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Table of Content

    16 December 2013 Volume 27 Issue 6
      
    Articles
    Standardized application of harmonic Focus during thyroidectomy and parathyroidectomy
    HE Qing-qing, ZHAO Guo-wei, ZHUANG Da-yong, ZHENG Lu-ming, FAN Zi-yi, ZHU Jian, ZHOU Peng, HOU Lei, YU Fang, LI Yan-ning
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  1-5.  doi:10.6040/j.issn.1673-3770.0.2013.297
    Abstract ( 1033 )   PDF (1022KB) ( 1759 )   Save
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    Harmonic Focus is an emerging surgical equipment of energy surgery, which is used to cut the organization and stop bleeding by mechanical energy made by ultrasonic frequency generator. In this paper, the advantages and disadvantages of harmonic Focus surgery and traditional surgery were compared.

    Intra-operative nerve monitoring in re-operation for differentiated thyroid carcinoma
    ZHUANG Da-yong, HE Qing-qing, FAN Zi-yi, ZHENG Lu-ming, ZHU Jian, ZHOU Peng, DUAN Song-jian, YUE Tao, DONG Xue-feng
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  5-8.  doi:10.6040/j.issn.1673-3770.1.2013.302
    Abstract ( 1484 )   PDF (943KB) ( 1393 )   Save
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    Objective    To investigate the value of intra-operative nerve monitoring(IONM) in re-operation for differentiated thyroid carcinoma. Method    Forty-seven patients enrolled in our department were performed IONM in re-operation. Results    Post-operative pathology showed that 45.45% of the lesions were cancer and 82.98% of the lymph nodes were transferred. No vagus nerve and recurrent laryngeal nerve injures happened in the operations. Conclusion    First inappropriate operative procedure is the main reason resulting in re-operation. IONM can be used to prevent and reduce the recurrent laryngeal nerve injure.

    Clinical analysis for 57 re-operational cases of differentiated thyroid cancer
    ZHU Jian, HE Qing-qing, ZHENG Lu-ming, FAN Zi-yi, ZHAO Guo-wei, HOU Lei, SHI Hou-bin
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  9-12.  doi:10.6040/j.issn.1673-3770.0.2013.301
    Abstract ( 1793 )   PDF (939KB) ( 1397 )   Save
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    Objective    To explore factors influencing the metastasis of lymph nodes in clinical analysis negative (cN0)  papillary thyroid microcarcinoma and to analyze the value and feasibility of total thyroidectomy and prophylactic lymph node cleaning in Ⅶ)Ⅵ, Ⅲ and Ⅳ(+)Ⅱ. Methods    The clinical statistics of 162 patients with cN0 papillary thyroid microcarcinoma treated by total thyroidectomy and prophylactic lymph node cleaning in Ⅵ, Ⅲ and Ⅳ(+)Ⅱ in Jinan Military General Hospital from November 2008 to March 2012 were systemically retrospectively analyzed. Results    Of the 162 cases, 74 cases(74/162,45.7%) were positive in lymph node in which 71 cases(71/162,43.8%) happed in central line and 45 cases (45/ 162,29.6%) in lateral line III and Ⅳ(+)Ⅱ. The relative risk factors of neck lymph node metastasis in PTMC reside in age and invasion state of tumor capsule. There was only one single laryngeal recurrent nerve injury for tumor invasion. There was 1 case of breeding(0.62%), 2 hematoma(1.23%) and 59 temporary parathyroid function decline. All were cured after treatment. No permanent parathyroid gland damage happened. Conclusion    It is safe and of great important and operable probability to do the total thyroidectomy and VI neck lymph node cleaning (high risk including  Ⅲ, Ⅳ(+)Ⅱ) for cN0 PTMC.

    Regularity of lymph node metastasis in papillary thyroid carcinoma
    ZHOU Peng, HE Qing-qing, ZHUANG Da-yong, FAN Zi-yi, ZHENG Lu-ming, ZHU Jian, YU Fang, YUE Tao, DONG Xue-feng
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  12-15.  doi:10.6040/j.issn.1673-3770.0.2013.300
    Abstract ( 2027 )   PDF (946KB) ( 1450 )   Save
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    Objective    To explore the regularity of cervical lymph node metastasis of papillary thyroid carcinoma and to select an appropriate surgical method for papillary thyroid carcinoma. Methods    The clinical data of 616 cases of papillary thyroid carcinoma treated in this hospital between January 2001 and August 2013 were retrospectively analyzed. Results    The total lymph node metastasis rate was 58.77% (362/616). The lymph node metastasis rate was 48.70% (300/616) in level Ⅵ and was 38.80% (239/616) in level Ⅱ,  Ⅲ,  Ⅳ and Ⅴ.  There was significant relationship between the site of the original tumor, maximum diameter, amicula invasion, multifocality, age of patients and cervical lymph node metastasis (P<0.05). Conclusion    Lymph nodes of level Ⅵ should routinely be dissected in the first surgery in patients with thyroid papillary carcinoma. When the tumor is invaded to amicula, or whose diameter is >1.0cm or is multifocality, the cervical lymph node should be dissected and frozen biopsy should be made in the operations to determine the extend of lymphadenectomy.

    Benefits and risks of I-131 therapy in patients with differentiated thyroid cancer
    ZHAO Guo-wei, HE Qing-qing, ZHUANG Da-yong, ZHENG Lu-ming, FAN Zi-yi, ZHU Jian, YU Fang, ZHOU Peng, HOU Lei, JIANG Hui-ping
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  16-21.  doi:10.6040/j.issn.1673-3770.1.2013.299
    Abstract ( 1246 )   PDF (957KB) ( 1993 )   Save
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    The benefits of131I remnant ablation include: ① facilitating the interpretation of subsequent serum thyroglobulin levels; ② increasing the sensitivity of detection of locoregional and/or metastatic disease on subsequent follow-up radioactive iodine whole-body scans; ③ maximizing the therapeutic effect of subsequent treatments, and ④ allowing a postablation scan to help identify additional sites of disease that were not identified on the preablation scan or when a preablation scan was not performed. The potential benefits of 131I adjuvant treatment include decreasing recurrence and disease-specific mortality for unknown microscopic, locoregional, and/or distant metastatic disease. The potential benefits of 131I treatment of known locoregional and/or distant metastases are ① decreasing recurrence, and ② decreasing disease-specific mortality and/or palliation. The more significant risks and side effects involve organ systems including eye/nasolacrimal, salivary, pulmonary, gastrointestinal, hematopoietic, and gonads as well as secondary primary malignancies. Although there are never-ending controversies regarding 131I therapy in differentiated thyroid cancer, the benefits and risks are becoming better understood. This in turn helps the treating physician and patient in making decisions regarding therapy.

    Diagnosis, treatment and biocharacteristics of myoepithelial Carcinoma in head and neck
    CHEN Zhi-xi1, LIU Yang-yun2, ZHOU Wen-fang1, ZHANG Jin-ping1, LUO Xu-yong1, YE Xue-meng1, XIONG Qi-bin1, LIU Huo-wang3
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  22-25.  doi:10.6040/j.issn.1673-3770.0.2013.148
    Abstract ( 1911 )   PDF (936KB) ( 1356 )   Save
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    Objective    To explore the clinical, histopathologic and immunohistochemical features and the methods of diagnosis and treatment of myoepithelial Carcinoma in head and neck. Methods    A retrospective study was carried out in 5 cases of myoepithelial carcinoma in head and neck from January 2003 to December 2012.  With literature review, the clinical, histopathologic and immunohistochemistic characteristics of this disease were discussed. Results    There were 3 cases originated in parotid gland, 1 case in hard palate, and 1 in nasal cavity and nasal sinus. All cases were diagnosed by pathohistological and immunohistochemical findings. 4 cases underwent  radical surgery, while 1 case received  radio-chemotherapy. After the operation,  local recurrenceoccurred in 3 cases, in which 2 cases of cervical lymph node metastasis  underwent secondary neck dissection, while  distance metastasis was identified in 2 cases. During the follow-up, four patients died of tumor , and 1 patient was tumor-free survival(10 months after operation). Conclusion    Myoepithelial carcinoma in head and neck is a malignant epithelial tumor with poor prognosis, which mostly occurs in the salivary glands, rarely in nasal cavity and nasal sinus, with  high  occurrence of  cervical lymph nodes and/or distance metastasis. Comprehensive treatment is recommned, however,  postoperative recurrence  is still common.

    Application of holmium laser in the treatment of laryngeal tumor and cicatricial stenosis (8 cases report)
    MAO Hua-dong, DU Jing-dong, CHENG Jie
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  26-27.  doi:10.6040/j.issn.1673-3770.0.2013.089
    Abstract ( 1514 )   PDF (946KB) ( 1438 )   Save
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    Objective    To observe the clinical effectiveness of holmium laser in the treatment of laryngeal tumor and cicatricial stenosis. Methods    8 cases of laryngeal tumor and cicatricial stenosis underwent holmium laser surgery under laryngoscope under general anesthesia. Follow up was 6-12 months. Results    During the 6-12 months folow-up, 4 cases of laryngeal cancer showed no recurrence but satisfying pronunciation, while 3 cases of laryngeal stenosis showed no re-stenosis. 1 case of laryngeal papilloma was followed up for 8 months without recurrence. Conclusion    The laryngeal holmium laser microsurgery is minimally invasive to treat laryngeal benign tumors, early laryngeal cancer and laryngeal stenosis, with short recovery time and few complications.

    Correlation of segment of lesion with prognosis in peripheral facial palsy by MRI study
    SHAN Liang1, CHEN Wen-wen1, NI Guan-sen1, LUO Yu2. 1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  28-30.  doi:10.6040/j.issn.1673-3770.0.2013.100
    Abstract ( 1641 )   PDF (1036KB) ( 1565 )   Save
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    Objective    To recognize the correlation of segment of lesion and prognosis in the patients with peripheral facial palsy by Gd-enhanced MRI. Methods    The patients were scanned by Siemens Magnet V1.5 T, while contralateral as control. The conventional T1WI, T2WI axial and coronal thin layer scanning, Gd-DTPA-enhanced, delayed 30min re-imaging and multi-plane reconstruction were performed. Results     ① In 3 patients who underwent operation, 1 displayed in reconstruction full-distance normal nerve without interruption and edema. She recovered completely to the H-B 1 grading in 3 months. Another patient had facial palsy before the operation due to huge cholesteatoma.  Entire facial nerve showed edema but no discontinuity.  The patient recovered to H-B 3 grading after the operation. MRI reconstruction of the last huge vestibular schwannoma patient demonstrated facial nerve continuous as same as before the operation. H-B grading remained at 6 before and after the operation. ② Among six Bell′s palsy patients, enhancement were noted from inner ear to tympanic segment in one case, inner ear to labyrinth segment in one case, geniculate ganglion and tympanic segment in one case,  geniculate ganglion to mastoid segment in two cases, and only inner ear segment in two cases. All six patients were cured after the treatment with H-B grading 1. ③ Among six Ramsay Hunt syndrome patients, facial nerves showed normal in one case and enhancement in inner ear segment in two cases. Of the 3 remaining cases, 2 showed enhancement in inner ear segment, while 1 in mastoid segment. After the treatment, 5 patients showed enhancement in cochlea, but all six recovered to H-B grading 1. Conclusion    MRI enhancement and reconstruction can clearly reveal segment and extent of facial nerve lesion, in addition to prognostic information.

    Reconstruction of ear canal wall with periosteo-bone graft and postoperative mastoid cavity inflation for huge radical cavity after mastoidectomy
    TONG Jun1, LI Ke-yong1, CHEN Wen-wen2, DENG Ya-xin2, CAI Xun-hua2, SHAN Liang2, DU Li-jun2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  31-34.  doi:10.6040/j.issn.1673-3770.0.2013.083
    Abstract ( 1045 )   PDF (1234KB) ( 1400 )   Save
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    Objective    To investigate the effectiveness of defect repair of ear canal with autologous periosteo-bone graft and postoperative mastoid cavity inflation. Methods    Clincal data of 43 cases (40 patients) were reviewed. All patients underwent radical mastoidectomy before. The mean pre-operative air conduction (AC) was 68.27±14.13 dBHL, and the mean GAP was 47.02 ± 12.72 dBHL. These cases were further divided into two groups: a) 20 cases received ear ossicle remodeling surgery and the radical mastoid cavity was repaired by periosteo-bone graft; b) The other 23 cases(among them, 3 cases from the former group were re-operated )received additional postoperative mastoid cavity inflation twice per day. Follow-up lasted 9-60 months (mean 16.46±8.36 months). Result s    All ear canals recovered with smooth appearance .In eight cases, postoperative CT scans showed re-gasification of attic and/or mastoid cavity. Compared with the preoperative, postoperative mean AC and GAP were 47.02±12.72 and 23.04±15.30 dBHL, respectively (both P<0.01). The effective rate was 62%(27 cases) and mild effective rate was 37%. In the 3 cases reoperated, poor postoperative hearing  were noted and the adhesion located between the mesotympanum and attic. After the revising surgery, 2 cases gained satisfying GAP. Conclusion    Bone graft containing periosteum can be used to reconstruct the ear canal. Auxiliary inflation of middle ear can promote the attic and/or mastoid cavity re-gasification and hearing recovery.

    Expression of MCP-1 and BMP-7 in auricular keloid
    JIN Jian-ping
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  35-37.  doi:10.6040/j.issn.1673-3770.0.2013.133
    Abstract ( 1651 )   PDF (1966KB) ( 1295 )   Save
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    Objective    To explore the roles of MCP-1 and BMP-7 in the formation of auricular keloids. Methods    Immunohistochemistry method was used to detect MCP-1 and BMP-7 expression in 29 cases of auricular keloid tissues and 22 cases of normal skin tissue. The correlation between MCP-1 and BMP-7 expression in auricular keloid tissues was discussed. Results    The positive rate of MCP-1in auricular keloids group was 82.76%, which was significantly higher than that of non-pathological scar group (28.57%) and the control group(9.09%) (χ2=12.033, 24.350;  all P<0.05); The positive rate of BMP-7 in keloids group was 17.24%, which was significantly lower than that of non-pathological scar group (57.14%) and the control group(81.82%) (χ2=9.442, 18.432; all P<0.05). A negative correlation between MCP-1 and BMP-7 expression of auricular keloid tissues was noted(r=-0.538,P<0.05). Conclusion    MCP-1 and BMP-7 participate in the regulation of auricular keloid formation process.  BMP-7 can be used as an ideal target in gene therapy to prevent keloids.

    Objective hearing evaluation of infants failed in hearing screening
    YU Chong-xian, YANG Ke-lin, ZHANG Xiao-min, WANG Ping
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  38-41.  doi:10.6040/j.issn.1673-3770.0.2013.181
    Abstract ( 1603 )   PDF (943KB) ( 1993 )   Save
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    Objective    To analyze the audiological characteristics in infants failed in hearing screening and provide useful information for early intervention in this population. Methods    Between January 2011 and December 2012, 286 infants who failed hearing screening in one or two ears received a full audiological test battery consisted of auditory brainstem responses(ABRs), 40Hz auditory event related potential(40Hz—AERP), distortion product otoacoustic emissions(DPOAEs)and tympanometry. Results    95(33.22%) infants were normal hearing subjects and 191(66.78%)showed hearing loss, which was either unilateral(n=70, 24.47%) or bilateral(n=121, 42.31%), including 59 cases(20.63%) of conductive hearing loss and 132 cases(46.15%) of sensorineural hearing loss. Hearing loss ranged from mild(n=91, 31.82%), moderate(n=43, 15.03%), severe(n=20, 6.99%) to profound(n=37, 12.94%). Testing  was repeated in 16(8.38%) of these 191 infants with hearing loss. The results turned out that 2 of them became normal, while 10 were bilateral loss and  4  were unilateral loss. Conclusion    The hearing level in some infants who failed hearing screening can turn into normal owing to the development of auditory system. Middle ear function may be a confusing factor in hearing screening. The audiological characteristics in infants failed in hearing screening can be evaluated by audiological test battery, which provides useful information for early identification and intervention in this population. The results of hearing screening should be interpreted appropriately. However, poor follow-up compliance is still a big problem in such efforts.

    Therapeutic effects of otoscopic myringoplasty with autogenous adipose tissue
    WU Long-jun1,2, HUANG Yi-deng2, XIA Si-wen2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  42-44.  doi:10.6040/j.issn.1673-3770.0.2013.106
    Abstract ( 1537 )   PDF (2035KB) ( 1135 )   Save
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    Objective    To investigate the therapeutic effects of otoscopic myringoplasty with autogenous adipose tissue. Methods    128 cases of otoscopic myringoplasty with autogenous adipose tissue, which were harvested from earlobe or abdomen, were analyzed. The surgical procedure might be repeated due to difficult closure for large tympanic perforation. Results    The perforation of tympanic membranes were successfully repaired with one myringoplasty in 120 patients, twice in 6 patients and three times in 2 patients. The total cure rate was 100%. Hearing examination six months postoperative showed the average threshold of pure tone air conduction was(21.4±8.6)dB. The threshold difference between pure tone bone-conduction and air-conduction was only(10.2±4.6)dB. Conclusion    Otoscopic myringoplasty with autogenous adipose is a simple, easy  and minimally invasive procedure, which can be applied in the repair of large central perforation of membrana tensa,and the patients with failed operation.

    Significance of preoperative temporal bone CT and endoscopy on the treatment of chronic suppurative otitis media
    WANG Jin, HE Yue
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  45-47.  doi:10.6040/j.issn.1673-3770.0.2013.084
    Abstract ( 2278 )   PDF (922KB) ( 1315 )   Save
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    Objective    To explore the significance of CT scan and endoscopy on the treatment of chronic suppurative otitis media. Methods    Clinical data of 35 patients (42 ear) suffering from chronic suppurative otitis media or middle ear cholesteatoma between January 2008 and Januaryr 2011 were reviewed.  Results of temporal bone CT scan and otoscopy were analyzed. Results        ①CT results of chronic suppurative otitis media could be divided into simple, sclerotic, granular  and mixed type.  Feature of middle ear cholesteatoma was the disappearance of ossicular chain or incudomalleolar joint and attic mesotympanum was occupied by soft tissue. Lateral semicircular canal bone, horizontal segment of the facial nerve canal and external auditory canal bone were destroyed in some cases. In simple type, incomplete mastoid gasification was noted.  In sclerotic type, sclerotic mastoid and similar bone shadow around the handle of malleus and stapes were prominent. CT results of granular type and mixed type were similar, in which the lesions involved the tympanic and mastoid, but not ossicular chain and facial nerve canal. ② Characteristic of otoscopy for chronic suppurative otitis media was the perforation of membrane tensa and eardrum calcification. For middle ear cholesteatoma,  perforation of shrapnell’s membrane, posterior superior quadrant and fall down of  the top wall of external auditory meatus, et al, could be identified. Conclusion    CT scan and otoscopy are important methods to assess the nature of the lesions, range, degree, and surgical options for chronic suppurative otitis media and middle ear cholesteatoma.

    Impact of persistent allergic rhinitis of different degrees on the lower airway
    ZHANG Kai1, WANG Qiu-ping1, WU Kun-min1, WANG Zhi-yi1, ZHANG Yong1, JI Jun-feng1, CHENG You1, XIE Yan-qing2, ZHONG Nan-shan2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  48-52.  doi:10.6040/j.issn.1673-3770.0.2013.165
    Abstract ( 1187 )   PDF (1138KB) ( 1155 )   Save
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    Objective    To determine the characters and difference of the impact of persistent allergic rhinitis of different degrees on the lower airway. Methods    All patients enrolled in this study were categorized into three groups, the mild group(165 subjects), the moderate/severe group(101 subjects), and the normal control group(136 healthy subjects). Induced sputum differential cytology tests, measurements of exhaled nitric oxide concentration and methacholine bronchial provocation tests were performed. The character and difference in the lower airway among the three groups were compared. Results        ① The measurements of fractional exhaled nitric oxide concentration and the positive rate of fractional exhaled nitric oxide concentration of the moderate/severe group and the mild group both had significant statistical difference with the normal control group(39.07±24.29 vs 25.81±18.68 vs 9.01±10.01, P<0.01; 66.19% vs 33.33% vs 8.82%, P<0.01) ; ② Proportion and positive rate of eosinophils in induced sputum of the two rhinitis groups had no significantly statistical difference with each other(5.51±9.11% vs 4.02±7.10%; 40.59% vs 35.57%, P>0.05), but they both had significantly statistical difference with the normal control group(5.51±9.11% vs  0.48±1.28%, 4.02±7.10% vs 0.48±1.28%; 40.59% vs 1.47%, 35.57% vs 1.47%, P<0.01); ③ Positive rate of bronchial provocation test of the moderate/severe group had significantly statistical difference with the mild group and the normal control group(14.85% vs 4.24%,14.85% vs 1.23%, P<0.01), but the mild group had no significantly statistical difference with the normal control group(4.24% vs 1.23%, P>0.05). Conclusion    ① The disparity of the lower airway inflammation consists in perennial allergic rhinitis of different degrees; ② Our research demonstrates that the moderate/severe perennial allergic rhinitis exhibits superior lower airway abnormality, indicating that such patients have high-risk of suffering from asthma, in view of this condition, they should be paid sufficient attention to by otorhinolaryngologists and respiratory physicians.

    Relationship between allergic rhinitis and secretory otitis media in children with adenoid hypertrophy
    WU Jia-li, CHEN Shu-mei, TIAN Xin, ZHAO Li-min, NI Kun, GU Mei-zhen, CHEN Jia-rui, ZHOU Jia-lei, LI Xiao-yan
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  53-56.  doi:10.6040/j.issn.1673-3770.0.2013.189
    Abstract ( 1638 )   PDF (1002KB) ( 2043 )   Save
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    Objective    To investigate the correlation between otitis media with effusion (OME) and allergic rhinitis(AR) in children with adenoid hypertrophy. Methods    870 patients under 12 years old with adenoid hypertrophy were collected for current retrospective analysis. Association between AR and eustachian tube dysfunction and OME was calculated by Chi-square test and logistic regression model. Results        The prevalence of allergic rhinitis children with adenoid hypertrophy was 30.11%. The prevalence of allergic rhinitis in different age groups had significant difference and increased with age(P< 0.01). The probability of eustachian tube dysfunction and OME occurring in patients younger than 6 years was high and reached the highest in 1 to 3 years old patients(P=0.001). OME prevalence was higher in spring(P=0.001) than in other seasons. The prevalence of allergic rhinitis with eustachian tube dysfunction was 1.4 times higher than those without allergic rhinitis(P=0.042). The detection rate of OME with AR was 0.32 times hihger than that of OME without AR(P=0.052). Conclusion    The structures, physiological and pathological characteristics of eustachian tube are the main factors causing eustachian tube dysfunction and high incidence of OME. Allergy maybe the secondary factor. With children′s growth,the pathogenicity of the former becomes lower and the latter becomes higher, but the incidence of otitis media with effusion decreases.

    A clinical evaluation on septo-rhinoplasty with hammer hitting in the treatment of delayed traumatic C-type deviated nose
    CHEN Gang, ZHAO Hua, ZHENG Liang, WANG Hui, LIU Gang, LI Shu-hong
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  57-58.  doi:10.6040/j.issn.1673-3770.0.2013.191
    Abstract ( 2231 )   PDF (1347KB) ( 1598 )   Save
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    Objective    To explore an effective method of correction of delayed traumatic C-type deviated nose and functional reconstructive nasal surgery. Method    All 32 cases were treated by septoplasty and rhinoplasty with hammer hitting. Result    The successful rate was 96.9% (31/32) with a period of 6 to 24 months follow-up. Conclusion    Correcting the delayed traumatic C-type deviated nose to reconstruct its function with septo-rhinoplasty with hammer hitting can benefit both cosmetology and nasal functional improvement.

    Endoscopic nasal dilatancy surgery in treatment of intractable  epistaxis
    XIAO Lu, LIAN Zhuang, WEI Yi-ling
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  59-60.  doi:10.6040/j.issn.1673-3770.0.2013.196
    Abstract ( 1889 )   PDF (966KB) ( 1350 )   Save
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    Objective    To investigate the effect of intractable epistaxis. Methods    28 patients with intractable epistaxis were performed endoscopic nasal dilation operation and electric coagulation. Results        During a follow-up of 6 months, 25 cases had no recurrence and nasal cavity adhesion; 2 cases had nasal septum and inferior turbinate mild adhesion two weeks later and  were cured by lysisadhesions without relapse during a follow-up of six months; 1 case had relapse at one month after leaving hospital and was cured after re-operation without recurrence in a 6 month follow-up. 28 patients had no nasal dryness and headaches. Conclusion    Endoscopic nasal dilatancy surgery is reliable for intractable epistaxis.

    Clinical effect of nasal endoscopic dacryocystorhinostomy in 38 cases
    LIU Yan-bo, LIN Wen, WANG Qiu-yu
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  61-62.  doi:10.6040/j.issn.1673-3770.0.2013.167
    Abstract ( 1640 )   PDF (910KB) ( 1141 )   Save
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    Objective    To study the clinical effect of nasal endoscopic dacryocystorhinostomy and analyze the cause of invalid. Methods    38 patients (38 eyes) accepted dacryocystorhnostomy under endoscopy. Results        The operations were well done. After 6 months′ follow-up, 36 cases (36 eyes) were cured and 2 cases (2 eyes) did not. One case had the polyp relapsed and refused treatment. One case of complex maxillofacial fractures resulted in post-operative overflow of tears but no longer pus. Conclusion    Nasal endoscopic dacryocystorhinostomy has many advantages, such as simple operation, little bleeding, light pain, fewer complications, no scar on the face, clear field of vision and minor intraoperative injuries.

    11 cases of oropharyngeal hairy polyp in infants
    XU Feng-lei1, XIA Ming2, QIAN Ye2, SUN Rui-jie2, LIU Da-yu2, WEI Wei3.
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  63-65.  doi:10.6040/j.issn.1673-3770.0.2013.095
    Abstract ( 1887 )   PDF (1619KB) ( 1939 )   Save
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    Objective    To investigate the clinical characteristics of oropharyngeal hairy polyps in infants. Methods    Clinical data of 11 infant cases of oropharyngeal hariy polyp, hospitalized from Mar. 2000 to Dec.2012, were reviewed. Results        With confirmed diagnosis, hairy polyps in all the patients were removed surgically without any postoperative complication. During 3-month to 3-year follow-up, no occurrence was noted. Conclusions    Early diagnosis and timing surgery are the key to achieve the good results in the treatment of oropharyngeal hairy polyp in infants.

    Correlation of hyoid position, minimal retroglossal cross-section area and severity of obstructive sleep apnea hypopnea syndrome
    MA Guo-wei1, ZHANG Qing-quan2, ZHOU Wen-liang1
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  66-68.  doi:10.6040/j.issn.1673-3770.0.2013.064
    Abstract ( 1690 )   PDF (1036KB) ( 1312 )   Save
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    Objective    To assess the correlation of hyoid position, minimal section area of retroglossal space and severity of patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods    57 adult OSAHS patients, diagnosed by polysomnography (PSG), were included in the study, and the apnea-hypopnea index (AHI) was used as an indicator for the severity of OSAHS. All the patients underwent upper airway 64-row CT scanning in supine and FH perpendicular to the ground position.  The computerized 3D reconstruction technique was used to reconstruct the sagittal and axial images. With the help of sagittal images, the angle between the hyoid bone and mandibular planes (α) was measured and used as the indicator for the vertical position of the hyoid bone; Meanwhile, the ratio(R) of hyoid-anterior mandible distance to hyoid-posterior mandible distance was measured and used as the indicator of the anteroposterior position of the hyoid bone. With the help of axial images, the sectional area (s) of the retroglossal space was measured. The correlation of such indexes as, R, s, as well as AHI were analyzed by SPSS.  Results    In 57 cases,α positively correlated with AHI (R=0.305, P=0.021).  There was no correlation between AHI and R . Both α and R didn′t show any correlation with s. Conclusion    In OSAHS patients, the severity of the disease is related to the position of the hyoid bone. With the advancement of OSAHS, the position of the hyoid tends to move downwardly. The possible causes could be the aggregation of soft tissues, such as fat and etc., at the mouth floor and the hypofunction of muscles related to the hyoid. But, under its natural condition, the change of the hyoid position in OSAHS patient would not lead to the transformation of the sectional area  of the retroglossal space.

    Misdiagnosis of upper airway cough syndrome in children (140 cases report)
    HE Cheng
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  69-71.  doi:10.6040/j.issn.1673-3770.0.2013.107
    Abstract ( 1727 )   PDF (920KB) ( 1104 )   Save
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    Objective    To investigate the clinical features, diagnosis and treatment of upper airway cough syndrome (UACS) in children. Methods    A retrospective analysis of 140 cases of juvenile UACS was performed. Among the patients, there were 102 cases misdiagnosed as chronic bronchitis, 25 cases as cough variant asthma, and 13 cases as Tourette′s syndrome. After the diagnosis were corrected,  all the patients underwent the treatment for nasal diseases. Results        After one 14-day course of treatment,  cough in the patients disappeared or ameliorated, with total remission rate at 92.1% (129/140).  Conclusion    UACS is prone to be misdiagnosed. Nasopharyngeal endoscopy (endoscopic or electronic nasopharyngoscope) is a useful tool to diagnose UACS and  the  prognosis of  UACS is good.

    The clinical efficacy of systemic corticosteroids and thalidomide for oropharyngeal major recurrent aphthous ulcer
    WANG Wei-zhi1, ZHANG Bing-feng2, LIU Shao-hua1, WANG Xin2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  72-73.  doi:10.6040/j.issn.1673-3770.0.2013.249
    Abstract ( 1962 )   PDF (955KB) ( 1508 )   Save
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    Objective    To evaluate the clinical efficacy of small dose systemic corticosteroids  and  thalidomide for oropharyngeal major recurrent aphthous ulcer (MjAU). Methods    Clinical data of 50 MjAU patients (experimental group), administered orally with small doses of corticosteroids and thalidomide, and the other 42 MjAU patients (control group) treated only with middle dose corticosteroids were compared. Results        In the experimental group, the course was 15-180days(47.80±38.79) and  the ulcers were healed after 14-41days(22.12±7.39)treatment. In the control group, the course was 12-145days(44.62±36.03)and the ulcers  were healed after 12-36 days(19.77±8.92)medication. There was no significance between the two groups(P>0.05). Conclusion    Combination of small dose systemic corticosteroids and thalidomide shows similar efficacy as middle dose systemic corticosteroids in the treatment of oropharyngeal MjAU.

    Tonsillectomy with monopolar cautery under general anesthesia (90 cases report)
    WU Yun-gang1, LIU Li-ming2, SONG Jian-mei3, PANG Tai-zhong1, LI Xiao-yu1, ZHANG Hui1, YANG Xin-xin1, DING De-tao1, ZHANG Yong-hong1 .etc
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  74-76.  doi:10.6040/j.issn.1673-3770.0.2013.132
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    Objective    To  investigate the tonsillectomy with monopolar cautery under general anesthesia. Methods    180 patients were divided into two groups: experimental  group A and control group B ( 90 patients per group).The experimental group was treated with monopolar cautery, while the control group was treated with conventional tonsillectomy. The operating time,hemorrhage during the operation, the condition of white membrane and postoperative pain were analyzed. Results        Compared with the control group ,the experimental group presented with less hemorrhage, shorter operating time, but longer time of white membrane (P<0.05). Conclusion    Tonsillectomy with monopolar cautery is effective and safe, with minimal invasion,few bleeding, rapid recovery and little adverse effect. It is highly recommended in the practice.

    Rare complications of tracheabronchial foreign body ( 5 cases report)
    HUA Xia,LI Pei-hua
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  77-78.  doi:10.6040/j.issn.1673-3770.0.2013.122
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    Objective    To investigate the treatment of some rare complications of tracheobronchial foreign body. Methods    Clinical data of 943 cases of tracheal, bronchial foreign bodies in children were reviewed. Among them, foreign body was successfully removed in 907 cases. Complications occurred in 36 cases.  Results     The complications consisted of 3 cases of pneumatorrhachis ,1case of tracheoesophageal fistula ,and 1case of negative pressure pulmonary edema. Conclusion    Understanding of these rare perioperative complications is important to prevent and reduce the morality and mortality.

    Different expression of miR-29b in serum of primary open-angle glaucoma patients
    ZHAI Yu-xi, GAO Jian-lu
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  79-81.  doi:10.6040/j.issn.1673-3770.0.2012.380
    Abstract ( 1295 )   PDF (1613KB) ( 1510 )   Save
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    Objective    To test the expression of miR-29b in primary open-angle glaucoma(POAG) patients′ serum and discuss its function in the pathogenesis of POAG. Methods    qRT-PCR was used to detect the expression of miR-29b both in 20 sporadic POAG patients and 20 healthy people. The results were compared. Results        The expression of miR-29b in sporadic POAG patients was 0.15times the value of healthy group. The difference was statistically significant(P=0.03). Conclusion    The expression of miR-29b in sporadic POAG patients′ serum was significantly downregulated, which indicated that miR-29b may play an important role in the pathogenesis of POAG.

    Observation of the endothelial cells of corneal endotheliitis after treatment
    CHEN Kai1, ZHANG Yu-guang2, HAN Xu-guang2, XU Xiang-hui2, DING Gang2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  82-84.  doi:10.6040/j.issn.1673-3770.0.2013.239
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    Objective    To investigate the effect of corneal endotheliitis on the number and morphology of corneal endothelial cells. Methods    The study group included 20 cases (20eyes), including 13 cases of disciform endotheliitis and 7 cases of diffuse endotheliitis. All patients accepted systemic and topical antiviral medications combined with corticosteroids. The endothelium cells checked by corneal endothelial microscope were analyzed for cell density, coefficient variation of cell size and hexgonality 4-6 weeks after the patients were cured. The healthy eyes were set as the control group. Results        Compared with the control group, the treatment group had lower corneal endothelial cell density and hexagonal cell ratio and higher variation coefficient. Compared with the disciform endotheliitis group, the diffuse endotheliitis group had lower corneal endothelial cell density and hexagonal cell ratio and higher variation coefficient. Conclusion    Corneal endotheliitis can damage the corneal endothelial cells, leading to significant changes in their number and morphology. There were distinctions between different types.

    Surgical treatment of primary acute angle-closure glaucoma with sustained high intraocular pressure
    ZHANG Xiu-ping, HU Hai-peng, LIU Yun-xia
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  85-86.  doi:10.6040/j.issn.1673-3770.0.2013.025
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    Objective    To explore the feasibility of surgical treatment of acute angle-closure glaucoma with sustained high intraocular pressure. Methods    37 patients (39 eyes) with acute angle-closure glaucoma accepted trabeculectomy and peripheral iridectomy. They visited clinic at acute stage and their intraocular pressures sustained over 40 mmHg even after maximal drug treatment. Results        The procedure was successful in a11 the 39 eyes without severe complications. The patients were followed up for more than half a year and the postoperative IOP was well controlled. The visions were raised in 15 eyes. Conclusion    Surgical treatment for the acute angle-closure glaucoma with sustained high intraocular pressure is safe and effective.

    Application of silicone tube double-passage intubation in anastomosis for superior and inferior lacrimal canalicular laceration (15 cases report)
    JIN Wen-yan, ZHANG Chun-xia, LIU Shou-li, LIU Ya-hui
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  87-88.  doi:10.6040/j.issn.1673-3770.0.2013.123
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    Objective    To investigate the use and value of silicon tube double-passage intubation in anastomosis for superior and inferior lacrimal canalicular laceration. Methods    The clinical data of 15 patients (15 eyes) who underwent silicon tube double-passage intubation in anastomosis for superior and inferior lacrimal canalicular laceration were reviewed. The follow-up was from 3 months to 2 years. Results        The shape of eyelid and inner canthus were normal while the silicon tube was in place. Though mild epiphora was observed within the first three months after the surgery,  no foreign body sensation, hyperemia or secretions was noted in all cases. No prolapse of silicon tube and other complications occurred. Without epiphora in all  the patients, irrigation of lacrimal passage was easy and smooth after tube extraction. Conclusion    Silicone tube double-passage intubation could help link the canalicular ends firmly, which is satisfying method to treat superior and inferior lacrimal canalicular laceration, with few complications, good efficacy, and normal appearance.

    Perioperative-nursing of 68 patients with obstructive sleep apnea hypopnea syndrome in children
    WANG Xiu-zhen1, HAN Yu-ping2
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  89-91.  doi:10.6040/j.issn.1673-3770.0.2013.164
    Abstract ( 1453 )   PDF (915KB) ( 1131 )   Save
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    A case of dyspnea caused by giant thyroglossal duct cyst
    MA Wen-xue, PAN Song-lin
    J Otolaryngol Ophthalmol Shandong Univ. 2013, 27(6):  92-93.  doi:10.6040/j.issn.1673-3770.0.2013.111
    Abstract ( 1584 )   PDF (1574KB) ( 1371 )   Save
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