Table of Content

24 April 2008 Volume 22 Issue 2

  

Articles

Peri-operative treatment for obstructive sleep apnea hypopnea syndrome

LI Yan-zhong,WANG Yan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  97-101 . 

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To investigate the management and implications during the peri-operative period of obstructive sleep apnea hypopnea syndrome(OSAHS). MethodsSerious complications during 1030 OSAHS operations from 1998 to 2007 were retrospectively analyzed. Of them, before September 2002, 396 patients (group A) were not treated with comprehensive management, and after September 2002, 634 patients (group B) were treated with comprehensive managements. ResultsIn group A, one patient died of complications, ten had primary hemorrhage, fifteen had secondary hemorrhage, thirty-five had nasopharyngeal refluxing in the short term, and one had nasopharyngeal clausura after the operations. In group B, four had primary hemorrhage, nine had secondary hemorrhage, eleven had nasopharyngeal refluxing in the short term after the operations. Complications were decreased in group B compared with group A (P＜0.05). ConclusionComprehensive pre-operative management can improve the patients′ tolerance of surgery and anesthesia, and reduce surgical risks and post-operative complications.

Nostril surgeries and other plan surgeries in treatment of obstructive sleep apnea hypopnea syndrome

ZHANG Qing-quan,SONG Xi-cheng,ZHANG Hua,SUN Yan,WANG Qiang,WANG Yong-fu

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  102-104 . 

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To investigate the therapeutic effect of nostril surgeries combined with other plan surgeries for obstructive sleep hypopnea syndromes (OSAHS). MethodsOf 32 patients with OSAHS, 18 received sub-mucous resection of the nasal septum, 10 received sub-mucous resection of the nasal septum and unilateral sub-mucous inferior turbinectomy, 2 received sub-mucous resection of the nasal septum and bilateral submucous inferior turbinectomy, and 2 received sub-mucous resection of the nasal septum and unilateral polypectomy and ethmoidotomy. Also 26 patients receivedｕｖｕｌｏｐａｌａｔｏｐｈａｒｙｎｇｏｐｌａｓｔｙ(UPPP). And 4 patients received combination therapies including nostril surgeries, UPPP, partial resection of the lingual root and suspension of the lingual bone, and 2 received combination therapies including nostril surgeries, partial resection of the lingual root and suspension of the lingual bone. Among 32 patients, 2 severe patients received combination therapies under general anaesthesia, 2 received a tracheotomy at the end of the operations and the other 28 received the operations under general anaesthesia. All patients received guardianship therapies for 12-24 hours in the ICU after the operations and a follow-up for one year. ResultsAccording to the standard of the Hangzhou conference， 10 cases were cured, 12 cases were improved, 9 cases were relieved and 1 case was invalid. No complications occurred. ConclusionsNostril surgeries combined with other plan surgeries can obtain favorable effect for OSAHS. For severe patients, tracheotomy should be performed before or after the operations to prevent complications.

Influence of obstructive sleep apnea hypopnea syndrome on physical growth characters of preschool children and the effect of the operations

SUN Yan,LI Na,TIAN Ying,YI Ming-ji,YAO Yan-ting

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  105-108 . 

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To explore the influence of obstructive sleep apnea hypopnea syndrome(OSAHS) on physical growth characters in preschool children and the effect of the operations. Methods49 children with OSAHS proved by polysomnography(PSG)had their physical growth characters determined before and 6 months after the operations. 40 healthy children served as controls. Results① Before the operations, all physical growth characters of the moderate and severe OSAHS groups were significantly lower than those of the control group, however only the height and sitting height of the mild OSAHS group were lower than those of the control group. ② 6 months after the operations, physical growth characters of the mild and moderate OSAHS groups were not significantly lower than those of the control group, but some of the severe OSAHS group still were lower than those of the control group. ConclusionsOSAHS can effect physical growth and neuropsychological characters of preschool children and should be operated on early.

Polysomnography analyses of obstructive sleep apnea-hypopnea syndrome with hypertension in middle-age patients

ZHAN Xiu-lan, YUAN Ke-mei, ZHANG Yan-fen

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  109-111 . 

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To analyze the characteristics of polysomnography in middle-age patients with obstructive sleep apnea hypopnea syndrome(OSAHS) and hypertension. Methods32-polysomnography was performed on 141 middle-age OSAHS patients. Of them, 69 iad hypertension (the hypertension group) and 72 did not (the control group). ResultsThe BMI level was significantly higher in the hypertension group than in the control group ［(30.7±3.5)kg/m2 vs (28.2±3.0)kg/m2, P＜0.05］, also the apnea-hypopnea index of the hypertension group was higher than that of the control group ［(54.6±26.5) vs (42.2±26.3), P＜0.05］. The structure of NREM and REM was not significantly different between the hypertension group and the control group. ConclusionThe sleep structure disorder is similar in the two groups. The low oxygen saturation of blood and apnea-hypopnea index are more serious in middle-age OSAHS patients with hypertension than in patients without hypertension.

An analysis of the pre-operative and post-operative X-ray projection of patients with hyoid suspension and uvolopalatopharyngoplasty surgery

WANG Yong-fu,ZHANG Qing-quan,ZHANG Jie,MA Hou-sheng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  112-114 . 

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To investigate the differences of airway space pre-operatively and post-operatively using X-ray projection in patients with hyoid suspension and uvolopalatopharyngoplasty surgeries and to provide a morphological basis for the treatment of glossopharyngeal　stegnosis. Methods30 patients with moderate or serious OSAHS were diagnosed with stegnosis both on glossopharyngeal and palatopharyengeal　planes using polysomnography（PSG） and the Müller test. All patients underwent hyoid suspension and uvolopalatopharyngoplasty surgeries and a pre-and post-operative follow-up of one year, and PSG as well as X-ray projection were used to analyze the therapeutic efficacy. ResultsA one-year follow-up indicated that the apnea hyponea index decreased from 63±11.23 to 19±4.52. Based on the standard set up in the Hangzhou meeting, 12 cases (40.00%) were healed, 10(33.33%) had excellent effects, 3(10.00%) had effects, and 5 had no effects (16.67%), and the total effective rate was 83.33%. X-ray projection showed superioranterior displacement of hyoid bones and enlarged posterior space. ConclusionsHyoid suspension surgery can treat patients with OSAHS suffering from glossopharyngeal stegnosis by dragging the hyoid bone anterior-superiorly to enlarge the airway space on the glossopharyngeal plane.

Misdiagnosis of glomus jugulare tumor

SHENG Hong-shen,HUANG De-liang,HAN Dong-yi,WU Wen-ming,YANG Wei-yan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  120-122 . 

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To improve the successful diagnosis rate of glomus jugulare tumor(GJT). MethodsClinical diagnosis, imaging diagnosis, and pre-operative pathological diagnosis were retrospectively analyzed in 47 GJT patients (18 males and 29 females) treated at our department from July 1987 to October 2006. ResultsIn this group, 34 patients failed to be diagnosed at the first time of medical consultation. The misdiagnosis ratio of the clinic, imaging and pathology was 34/47 (72.3%), 8/47 (17.0%) and 8/10 (80.0%). The disease was clinically misdiagnosed as chronic otitis media in 14/47 (29.8%), secretory otitis media 6/47(12.8%), external acoustic meatus mass 3/47(6.4%), nervous tinnitus 2/47 (4.3%), Bell′s palsy 2/47 (4.3%), chronic pharyngo-laryngitis 2/47 (4.3%), sensorineural deafness 2/47 (4.3%), vertigo 1/47 (2.1%), sudden hearing loss 1/47 (2.1%), and vocal cord paralysis 1/47 (2.1%). Pre-operative imaging studies were misdiagnosed as chronic otitis media in 7/47(14.9％) and hemangioma in 1/47(2.1％). The disease was pathologically misdiagnosed as inflammatory granulation tissue in 4 cases (40.0%), hemangioma in 2 (20.0%), inflammatory polyp in 1 (10.0%) and keratinized squamous epithelium in 1(10.0%). ConclusionsGJT is likely to be misdiagnosed. The main causes of misdiagnosis are: low incidence of the disease, nonspecific clinical symptoms and unawareness of the doctor. CT and MRI play important roles in diagnosis and also immunohistochemical analysis is beneficial in diagnosis and differential diagnosis of GJT.

STAT3 expression in laryngeal carcinoma tissues and its relation with Survivin expression

ZHANG Han-bing,ZHANG Dao-gong,PAN Xin-liang,LUAN Xin-yong,XIE Guang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  123-126 . 

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To investigate the expression characters of signal transducer and activator of transcription 3(STAT3) and its relation with the expression of Survivin in laryngeal carcinoma. MethodsImmunohistochemistry (IHC) was used to determine the protein expressions of STAT3, p-STAT3 and Survivin in 40 laryngeal squamous cell carcinoma tissues and 12 normal control laryngeal mucous tissues. Also RT-PCR was used to determine the expressions of STAT3 mRNA and Survivin mRNA. ResultsThe expressions of STAT3, p-STAT3 and Survivin protein in laryngeal carcinoma tissues were significantly higher than those in normal laryngeal tissues (P＜0.01). And the expressions of STAT3 mRNA and Survivin mRNA were significantly higher in laryngeal carcinoma tissues than those in normal laryngeal tissues (P＜0.01). Positive expressions of STAT3, p-STAT3 protein and STAT3 mRNA were correlated with the clinical stage and had no relationship with patient age, tumor position, histological grade, and lymph node metastasis, and also positive expression of Survivin protein and Survivin mRNA was correlated with the clinical stage and lymph node metastasis. There were positive correlations between STAT3 and Survivin expression in laryngeal carcinoma. Conclusions Over-expression of STAT3 may play an important role in the genesis and growth of laryngeal carcinoma. STAT3 may prolong the survival time of laryngeal carcinoma by increasing the expression of Survivin.

Clinical features and management of Methicillin-resistant Staphylococcus Aureus (MRSA) infection after laryngectomy

WANG Lin,SUN Yan,CHEN Zhi-jun,LI Wei,SUN Wen-hai

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  127-129 . 

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To investigate the clinical features and treatment for patients with Methicillin-resistant Staphylococcus Aureus (MRSA) infection after laryngectomy. Methods The clinical data of 7 patients who had MRSA infection after laryngectomy in our hospital from Aug 2002 to Oct 2007 were retrospectively analyzed. ResultsAmong the 7 patients, 4 patients with pharyngeal fistulas were treated by drainage and dressing change and 1 of them was also treated with vancomycin, 2 with pulmonary infection and 1 with trachea stoma infection were treated with vancomycin. All 7 patients were cured. ConclusionVancomycin, drainage and dressing change are effective for laryngeal carcinoma patients with pulmonary infection or local MRSA infection after laryngectomy.

Maxillectomy and ethmoidectomy in the treatment of early carcinomas of the nasal cavity and the ethmoid sinus

QIU Lian-sheng,LU¨ Jia-bao,WANG Jia-rong,LIN Po-shui

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  130-131 . 

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To explore the treatment methods and long-term effect for early carcinomas of the nasal cavity and the ethmoid sinus. Methods25 cases of I or II stage carcinoma received medical maxillectomy and ethmoidectomy from 1995 to 2001. ResultsFollowed up for 3 to 5 years, the 3-year survival rate was 70.8%（17/24）, 5-year survival rate was 50.0%（8/16）. 2 cases failed to be followed up. 6 cases had local relapse, but no severe complications occurred. ConclusionsMaxillectomy and ethmoidectomy are effective for I or II stage carcinoma of the nasal cavity and the ethmoid sinus.

Effect of intranasal endoscopic dacryocystorhinostomy

XU Hao-jie,LI Xue-zhong,CHEN Cheng-fang,WANG Xue-hai

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  132-134 . 

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ObjectiveTo investigate the clinical effect of dacrycystrhinostomy by nasal endoscopy. MethodsThe clinical data of 17 cases (19 eyes) from July 2004 to July 2006 were retrospectively analyzed. ResultsThe symptoms were obviously alleviated. 16 cases (18 eyes) were cured and 1 case (1 eye) was effective. All had epithelizations within 3 months. The successful rate of the operations was 100%. ConclusionDacrycystrhinostomy by nasal endoscopy is an effective method for chronic cystitis.

Relationship between Eotaxin-1 expression and eosinophili infiltration in nasal polyps with fungal ball rhino-sinusitis

HONG Juan,HUANG Jian-min,LIN Guo-jing

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  135-138 . 

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To explore the histopathological characteristics of nasal polyps with fungal ball rhino-sinusitis, and to determine the expression of Eotaxin-1 and its relationship with eosinophili infiltration. MethodsTwenty cases of nasal polyps with fungal ball rhino-sinusitis and fifteen cases of normal inferior turbinate mucosa were enrolled in this study. Immunohistochemical staining for Eotaxin-1 protein and HE staining for eosinophils were performed in two groups. Results① Lost epithelium and squamous metaplasia were usually observed in nasal polyps with fungal ball rhino-sinusitis. In the stroma there were a lot of lymphocyte, eosinophil and phagocyte infiltration, sometimes there were a lot of fibrocytes, also there were briskly capillary hyperplasia, but there were no fungi in the nasal mucous. ② Eotaxin-1 constitutively expressed in the inferior turbinate mucosa and highly expressed in nasal polyps with fungal ball rhino-sinusitis (P＜0.05). Eotaxin-1 immuno-reactivity was mostly determined in the epithelium and vascular endothelial cells. Some eosinophils and phagocytes in the stroma were also identified as Eotaxin-1 positive cells; ③ Tissue eosinophilia in nasal polyps with fungal ball rhino-sinusitis was associated with the expression of Eotaxin-1 protein (P＜0.05). ConclusionFungi are probably responsible for tissue eosinophilia by increasing the Eotaxin-1 protein in nasal polyps with fungal ball rhino-sinusitis. Eotaxin-1 antagonist may contribute to the treatment of nasal polyps with fungal ball rhino-sinusitis.

Measurement of the pterygoid canal and its clinical significance

LIU Lin-zheng,LIU Hong-jun,LI Wei-min

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  139-140 . 

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To provide an anatomical basis for vidian neurotomy by endonasal endoscopy. MethodsWith the assistant of a metal stylet and X-ray, the pterygoid canal and its track and orientation were dissected and observed on 56 sides of a skull. ResultsThe average length of the pterygoid canal was 16.03±1.48 mm and from the lower border midpoint of the nose bone to the anterior openings of the pterygoid canal was 60.70 ±8.86mm. Spacing between the twin anterior openings of the pterygoid canal was 27.56±3.11mm and between the twin back opening of the pterygoid canal was 34.41±3.37mm. The angle of the double pterygoid canal was 23.9±2.25°. The average length from the front nose thorn to the anterior opening of the pterygoid canal was 58.16±5.80mm and the average angle between their line and the pterygoid canal was 33.50±3.52°. The average angle between the pterygoid canal and the Frankfurt horizontal plane was 6.86±3.37° and between the pterygoid canal and the nose fundus plane was 9.68±4.60°. ConclusionThe resultant data attained in this research can be used as momentous parameters for vidian neurotomy by nostril endoscopy.

No packing after functional endoscopic sinus surgery in 148 cases

LI Jian-dong,CAO Ying-chun,SU Yi,XU Jin-feng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  141-143 . 

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To explore the efficacy and safety of no nasal packing after functional endoscopic sinus surgery (FESS). Methods148 patients were not packed after FESS and 60 were packed, and the clinical symptoms and complications were compared between the two groups. ResultIn the no-packing group, no serious bleeding happened, the exudation ceased in 2 to 7 hours after FESS, and no severe adhesion occurred in 3 months. ConclusionMost post-FESS patients could avoid packing so as to reduce discomfort and cost by proper management.

3D reconstruction and visualization of nasal anatomical structures of the Chinese digitized human

HAO Kai-fei,ZHANG Shao-xiang,WANG Bin-quan,TAN Li-wen

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  144-147 . 

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To build a digitized visible model of nasal anatomical structures. MethodsData of the cross-sectional image range of the first set of Chinese visible human female database(CVH-2) from the top layer of the frontal sinus to the bottom layer of the maxillary sinus were used in this study. The contour of organs was segmented from the cross-sectional images and 3D reconstructed by the Amira 4.1 and Radio- Dexter software in a computer. ResultWe successfully reconstructed 3D visible models of the main nostril structures, such as the nasal bone， frontal sinus， ethmoidal sinus， sphenoidal sinus， maxillary sinus， nasal cavity， superior, middle or inferior nasal turbinate， crista galli， nasal septum， uncinate process， nasolacrimal canal， internal carotid artery， and optic nerve. These models could be displayed from any directions, and the spatial positions and adjacent relationships of different anatomical structures， also the reconstructed structures could be determined in 3D space. ConclusionThese visible nasal models have facilitated observing and understanding of the anatomical structures in this area, provide the morphological data for imaging diagnosis of nasal diseases and nasal endoscopic surgeries, and also could be used in virtual surgeries.

Fungus ball nasosinusitis in 42 cases

YU Qian-qian,LI Na,ZHANG Nian-kai

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  148-149 . 

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To review the diagnosis and treatment for fungus ball nasosinusitis. MethodA retrospective study on 42 cases of fungus ball nasosinusitis was carried out. ResultPatients were followed up for 6 months to 6 years, and 39 were cured and 3 were improved. ConclusionPathological examination and CT scanning are valuable for diagnosis of fungus ball nasosinusitis, and FESS is effective in treating fungus ball nasosinusitis.

Expression and significance of VEGF in nasal polyps

GAO Ying,PAN Xin-liang,WANG Yan,LIU Ping-yun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  150-152 . 

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To evaluate the role of vascular endothelial growth factor (VEGF) in the pathophysiology of nasal polyps. MethodsForty patients with nasal polyps were divided into two groups: group A (representing type 2 phase 1-2) and group B (representing type 2 phase 3 and type 3). Also 20 normal inferior turbinate tissues served as the control. The expression of VEGF in three groups was determined by an immunohistochemical method. ResultsThe expression of VEGF was weak in normal nasal mucous but strong in nasal polyps. The expression rate of VEGF in groups A and B was significantly higher than that in the control group, furthermore it was higher in group B than in group A. VEGF is mainly located in the inflammatory cells and epithelial cells surrounding the basilar membrane and inflammatory cells and endothelial cells surrounding the vessels. ConclusionOverexpression of VEGF in nasal polyps may contribute to growth of vessels and accumulation of inflammatory cells, and as a result, enhances development of nasal polyps.

Unilateral cleft lip cheiloplasty for nasal deformity

JIANG Sheng-yang, ZHANG Feng ,LIU Xian-guo,XIANG Jin-gui

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  153-154 . 

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To explore the effects of unilateral cleft lip (UCL) cheiloplasty on nasal deformity. MethodThe operative methods and post-operative conditions of 186 cases of unilateral cleft lip cheiloplasty in our hospital from 2002 to 2006 were retrospectively analyzed. ResultsAfter unilateral cleft lip cheiloplasty, 35 cases had nasal deformity, of them, 12 cases were repaired by the Millard method, 16 by the Tennison method and 7 by rotation advancement and the triangular flap method. ConclusionThe appropriate operative method can simultaneously repair both unilateral cleft lip and nasal deformity.

Penetrating keratoplasty refraction control directed by the corneal refractive law of the springy hemisphere

JIANG Hua,ZHANG Xia,GAO Hong-rui,WEI Jie,LU Zhen-li,WANG Guang-jie

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  159-161 . 

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To evaluate the refractive efficacy of penetrating keratoplasty（PKP）following refraction control directed by the corneal refractive law of the springy hemisphere. MethodsPKP was performed on 85 eyes of 68 patients. The sutures were selectively detached directed by the corneal refractive law of the springy hemisphere. Visual acuity, corneal curvature and spherical equivalent were determined before and 1,3,6,12 and 15 months after the operations. Results15 months after the operations, the mean uncorrected visual acuity of 59 eyes was ≥0.5 and of 20 eyes ≥1.0. The mean corneal curvature was 37.26±2.85D before the first suture removal and was 43.52±2.25D after all suture removal (P＜0.05). The mean corneal astigmatism was 4.83±4.16D before the suture removal and was 1.97±2.69D 15 months after the operations (P＜0.01). The spherical equivalent of the corneas was different between post-operative 1 month and post-operative 3,6,12 and 15 months (P＜0.05), also it was statistically different between post-operative 15 months and 18 months (P＞0.05). ConclusionSuture removal selectively directed by the corneal refractive law of the springy hemisphere combined with other techniques can reduce post-operative refractive errors, improve visual acuity and control post-operative visual performance.

Fundus angiography with fluorescein and optical coherence tomography in Stargardt′s disease

PAN Xue-mei,WANG Xing-rong,YUAN Ming-jun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  162-164 . 

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To determine the characteristics of the results of fluorescein angiography (FFA) and optical coherence tomography (OCT) in Stargardt′s disease（STGD）. Methods7 patients (14 eyes) with Stargardt′s were diagnosed by ocular fundus photochromy, and 6 patients (12 eyes) received FFA and 7 patients (14 eyes) received OCT. ResultsPigment was disordered at the macula in 4 eyes by ophthalmoscopy. A “dark choroid" and window defect (bulls-eye pattern hyperfluorescence) were found by FFA, yellow-white fleck lesions were found in the pole in 8 eyes by ophthalmoscopy, also hypofluorescent became more apparent in the later phase by FFA, and the retina was reduced or deleted in 14 eyes by OCT. 　ConclusionFFA combined with OCT is useful for studying the clinical features and pathological mechanism of Stargardt's disease.

Phacoemulsification for 23 eyes with posterior polar cataract

ZHAI Hong,ZHAO Lu-xin,YU Xiao-hui

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  168-170 . 

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To evaluate the effects of phacoemulsification for eyes with posterior polar cataract and approach the surgical strategy. Methods16 (23 eyes) patients were enrolled in this study. The surgical techniques, pre- and post-operative visual acuities, and intra-operative complications were determined. ResultsPosterior capsule rupture occurred in 2 eyes (8.7%)，in which one had the entire lens nucleus dropped into the vitreous cavity and the other did not. Mean pre-operative visual acuity was 3.77±0.54 and mean post-operative visual acuity was 4.86±0.12 (P=0.000, paired-t test). Intraocular lens (IOL) were implanted into the capsular bag in 22 eyes and into the sulcus in 1 eye. Conclusion Phacoemulsification with foldable IOL implantation is effective for posterior polar cataracts. Complications can be decreased by continuous curvilinear capsulorhexis (CCC), non-hydro-dissection and in situ fracture .

Painless esophagoscopy in extraction of foreign bodies in the esophagus

HE Zhong-yang,LIANG Hua,QIN Hong-kang,TANG Liang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  171-172 . 

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To evaluate the effects and advantages of propofol intravenous anesthesia in painless esophagoscopy for extraction of foreign bodies in the esophagus. Methods46 patients underwent painless esophagoscopy, and on other 46 patients undergoing conventional esophagoscopy served as the control. The successful rate，operative time and adverse reactions were compared between the two groups. ResultsAdverse events of bucking, nausea and vomiting, restlessness breath holding in the painless group were much lower than those in the control group. There were statistic differences between the two groups(P＜0.005). However, the operative time and the successful rate were not significantly different between the two groups(P＞0.05). No severe complication was found in either group. None needed endotracheal intubation. ConclusionIntravenous sedation with propofol in extraction of foreign bodies in the esophagus can relieve the suffering and adverse reactions, and it is safe, quick, comfortable and effective for extraction of foreign bodies in the esophagus and is worthy to be applied in the clinic.

Effect of bilateral superior laryngeal nerve block on preventing cardiovascular reaction

LOU Feng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  173-175 . 

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To explore the effects of bilateral superior laryngeal nerve block on preventing cardiovascular side-reactions under general anesthesia. Methods60 cases were randomly divided into two groups: the A and B groups. In the A group, both sides of the superior laryngeal nerve were blocked before general anesthesia, while in the B group, no treatment was performed before general anesthesia. The cardiovascular effects when the supporting-laryngoscope was placed and the tracheal catheter was extubated during the larynx micro-surgeries were evaluated. ResultsThe BP and HR levels were significantly decreased in the A group compared with the B group at three phases: the time when the supporting-laryngoscope was immediately placed; 5 minutes after the supporting-laryngoscope was placed; and 1 minute after the tracheal catheter was extubated(P<0.05). The cardiovascular side-effects in the B group were more serious than those before induction(P<0.05), also serious bradycardia was found. ConclusionsBilateral superior laryngeal nerve block can obviously suppress cardiovascular side-reactions of larynx micro-operations.

Complicated trachea or bronchus foreign bodies in 4 cases

LI Zhao-sheng,HONG Yan-li,XU Zhen-yue,HONG Bin,CHEN Rui-kun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  176-179 . 

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ObjectiveTo improve the diagnosis and cure rate of complicated trachea or bronchus foreign bodies. MethodsThe clinical data of 4 cases of complicated trachea or bronchus foreign bodies from June 2004 to June 2007 were retrospectively analyzed. Results2 cases received rigid bronchoscopies two times because of foreign body inlaying but avoided thoracotomy. 1 case of pairs of side bronchi foreign bodies received one operation. 1 case of upper lobe bronchus foreign body was partly taken out, one month later its residue happened to be coughed out. ConclusionsWe should make a full preparation before the operations. The fiberoptic bronchoscopy for a foreign body should be suitable for children above 3 years old. Whether patients with trachea or bronchus foreign bodies should be carried on a routine CT inspection still deserves discussion. A define foreign body can be fetched hard. For the fragile foreign body, we should pay attention to possible multiple ones in the trachea or bronchi. Also there should be such simple apparatus as a crocodile clamp in the emergency room to rapidly remove foreign bodies inlaid in the glottis.

Treatment of deep neck abscess in 37 cases

LIU Lian-he

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(2):  180-181 . 

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To investigate an effective method for deep neck abscess. MethodThe clinical data of 37 cases of deep neck abscess in our hospital from January 2000 to May 2007 were respectively analyzed. ResultsFollowing treatment in time, all were cured. During a follow-up from 6 months to 1 year, no accident and complications happened. ConclusionsEarly abscess surgical drainage，appropriate antibiotics and nutrition supporting treatment are effective for deep neck abscess.