye emulsion. Vernier caliper was used for measurement and statistical analysis parameters, including initial diameter of the submental artery and its accompanying vein, length and main branch of submental artery and its relation with surface mark. Typical specimen and variations were observed and photographic retained. After artery was perfused with black ink, submental skin dyeing range was observed, the maximum length and width of the SAIF were measured and recorded, and the ranges that the flaps cover were surveyed. Results    The submental artery was a well defined and stable branch of the facial artery, and its length was (69.1±7.47; mean±SD) mm. At its origin, the diameter of the submental artery was (1.6±0.47) mm. The distance from mandible lower edge to submental artery was (5.4±1.63) mm. As it courses, the submental artery gave off (6.5±1.09) branches. The venous drainage of the SAIF was via the submental vein into the facial vein. The vein had a diameter of (2.30±0.58) mm at the origin. The maximum size of the flap could be 84.6mm×53.5mm. Conclusion    The submental artery is a major blood-supple artery of the SAIF, which is a constant branch of the facial artery. Because of its abundant blood supply and convenient surgical proceeding, SAIF is a useful flap in head and neck repair and reconstruction.

    Correlation analysis of VEGF expression and the content of dendritic cells in nasopharyngeal carcinoma and its clinical significance
    MIAO Bei-ping1, ZHANG Rui-shi2, GUO Zhi-hong3, SUN Huan-ji1, MENG Qing-guo1, WANG Xiao-bin1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  62-65.  doi:10.6040/j.issn.1673-3770.0.2013.209
    Abstract ( 1351 )   PDF (1185KB) ( 551 )   Save
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    Objective    To investigate the correlation between VEGF expression and the content of dendritic cells in nasopharyngeal carcinoma.  Methods    25 cases of nasopharyngeal carcinoma and 25 cases of nasopharyngeal lymphoid tissue were collected. The expressions of VEGF in the nasopharyngeal carcinoma and nasopharyngeal lymphoid tissues were detected by ELISA. The content of dendritic cells and regulatory T cells in the nasopharyngeal carcinoma and nasopharyngeal lymphoid tissues were detected by flow cytometry.  Then the correlation between VEGF expression and the content of dendritic cells was analyzed. Results     Expression of VEGF in nasopharyngeal carcinoma was higher than that in nasopharyngeal lymphoid tissues (t=12.324,P<0.01); the content of CD4+ lymphocyte in nasopharyngeal carcinoma was lower than that in nasopharyngeal lymphoid tissues(t=14.304, P<0.01). While the content of CD4+CD25+ regulatory T cells in nasopharyngeal carcinoma was higher than that in nasopharyngeal lymphoid tissues, and the difference was statistically significant(t=5.910, P<0.01). The content of CD123+ dendritic cells in nasopharyngeal carcinoma was lower than that in nasopharyngeal lymphoid tissues, and the difference was statistically significant(t=7.866, P<0.01). The content of CD11c+ dendritic cells in nasopharyngeal carcinoma was lower than that in nasopharyngeal lymphoid tissues, and the difference was statistically significant(t=3.411, P<0.01). The expression of VEGF was positively correlated with the content of CD4+CD25+ lymphocytes in nasopharyngeal carcinoma(r=0.966, P<0.01), and negatively correlated with the content of CD123+ dendritic cells (r= -0.946, P<0.01) and negatively correlated with the content of CD11c+ dendritic cells(r=-0.954, P<0.01). Conclusion    Expression of VEGF is related to the content of CD4+CD25+ regulatory T cells and the content of dendritic cells in nasopharyngeal carcinoma, which may engage in the immune escape of nasopharyngeal carcinoma.

    Visual analogue score on treatment choice for nasopharyngeal carcinoma patients with post-radiotherapy chronic rhino-sinusitis
    LIU Yang-yun, LI Zheng-xian, JIANG Wen, MAO Kun-hua, CHEN Qiong, CHANG En-ge
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  66-69.  doi:10.6040/j.issn.1673-3770.0.2013.146
    Abstract ( 1584 )   PDF (882KB) ( 1190 )   Save
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    Objective    To investigate the value of visual analogue score(VAS) on nasopharyngeal carcinoma patients with post-radiotherapy chronic rhino-sinusitis (post-RT-CRS) by treatment choice. Methods    98 patients were divide into three groups: the expectant treatment(group 1), the maxillary natural ostium enlargement (group 2) and the combined fenestration operation(group 3) under nasal endoscopy groups. The VAS before and after treatment was analyzed. Result    Only the VAS of purulent secretion was statistical difference in group 1,but the VAS of  purulent secretion and facial gas pains were statistical difference in group 2 and 3 and the curative effect of group 3 was better than that of group 2. Conclusion     Maxillary natural ostium enlargement in combination with fenestration operation by nasal endoscopy is suitable for post-RT-CRS patients with high VAS at purulent secretion and facial gas pains.

    Aspirin intolerance triad and its impact on pulmonary function and asthma control
    ZHANG Tao1, ZHANG Zhi-jun1, TENG Lei1, WANG Qiong-lin2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  70-72.  doi:10.6040/j.issn.1673-3770.0.2013.019
    Abstract ( 1890 )   PDF (875KB) ( 521 )   Save
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    Objective    To investigate the impact of aspirin intolerance triad on pulmonary function and asthma clinical control. Methods    106 patients with asthma alone or with asthma in combination with allergic rhinitis or patients with aspirin intolerance triad were divided into the asthma group(n=35), the asthma combined with allergic rhinitis(AR) group(n=35) and the aspirin intolerance triad(AIT) group(n=36) at Shanghai Shuguang Hospital. Forced vital capacity(FVC), forced expiratory volume in one second(FEV1), forced expiratory volume in one second/ forced vital capacity(FEV1% FVC),peak expiratory flow(PEF), the Asthma Control Test(ACT) score and the Asthma Control Questionnaire(ACQ)score were evaluated respectively among the asthma alone group ,the asthma combined with AR group and the AIT group. Results    Patients in the AIT group had significantly(P<0.05) lower FVC, FEV1, FEV1% FVC and PEF than the asthma alone group. However patients in the AIT group had the same FVC, FEV1 and PEF as those in the asthma combined with AR group except for FEV1% FVC. The ACT score(14.2±4.5) and the ACQ score(2.7±1.5) in patients with AIT were significantly different with the asthma alone group, but were not significantly different with the asthma combined with AR group. Conclusion    AIT patients have serious airway inflammation and high airway resistance, and their lung functions and level of asthma control are bad. FEV1% FVC may be an effective and sensitive index to diagnose or evaluate AIT.

    Clinical analysis of 5 laryngeal mycosis cases
    WANG Xiao-feng, GAO Xing-qiang
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  73-75.  doi:10.6040/j.issn.1673-3770.0.2013.051
    Abstract ( 1702 )   PDF (1077KB) ( 833 )   Save
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    Objective    To discuss the strategies in the diagnosis and treatment of laryngeal mycosis. Methods    A retrospective analysis was performed on the clinical data of 5 laryngeal mycosis patients treated in our hospital from 2007 to 2012. Results    In all these cases, diagnosis were confirmed as laryngeal mycosis by pathological findings. They were cured by a comprehensive therapy, including voice prohibition, and antifungal drugs ,without antibiotics and hormone.  No recurrence was noted in 2-month to 5-year follow-up. Conclusions    The laryngeal mycosis is easy to be misdiagnosed, and the sufferer is usually in poor immune function. The pathological biopsy is the most important method to reach the diagnose. It can be cured by voice prohibition and antifungal treatment.

    Retinopathy of prematurity in extremely low birth weight infants and very low birth weight infants and its risk factors
    MEI Fang, CHEN Zhi-jun
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  76-78.  doi:10.6040/j.issn.1673-3770.0.2013.154
    Abstract ( 1748 )   PDF (913KB) ( 653 )   Save
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    Objective    To investigate the incidence of retinopathy of prematurity (ROP) in extremely low birth weight infants (ELBWI) and very low birth weight infants (VLBWI) and to explore its risk factors. Methods    A retrospective analysis was carried out for the screened 53 ELBWI and 974 VLBWI. Comparison of ROP incidence between ELBWI and VLBWI groups was statistically analyzed. Birth weight, gestational age and gender between ROP and non-ROP groups, and mild ROP group and severe ROP group were compared. Results    23/53 ELBWI developed ROP with an incidence of 43.4%, while 15 of them developed severe ROP with an incidence of 28.3%. 177/974 VLBWI developed ROP with an incidence of 18.2%, while 33 of them developed severe ROP with an incidence of 3.4%. The difference of ROP incidence between ELBWI and VLBWI was statistically significant (χ2=20.39,P<0.001), while the differences of birth weight (χ2=20.39,P<0.001) and gestational age (χ2=50.06,P<0.001) between ROP group and nonROP group were statistically significant. Also, the differences of birth weight (χ2=24.21,P<0.001) and gestational age (χ2=53.67,P<0.001) between mild ROP group and severe ROP group were statistically significant. Conclusions    The incidences of ROP and severe ROP in ELBWI are higher than those in VLBWI. ROP risk factors are various and mainly include gestational age less than or equal to 28 weeks and low birth weight.

    Effect of mitomycin C in treatment of epithelial ingrowth after LASIK
    SUN Li-wang, CHE Cheng-kai, SU Gang, LIU Guang-yuan
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  79-80.  doi:10.6040/j.issn.1673-3770.0.2013.099
    Abstract ( 1741 )   PDF (859KB) ( 1422 )   Save
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    Objective    To observe the clinical effect of mitomycin C(MMC)during treatment of epithelial ingrowth(EI) after laser in situ keratomileusis(LASlK). Methods    10 patients (12 eyes) with epithelial ingrowth after LASlK were treated with surgery. MMC 0.02% was applied in treatment of epithelial ingrowth. Results    The uncorrected visual acuity increased to 0.86±0.15 after surgery. The corneal flaps recovered well. Conclusion    MMC treatment of corneal epithelial ingrowth after LASIK can effectively prevent recurrence and achieve good clinical effect.

    Application of intranasal dilator in the treatment of obstructive sleep apnea-hypopnea syndrome
    YU Lei-lei, CHEN Xi, LI Jin-rang
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  81-83.  doi:10.6040/j.issn.1673-3770.0.2013.081
    Abstract ( 1612 )   PDF (996KB) ( 505 )   Save
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    Sleep apnea-hypopnea syndrome(OSAHS) is very common in clinic, and nasal problem is one of the cause. Since intranasl dilator has been used in clinic recently, it  can relieve the impact of nasal factors on OSAHS effectively. The etiopathogenesis of OSAHS, design principle of intranasal dilator, advantages and disadvantages in clinic work were reviewed  in this paper.

    A pear-shaped tracheal catheter and sputum scab cleaning device
    ZHU De-feng, WANG Xiao-guang
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  84-86.  doi:10.6040/j.issn.1673-3770.0.2013.114
    Abstract ( 1384 )   PDF (1042KB) ( 610 )   Save
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    Sinus histiocytosis with massive  lymphadenopathy involved in the nasal cavity and the paranasal sinus in one case
    ZHAO Wei, ZHOU Yan, HU Yan, WANG Ya-ling, GAO Mi
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  87-89.  doi:10.6040/j.issn.1673-3770.0.2012.300
    Abstract ( 1635 )   PDF (1104KB) ( 659 )   Save
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    Pleomorphic adenoma in nasal septum in 5 cases
    YU Xiao-wei, LIU Li, WANG Xia
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  90-91.  doi:10.6040/j.issn.1673-3770.0.2013.078
    Abstract ( 1218 )   PDF (887KB) ( 558 )   Save
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    Foley tube method in taking children esophageal foreign bodies: 30 cases report and literature review
    CHEN Yu-kai, ZHANG Shu-xia, YI Xin, ZHAO Xiao-yun
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(4):  92-93.  doi:10.6040/j.issn.1673-3770.0.2013.009
    Abstract ( 1360 )   PDF (849KB) ( 693 )   Save
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