Table of Content

16 August 2014 Volume 28 Issue 4

  

New advance in sleep disorders of Alzheimer’s disease

HE Ying-xue, CONG Lin, DU Yi-feng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  1-5.  doi:10.6040/j.issn.1673-3770.0.2014.235

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The incidence of sleep disorder is high in patients with Alzheimer's disease. It is characterized by the increase of nocturnal awakenings and sleep time during the day. Polysomnography shows the stage 3, 4 and REM sleep time decrease and the number of WASO(wake after sleep onset) increases. The main types of sleep disorder in AD patients are sleep disordered breathing, sleep-wake cycle disorders, restless leg syndrome, hypersomnia and sundowning.The sleep disorders occur in AD patients via the following principal mechanisms: the deposition of Aβ in brain and the degeneration of suprachiasmatic nucleus and nucleus basalis of Meynert. The sleep disorders are mainly related to the following aspects: gender, physiological function, degree of dementia, psychiatric syndromes and the use of hyptonic agents. Cholinesterase inhibitors, melatonin, behavior therapy, continuos positive airway pressure have been reported effective against sleep disorders, while they need to be proven in larger clinical studies. Sleep disorder is a common manifestation in AD patients, generated by brain neuronal degenerations, and are affected by many factors. However, there is little confirmed effective therapy for sleep disorder.Therefor,further researches are needed for its prevention and treatment.Relevant literatures about sleep disorder in AD patients at home and abroad are reviewed in this paper.

Research of health-related dangerous factors in adult patients of sleep breath disorder

LI Xue-zhong, LIU Hong-ying, LI Xin-qin, CAI Xiao-lan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  6-10.  doi:10.6040/j.issn.1673-3770.0.2014.221

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Objective To investigate health-related behavior and its affecting factors in adult patients with sleep breath disorder(SBD) and provide dangerous evidence for health management services. Methods 2 596 patients aged above 18 years in clinic were invited to our research from May 20011 to Dec 2013. Questionnaire included height, body weight, diet, physical exercise and health-related behavior factors. Multivariate stepwise logistic regression was used for statistics analysis. Results The effective responding rate was 86.5%. In adult patients with sleep breath disorder, the incidence of lack of physical exercise, obesity, smoking, drinking and diet high in salt and fat was in high proportion. In multivariate Logistic regression analysis, risk factors in lack of physical exercise were smoking and diet high in salt and fat, its protective factors were female, age and higher educational level (P<0.05). Risk factors of obesity were male, age, alcohol drinking and over-intake of salt and fat, and its protective factor was higher educational level (P<0.05). Risk factors of cigarette smoking were male, age, alcohol drinking, lack of physical exercise and over-intake of salt and fat, and its protective factors was higher educational level (P<0.05). Risk factors of alcohol drinking were male, age, overweight and obesity, smoking, and diet high of salt and fat (P<0.05). Risk factors of over-intake of salt and fat were obesity, smoking, drinking and lack of physical exercise, and its protective factor was higher educational level (P<0.05). Conclusion Health education and behavioral intervention should be offered to adult patients with sleep breath disorder.

Clinicians’ knowledge about obstructive sleep apnea hypopnea syndrome：a survey study

LI Xue-zhong, LIU Hong-ying, CAI Xiao-lan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  11-15.  doi:10.6040/j.issn.1673-3770.0.2014.219

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Objective To analyze the knowledge about obstructive sleep apnea hypopnea syndrome(OSAHS) of physicians of otolaryngology, and to provide a basis for clinical diagnosis and treatment as an integrated intervention. Methods The survey was carried on by questionnaires for 1966 doctors of 6 ENT departments in Shandong Province. Accuracy of the answers was chose to evaluate the knowledge. Results Compared to those from provincial and municipal hospitals, physicians from county hospitals had significant less knowledge of OSAHS. Residents and attending have less knowledge than professors or vice-professors. The survey shows an obscure cognition between physicians for the diagnosis and treatment of OSAHS. Conclusion Knowledge about OSAHS of physicians in Shandong Province is uneven, and the diagnosis and treatment of OSAHS have to be improved.

Influence of nasal expansion surgery in combination with H-UPPP on blood pressure for OSAHS patients

LI Jing-hui, WU Hong-min

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  16-19.  doi:10.6040/j.issn.1673-3770.0.2013.327

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Objective To observe the changes of blood pressure in the patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and hypertension after nasal expansion surgery, modified uvulopalatopharyngoplasty or both. Methods 158 OSAHS patients with hypertension diagnosed by polysomnography were enrolled. With upper airway CT scan and fiber laryngoscopy, the obstructive levels were determined in nasal cavity and pharynx. 53 cases (group A) underwent nasal cavity expansion surgery, while 52 cases (group B) underwent modified uvulopalatopharyngoplasty. Another 53 cases (group C) underwent the both procedures. The followed up was set for 1 year. Curative effectiveness and the change of blood pressure were compared among the three groups. Results 124 patients were successfully followed up. The total effective rate was 12.2%, 62.8% and 77.5% in group A, B, C, respectively. Significant changes of blood pressure were noted in the latter two groups. Conclusion H-UPPP alone or combined with nasal expansion surgery demonstrate good therapeutic results in the treatment of OSAHS, and can effectively decrease the patient's blood pressure.

Residual dizziness after repositional maneuvers for benign paroxysmal positional vertigo

WANG Li-yi, GAO Bo, HUANG Wei-ning

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  20-21.  doi:10.6040/j.issn.1673-3770.0.2013.250

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Objective To investigate the residual dizziness after repositional maneuvers for benign paroxysmal positional vertigo. Methods 418 patients were divided into two groups: the elderly group and the control group. The incidence rate and durations of dizziness were evaluated. Results 62 patients(45.3%) reported residual dizziness in elderly group and 76 patients(27%) in control group(P<0.01), the mean durations of the residual dizziness was 14.6±4.4 days in elderly group and 8.9±4.7 days in control group(P<0.01). There was no correlation between residual dizziness and sex in elderly group. Conclusion After the repositional maneuvers for benign paroxysmal positional vertigo, the incidence rate of residual dizziness and the duration in the elderly are higher and longer than the younger.

Effect of Nasopore as packing material for middle ear surgery in 33 chronic otitis media patients

SU Li-sha, LI Zhi-yong, FANG Xue, YANG Xiang, LUO De-yan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  22-25.  doi:10.6040/j.issn.1673-3770.0.2014.100

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Objective To compare the effects of Nasopore and iodoform gauze as packing material in chronic otitis media surgery. Methods 60 patients with unilateral chronic otitis media and cholesteatoma underwent modified radical mastoidectomy and ear cavity angioplasty were divided into experimental group (33 cases) and control group (27 cases). Nasopore was applied in the former group but iodoform gauze in the latter group. There was no significant difference between both groups with regard to the general clinical data(P>0.05). Incidence of complications, otalgia in 24 hours, sleep time within 48 hours and bleeding rate after removing packing material 2 weeks after surgery were compared. Results The incidence of complications was 9.1% in experimental group and 33.3% in control group (P<0.05). There was 32 cases of grade Ⅰ and 1 case of grade Ⅱ of otalgia in experimental group, but 22 cases of grade Ⅰ and 5 cases of grade Ⅱ in the control group (P<0.05). Sleep time in experimental group was (15.61±0.93) hours compared with (12.44±1.31) hours in the control group (P<0.05). Bleeding rate was 6.1% in experimental group compared with 29.2% in the control group (P<0.05). Conclusion Preliminary evidence suggests that Nasopore is better than iodoform gauze as a packing material for chronic otitis media surgery, with less incidence of complications, otalgia, secondary trauma and more sleep time in the patients after middle ear surgery.

Characteristics of vestibular evoked myogenic potentials in patients at early stage of Meniere’s disease

SU Yi, ZHANG Ge-hua, ZENG Xiang-li

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  26-29.  doi:10.6040/j.issn.1673-3770.0.2014.027

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Objective To establish the normal values of vestibular evoked myogenic potentials (VEMPs) in the patients at early stage of Meniere's Disease(MD), including the latency, interaural latency, rate of amplitude and interaural amplitude difference (IAD) ratio. Methods 39 cases of healthy adults with normal hearing were chosen as the controls, while 37 patients with unilateral Ménière's disease at early stage were enrolled into the MD group. The characteristics of VEMPs in MD group were analyzed. Results In MD group, the rate of abnormal VEMPs was 81.08%, in which VEMPs was not present on affected side in 11 cases and on both sides in 4 cases. The characteristics of the VEMPs consisted of prolonged latency of p13 or n23, prolonged IAL difference, and augmented or depressed amplitude. Conclusion The prolonged IAL difference and altered amplitudes of VEMPs are prominent in the early stage of Meniere's Disease.

Experimental study on Scutellarin influence DEX in the process of chemotherapy for nasopharyngeal carcinoma

ZHOU Hui, HUANG Xue-qin, HU Jun-li, YAO Jun, ZHANG Yue-fei, JIANG Feng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  30-32.  doi:10.6040/j.issn.1673-3770.0.2014.076

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Objective To investigate the influence of Scutellarin reverse that dexamethasone(DEX)interference on tumor cells-CNE-2Z by Paclitaxel chemotheraping. Methods CNE-2Z cells were treated with Paclitaxel or DEX pretreatment, or in combination with Scutellarin. The cell proliferation was measured by the MTT-assay; Expressions of Caspase-12 and Cyclin D1 were detected by RT-PCR. Results DEX reduced the effect of Paclitaxel -induced proliferation inhibition and apoptosis induction in CNE-2Z cells. But after treated by Scutellarin, the tumor cell sensitivity to Paclitaxel was partially restored. Conclusion DEX could inhibit the effect of the growth inhibition and apoptosis induction by the chemotherapeutic drugs Paclitaxel, but Scutellarin could reverse these effection and restore the sensitivity of CNE-2Z cells to Paclitaxel.

Myoepithelial carcinoma in the nasopharynx：a case repot and literature review

ZHOU Rong-jin, WANG Jun-guo

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  33-34.  doi:10.6040/j.issn.1673-3770.0.2013.345

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Objective To investigate the clinical features and treatment methods for myoepithelial carcinoma in the nasopharynx. Methods The clinical data of one case of myoepithelial carcinoma in the nasopharynx was retrospectively analyzed. Also, with a literature review, the clinical features and treatment methods were analyzed. Results Myoepithelial carcinoma is an extremely rare, malignant epithelial tumor, which usually occurs in the parotid region. Very few cases of myoepithelial carcinoma in the nasopharynx were reported. The preferred treatment is surgery with or without radiotherapy. Conclusion Early treatment by surgery for total resection of myoepithelial carcinoma in the nasopharynx with radiotherapy in necessary can take a good result.

Sinus balloon dilatation for the treatment of chronic maxillary sinusitis：a nonrandomized control prospective clinical study

JIANG LU-yun, LIU Yang, XIE Yan, XIE Hui, ZHOU Li

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  35-39.  doi:10.6040/j.issn.1673-3770.0.2014.179

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Objective To evaluate the curative effect, safety and degree of patients' accept of the sinus of balloon dilatation in the treatment of chronic maxillary sinusitis in. Methods 50 patients with chronic maxillary sinusitis were randomly divided into two groups on average: group A of 25 patients with sinus balloon dilatation and group B of 25 with maxillary sinus endoscopic operation. Results In examination and post-operative follow-up period of 1 year, there were 2 cases fell off in group A and 3 cases in group B. The 23 cases in group A and 22 cases in group B with clinical symptoms were significantly improved. Through post-operative nasal endoscopic examination, the group A's patency of maxillary sinus ostium maintained well in 30 cases, sinus stenosed in 1 case and sinus mucosa edema around in 2 cases; the group B's patency of maxillary sinus ostium maintained well in 27 cases, sinus stenosed in 2 cases and sinus mucosa edema around in 3cases. There were no post-operative complications of eyes and cerebrospinal fluid leak occurred in two groups. The grades of CT scores of post-operation 12months, and SNOT-20 of post-operative 3 months and 12 months had no significant differences between the group A and B. The Lund -Kennedy endoscopic mucosal morphology scores of post-operative 3 months and 12 months, and the comfort score (the day discharged from hospital after recovery) in group A were better than in group B(P<0.05). Conclusion The nasal endoscopic balloon dilatation and traditional functional endoscopic sinus surgery have the same therapeutic effect and safety in chronic maxillary sinusitis. But in aspect of long-term curative effect and operation comfort, balloon dilatation is better than traditional nasal endoscopic sinus surgery and worthy of clinical popularization and application.

Management of the intraorbital and orbital wall disease by the intranasal endoscopic approach

TAO Jing, LU Yong-tian, WANG Xiao-bin, LIU Gui-qin, GUO Jiang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  40-42.  doi:10.6040/j.issn.1673-3770.0.2014.122

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Objective To investigate the endoscopic operative technique and efficacy for orbital and orbital lesions. Methods The clinical data of 48 cases of orbital lesions were retrospectively analyzed. The observation group of 23 patients was treated by endoscopic surgery without orbital wall reconstruction. The control group consisting of 25 cases was treated by traditional subconjunctival approach using titanium mesh and porous polyethylene sheet implants (MEDPOR) to perform orbital wall reconstruction. Results During a follow-up period of 6 months, there were no significant differences in efficacy; the hospital stay and hospitalization costs in the observation group were all better than the control group (P<0.05). Conclusion Endoscopic treatment of orbital and orbital lesions is effective and has certain advantages.

Budesonide used after functional endoscopic sinus surgery

ZHANG Wei-shi, GAO Gang, QIAN Mao-hua, JI Chao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  43-45.  doi:10.6040/j.issn.1673-3770.0.2013.319

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Objective To investigate the effect of Budesonide after functional endoscopic sinus surgery (FESS) for chronic nasal-sinusitis. Methods A total of 280 cases of chronic nasal-sinusitis(CRS) which underwent FESS were randomly divided into two groups: A group was regular dressing group with Budesonide nasal spray; B group was put gelatin sponge with Budesonide infiltration at vesicles and edema place in the post-operative dressing process, 1-2 times a week. Then we adopted VAS visual assessment and Lund-Kennedy assessment to assess the dressing effect after one, three and six months of FESS. Results The VAS scores and Lund-Kennedy scores of A and B groups at 1, 3 and 6 months were 4.48±1.33, 2.16±0.81, 2.04±0.96; 3.85±1.09,1.90±0.88,1.93±0.74 and 11.44±1.73, 4.51±1.05,3.94±0.86; 6.82±2.08,4.26±1.17,2.17±0.79. The VAS score at the three time points was statistically significant between the two groups (P<0.05); The VAS score of the 3 and 6 months was statistically significant with that of 1 month(P<0.05); while it was not statistically significant between the 3 and 6 months. The Lund-Kennedy score at 1 and 6 months was statistically significant between the two groups (P<0.05); The Lund-Kennedy score at 3 and 6 months was statistically significant (P<0.05); while between 3 months and 6 months, it was statistically significant in the A group, but not in the B group. Conclusion Budesonide after FESS of CRS can better reduce vesicle formation, mitigate edema and promote mucosal epithelium.

Comparison of curative effect of endoscopic endonasal dacryocystorhinostomy with open surgery

ZHAO Ya-ming, ZHANG Wei-tian, LI Yin, ZHU Hua-ming, SU Kai-ming

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  46-48.  doi:10.6040/j.issn.1673-3770.0.2014.060

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Objective To compare the effects of intranasal endoscopic dacryocystorhinotomy with open dacryocystorhinostomy on chronic dacryocystitis and obstruction of nasolacrimal duct. Method 53 cases including 27 cases on intranassal endoscopic dacryocystorhinostomy and 26 cases on open dacryocystorhinostomy were retrospectively studied. Results In the endonasal endoscopic group, the cure rate was 92.6% and the effective rate was 100%.While in the open group, the cure rate was 96.2% and the effective rate was 100%. There was no statistical significance in the two groups(P>0.05). Conclusion The endonasal endoscopic dacryocystorhinstomy as an effective micro-invasive surgery is worthy of clinical application.

Laryngeal function reconstruction with outer thyroid perichondrium and sternohyoid muscle in glottic carcinoma laryngectomy

LIU He-zhen

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  49-51.  doi:10.6040/j.issn.1673-3770.0.2013.367

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Objective To investigate the application of outer thyroid perichondrium and sternohyoid muscle in laryngeal reconstruction in glottic carcinoma partial laryngectomy. Methods 38 cases of glottic carcinoma undergoing partial laryngectomy and laryngeal reconstruction with outer thyroid perichondrium and sternohyoid muscle were retrospectively analyzed. Results All 38 cases survived with satisfactory laryngeal cavities. The decannulation rate was 97.4% and their pronunciation and swallow functions were recovered well without complications. Five-year survival rate was 86.8%. Conclusion For the laryngeal carcinoma patients with preservation of at least two-thirds of one-side thyroid cartilage,outer thyroid perichondrium and sternohyoid muscle is an ideal and feasible method to restore laryngeal function.

Preliminary application of MR and CT image fusion in laryngocarcinoma

TIAN Jun, WANG Dan-dan, HUAHG Fu-hui, WANG Bin-quan, LI Le

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  52-55.  doi:10.6040/j.issn.1673-3770.0.2013.340

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Objective To explore the establishment and significance of image fusion of MRI and CT scans in laryngeal carcinoma. Methods Conventional body frame and thermoplastic mask were improved and its set-up error were compared with the old one. Thirty one laryngeal carcinoma patients underwent MRI and CT scan with same protocol in the same body position. The two images were transferred into Pinnacle³ V8.0 for registration and fusion. Images of CT, MRI and the fusion were evaluated subjectively. Results Quality of fused images from the 23 patients were satisfying. The result of fusion could be displayed in three ways, including Alpha Blending, Checkerboard and Target Region. In these fused images, both cartilages and soft tissue lesions could be clearly displayed. Conclusion Image fusion of MRI and CT scans in the patients with laryngeal carcinoma can correct the disadvantages of CT scan by improving the visualizaion of soft tissue lesions in the throat, to facilitate the evaluation of the tumor infiltration.

Surgical treatment of parapharyngeal space tumors via endoscopic transoral approach：a retrospective analyses of 5 cases

LUO Xing-gu, LU Yong-tian, WANG Xiao-bin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  56-58.  doi:10.6040/j.issn.1673-3770.0.2013.291

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Objective To investigate the surgical indications, technique, and advantages of resection of parapharyngeal space(PPS) tumors through endoscopic transoral approach. Method Retrospective analysis were carried out in 5 parapharyngeal space tumors patients who received endoscopic transoral approach surgery. Results All the tumors were completely removed and the intraoperative blood loss was 20~60 mL. No serious complications occured and all the patiens were discharged in 5 days after the operation. No recurrence was found in a 1-2 years follow-up. Conclusion Preoperative CT and MRI provide useful clinical informations for surgical planning, such as tumor's location, size, state of invasion, the relationship with adjacent structures, and the likely origin. The endoscopic transoral approach is a good procedure to remove the tumors located anteromedially to the carotid sheath, with minimal invasiveness, no scar in the neck and few complication. However, it is not applicable for PPS tumors encasing the internal carotid arteries or located posterior or posterolateral to the carotid sheath, operative

Diagnosis and treatment of the malignant parapharyngeal space tumors

BAI Yong, YIN Zhao-fu, ZHANG Min, MA Li-juan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  59-61.  doi:10.6040/j.issn.1673-3770.0.2013.360

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Objective To study the clinical characteristics, diagnosis and treatment of the malignant parapharyngeal space tumors. Methods A retrospective study of 5 patients with primary malignant parapharyngeal space tumors treated from 2000 to 2013 was performed. All the 5 patients received B-ultrasound and CT scan, while 3 patients underwent further enhanced MRI scanning. The transcervical approach surgery was applied in 5 patients and functional neck dissection was performed in 2 patients. Postoperative radiotherapy were applied in 3 patients. Final diagnosis was reached by frozen section and pathological studies. Results There were one malignant neurofibroma, one malignant peripheral nerve sheath tumor, one branchial cleft carcinoma, one synovial sarcoma, and one undifferentiated carcinoma. Preoperative imaging studies were very important for precise tumor localization and its relation to adjacent structures. 3 patients were alive in 1-year following-up, however, 1 patient died 3 years later and 1 patients was gone half a year later after the operation. Conclusion The malignant parapharyngeal space tumors are various in histopathology. B-ultrasound, CT scan and enhanced MRI study are helpful for diagnosis. Appropriate approach is key in the surgery of parapharyngeal space tumors. Comprehensive treatment is very important to the prognosis.

Application of double-tube drainage under ultrasound-guided percutaneous puncture in the treatment of parapharyngeal space abscess (15 cases report)

HE Zheng, YAO Yu-fen, GAO Zhi-ling, CHEN Kun, ZHANG Zhi-jun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  62-64.  doi:10.6040/j.issn.1673-3770.0.2014.120

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Objective To evaluate the reliability and effectiveness of double tube drainage under ultrasound-guided puncture in the treatment of parapharyngeal space abscess. Methods 15 patients, with single abscess in the parapharyngeal space and the diameter of abscess no less than 6 cm, were included into the study. Routine ultrasound and color Doppler were applied to locate the site for the puncture. After iodine disinfection and 2% lidocaine(5-10 mL)local anesthesia,A 10Fr's Skater drainage tracer was inserted into the deep side of the abscess, but the other one to a shallower side. The distance between the ends of two tubes was about 3cm. After removing the inner needle, the pus was extracted for bacterial culture and drug sensitive test. The rest of pus was pumped with a syringe as much as possible, and then rinse solution (500 mL of 0.9% sodium chloride injection plus 240 000 units of gentamicin and 250 mL of 0.2% metronidazole injection) was applied to irrigate abscess repeatedly. At the end of irrigation, a negative pressure suction device would be connected with the deeper tube. The above irrigation was performed twice a day. If the pus was too sticky to drain, 25 mL of 0.1% α-chymotrypsin saline solution would be injected into the abscess cavity, followed by approximately 20 mL of 0.5% metronidazole. In this way, the tubes were not removed until the rinse solution became clear. All the patients were treated with intravenous cefuroxime. Results The fever dropped or disappeared after 48-hour drainage. All of 15 patients were discharged with full recovery, and were followed up for six months without recurrence. Conclusion It is safe and reliable to drain the parapharyngeal space abscess with double tubes under ultrasound guide. Due to less complication and curative effects, it should be recommended.

Surgical treatment of 46 cervical neurilemmoma

WANG Bao-xin, DONG Pin, XIE Fang, DING Jian, SHEN Bin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  65-66.  doi:10.6040/j.issn.1673-3770.0.2013.329

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Objective To improve the diagnosis and surgical treatment of cervical neuriemmona. Method The clinical data of 46 patients with schwannoma of head and neck from January 2003 to December 2012 were reviewed. Results Clinical symptoms and signs, auxiliary examination (e.g. ultrasound imaging, CT, MRI) and Fine Needle Aspiration Cytology (FNAC) might be useful in the diagnosis of schwannomas, while the postoperative histopathologic examination was the gold standard. The origin of tumors were nerves, in which brachial plexus was the most common. All the patients undertook the surgery. During the follow-up, there was no recurrence. All of them showed no evident neurological sequelae except for the 14 patients who presented neurological symptoms before the operation and the other 2 patients whose nerves of origin were sacrificed. Conclusion Tumor resection is still the most effective treatment available for patients with schwannomas. Although the tumour is benign, surgeons should choose the appropriate approaches to maintain the integrity of nerve based on the tumour's size, location, clinical symptoms and signs, and the patients' desire.

Immediate reconstruction of mandiblular segmental defects with nonvascularized rib grafts or iliac grafts

GOU Dong-ming, WANG Ming-fu, HUANG Xu-dong, LI Long-jiang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  67-70.  doi:10.6040/j.issn.1673-3770.0.2014.140

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Objective To explore the effect of stage-I reconstruction with nonvascularized rib grafts or iliac grafts post mandibular segmental resection. Methods The analysis was based on the 16 patients admitted in our hospital from 2004 to 2012. They developed with severe mandiblular defects resulting from benign tumors and mandibular segmental resection and were chosen to undertake stage-I reconstruction with autologous nonvascularized rib grafts or iliac grafts. Results Incisions of all cases recovered in phase I. During the follow-up period of 1 to 12 months, one case of fistula and one case of graft necrosis were observed in all cases. All grafted bones survived with satisfied occlusions and appearances. The effects of the cases with half mandible defects were also accepted with appearance repair and basic occlusive function. Conclusion Satisfactory effect can be achieved by applying nonvascularized rib or iliac grafts to stage-I postoperative reconstruction post mandibular segmental resection. The operative procedure is relatively simple and no vascular anastomosis technique is needed. Taken together, it makes nonvascularized rib or iliac grafts to be an applicable method of mandibular defect repairing.

Tracheal CT reconstruction and Hopkins endoscopy in diagnosis and treatment of special tracheobronchial foreign body

LI Xiu-guo

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  71-73.  doi:10.6040/j.issn.1673-3770.0.2014.046

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Objective To evaluate the application of tracheal CT three-dimensional reconstruction in the diagnosis of special tracheobronchial foreign body and the Hopkins endoscopy in surgery. Methods Tracheal CT three-dimensional reconstruction was applied to 20 patients with suspected special foreign body. Then Hopkins endoscopy was used to locate and remove the foreign bodies. Results Findings of bronchoscopy were consistent with the results of CT reconstruction in all the patients. And all the foreign bodies were successfully removed. Conclusion Tracheal CT reconstruction can help diagnose specific tracheobronchial foreign body, and Hopkins endoscopy makes the removal of foreign body more precise and safe.

Clinical efficacy of suspension laryngeal endoscopy and powered laryngeal system in minimally invasive surgery

LIU Jian-bing, LI Man, BAI Zheng-qun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  74-76.  doi:10.6040/j.issn.1673-3770.0.2014.047

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Objective To evaluate the clinical effects of laryngeal endoscopy and powered laryngeal system in minimally invasive surgery. Methods 215 patients with vocal cord lesions were treated with powered laryngeal instruments under laryngeal endoscopy, Clinical efficacy was evaluated before and after the surgery, including laryngoscopy and self-assessment of Voice Handicap Index (VHI-10). Results The surgical exposure was excellent and the operational cut was precise and less invasive. The vocal function in 215 patients was satisfying. The voice handicap index were different between pre-operative and four weeks postoperative (P<0.05). Conclusion Laryngeal endoscopy combined with powered laryngeal system is ideal in minimally invasive surgery.

Expression and significance of insulin-like growth factor-1 and extracellular-signal regulated kinase1/2 in human glomus jugular tumor

SHENG Hong-shen, HE Yue, HUANG De-liang, HAN Dong-yi, YANG Shi-ming, DAI Pu, WU Wen-ming

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  77-80.  doi:10.6040/j.issn.1673-3770.0.2013.318

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Objective To investigate the expressions and significance of insulin-like growth factor-1(IGF-1) and extracellular-signal regulated kinase1/2(ERK1/2) in human glomus jugular tumor. Methods Immunohistochemistry was used to detect the expressions of IGF-1, ERK1 and ERK2 in 33 cases of human glomus jugular tumor and 9 cases of normal adrenal medulla. Results The expressions of IGF-1were found in 26 cases of glomus jugular tumor in which the expressions located mostly in the cytoplasm of chief cells while some in the nucleus. The expressions of IGF-1 were found in 5 cases of adrenal medulla which located mostly in the cytoplasm. The expressions of ERK1 and ERK2 were found in 24 and 25 cases of glomus jugular tumor with similar distribution restricted in the cytoplasm of chief cells. The expression of ERK1 and ERK2 were found in 4 and 5 cases of adrenal medulla with the pattern restricted in the cytoplasm. Overall, the expression intensities for IGF-1, ERK1and ERK2 in glomus jugular tumor cases were higher than those in the adrenal medulla cases. Furthermore, the expression of IGF-1 was significantly correlated with those of ERK1 and ERK2(r=0.553, 0.601, P<0.05). Conclusion The overexpression of IGF-1 may play an important role in tumor genesis and development via ERK1/2 signal pathway through a paracrine or autocrine manner in human glomus jugular tumors.

Expression of survivin in animal model of posterior capsule opacification

LIU Shu-jun, DAI Xiu-yu, LIU Shao-yi, WANG Wen-ting, LI Yuan-bin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  81-84.  doi:10.6040/j.issn.1673-3770.0.2013.172

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Objective To establish animal model of posterior capsule opacification (PCO) in New Zealand white rabbits and detect survivin expression in PCO tissue. Methods Thirty adult New Zealand white rabbits were randomly divided into control group and experimental group. The 5 rabbits in control group were executed. Ultrasonic phacoemulsification was performed in the 25 experimental rabbits' eyes. Their eyes were examined by slit lamp microscope to observe the development of PCO immediately and 3, 7, 14 and 28 days after surgery, and then they were executed. The posterior capsule of right eyes was taken in all the rabbits. Western blotting and reverse transcription polymerase (RT-PCR) were performed to detect survivin expression in PCO at different time points postoperatively. Results Both Western blotting and RT-PCR method indicated that different level of survivin expression was detected in the tissue of PCO 3, 7, 14 and 28 days after surgery. It reached the peak at the 7th day, and began to decrease at the 14th day after surgery. Conclusion The survivin expression can be detected in the tissue of PCO in certain time, which indicated that survivin is correlated with the pathogenesis of PCO.

Fractional laser photocoagulation and prednisone in treatment of shallow rhegmatogenous limited retinal detachment

YAN Xiao-teng, FENG Jun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  85-86.  doi:10.6040/j.issn.1673-3770.0.2013.370

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Objective To evaluate the effect of fractional laser photocoagulation and prednisone in treating shallow rhegmatogenous limited retinal detachment. Methods A total of 42 patients(43 eyes) with shallow rhegmatogenous limited retinal detachment was treated by laser photocoagulation for 2 to 4 times with an interval of 7 to 14 days and were taken oral prednisone 30 mg per day lasting 1 to 4 weeks after the laser therapy. Results Of them, 37(86%) eyes achieved good curative effect. Among 9 eyes that the retinal detachment's area ranged over 3 PD(papillary diameter), 5(55.6%)eyes achieved good curative effect. Among 34 eyes that the retinal detachment's area ranged within 3 PD, 32(94.1%) eyes achieved good curative effect. Conclusion Fractional laser photocoagulation in combination with prednisone is an effective and safe treatment for shallow rhegmatogenous limited retinal detachment.

Clinical effect of hydroxyapatite orbital implantation with scelral cover at the top of hydroxyapatite

SUN Xin-cheng, LU Guo-hua, CHEN Chen, XIE Yang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  87-89.  doi:10.6040/j.issn.1673-3770.0.2014.106

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Objective To investigate the operation methods and clinical effects of hydroxyapatite (HA) orbital implantation with scleral cover at the top. Methods The clinical data of 37 cases treated with hydroxyapatite orbital implantation with scelral cover at the top of hydroxyapatite were retrospectively analyzed. Results During a follow-up period of 6 to 24 months, exposure, exclusion, infection, prolapsus associated with orbital hydroxyapatite implantation were not observed. No orbital infection and ptosis occured. Conclusion The described modified implantation technique is a safe and dependable method with few complications, such as exposure of hydroxyapatite orbital implantation.

Application of CBL and elicitation teaching mode in teaching of otolaryngology-head and neck surgery for undergraduates

CHEN Fu-quan, LU Lian-jun, CHEN Yang, SHI Zhao-hui

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  90-91.  doi:10.6040/j.issn.1673-3770.0.2014.028

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Objective To overcome defects such as lack of ability in flexible application of knowledge and clinical thinking in traditional teaching mode for medical undergraduates and to promote the conversion from lecture based learning. Methods CBL was used in combination with elicitation teaching mode in teaching of Otolaryngology-Head and Neck in medical undergraduates in recent 3 years. The effectiveness of CBL combined elicitation teaching mode was evaluated with questionnaire in class 2010. Results In this study, 93.8% undergraduate students satisfied with the new mode and 90.6% undergraduate students agreed that it is helpful in establishing clinical thinking. Conclusion CBL in combination with elicitation teaching mode helps to promote the establishment of student-centered clinical teaching mode and to found ability in clinical thinking and clinical innovation.

Application of endoscopic imaging system in otorhinolaryngology department trainee teaching

WEN Han-guang, CHEN Miu'an, LIN Ting-ting, ZHU Qiu-bei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  92-94.  doi:10.6040/j.issn.1673-3770.0.2014.096

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Objective To investigate the effect of endoscopic imaging system in otorhinolaryngology trainee teaching. Methods A total of 50 students were randomly divided into the experimental group and the control group. The experimental group was trained on the basis of traditional teaching with the assistant of endoscopic imaging system, while the control group was trained with traditional teaching. Theory exams were counted statistically and questionnaires were carried out. Results Theoretical results of the experimental group were higher than those of the control group (P<0.05). The satisfaction with the teaching methods, learning interest, understanding and learning efficiency in all aspects of teaching contents, etc. were higher than the control group. Conclusion Using endoscopic imaging system in otorhinolaryngology trainee teaching is a good teaching manner that can be further promoted and applied.

Review on mtDNA^CD4977 and presbyacusis

LIU Hong, WANG Shuai, WANG Hai-bo

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  95-99.  doi:10.6040/j.issn.1673-3770.0.2013.308

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Since half a century ago, the incidence of presbycusis grows worldwide. Based on the data from United States Public Health Service (PHS), hearing loss affects approximately 40%～66% of adults age 75 and older. Among them, more than 80% were older than 85 years old^[1-3]. Presbycusis, also called age-related hearing loss, is a chronic, progressive, bilateral, symmetrical and sensorineural hearing loss^[4-6]. It's a pregressive aging of auditory organs, which involves in the disorders of fine-structure in auditory system dealing with information^[7]. Presbycusis is caused by long-term cumulative damage under a variety of risk factors. Age is the most important risk factor. Chronic diseases, such as diabetes and hypertension, could also cause blood supply decrease in inner ear, which further leads to the hearing damages^[1,8-9]. With the development of biomedicine, many scholars have found that alternation of nuclear genome, mutation and deletion of mitochondrial DNA play significant roles in the onset and development of presbycusis^[2,6,10].

Applied anatomy and advances of endoscopic surgeries in the palatovaginal canal,vidian canal and petrous internal carotid artery

HU Jin-cheng, LU Yong-tian

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  100-104.  doi:10.6040/j.issn.1673-3770.0.2013.330

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In recent years, the lesions of the pterygopalatine fossa and the carotid artery are treated with transnasal endoscopic approaches in foreign countries gradually. The anatomy of the pterygopalatine fossa and its canals, such as palatovaginal canal and vidian canal, have been studied thoroughly. However, literatures about the anatomy and clinical applied anatomy of the petrous apex, internal carotid artery,c livus and cranio-vertebral junction space were reported rarely in China. The main causes to cast negative influence on the endoscopic skull base surgery are the complicated structures, anatomical variations and lack of reliable anatomical landmarks. Disorientation of the surgical field is the major risk faced by otorhinolaryngologists and neurosurgeons during endoscopic surgery.

A case report of cervical foreign material with infection migrating from foreign body ingestion

QIU Zhi-li, JIANG Xiao-ping

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(4):  105-106.  doi:10.6040/j.issn.1673-3770.0.2013.323

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