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Table of Content

    16 October 2014 Volume 28 Issue 5
      
    Effect of melatonin on the cTnT and Ca2+-ATPase of chronic intermittent hypoxia cardiac muscular tissues
    DONG Yi-yuan, LING Yue-fu, ZHANG Yao-ting
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  1-3.  doi:10.6040/j.issn.1673-3770.0.2014.139
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    Objective To investigate whether the melatonin (melatonin, MLT) could protect SD rats' cardiac muscular tissues from chronic intermittent hypoxia damage in the atmospheric pressure. Methods The 24 male, SD rats(5 weeks) were randomly divided into three groups: the Control group, the experimental group A and the experimental group B. The control group rats were fed with normally reared in the air, and the experimental group A and B rats were living in the atmospheric pressure and chronic intermittent hypoxia boxes. The control group rats and the experimental group B rats were fed with normal saline solution(NS), and the experimental group A rats were fed with melatonin (MLT). After 8 weeks, the cTnT capacity and Ca2+- ATPase activity of each rat were detected, and the right ventricles were taken for pathological section. Results ①Comparison of the experimental group B and the experimental group A: The cTnT capacity of the experimental group B was increased (P<0.05), and the Ca2+- ATPase activity of the experimental group B was decreased (P<0.05). Individual myocardial cell nuclei disappeared. Myocardial cells were hypertrophy and there was a large amount of bleeding between myocardial. ②Comparison of the experimental group A and the control group: The above indicators had no obvious differences (P>0.05). There was a small amount of bleeding between myocardial. ③Comparison of the experimental group B and the control group: The cTnT capacity of the experimental group B was increased (P<0.05), and the Ca2+-ATPase activity of the experimental group B was decreased (P<0.05). Individual myocardial cell nuclei disappeared. Myocardial cells were hypertrophy, and there was a large amount of bleeding in myocardial. Conclusion MLT can protect rats' cardiac muscular tissue from injury of chronic intermittent hypoxia.
    Minimally invasive one-stage multilevel treatment for mild and moderate obstructive sleep apnea hypopnea syndrome in 35 patients
    XU Jin-cao, ZHANG Mei-guang, WANG Wei, FENG Yong, LU Ya-yan, JI Yu-bin, GAO Xue
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  4-6.  doi:10.6040/j.issn.1673-3770.0.2014.121
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    Objective To explore safety and efficacy of minimally invasive one-stage multilevel treatment for mild and moderate obstructive sleep apnea hypopnea syndrome. Methods Clinical data of 35 cases of mild and moderate OSAHS underwent minimally invasive one-stage multilevel treatment, from January 2011 to June 2013 in Department of Otorhinolaryngology and Head & Neck Surgery, were reviewed. Results Minimally invasive one-stage multilevel treatment improved the sleep and daytime symptoms related to OSAHS. After at least 6 months of follow-up, there were eight cured(22.9%), twenty-two improved markedly (62.7%), five effective(14.3%) without invalid case. The average apnea-hypopnea index was decreased from 18.6 to 8.0 (P<0.05); The mean of lowest oxygen saturation was increased from 78.4% to 84.4% (P<0.05) and the average Epworth sleepiness scale score was decreased from 11.6 to 7.7 (P<0.05). Also, there was significant improvement in snoring, daytime sleepiness, and overall impact of the disease on quality of life. All patients returned to normal swallowing one month after the surgeries. Conclusion AHI, LSaO2 and ESS are significantly improved in OSAHS patients treated with minimally invasive one-stage multilevel treatment. The procedure is recommended for mild and moderate OSAHS.
    Changes of blood pressure in severe OSAHS patients with hypertension before and after Uvulopalatopharyngoplasty
    WANG Yu-zhi, L Ling-yan, QU Zhe, WANG Xing-jie, ZHOU Xuan-yan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  7-9.  doi:10.6040/j.issn.1673-3770.0.2014.186
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    Objective To investigate changes of blood pressure in the patients with severe obstructive sleep apnea hypopnea syndome(OSAHS) complicated with hypertension between before and after uvulopalatopharyngoplasty (UPPP). Methods 32 Patients suffering from severe OSAHS with hypertension were enrolled. All of them have taken oral antihypertensive drugs for more than three years and the blood pressure was poorly controlled. All the 32 patients were treated with modified UPPP. The polysomnograpy(PSG) and 24-hour dynamic blood pressure were monitored before operation and six months after operation. The results were compared. Results ①Six months after modified UPPP, median of apnea/hypopnea index(AHI)/Apnea index(AI)/ microarousal index(MAI)were all decreased obviously( P<0.05). The average SaO2 and lowest SaO2 were higher significantly (all P<0.05).②Six months after modified UPPP, the 24-hour average systolic blood pressure(SBP)/diastolic blood pressure (DBP), daily and nightly average SBP/DBP all were decreased obviously(P<0.05). Conclusion UPPP is good at blood pressure control for the patients with severe OSAHS complicated with hypertension.
    An epidemiological survery of severe snoring and SAHS in Xuzhou
    GE Xing, LÜ Ling-shuang, PAN Ming, SHI Qiao-mei, XU Jian-feng, LIN You-jie, SUN Ya-hui, SHEN Ping
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  10-13.  doi:10.6040/j.issn.1673-3770.0.2014.031
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    Objective To investigate the current situation and risk factors for severe snoring and sleep apnea hypopnea syndrome (SAHS) in Xuzhou area. Methods In Xuzhou, three urban areas and three rural areas were investigated with questionnaire by using random cluster sampling. The SAHS subjects underwent further polysomnography. With a database established by EpiData3.0 software, all the data was inputed based on the protocol of double entry verification and analyzed by SPSS 13.0. Results The effective questionnaire obtained was 1 223 (effective rate: 94.1%), including 473 men(38.7%) and 750 females(61.3%). The prevalence of snoring at grade 3 or above was 14.0%, while the prevalence of positive SAHS was 6.2% The risk factors consisted of gender, drinking, hypertension, BMI, nasopharyngeal diseases, and family history etc. Conclusion The prevalence of severe snoring and SAHS in Xuzhou is lower than other regions, which can be reduced by containing the risk factors, such as drinking, blood pressure, body mass index, nasopharyngeal diseases and so on.
    Psychoacoustic characteristics of 90 tinnitus patients
    ZHU Ya-jiao, XUE Fei, WANG Qiu-ping
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  14-17.  doi:10.6040/j.issn.1673-3770.0.2014.004
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    Objective To study the psychoacoustic characteristics of tinnitus by investigating the relationship of gender, age, THI and residual inhibition with tinnitus. Methods 93 tinnitus patients underwent psychoacoustic tests with TinniTest-1000A, and the results were analyzed. Results The tinnitus frequency was closely related with the frequency of hearing loss. Conclusion There were significant deviations in THI score for different residual inhibition and therapeutic efficacy. In the patients with higher THI scores, the significant deviations in residual inhibition and therapeutic efficacy between male and female were noted.
    Application of mastoid-cavity obliteration and ear canal posterior-wall renovation with mesodermal-tissue graft of postauricular region and mastoid cortex-bone pate in canal wall-down tympanoplasty
    CHEN Xue-sheng, WANG Wei, TAO Jing, YIN An-ping
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  18-22.  doi:10.6040/j.issn.1673-3770.0.2014.177
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    Objective To explore the clinical method to obliterate mastoid-cavity being and renovate ear canal posterior-wall by using various mesodermal-tissue grafts of postauricular region and mastoid cortex-bone pate in canal wall-down tympanoplasty (CWdT) to treat chronic suppurative otitis media or cholesteatoma otitis media. Methods From January 2011 to December 2013, 21 cases of patients with the two types of otitis media mentioned above were subjected to the procedure. Results After more than 6 months of follow-up, except for one case who succeeded in dry ear with small eardrum perforation, all the other cases presented a dry ear, with slightly big canal and no secretion or recurrence of cholesteatoma. The posterior-walls of the canal were smooth without perforation on eardrum, and the obtuse angle was not formed between the inner upper of posterior-wall and the new eardrum. The rate of dry ear was 100%, and the rate of eardrum healed was 95.2%. Conclusion Self postauricular mesodermal-tissue graft and mastoid cortex-bone pate are simple methods to obliterate mastoid cavity and renovate posterior-wall of ear canal. After the procedure, the repairing tissue heals well with no liquefaction or necrosis. Long-term follow up confirms that the canal is slightly bigger and stable. Physiological states, such as shape, epithelization and skin color of the posterior-wall of the ear canal are satisfying.
    Intratympanic steroids to treat refractory sudden sensorineural hearing loss(52 cases report)
    YAN Xiao-ling, MAO Min, ZHAI Jin-ming, CHEN Guan-gui, ZHANG Jian-guo, LIU Qi-ming, XUE Jin-ping
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  23-26.  doi:10.6040/j.issn.1673-3770.0.2014.045
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    Objective To investigate the effect of intratympanic steroids as a salvage method to treat the patients with refractory sudden sensorineural hearing loss who did not respond to initial primary systemic steroid therapy. Methods Reviews were performed for 96 patients hospitalized between 2010 and 2013. Among them, 52 patients accepted intratympanic steroids injection, and the remaining 44 patients who refused intratympanic treatment were served as the control group. Mean air conduction at four frequencies (0.5, 1, 2, and 4 kHz) were monitored. Hearing results was compared before and 1 month after the treatment. Results Hearing improvement was defined as more than 10 dB in pure tone average(PTA). The hearing improvement was 30.8%(16 cases) in the intratympanic group but 6.8%(3 cases) in the control (P<0.01). Conclusion Intratympanic steroid injection is an effective therapy for sudden sensorineural hearing loss patients who are refractory to primary systemic steroid therapy.
    Surgical treatment of auricle pseudocyst by removing anterior auricular cartilage and sutured bandaging in 57 patients
    WANG Xu-zeng, QU Qian, LIU Ling-bing, ZHANG Yong-chao, XU Shi-cai, LIU Lei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  27-28.  doi:10.6040/j.issn.1673-3770.0.2014.080
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    Objective To investigate the surgical outcomes of removing anterior auricular cartilage and sutured bandaging in the treatment of auricular pseudocyst. Methods Clinical data of 57 auricular pseudocyst cases (60 ears), underwent anterior auricular cartilage removal and sutured bandaging, were reviewed. Results All 57 patients were followed up for 6 to 24 months. Among them, there were 85% cured, 11.67% markedly effective, and 3.33% invalid. The total effective rate was 96.67%. No recurrence was noted except for 2 invalid cases. Conclusion Removing anterior auricular cartilage and suture bandaging can shorten the treatment time and improve the cure rate for auricle pseudocyst.
    Application of rotation skin flap in the repair of auricle injuries
    SONG Sheng-hua, ZHAO Wei, JIANG Jin-qin, ZHAO Meng-ying
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  29-33.  doi:10.6040/j.issn.1673-3770.0.2014.050
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    Objective To investigate the techniques to repair partial or total auricle avulsions at the middle-upper part. Methods In the repair of ten partially injured auricles, the skin at the side of the injury connected with the normal was reserved as much as possible and sutured directly, while the skin at the opposite side of injured auricle was removed, and the skin defect was repaired with adjacent skin flap. One auricle was bitten off and lost. For such a U shape defect, the skin at both sides of the remnant auricle was removed and repaired with a flap formed by the skins from crus of helix to tragus combined with the tragic cartilage. Results The patients were followed up from six months to eight years. All the auricles recovered well with good shapes and without obvious deformities. Conclusions To the partial or total auricle avulsions injured at the middle-upper part, the skin at the side of the injury connected with the normal can be sutured directly. The skin at the opposite side of the injury, the skin defect can be repaired with adjacent skin flap. If the defect of the auricle at the middle-upper part is a little smaller than tragic cartilage, it can be repaired with pre-auricular composite tissue flap and post-auricular rotation skin flap.
    Clinical efficacy of sublingual dermatophagoides farinae drops in combination with intranasal steroids in treatment of allergic rhinitis
    XIE Xiao-hong, HU Zhi-bang, SONG Pan-pan, DAI Yan-hong, CHEN feng, YU Chen-jie, GAO Xia
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  34-37.  doi:10.6040/j.issn.1673-3770.0.2014.227
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    Objective To evaluate the clinical efficacy of sublingual immunotherapy(SLIT) in the treatment of allergic rhinitis in combination with intranasal steroids. Methods Ninety AR patients were randomly divided into two groups: 60 patients treated by SCIT+steroids and the other 30 patients only treated with intranasal steroids. The nasal symptom scores of pruritus, sneezing, rhinorrhea and nasal obstruction were evaluated using a four-point raiting scale (from 0=absent to 3=severe) before the treatment and six months and a year after the treatment. Then the scores were compared. Results The nasal symptom scores of all patients were significantly decreased after treatment(P<0.05), and the symptoms after treatment were alleviated more significantly after one year than after 6 months in the combination group(P<0.05). However, there were no significant difference between the two periods in the single nasal spray group (P>0.05). The scores of nasal symptom in the combination group were significant lower than the single nasal spray group whether after 6 months or after 12 months. Conclusion Combination therapy of SLIT and intranasal steroids is more effective for allergic rhinitis than intranasal steroids alone.
    Relationship between Treg cells in peripheral blood of patients with allergic rhinitis and special immunotherapy efficacy
    YU Yue-jin, TAN Jun, CAO Yun-hong, ZHANG Hui, JIA Xiu-hua, YE Qing
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  38-41.  doi:10.6040/j.issn.1673-3770.0.2014.189
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    Objective To explore the expression difference of the levels of Treg cells and IL-10 of patients with allergic rhinitis (AR) in serum in different courses of special immunotherapy treatment (SIT) and to explore whether the expressions can forecast the efficacy of SIT. Methods From January 2011, 30 patients with AR were randomly collected and distributed into the 12 months SIT group and the 24 months SIT group. The peripheral blood was taken before and after the SIT, and the expressions of Treg cells were measured by FCM and IL-10 were calculated by ELISA. Results The percentage of Treg cells and the level of IL-10 in the AR groups were significantly decreased compared with those of the control group; After SIT, the percentage of Treg cells and the level of IL-10 in serum were significantly increased than those before SIT. Correlation analysis showed IL-10 was positively related with Treg cells. The clinical efficacy of the 24 months SIT group were higher than that of the 12 months SIT group, and furthermore the percentage of Treg cells and the level of IL-10 in the 24 month SIT group were significantly higher than those in the 12 month SIT group. In effective group, IL-10 level increased significantly after the SIT treatment, while the level of IL-10 did not significantly change after the treatment in non-effective group. Conclusion The percentage of Treg cells in peripheral blood of patients with AR may be useful in predicting the efficacy of the SIT treatment. A 24-month course SIT treatment is better than a 12-month course SIT treatment.
    Endoscopic medial maxillectomy in combination with lacrimal passage implantation of tube for sinonasal inverted papilloma invading maxillary sinus
    MAN Rong-jun, ZHU Yong-kang, ZHANG Xiu-fang, WANG Hai-peng, WANG Xiao, WANG Hui-zhong, HU Yan-sheng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  42-44.  doi:10.6040/j.issn.1673-3770.0.2014.041
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    Objective To evaluate the efficacy of endoscopic medial maxillectomy in combination with lacrimal passage implantation of tube for sinonasal inverted papilloma invading maxillary sinus. Methods From January 2006 to October 2010, 32 patients with sinonasal inverted papilloma invading maxillary sinus received endoscopic medial maxillectomy in combination with lacrimal passage implantation of tube in our hospital. The clinical data of the patients were analyzed retrospectively. Results All the tumors were in T3 Krouse stage and were thoroughly excided. 2 cases had recurrence and were cured after local debridement. The overall recurrence rate was 6.3%(2 of 32). Followed up from 12 to 72 months, all of the patients had no epiphora and other complications. Conclusion Endoscopic medial maxillectomy is a good technique for maxillary sinus inverted papilloma of T3 Krouse stage, and lacrimal passage implantation of tube can be used to prevent stenosis of nasolacrymal duct.
    Characteristics of computed tomography of fungal rhino-sinusitis
    ZHENG Jiong, LI Jing
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  45-48.  doi:10.6040/j.issn.1673-3770.0.2014.042
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    Objective To study the CT features of fungal rhino-sinusitis and to assess its diagnostic value. Methods CT features of 47 cases of fungal rhino-sinusitis proved by surgery and pathology from January 2007 to December 2013 were retrospectively analyzed. Results There are 43 cases of unilateral fungal infection and 4 cases of double sides. On CT scanning, soft tissues were presented in all the infected sinuses of all cases, heterogeneous density with spot,strip or lump calcification was presented in 37 cases(78.7%) and homogeneous density was presented in 10 cases(22.2%). There were bones thickening in 39 lesions(83.0%), dwindling of sinus in 20 patients(42.6%), and air bubble in 11 cases(23.4%).In 41 cases that lesions implicated in the maxilla, 33 cases(80.5%) showed obstruction and dilation of maxillary sinus ostium and 15 cases(36.6%)showed damage or resorption of medial wall. Conclusion Fungal rhino-sinusitis has characteristic findings on CT. The major CT findings are heterogeneous density of sinusal cavity with small calcification appeared as spots,floccose,sand-like or patchy shadows and local bone destruction. CT is a valuable method for diagnosis and treatment of fungal rhino-sinusitis.
    Treatment of maxillary sinus cyst by maxillary anterior dual puncture
    YANG Kai-yan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  49-50.  doi:10.6040/j.issn.1673-3770.0.2014.021
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    Objective To explore the clinical efficacy of minimally invasive surgical technique of endoscopic treatment of maxillary sinus cyst by maxillary anterior dual puncture. Methods 40 cases of maxillary simple sinus cyst were performed endoscopy by the maxillary anterior dual puncture. All were followed up by endoscopy and CT 3 months after surgery. Results All had an average hospital stay of 3 days. Followed up 3 to 6 months, no dentition pain, headache as well as cheek numbness and other complications occurred. The maxillary sinus was smooth without purulent secretion and recurrence under endoscopic examination and nasal CT. Conclusion Nasal endoscopic treatment of maxillary sinus cyst by maxillary anterior dual puncture has the characteristics of safe, easy operation, good effect, few adverse reaction and few complications.
    Clinical analysis of nasal endoscopic operation in treatment of nasal mucosa contact point headache
    WANG Hai-ying, YANG Jie, HE Yong-xia
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  51-52.  doi:10.6040/j.issn.1673-3770.0.2014.303
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    Objective To investigate the diagnosis and effect of nasal endoscopic operation in treatment of nasal mucosa contact point headache. Methods A total of 65 cases underwent nasal endoscopy and sinus CT scanning. Results Followed up for 6 months, 52 cases were cured (80%), 10 cases (15.3%), invalid 3 cases (4%), the total clinical efficiency rate was 95.3%. Conclusion Endoscopic operation is useful for nasal mucosal contact point headache.
    Analysis of clinical manifestations and misdiagnosis of jugular phelebectasia in children
    SUN Chang-zhi, LUO Ren-zhong, LIU Wen-long, LI Yan, HOU Chao
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  53-55.  doi:10.6040/j.issn.1673-3770.0.2014.018
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    Objective To analyze the clinical manifestations and the cause of misdiagnosis of jugular phelebectasia in children. Methods From January 2006 to June 2013, 21 cases of jugular phelebectasia in children were collected and reviewed. Their clinical manifestation, diagnostic methods and the cause of misdiagnosis were analyzed. 21 children without jugular phelebectasia were selected as control group. Results Their clinical manifestations showed a soft cystic cervical mass during Valsalva manoeuvre or loud speaking. All the cases visited other hospital 2.4 times averagely and received imaging exams 1.9 times averagely before final diagnosis. There was no significant difference in the diameter of jugular vein between jugular phelebectasia patients and the control group during the resting state(P>0.05), however, the diameter of jugular vein were larger in jugular phelebectasia patients during Valsalva manoeuvre or load speaking(P<0.05). All the jugular phelebectasia were diagnosed by color Doppler ultrasonography. Conclusion The manifestation of jugular phelebectasia is typical. The effective method to diagnose jugular phelebectasia is color Doppler ultrasonography. Deepening the understanding of jugular phelebectasia could decrease the misdiagnosis.
    HIV/AIDS in throat in 6 cases
    ZUO Wen-na, WANG Hong-qin, LI Guo-li
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  56-57.  doi:10.6040/j.issn.1673-3770.0.2014.134
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    Objective To deepen the understandings of ENT doctors on HIV infection in which primary complains were sore throat and/or fever to avoid misdiagnosis. Methods Clinical data of 6 cases of HIV infection, whose initial office visits were ENT department, were reviewed. Results Of 6 patients, there were 3 cases of tonsillitis, 2 cases of oral candida infection, and 1 case of Kaposi sarcoma in throat. Conclusion The diagnosis of AIDS, complained primarily of sore throat, can be established by combining with medical history, clinical manifestation and serological examination. ENT doctors must pay much attention to it.
    Anti VEGF drugs(lucentis) to treat different courses of wet age-related maculardegeneration (62 cases report)
    GONG Bin, FAN Chuan-feng, WANG Yu
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  58-61.  doi:10.6040/j.issn.1673-3770.0.2014.075
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    Objective To observe the effectiveness of lucentise, an anti- VEGF drug, in the treatment of different courses of wet age-related macular degeneration. Methods 62 cases of wet age-related macular degeneration, including 62 eyes, enrolled into the study. According to the courses of disease, 32 eyes were divided into group A (<6 months) and the other 30 eyes in group B (6-12 months). All the patients received intravitreal injection of ranibizumab (0.5 mg)once a month for 3 consecutive months. At the end of each month, assessment were made to determine whether the next injection was necessary. In a 12-month follow-up,FFA examination was performed every three months. For group A, the average number of letters on ETDRS visual acuity chart was (52.36±8.62), and the average CRT was (334.62±50.26) μm. The corresponding results for Group B were (36.41±6.73) and (368.37±40.52) μm. Visual acuity before and after treatment were observed. The number of letters, macular retinal thickness (CRT) and the injection times between the two groups were compared. Results In group A, 3,6,12 months after the first injection,the improvements of the number of letters in ETDRS eye chart were 16.82 ± 3.56,17.33±3.47 and 15.72±4.38, respectively, compared to 9.23±2.51,10.22±3.46 and 8.34±3.51 in group B (t=9.643,8.074,7.290; P<0.05). The decrease of CRT at 3, 6, 12 months after the first injection were 175.86±55.23 μm, 168.75±46.38 μm and 173.58±35.63 μm in group A,compared to 102.34±32.31 μm, 93.76±28.73 μm and 89.65±27.82 μm in group B (t=6.342,7.593,10.291; P<0.05). In the first year of follow-up, the patients in group A were injected 4.6±1.7 times on average, while the number in group B were 6.8±2.2 times (t=4.422, P<0.05). Conclusion Anti-VEGF drugs (lucentise) demonstrates better clinical results on visual acuity improvement and decrease of CRT thickness for wet age-related macular degeneration patients with duration less than six months than those with duration between six to twelve months. Early application of lucentise injection can reduce the injection times and cost for the treatment.
    Effects of bilateral lateral rectus recession in the treatment of simulated divergence excess intermittent exotropia in children
    MA Xiang, GUO Jing-li, WANG Li-hua
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  62-65.  doi:10.6040/j.issn.1673-3770.0.2014.065
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    Objective To observe the surgical outcome of bilateral lateral rectus recession in children with simulated divergence excess intermittent exotropia. Methods Twenty-two children with simulated divergence excess intermittent exotropia underwent bilateral lateral rectus recession from December 2010 to August 2013 were recruited in this study. The exodeviations were measured by the alternate prism cover test at both distances (6 m and 33 cm) with fixation on accommodative targets before and after 1-hour diagnostic occlusion test. The Worth 4-Dot test was employed to assess central and peripheral fusion. The Titmus stereo test was used to assess stereoacuity. The target angle for the symmetrically quantitative bilateral lateral rectus recession was determined according to the largest distance deviation before or after diagnostic occlusion test. The examinations were carried out on the first postoperative day, 1 months, 3months and 6 months later. A successful alignment was defined as ±8 PD or less in primary gaze while viewing distant and near targets. Results The average age of patients was 6.3±2.9 years. The disparity between distance deviation and near deviation before and after diagnostic occlusion test was 17.3±7.9 PD and 0.5±3.3 PD, respectively. The amount of bilateral lateral rectus recession was 7.2±1.2 mm. Mean postoperative follow-up period was 8.6±5.4 months. The successful rate, overcorrection rate, undercorrection rate at the end of follow-up was 81.8%(18 in 22), 4.5%(1 in 22), 13.6%(3 in22), respectively. There was no significant difference in fusion and stereoacuity before and after surgery (P>0.05). Conclusion Based on the largest distance deviation before and after diagnostic occlusion test, bilateral lateral rectus recession could effectively treat simulated divergence excess intermittent exotropia in children.
    Pre-operative irrigation of conjunctival sac using 0.5% povidone-iodine in preventing endophthalmitis after cataract surgery
    FANG Xiu-ling, JIANG Hu-lin, WU Jian-xia, HAN Xu-wei, ZHANG Liao
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  66-67.  doi:10.6040/j.issn.1673-3770.0.2014.282
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    Objective To explore whether the irrigation of conjunctival sac using 0.5% povidone-iodine would prevent endophthalmitis after cataract surgery. Methods A total of 4 000 patients underwent cataract surgeries in our hospital from October 2012 to October 2013 were randomly enrolled in this study. All were divided into two groups: the experimental group and the control group. The experimental group used 0.5% povidone-iodine for conjunctiva sac irrigation before surgery and the control group used tobramycin. The bacterial rate of the conjunctival sac, the ocular surface side effects and post-operative endophthalmitis incidence were evaluated. Results The bacterial rate had statistically significant difference between the two groups (P<0.05); the ocular surface side effect had no statistically significant difference (P>0.05); There was no intraocular inflammation appeared in the experimental group, however, two cases of endophthalmitis occurred in the control group. Conclusion Tobramycin could be replaced by 0.5% povidone-iodine for pre-operative irrigation of conjunctival sac.
    Levator excision and frontalis suspension to treat Marcus-Gunn jaw-winking syndrome (11 cases report)
    ZHANG Shi-xi, ZHANG Hua, WANG Hong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  68-71.  doi:10.6040/j.issn.1673-3770.0.2014.063
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    Objective To explore the clinical effectiveness of levator excision and frontalis suspension in the treatment of Marcus-Gunn jaw-winking syndrome. Methods 11 cases (11eyes)of Marcus-Gunn jaw-winking syndrome received surgical treatment of levator excision and frontalis suspension. All patients presented ptosis, and when the patients opened mouth, jaw moved toward the healthy side or moved forward, the saggy eyelid would rise suddenly even more than the contralateral eye. Results All patients had good curative effect. Binocular palpebral fissure height was symmetrical and all eyelids showed complete resolution of jaw-winking. The upper palpebral margin was natural. Some patients presented incomplete eyelid closure and winking to some extent. Conclusion Marcus-Gunn jaw-winking syndrome presents typical clinical features but not obvious signs. Dynamic observation is necessary to achieve the diagnosis. Without careful examination, it's very easy to be misdiagnosed as simple ptosis, which will lead to inappropriate treatment. Levator excision and frontalis suspension is a feasible surgical approach to treat Marcus-Gunn jaw- winking syndrome.
    Sevoflurane inhalation anesthesia with laryngeal mask spontaneous ventilation in ptosis surgery
    LI Xiao-jing, LIU Huai-gang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  72-73.  doi:10.6040/j.issn.1673-3770.0.2014.053
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    Objective To investigate the effect of Sevoflurane inhalation anesthesia with laryngeal mask spontaneous ventilation in ptosis surgery. Methods 50 patients were performed ptosis surgery in our hospital using laryngeal mask of spontaneous ventilation for Sevoflurane inhalation anesthesia. Result All were successfully done except for 4 transient respiratory depression but no movement. The 4 patients were improved by assisted respiration. Conclusion Sevoflurane inhalation anesthesia with laryngeal mask of spontaneous ventilation is an ideal anesthetic method that can meet the operation requirements, with controlled safety of respiratory tract, quick post-operative awake and low adverse reactions.
    Trabeculectomy with scleral reflexed trabecular tissue padding in treatment of glaucoma
    HAN Ping, XU Jia-feng, HU Kai
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  74-75.  doi:10.6040/j.issn.1673-3770.0.2014.168
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    Objective To reduce the post-operative blocking of filtration canal in trabeculectomy with scleral reflexed trabecular tissue padding into the operation. Methods 36 patients with glaucoma (36 eyes) were enrolled in this study. The modification of the procedure of routine trabeculectomy was that one end of the layer sclera tissue including part of trabecular meshwork want cut. Instead, the free end of the strip of deep sclera tissue was vertically rotated and sutured on the deep layer of the scleral bed posterior to it. The projection of the strip was utilized to prevent post-operative blocking of filtration canal. Results The post-operative intraocular pressure was below 21 mmHg in 33 eyes of 33 cases, the average as (15.86±3.01)mmHg, significantly lower than the average level before operation (29.62±5.49)mmHg(t=7.398, P<0.001). The success rate of operation was 94.45%. Conclusion Trabeculectomy with scleral reflexed trabecular tissue padding into the operation can effectively control the intraocular pressure and reduce the filtering bleb scar obstruction.
    Clinical observation of corneal stronmal layer injection in the treatment of fungal keratitis
    SHUAI Shao-shuai, HE Xia-yi, NING Hong- zhu, LUO You-qiong, LIANG Si-min
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  76-78.  doi:10.6040/j.issn.1673-3770.0.2014.142
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    Objective To observe clinical effect of the stromal layer of fluconazole injection of fungal keratitis. Methods 70 eyes diagnosed as fungal keratitis were randomly divided to two groups with 35 eyes in each. The treatment group was firstly treated helcoma with stomal layer of fluconazole injection, then treated with fluconazole eye ointment and recombinant bovine basic fibroblast growth factor gel enveloping eyes. The control group was firstly treated helcoma with iodine cautery and then used fluconazole eye ointment and recombinant bovine basic fibroblast growth factor gel enveloping eyes. The clinical feasibility of iodine cautery and the stromal layer of fluconazole injection in the treatment of fungal keratitis were observed and compared. Results Thirty-five eyes in the treatment group used the stromal layer of fluconazole injection, all helcoma healed up. The course was shorten and the effect was better than the control group(P<0.05).The average visual acuity of two groups before and after treatment was statistical different(P<0.05). Conclusion Corneal stromal layer injection in the treatment of fungal keratitis can enhance the curative rate obviously. It is an effective and safe therapeutic method.
    Clinical analysis of 7 patients with phacolytic glaucoma treated by phacoemulsification
    YAN Shi-long, YANG Ming, HU Zun-xia, LIU Zhi-gao, LI Jing-hai
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  79-81.  doi:10.6040/j.issn.1673-3770.0.2014.126
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    Objective To explore the clinical characteristics and treatment method of cataract blindness screening crystal solubility in glaucoma. Methods The clinical data of 7 cases diagnosed as crystal solubility glaucoma were retrospectively analyzed. Admitted to hospital after diagnosis, they were given phacoemulsification to remove the lens. Results There were crystals dissolve glaucoma in 4 cases, uveitis secondary glaucoma in 2 cases, and age-related cataract overmature in 1 case which had specialized examination after hence dissolved lens membrane rupture cortex. 6 cases had their postoperative intraocular pressure decreased to normal in 1 day, 1 case had the postoperative intraocular pressure decreased to 30 to 42 mmHg in 3 days and had it gradually be back to normal after repeated anterior chamber fluid and drug treatment in 2 weeks. Followed up in 3 months, visions were all increased. Conclusion Crystal solubility in glaucoma patients is difficult to be diagnosed. Anterior chamber irrigation after cataract extraction is the effective way for crystals dissolve glaucoma. There are still more patients with cataract overmature period in the backward area.
    Effect of vascular factors on normal tension glaucoma
    FU Hao-qin, MAO Wen-juan, ZHANG Jian-hong, XU Wei-qi, ZHU Sheng-jie
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  82-84.  doi:10.6040/j.issn.1673-3770.0.2014.147
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    Objective To observe the effect of vascular factors on normal tension glaucoma(NTG). Methods The NTG group of 40 eyes,and the age and sex matched normal control group of 40 eyes were enrolled in this study. Color Doppler flow image (CDFI) was used to analyze the peak systolic velocity(PSV), the end diastolic velocity(EDV) and the resistance index(RI) of the carotid artery(CA), the internal carotid artery(ICA), the ophthalmic artery(OA), the central retinal artery(CRA) and the shortposterior ciliary artery(SPCA). Results The PSV of ICA,OA,CRA and SPCA in the NTG group was decreased (P<0.01, P<0.05) and RI was significantly increased (P<0.01).The EDV of OA and CRA in the NTG group compared with the normal control group was decreased (P<0.01, P<0.05), while the EDV of ICA and SPCA in the NTG group compared with the normal control group showed no significant difference (P>0.05), and the parameters of CA in the NTG group compared with the normal control group showed no significant difference (P>0.05). Conclusion The increasing RI of ICA, OA, CRA and PCA should be used as important indicators in the early diagnosis and judgment prognosis of NTG, and should also be referred to if the EDV numerical value of OA and CRA is decreased, to provide favorable information for judgment prognosis and treatment project of NTG patients.
    Diagnosis and treatment of parapharyngeal space neoplasms
    HU Juan-juan, HONG Yu-ming
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  85-90.  doi:10.6040/j.issn.1673-3770.0.2014.159
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    Anatomy of parapharyneal space is very complicated. Many types of parapharyngeal space neoplasms can occur, and all of them demonstrate different clinical manifestations. Therefore, it is more difficult to diagnose and treat the parapharyngeal space neoplasms than other head and neck neoplasms. Common diagnostics methods include bimanual examination, imaging studies, cytopathology, transoral and transcervical biopsy. All these methods can help doctor determine the nature and blood supply of tumors and understand the relationship between neoplasms and adjacent structure, which provide a reliable basis for the ensuing treatment. This paper aims to state the diagnosis and treatment of parapharyngeal space neoplasms, especially how to select surgical procedures.
    Diagnosis and treatment of standardization of rhinitis and sinusitis in children
    JING Shang-lin, LIN Nan, CHEN Ji-chang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  91-94.  doi:10.6040/j.issn.1673-3770.0.2014.105
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    Rhinosinusitis is a common disease in children. Because of anatomical, physiological and immunological factors in different ways, its clinical diagnosis and treatment procedures are obviously different from adults'. In this paper, literatures about standardization diagnosis and treatment of children with rhinosinusitis at home and abroad are reviewed.
    Application of proteomics in nasal benign disease
    ZHANG Jian, WU Jian
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  95-98.  doi:10.6040/j.issn.1673-3770.0.2014.083
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    Proteomics is a new kind of technology in detection and identification of the different expressed proteins and has been widely used in the field of biology. Allergic rhinitis, sinusitis and nasal polyps are common nasal benign diseases which need deep research of the pathogenesis and pathological processes. In this paper, the recent application of proteomics in nasal benign disease is reviewed.
    Application of 5-fluorouracil and mitomycin C in improved external dacryocystorhinostomy
    FAN Wei, WANG Tian-yi, DENG Ai-jun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  99-100.  doi:10.6040/j.issn.1673-3770.0.2014.278
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    A case of ceruminoma in right external auditory canal
    YU Hai-yang, ZHANG Zeng, DIAO Xiu-li, WANG Wei-guo
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  101-102.  doi:10.6040/j.issn.1673-3770.0.2014.009
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    Eustachian tube fracture of the right side in one case
    LIU Hong, LIU Tian-yue, WANG Chun-jiao, WANG Juan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  103-104.  doi:10.6040/j.issn.1673-3770.0.2014.141
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    Approaches of removal of the fungous maxillary sinusitis with the nasal sinus endoscope
    GUO Ming-kun, XUE Ming, GUO Yan-hong, WANG Ji-sheng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2014, 28(5):  105-106.  doi:10.6040/j.issn.1673-3770.0.2014.008
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