Table of Content

16 June 2015 Volume 29 Issue 3

  

Sources of snoring sound during drug-induced sleep observed with fiberoptic laryngoscope

XU Huijie, JIA Ruifang, YU Hui, GAO Zhan, PENG Hao, YANG Yi, ZHANG Lei, HUANG Weining

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  1-5.  doi:10.6040/j.issn.1673-3770.0.2015.054

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Objective To investigate the sources of snoring sound in simple snores and in patients with different degrees of obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods A total of 15 subjects with simple snores and 37 patients with mild to severe OSAHS were involved. Sites of vibration from nasopharynx to laryngeal pharynx while snoring in each patient were observed with fiberoptic laryngoscope during drug-induced sleep. Results Vibration of soft palate, lateral wall, epiglottis and tongue base could be observed during snoring, and the distribution of lateral wall vibration had statistical significance among different groups.52 snores showed two types of source of snoring in general: palatal fluttering only(type Ⅰ) and multisite vibration (type Ⅱ). The latter could be divided into 3 subtypes further: palatal fluttering with vibration of epiglottis (type Ⅱa), palatal fluttering with vibration of Lateral wall(type Ⅱb), and palatal fluttering with vibration of lateral wall, epiglottis and tongue base together(type Ⅱc). Percentage of type Ⅰ decreased as the severity of OSAHS increased. Type IIb was more common in patients with media and heavy OSAHS, and type IIc were most common in patients with heavy OSAHS. Conclusion Source of snoring is of diversity, snorers with different severity of sleep breath disorder shows different patterns of that. The main source of snoring should be identified when we choose treatment method for snorers.

Effect of allergic rhinitis on obstructive sleep apnea hypopnea syndrome in children

YANG Yang, ZHANG Jie, CHEN Min, ZHANG Yamei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  6-8.  doi:10.6040/j.issn.1673-3770.0.2015.003

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Objective To investigate the effects of allergic rhinitis (AR) on obstructive sleep apnea hypopnea syndrome in children. Methods Ninety one children diagnosed as obstructive sleep apnea hypopnea syndrome by polysomnography were divided into non-AR (NAR) group or AR group according to the history, physical examination and allergen testing. The apnea hypopnea index and the lowest saturation of oxygen between the two groups were compared. Results The apnea hypopnea index was higher and the lowest saturation of oxygen was lower in the AR group than those in the NAR group. Conclusion AR may aggravate obstructive sleep apnea hypopnea syndrome.

Changes of vestibular function in patients with obstructive sleep apnea-hypopnea syndrome

YIN Xueling

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  9-12.  doi:10.6040/j.issn.1673-3770.0.2015.060

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Objective To observe the changes of vestibular function in patients with obstructive sleep apnea hypopnea syndrom (OSAHS). Methods The video of nystagmus figure (VNG) check of 42 OSAHS cases and 30 healthy controls were examined. The results of spontaneous nystagmus test, oculomotor center test, vestibular bithermal calorid test and positional test conducted in the two groups were compared. Results The results of spontaneous nystagmus test and oculomotor center test were statistically different between the two groups (P<0.05). In OSAHS cases, the apnea hypopnea index (AHI) and history were closely related to vestibular dysfunction (P<0.05). Conclusion OSAHS may cause dysfunction of central vestibule. The changes of vestibular function can be timely detected with VNG tests and can help us further understand OSAHA effects on body systems.

Assessment ofquality of life in children with adenoid hypertrophy by OSA-18 questionnaire

LONG Chaoqing, YAN Yongyi, RONG Qingfeng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  13-15.  doi:10.6040/j.issn.1673-3770.0.2014.419

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Objective To investigate the value of OSA-18 questionnaire in assessment of quality of life in the children with adenoid hypertrophy. Methods Electronic nasopharyngoscopy and polysomnography (PSG) were underwent in 56 children with adenoid hypertrophy, and their quality of life were evaluated by OSA-18 questionnaire. The correlations between adenoid hypertrophy and OSA-18 scores were analyzed. Results The quality of life in 80.36% children with adenoid hypertrophy were significantly affected.Their OSA-18 total score were moderate and severe. There was significant correlation between OSA-18 total score and apneahypopneaindex(AHI), lowestoxygen saturation(LSaO₂), and adenoid size. Conclusion There is an obvious correlation between adenoid size and OSA-18 score. OSA-18 questionnaire can be used asan indicatorin assessment of quality of life in the children with adenoid hypertrophy.

Cytocompatibility research of schwann cells and neural stem cells co-seeded on electron spinning chitosan-PLGA

MEN Yongzhi, CHENG Yusheng, LI Yu, DONG Pin, YU Ziwei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  16-19.  doi:10.6040/j.issn.1673-3770.0.2015.087

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Objective To investigate cytocompatibility of the electron spinning chitosan-PLGA nerve conduits with Schwann cells (SCs)and neural stem cells(NSCs) as well as cells adhesion and migration on the arranged nanofibers inside the lumen. Methods Experiment was divided into three groups: the SCs group, the NSCs group and the SCs-NSCs co-culture group. Cells in these groups were co-seeded with Chitosan-PLGA. The biocompatibility and absorbability of SCs and NSCs were detected by MTT assays. Scanning electron microscopy(SEM) was used to detect cells adhesion and migration on the axially arranged nanofibers inside the lumen. Results Cell survival rate of the co-culture group was the highest, the higher in the SCs group, and the lowest in the NSCs group. SCs and NSCs had good compatibility and adhesion with Chitosan-PLGA, and the axial nanofibers in the lumen guided the growth of neurites in a particular direction. Conclusion Co-culture of SCs and NSCs can facilitate cells compatibility and adhesion with 3D Chitosan-PLGA, and the axial arranged nanofibers within the lumen has the effect of directional guide cell growth and migration.

Intratympanic budesonide suspension injection to treat idiopathic sudden deafness with type Ⅱ diabetes mellitus in 42 patients

JIANG Luyun, XIE Hui, XIE Yan, LI Xinrong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  20-23.  doi:10.6040/j.issn.1673-3770.0.2015.024

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Objective To observe the clinical effectiveness of oral prednisone and intratympanic plus intravenous budesonide injection in the treatment of the patients of sudden deafness with type Ⅱ diabetes mellitus (DM). Methods The patients with sudden deafness plus type Ⅱ diabetes mellitus (84 cases, 87 ears) were randomly divided into group A (42 cases, 43 ears) and group B(42 cases, 44 ears). Both groups were given individualized medication to lower blood glucose, but same conventional treatment for sudden hearing loss. Oral prednisone was added in group A, while intratympanic injection of Budesonide suspensinon was applied to group B. Results The improvements of pure tone average were classified as 4 grades: cured, markedly effective, effective, and ineffective. The result of Mann-Whitney U test showed the two strategies of treatment had significant difference in the improvement of profound idiopathic sudden hearing loss (Z=-3.274, P=0.001), and the result of chi-square showed that there was also a significant difference in the numbers of abnormal plasma glucose between group A and group B (χ²=214.482, P<0.001). Conclusion With the individualized medications to lower blood glucose and conventional treatments, Intratympanic Budesonide suspension injection plus conventional regimen could be more effective for idiopathic sudden deafness in type Ⅱ DM patients than oral prednisone. And it is beneficial to maintain the stability of blood glucose level by the way of intratympanic injection of glucocorticoid.

Audiologic features and differences ofchronic suppurativeotitis media or cholesteatoma of middleear in adults and elderly patients

LIU Qianxu, ZHANG Zhigang, ZHAO Xiaoming, LI Haiou

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  24-28.  doi:10.6040/j.issn.1673-3770.0.2015.012

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Objective To explore the audiologic features and differences between the adult and elderly patients with chronic suppurative otitis media (CSOM) or cholesteatoma of middle ear(CME). Methods A retrospective study was carried out on pure tone tests (at speech frequencies 0.5, 1.0, 2.0 and 4.0 kHz)in 74 adult patients (18-59 years) and 68 elderly patients (over 60 years) with unilateral CSOM or CME.The audiologic features and differences were analyzed between the ill ears and healthy ears, as well as between the two age groups. Results In adult patients, the thresholds of air and bone conduction at all speech frequencies were significantly higher in ill ears compared with healthy ears. In elderly patients, the same results were observed between ill ears and healthy ears, except at 4.0 kHz of bone conduction. Compared with the adult patients, interaural thresholds of air and bone conduction at all speech frequencies were higher in elderly patients.In non-cholesteatoma and normal ossicular chain groups, interaural thresholds of air conduction at 0.5, 1.0, 2.0 kHz and bone conduction at 4.0 kHz were significantly higher in elderly patients compared with the adult patients.Furthermore, in both the cholesteatoma and abnormal ossicular chain groups, elderly patients showed significantly higher interaural thresholds of air and bone conduction at all speech frequencies as compared with the adult patients. Conclusion CSOM and CME can cause air conduction and bone conduction damage in both adult and elderly patients. In addition, the damage to elderly patients is worse than adult patients. At severe levels of middle ear disease, hearing loss is more severe in elderly patients versus adult patients.

Efficacy of fluconazole for fungal otitis externa (71 cases report)

HUANG Xiongchao, LIAO Shouben, DONG Shiting, ZHONG Haijian, QIN Yongqian

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  29-30.  doi:10.6040/j.issn.1673-3770.0.2014.416

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Objective To investigate the method and efficacy of fluconazole in the treatment of fungal otitis externa. Methods 139 patients diagnosed as fungal otitis externa were divided into 2 groups, with 71 patients in observation group treated with fluconazole bathing, and 68 patients in control group treated with miconazole nitrate cream. All patients were followed up for 1 year. Results Both methods were effective in the treatment of fungal otitis externa, but the recurrence rate of the control group was higher than the observation group one year later(P<0.05). Conclusion The recurrence rate of fluconazole bathing to treat fungal otitis externa is low. This method is simple and easy to apply, with good compliance.

Pathogenic bacteria and drug sensitivity in 53 patients with chronic suppurative otitis media

LI Shenling, ZHANG Xiaotian, JIANG Xiaodan, HUANG Tianqiao, GUO Ge, LIANG Dapeng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  31-34.  doi:10.6040/j.issn.1673-3770.0.2014.396

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Objective To investigate the pathogenic bacteria and drug sensitivity tests in patients with chronic suppurative otitis media for drug application. Methods Secretion were collected from 53 patients with chronic suppurtive otitis media who were admitted into our hospital from March 2011 to March 2014.Bacterial culture and drug susceptibility tests using VITEK-2 COMPACT microbiological analysis system were performed. Results There were 49 stains of microbes isolated from 45 secretion specimens of middle ear. The first three most common pathogenic bacteria were Pseudomonas aeruginosa, Staphylococcus epidermidis and Staphylococcus aureus accounted for 22.4%, 16.3%, 16.3%, respectively. The common gram-positive and gram-negative bacteria all showed highly sensitive to levofloxacin. (81%, 90.9% correspondingly). Conclusion Pseudomonas aeruginosa, Staphylococcus epidermidis and Staphylococcus aureus are main pathogenic bacteria for chronic suppurative otitis media in our region, which are highly sensitive to general antibiotics. Culture and drug sensitivity test have great value for clinical drug application. The fungus infection can't be neglected.

Perioperative treatment in endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps and asthma

CHEN Guojing, CAI Xiaolan, LI Xuezhong, ZHANG Liqiang, ZHU Huitao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  35-38.  doi:10.6040/j.issn.1673-3770.0.2015.125

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Objective To explore the perioperative medicine treatment and notes of endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps(CRSwNP) and asthma. Methods From June 2010 to December 2013, 109 patients with CRSwNP accompanying with asthma were treated by endoscopic sinus surgery(ESS). All patients with asthma were evaluated pre-operation and performed ESS 6 months after completely controlled. Medication such as atomization inhalation and systemic corticosteroids were given to control and prevent asthma attack during peri-operation. Results No asthma attack happened during the treatment process. Only 1 patient had wheezing on the 2nd day post-operation by oral analgesics. Endoscopy examination was administrated in a follow-up period of 1 to 3 years after the surgery. Among them, 5 patients(4.59%) were completely controlled, 94(86.24%) were partly controlled and 10(9.17%) were not. Only 1 patient was treated with operation because of avascular necrosis of the femoral head 13 months after ESS. Conclusion It is useful to prevent asthma attack and improve ESS efficacy in CRSwNP that depends on asthma evaluation before ESS and rigorous medicine peri-operative treatment.

Clinical efficacy of Bidouyan oral liquid in combination with low-dose clarithromycin tablets for chronic sinusitis

LIU Qian, RUAN Yijin, ZHU Huaiwen, SHI Xiongzhou, CAI Zhuo

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  39-42.  doi:10.6040/j.issn.1673-3770.0.2015.067

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Objective To explore the clinical effect of Bidouyan oral liquid in combination with low-dose clarithromycin tablets in treatment of chronic sinusitis. Methods Eighty-six patients with chronic sinusitis were randomly divided into the treatment group and the control group, forty-three patients in each group. The patients in both groups received clarithromycin tablets 250 mg per time, once a day, besides patients in the treatment group were given Bidouyan oral liquid 10ml for per time, three times a day. Changes of visual analogue score, nasal endoscopy Lund Kennedy score and paranasal sinus CT scanning score were measured before and after a three- month treatment. Results The VAS core, nasal endoscopy and sinus CT scan score of the treatment group were significantly decreased (t=21.23, 30.23, 25.81, P<0.05), and compared with the control group, the difference was statistically significant (t=10.21, 12.79, 9.58, P<0.05). The total effect rates in the treatment group and the control group were 83.72% and 65.12% (U=752.5, P<0.05). Both groups had no obvious adverse reaction. Conclusion Bidouyan oral liquid in combination with low-dose clarithromycin tablets treatment has significant clinical efficacy on chronic sinusitis.

Expressions of S-100 protein and HLA-DR in nasal polyps

JIANG Haihua

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  43-45.  doi:10.6040/j.issn.1673-3770.0.2014.215

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Objective To explore the expressions of S-100 protein and HLA-DR in nasal polyps, so as to investigate the immune reaction mediated by the two mechanism of action in the pathogenesis of nasal polyps before and after glucocorticoid treatment. Methods From November 2010 to June 2012, 74 cases of nasal polyp were treated by endoscopy in our department, of them, 37 cases were treated with hormone and 37 cases were treated without. 21 cases of inferior turbinate mucosa taken from patients treated by Deviation of nasal septum served as the control group. Results Expressions of S-100 protein and HLA-DR in the nasal polyp tissues were significantly higher than those in the control group, and they were significantly higher in the treatment group than in the hormone 5 days treatment group (P<0.05). Conclusion In the nasal polyp tissues, high expressions of S 100 protein and HLA-DR suggest that the immune response mediated by the two play an important role in the pathogenesis of nasal polyps. After 5 days hormone treatment, the expressions of S 100 protein and HLA-DR decreased, which suggest that hormones play some role in anti-immune action.

Application of nasal septal suture in septoplasty

ZHANG Guohua, DENG Mingchao, RONG Qingfeng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  46-47.  doi:10.6040/j.issn.1673-3770.0.2014.410

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Objective To explore the efficacy and safety of nasal septal suture in septoplasty. Methods A total of 62 patients who had undergone septoplasty were randomly divided into two groups: the suturing group (n=31) and the packing group (n=31). Suturing group were treated with septal suture after septoplasty without nasal packing. Mercel was used for nasal packing after septoplasty in the packing group. The visual analogur scale(VAS) was used to analyze the symptoms of the two groups. Results The clinical symptoms in the suturing group were significantly reduced compared with the packing group(P<0.05). The VAS scores of post operative stuffy, nasal pain, headache, dyaphagia, difficult swallowing and sleep disturbancewere higher in the packing group than in the suture group(P<0.05). The complication rate of the suturing group was lower than that in the packing group. Conclusion Nasal septal suture has excellent therapeutic effects and deserves further dissemination.

Complications and treatment of nasal foreign body of button battery in 6 cases

JING Shanglin, LIN Nan, MO Lian, HE Lin, LIU Lihua

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  48-50.  doi:10.6040/j.issn.1673-3770.0.2014.329

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Objective To discuss the clinical characteristics, causes of misdiagnosis and complications in nasal foreign body of button battery. Methods The clinical data of 6 cases of nasal foreign body of button battery received and treated from January 2009 to December 2013 were retrospectively analyzed. Results All the button batteries were successfully removed. One case had no complications, 2 cases had perforation of the nasal septum, 2 cases had nasal synechia, and 1 case had partial necrosis of the turbinate. Conclusion Foreign body of button batteries in the nasal cavity can lead to serious complications which should be early discovered and early treated.

Construction and identification of small interfering RNA targeting silence Trop2 expression in human laryngeal carcinoma cell line HEP2

CHEN Xiaoling, FEI Bing, LI Xianbin, WU Hao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  51-53.  doi:10.6040/j.issn.1673-3770.0.2014.381

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Objective To construct the small interfering RNA(siRNA) that can silence Trop2 expression and to investigate the silencing effect of siRNA on Trop2 gene in human laryngeal carcinoma cell line HEP2. Methods Three different gene sequences siRNA specific targeting Trop2 gene were constructed and used to transfect into HEP2 cells by using Lipofectamine^TM 2000. The negative control group and blank control group were set up at the same time. These cells were divided into the W group (un-transfection), the NC group (transfection with negative control), the T1 group(S1 sequence), the T2 group(S2 sequence) and the T3 group(S3 sequence). The transfection efficiency was reported by green fluorescence protein expression and gene inhibition efficiency was analyzed by real-time RT-PCR. Results Green fluorescence observed by fluorescence microscopy showed that siRNA had been transfected into HEP2 cells, and the transfection ratio was 90%. The expression levels of Trop2 mRNA in cells transfected with Trop2-specific siRNA were lower than those in the untransfected cells or cells transfected with negative control siRNA. Compared with the T2 and T3 groups, siRNA in the T1 group had the strongest inhibitory effect on the expression of Trop2 mRNA, and the difference was significant(0.470±0.063 vs 0.749±0.024, 0.824±0.027, P<0.05 ). Conclusion Effective siRNA sequence has been successfully constructed and selected which can inhibit the expression of Trop2 gene in human laryngeal carcinoma cell line HEP2. It is fundamental for the study on the function of Trop2 gene and the gene therapy of laryngeal carcinoma.

Reinnervation vesus non-reinnervation surgery for vocal fold paralysis

FENG Yun, YANG Dazhang, LÜ Qiuping, LIU Dandan, WANG Naya

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  54-58.  doi:10.6040/j.issn.1673-3770.0.2015.077

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Objective To compare the efficacy of reinnervation and non-reinnervation surgery in the treatment of vocal cord paralysis (VCP). Methods ① Of the 21 cases of unilateral vocal cord paralysis (UVCP), 15 were treated with reinnervation (recurrent laryngeal nerve decompression, anastomosis of ansa cervicalis nerve and recurrent laryngeal nerve, anastomosis of end to end of recurrent laryngeal nerve, nerve muscular pedicle technique to lateral cricoarytenoid muscle), and 6 were treated with non-reinnervation (vocal cord autologous fat injection, type Ⅰ thyroplasty using autologous cartilage). ② Of the 16 cases of bilateral vocal cord paralysis (BVCP), 6 were treated with reinnervation (recurrent laryngeal nerve decompression, bilateral nerve muscular pedicle technique to posterior cricoarytenoid muscle), and 10 were treated with non-reinnervation (vocal cord lateralization, endoscopic resection of arytenoid). The therapeutic effects were evaluated with fiber laryngoscope, strobe laryngoscope, and voice assessment. Results ① Of the 15 UVCP cases treated with reinnervation, vocal cord regained different degrees of movement and adduction when pronunciating. Vocal cord vibration and mucosal wave regained symmetry, and glottal closure was good. MPT before and after surgery was 5.51±1.05 and 12.10±1.41 seconds (P<0.01). Of the 6 UVCP cases treated with non-reinnervation treatment, hoarseness symptoms were improved, but there was no movement of the vocal cords. MPT before and after surgery was 5.47±0.45 and 11.83±1.47 seconds (P<0.01). The difference between MPT of reinnervation and non-reinnervation surgery was not statistically significant (P>0.05). ② Of the 6 BVCP cases treated with reinnervation, 4 had partial vocal cord abduction restored and dyspnea was relieved. Of the 10 BVCP cases treatedwith non-innervation surgery, dyspnea was relieved. Decannulated rate of cases treated with reinnervation and non-reinnervation was 66.7% (4/6) and 100% (10/10), respectively. The difference between the two groups was not statistically significant as analyzed with Fisher exact test (P>0.05). Conclusion Reinnervation and non-reinnervation surgery have considerably good therapeutic effects on UVCP, and the former has a better long-term efficacy. In BVCP, non-reinnervation has better therapeutic effect than reinnervation, but the latter can maintain voice quality. Surgical treatment should be chosen based on surgeons’ expertise, and patients’ physical condition and needs.

Coblation unilateral vocal cord transection with arytenoidenctomy in the treatment of bilateral vocal cord paralysis

HAN Naigang, LI Xiaohong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  59-61.  doi:10.6040/j.issn.1673-3770.0.2015.174

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Objective To evaluate the clinical efficacy of endoscopic coblation unilateral vocal cord transection with arytenoidectomy for the treatment of bilateral vocal cord paralysis. Methods A total of 19 patients with bilateral vocal cord paralysis received unilateral vocal cord transection and arytenoidectomy using coblation under video suspension laryngoscope. During the follow-up of 6 to 42 months, the curative effects were analyzed. Results Decannulation was performed in 18 cases 1 month postoperatively, 8 of which had undergone tracheotomy before operation. Decannulation failed in 1 case due to dyspnea caused by scar diathesis, and then succeeded after the contralateral arytenoid was removed. Of all 19 cases, 14 achieved satisfactory vocal effects, 4 had acceptable vocal effects, and 1 case had worse trachyphonia. Conclusion Safe and minimally invasive, endoscopic coblation assisted vocal cord transection and arytenoidectomy is an effective treatment for bilateral abductor paralysis. It has a high decannulated rate while the voice quality remains satisfying.

Diagnosis and perioperative treatment of tongue base cyst in infants

WANG Guixiang, ZHANG Jie, ZHAO Jing, TANG Lixing, NI Xin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  62-64.  doi:10.6040/j.issn.1673-3770.0.2015.004

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Objective To discuss the diagnosis, surgery and perioperative treatment of tongue base cyst in infants. Methods Clinical data of 38 patients with tongue base cyst were reviewed. Diagnoses were confirmed by the medical history, physical examination and auxiliary examinations. Radiofrequency ablation was used to treat all the patients under general anesthesia. Symptomatic treatments were given post-operatively. Results The cysts were removed in all the 38 patients. Due to severe apnea, 3 patients were intubated preoperatively and sent back to intensive care unit (ICU) after the operation. They were extubated 2 or 3 days later and discharged. Another 5 patients were transferred to ICU with intubation after the operation because of other illness and extubated there. The rest 30 patients were extubated soon after the operation and sent back to ENT department. During the surgery, the cysts in 2 patients were punctured to decrease the size to ease the intubation. All the patients underwent electronic laryngoscopy postoperatively. No relapse was noted in 8 months to 2 years follow-up. Conclusion Electronic laryngoscopy and neck B ultrasound examination can accurately diagnose the tongue base cyst. There are significant advantages for radiofrequency ablation to treat tongue base cyst, such as less injury and less bleeding. The infants with tongue base cyst always have high risk for anesthesia and intubation. If necessary, puncture to relieve the tension of the cyst can be performed before the operation. Patients combined with other disease or neonatal patients can be transferred to ICU for further treatment. After the surgrey, all the patients should be monitored closely in case of apnea or other airway emergency.

Erythropoietin inhibits Müller cell apoptosis induced by oxidative damage

CHEN Chunli, SONG Zongming, JIA Xinguo, ZHOU Zhonglou, WANG Zhaoyang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  65-71.  doi:10.6040/j.issn.1673-3770.0.2014.293

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Objective To demonstrate whether EPO can inhibit Müller cell apoptosis induced by oxidative damage and to investigate the molecular mechanism. Methods The proliferation effect of EPO on cultured human Müller cell-MIO-M1 was determined by BrdU marking and MTT assay both under normal condition and exposed to H₂O₂ or GO with different concentration (0 U/mL, 0.01 U/mL, 0.1 U/mL, 1 U/mL, 10 U/mL, 30 U/mL and 100 U/mL) at 24 h, 48 h and 72 h after exposure. The Müller cell proliferation changes after the use of PI3K/PDK1/PKB(Akt) signal pathway blocker-LY294002 was surveyed by MTT assay. The Müller cell function on EPO expression and secretion was observed by ELISA. The EPO effect on ERK1/2 and Akt signal pathway was detected under different cultured condition in vitro by Western-blotting. Results EPO had no effect on Müller cell proliferation under normal culture condition. The 80% damaged Müller cell caused by 0.4 mmol/L H₂O₂ can secrete 1.42 times EPO as that under normal culture condition. Under oxidative damage condition, 0.08 mmol/L H₂O₂ or 8 U/L GO could cause half of Müller cells to be dead and activate Akt signal pathway. While adding EPO 2 h earlier, 30 U/mL of EPO can reduce the oxidative damage to the minimum. The protection effect of Akt signal pathway could be reduced by its blocker LY294002 spontaneously. Conclusion EPO has no proliferation and migration effects on Müller cells cultured in vitro. Under normal culture condition, Müller cells did not express and secrete EPO. While under oxidative damage, Müller cells can secret EPO which can protect Müller cells by Akt signal pathway.

Effect of intravitreal ranibizumab injection combined with trabelectomy and panretinal photocoagulation for neovascular glaucoma

CHAI Xuerong, ZHANG Shixi, TAO Yu, SHEN Jiaquan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  72-75.  doi:10.6040/j.issn.1673-3770.0.2015.076

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Objective To evaluate the efficacy and safety of intravitreal ranibizumab injection combined with trabelectomy and panretinal photocoagulation (PRP) in treatment of neovascular glaucoma. Methods Twenty-four patients (24 eyes) with neovascular glaucoma who underwent intravitreal ranibizumab injection combined with trabelectomy and PRP between December 2013 and May 2014 at Shandong Provicial Hospital were observed. During a follow-up period of 8.6±1.7 months, the pre-operative and post-operative visual acuity(VA), intraocular pressure (IOP) and number of anti-glaucoma medications, also the surgical complications and success rate were observed. Results Post-operative IOP was 10.9±2.7 mmHg, 13.3±3.2 mmHg, 14.0±3.4 mmHg and 15.4±5.1 mmHg at 1 week and 1, 3 and 6 months after the surgery, which was significantly decreased compared with pre-operative one(P<0.01). The number of anti -glaucoma medications was 0.2±0.5, 0.4±0.7, 0.4±0.8 and 0.5±1.0 at 1 week and 1, 3 and 6 months after the surgery, which was significantly decreased compared with the pre-treatment one(P<0.01). At the last visit, there were 14 eyes with stable VA, 8 with VA improvement, and 2 with diminished VA. Conclusion Intravitreal ranibizumab injection combined with trabelectomy and PRP is effective and safe for neovascular glaucoma.

In vitro study of the effect of Casein Kinase2 siRNA on anginogesis

DU Xiangge, ZHANG Yingchun, YAN Xin, WANG Cui, ZHAO Bojun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  76-80.  doi:10.6040/j.issn.1673-3770.0.2015.154

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Objective To prove the effect of Casein Kinase2 siRNA on vascular endothelial growth factor(VEGF) expression and the angiogenic capacity in human umbilical vein endothelial cells (HUVECs). Methods HUVECs were transfected with either Casein Kinase2 siRNA or negative control siRNA. Cell proliferation was analyzed by MTT assay; the angiogenic capacity was accessed by tube formation; cell migration was assessed by the wound-healing model. Gene and protein expressions of VEGF were examined by Real-time PCR and Western blotting methods. Results Casein Kinase2 siRNA decreased the expressions of Casein Kinase2 and declined HUVEC proliferation, tube formation and migration. It was also reduced the expression of VEGF mRNA and VEGF protein. Conclusion Our results demonstrated that Casein Kinase2 siRNA reduced the expression of VEGF and declined the capacity of angiogenesis in HUVECs.

Clinical observation of 131 cases of lacrimal canalicular anastomosis by microscopy

LI Shuyan, LI Xiaofeng, SONG Shuguang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  81-83.  doi:10.6040/j.issn.1673-3770.0.2014.361

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Objective To observe the post-operative effect of lacrimal canalicular anastomosis under microscopy. Methods A retrospective study was made for 131 patients who had received lacrimal canalicular anastomosis by microscope between August 2008 and August 2012 in Huai'an First People's Hospital, Nanjing Medical University. Results During a follow-up period of 6 months to 2 years after the operation, all were successfully performed lacrimal canaliculus anastomosis successfully, and 115 patients of them were cured (87.78%), 11 had improvement (8.40%)and 5 had not (3.82%). Conclusion Lacrimal canalicular anastomosis should be treated as soon as possible, and the second phase anastomosis also can achieve good post-operative effect.

Comparison of pseudoaccommodation measured by optical quality analysis system

WANG Jing, WU Qin, WU Hao, LIU Chunlei, BI Hongsheng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  84-85.  doi:10.6040/j.issn.1673-3770.0.2015.057

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Objective To study pseudoaccommodation of different intraocular lenses with a double-pass system, and the results were compared with those by the defocus method and push-up method. Methods A total of 30 outpatients with age-related cataract were selected in this study. All the enrolled eyes were implanted with the same aspheric intraocular lens. The pseudoaccommodation of each selected eye was measured by optical quality analysis system(OQAS), defocus system and push-up method one month after the operation. Results The average pseudoaccommodation by OQAS examination, defocus method and push-up method was 2.34D, 2.5D and 2.93D, respectively. There's no statistical difference between OQAS examination and defocus method(P>0.05). But there's statistical difference between OQAS examination and push-up method(P<0.05). Conclusion The pseudoaccommodation measured by OQAS was relatively small. The results measured by OQAS was in close agreement with that measured by defocus method.

Application of narrow band imaging in head and neck malignant neoplasm

HAN Shuang, YU Dan, WEN Lianji

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  86-89.  doi:10.6040/j.issn.1673-3770.0.2015.047

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The malignant neoplasm in head and neck region increased the mortality as for cervical lymph nodes metastasis and local invasion into the adjacent organs which influence the patient's quality of life. It is essential to detect and diagnose malignant tumors as early as possible.Endoscopy is useful for the diagnosis and treatment of cancers derived from the head and neck region. However, a laryngoscope with conventional white light (CWL) has technical limitations in detecting small or superficial lesions on the mucosa. Narrow band imaging(NBI), especially combined with magnifying endoscopy (ME), is a new non-invasive endoscopic imaging technique, which can clearly show the morphologic characteristics and sites of mucosal and submucosal vessels, known as intraepithelial papillary capillary loop(IPCL)). This article is a review of NBI's clinical application for head and neck malignant tumor.

Endoscopic surgery for surgical approache of benign lesion of maxillary sinus

WANG Xiaoyong, SONG Xicheng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  90-92.  doi:10.6040/j.issn.1673-3770.0.2015.096

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The benign lesions of maxillary sinus mainly include inflammatory lesions and benign tumorous lesions. Caldwell-Luc operation, the radical maxillary sinusotomy, was the major treatment for the benign lesions of maxillary sinus before the nasal endoscopic surgery was used. With the development of nasal endoscopy technology, basically replaced Caldwell-Luc operation, some operation for the benign lesions of maxillary sinus can be performed by endoscopy via the middle or inferior meatus approach. And open surgery with nasal endoscopy-assistedhas been improved as well. Nasal endoscopic surgery has the advantages of well surgical field, small trauma and keeping the organizational structure of inferior turbinate and nasolacrimal duct. With nasal endoscopic surgery becoming more mature, operation continues to develop with innovation. This paper will review the surgical approachs of nasal endoscopic surgery for maxillary sinus lesions.

Effect of pterygium excision with limbal-conjunctival flap grafting and wearing corneal contact lens

KONG Xiangfeng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(3):  93-94.  doi:10.6040/j.issn.1673-3770.0.2014.313

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