Table of Content

16 August 2015 Volume 29 Issue 4

  

Staged operation for simultaneous type Ⅰ and Ⅱ obstructive sleep apnea hypopnea syndrome.

TANG Zhi, WANG Jiqun, TU Zhifeng, CHEN Yongming, LI Guidi, LI Yulan, LIU Lingling

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  1-3.  doi:10.6040/j.issn.1673-3770.0.2015.041

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Objective To explore the efficacy of staged operation in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) diagnosed as type Ⅰ and Ⅱ simultaneously. Methods The OSAHS patients with nasal structural abnormalities underwent nasal cavity expansion surgery and uvelopalatopharyngoplasty 3 monthes later. Postoperative improvement were observed respectively 3 months and 6 months later. Results The symptoms of apnea and snore were improved, while AHI, LSaO₂ were significantly improved postoperatively. However, moderate snoring gradually appeared 6 months after the surgery. Conclusion The nasal cavity expansion surgery and uvelopalatopharyngoplasty to treat OSAHS demonstrates obvious curative effects, but long term snoring warrants further observation.

Relationship of neck circumference, waist circumference and extent of obstructive sleep apnea syndrome in males.

LIU Haiqin, SHANG Lei, HOU Jin, HE Cuilin, CHENG Ying, SHAO Na

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  4-6.  doi:10.6040/j.issn.1673-3770.0.2014.393

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Objective To investigate the relationship between neck circumference, waist circumference and extent of obstructive sleep apnea syndrome(OSAHS) in males. Methods Clinical data of 200 OSAHS patients, diagnosed by polysomnography from January 2013 to July 2013, were reviewed. The relationship between neck circumference, waist circumference, BMI, age, sex, and AHI, LSaO₂, TS90%, ESS were analyzed. Results ① No association was found between age, BMI, AHI, LSaO₂ and TS90%, ESS. Neck circumference and waist circumference were positively correlated with AHI, TS90% and ESS, but negatively correlated with LSaO₂. ② Stepwise multiple regression analysis showed both circumferences were associated with AHI, TS90% and LSaO₂. Conclusion Neck circumference and waist circumference are associated with severity of OSAHS in male patients.

Hearing screening and risk factors of hearing impairment in premature infants.

WANG Guoqiang, ZHAO Chunhong, HUO Hong, GONG Zhiyun, SONG Weiwei, YAN Lixia, LI Xuehua, WANG Weili

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  7-10.  doi:10.6040/j.issn.1673-3770.0.2014.386

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Objective To investigate the risk factors of hearing impairment by analyzing the results of hearing screening in the premature infants in the neonatal intensive care unit. Methods A total of 821 premature infants, admitted to the neonatal intensive care unit form January 2010 to December 2013, were screened for hearing functions. The risk factors for no passing in the screenings were analyzed. Results The failure rates in initial and secondary screening were 61.0% and 16.0%, respectively. The failure rate was 9.4% in the automatic auditory brainstem response (AABR) test conducted at three months after birth. With the growth of gestational age, pass rate increased and degree of hearing disorders decreased in the mean time. Logistic regression analysis showed that very low birth weight, hyperbilirubinemia, infection and suffocation were risk factors for hearing, while, gestational age > 32 weeks was protective factor (OR=0.499, P=0.022). Low birth weight was independent risk factor for hearing screening and hearing impairment (OR=2.385, P=0.038). Conclusion Due to immature development, premature babies suffer from high incidence of hearing loss. The smaller the gestational age is, more commonly hearing damages occur. Low birth weight, hyperbilirubinemia, infections are risk factors for hearing impairment. Early detection and timely follow-up are neccessary.

Diagnosis and treatment of otitis media with effusion in children with bilateral sensorineural deafness.

SUN Changzhi, LIU Wenlong, LI Yan, LUO Renzhong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  11-14.  doi:10.6040/j.issn.1673-3770.0.2014.291

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Objective To explore the clinical characteristics of otitis media with effusion (OME) in children with bilateral sensorineural deafness. Methods Clinical data of 17 pediatric OME patients (34 ears) with bilateral sensorineural deafness (Group A) and another 17 pediatric patients (34 ears) with simple OME (Group B) were reviewed. Incidences of middle air adhesion, and changes of auditory brainstem response (ABR) before and after operation were compared. Results In Group A, the primary symptom was hearing loss; 7 cases were misdiagnosed as sudden deafness, and 5 cases (7 ears) had middle ear adhesion; the response threshold of wave Ⅴ of ABR was improved from 0 to 30 dB nHL (average 17.3 dB nHL) after tympanostomy tube and the improvement had significant difference (P<0.05). In Group B, the primary symptoms included ear discomfort (15 cases) and hearing loss (2 cases), and 1 patient (1 ear) had middle ear adhesion. There was statistical difference between the two groups in the incidence of middle ear adhesion (P<0.05). Conclusion It is difficult to collect the history of pediatric patients with OME and bilateral sensorineural deafness, which is often misdiagnosed. Surgical intervention should be taken timely to prevent complications. Tympanostomy tube can effectively improve hearing in these patients.

Characteristics of tinnitus in patients with idiopathic sudden sensorineural hearing loss.

ZHONG Xiaosheng, YANG Haidi, ZHENG Yiqing

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  15-18.  doi:10.6040/j.issn.1673-3770.0.2015.126

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Objective To analyze the characteristics of tinnitus, correlation between tinnitus and hearing loss, effects of tinnitus, and mechanism of tinnitus in patients with sudden sensorineural hearing loss. Methods Clinical data of 231 tinnitus patients with idiopathic sudden sensorineural hearing loss were retrospectively reviewed. Results of Tinnitus Handicap Inventory (THI), visual analogue scale (VAS), pure tone audiometry, acoustic emission, tinnitus test and masking test were analyzed. Results ① Characteristics of hearing loss: Low-intermediate frequency hearing loss (rise type) was 8.7%, high-frequency hearing loss (fall type) was 26%, flat-type was 19%, total-deafness type was 34.2%, irregular type was 12.1%. ② Frequency of tinnitus: Low-frequency (<500 Hz) tinnitus was 21.2%, medium-frequency (51-2 000 Hz) tinnitus was 23.4%, high-frequency (>2 000 Hz) tinnitus was 52.8%, unmatched tinnitus was 2.6%. Of hearing loss with low-intermediate frequency, low, medium and high frequency tinnitus was 75%, 15% and 10% respectively. Of hearing loss with medium-high frequency, low, medium and high frequency tinnitus was 13.3%, 26.7% and 60.0% respectively. Of total deafness, low, medium and high frequency tinnitus was 17.1%, 19.0% and 63.3% respectively. There was an linear relationship between the frequency hearing loss and tinnitus frequency (r=0.590, P<0.01). ③ Tinnitus volume: Tinnitus volume was 0-30 dB HL(19.5%), 31-60 dB HL(26%), 60-90 dB HL(44.2%), >90 dB HL (27.8%), and unmatched (2.6%). Tinnitus volume was correlated with the degree of hearing loss (r=0.216, P<0.05). ④ Tinnitus disability level: According to THI scores, the tinnitus disability level was: grade 1 (11.7%), grade 2 (19%), grade 3 (28.6%), and grade 4 (40.7%). ⑤ The characteristics of THI and VAS scores: there was no correlation between THI scores and degree of hearing loss (r=0.087, P=0.287), no correlation between VAS score and degree of hearing loss (r=0.002, P=0.982), no correlation between THI and the logarithm of tinnitus frequency (r=-0.056, P=0.402), no correlation between VAS score and frequency of tinnitus (r=-0.003, P=0.970), no correlation between THI score and tinnitus volume, r=0.03, P=0.563), no correlation between VAS score and tinnitus volume (r=0.136, P=0.110). Conclusion ① High-frequency tinnitus with idiopathic sudden deafness is the most common among all types of hearing loss. ② There is a significant correlation between tinnitus frequency and type of hearing loss. ③ The frequency of the greatest hearing loss is consistent with the frequency of tinnitus. ④ Tinnitus disability level is grade 3-4 during the acute period of idiopathic sudden sensorineural hearing loss. ⑤ THI and VAS scores are not correlated with degree of hearing loss, tinnitus, tinnitus volume and frequency.

Perioperative treatment and precautions in cochlear implantation.

YIN Haiying, GU Lintao, YU Shudong, WANG Qirong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  19-21.  doi:10.6040/j.issn.1673-3770.0.2014.363

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Objective To discuss the perioperative treatment and matters needing special attention in cochlear implantation to improve the success rates of surgery, promote postoperative speech quality, and reduce errors and complications. Methods Clinical data of 61 patients with cochlear implantation surgery was reviewed. We summarized the matters needing attention, including preoperative screening, perioperative complications and treatment, and postoperative mapping. Results Good results have been achieved in 61 patients with preverbal deafness, postverbal deafness, large vestibular aqueduct syndrome, Mondini deformity, large vestibular aqueduct syndrome plus Mondini deformities, concurrent cerebral white matter abnormalities, or secondary implantation. Conclusion Accurate preoperative assessment, standardized but individualized operation, postoperative mapping and speech rehabilitation training are the keys for cochlear implantation surgery.

Remote fitting of hearing aid in 86 patients aged over 60 years.

WANG Haiying, YANG Meiyan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  22-24.  doi:10.6040/j.issn.1673-3770.0.2015.161

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Objective To investigate the characteristics of hearing aid fitting for elderly patients. Methods The pure tone audiometry of 186 cases with 250~8 000 Hz was measured. Based on these patients' hearing, conventional hearing aid fitting and debugging was performed in 100 cases, remote hearing aid fitting was conducted in 86 cases. The final results were tracked. Results Remote fitting and conventional fitting produced the same improvements in hearing and speech discrimination. Conclusion Both conventional and remote fitting can choose the right hearing aids for patients and improve their hearing. Remote fitting can reduce the costs and offer satisfactory service for elderly patients.

General anesthesia without muscle relaxant for microsurgery of radical mastoidectomy (30 cases report).

WANG Fengjuan, LI Chuangang, FAN Xianliang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  25-27.  doi:10.6040/j.issn.1673-3770.0.2014.420

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Objective To explore the feasibility of microsurgery of radical mastoidectomy under general anesthesia without muscle relaxant. Methods 60 patients with chronic otitis media under going microsurgery of radical mastoidectomy were divided into two groups randomly, with (MR group, n=30) or without (NMR group, n=30) muscle relaxant. For all the patients, SBP, DBP, MAP and HR were recorded at the time of skin incision (T1), drilling bone (T2), and extubation (T3). Meanwhile, the consumption of Propofol and Remifentanil, body movements, awakening time, time of extubation and adverse reactions were also monitored. Results There were significant differences in SBP, DBP, MAP and HR at T1, T2 and T3 between the two groups (P<0.05), but not in the trend of changes with time (P>0.05). The recovering time and time of extubation in NMR group were shorter than those of MR group (P<0.05). The consumption of Propofol and Remifentani was more in NMR group (P<0.05). The body movement showed no difference between the two groups (P>0.05). The adverse reactions of MR group, including hypoxemia, glossocoma, were more common than NMR group (P<0.05). Conclusion Microsurgery of radical mastoidectomy under general anesthesia without muscle relaxant is safer, more satisfying and feasible than that with muscle relaxant.

Treatment of the iatrogenic foreign body in the maxillary sinus via the endoscopic anterior prelacrimal recess approach.

XIA Siwen, SUN Yue, HUANG Yideng, LI Xiaomiao, HE Shuai

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  28-30.  doi:10.6040/j.issn.1673-3770.0.2015.075

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Objective To explore the skill and efficacy of treatment for the iatrogenic foreign body in the maxillary sinus via the endoscopic anterior prelacrimal recess approach. Methods A total of 11 patients with the iatrogenic foreign body in the maxillary sinus were treated by endoscopic anterior prelacrimal recess surgery from January 2012 to June 2014. Results The foreign body was removed totally in all 11 patients(100%). Mucosa was well recovered and drained. During a 3-6 months follow-up, no complications happened. Conclusion Endoscopic anterior prelacrimal recess approach in treatment of iatrogenic foreign body in the maxillary sinus has advantages of good vision, convenient operation, little injury and good protection. It has unique advantage for the huge foreign body in the maxillary sinus.

A comparative study on effect of the individual tension relaxing plasty versus traditional submucosal resection for deviation of the nasal septum.

LI Jia, LI Xiongwen, ZHANG Pengjian, YE Yuanhang, QIN Yong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  31-34.  doi:10.6040/j.issn.1673-3770.0.2015.033

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Objective To compare the effect of nasal septum support individual tension relaxing plasty with traditional submucousal resection for nasal septum deviation. Methods A case-control study was made on patients with deviation of nasal septum treated in our department during 2009 to 2013. Based on the lesion site, similar type and age difference of less than 5 years, 80 patients in the study group and 80 in the control group were one to one matched in this study. Followed up over 12 months, the operation time, intra-operative bleeding, post-operative nasal septal hematoma, post-operative pain, stuffy nose and nasal valve of the original symptom improvement were compared. Results The operation time was 20-60 (37.48±10.78) minutes in the study group and 20-55(34.66±10.86) minutes in the control group (t=1.644, P>0.05). The intra-operative bleeding was 3-15(9.38±3.02) mL in the study group and 5-20 (11.59±4.71) mL in the control group (t=-3.536, P<0.01). The post-operative pain was moderate in the two groups and it was the most on the first day 2-6 (4.59±0.82) points in the study group and 3-7 (4.95±0.86) points in the control group (t=-2.733, P<0.01), on the second day 1-5 (2.93±0.65) points in the study group and 2-5 (3.43±0.71) points in the control group (t=-4.649, P<0.01), on the third day 1-2 (1.55±0.50) points in the study group and 1-3 (1.69±0.52) points in the control group (t=-1.707, P>0.05). Post-operative complications: nasal septum hematoma, 1 case in the study group (1/80) while 5 in the control group (χ²=1.558 4, P>0.05); valvular nasal obstruction, none in the study group while 6 (6/80) in the control group (χ²=4.329, P<0.05); nasal obstruction, none in the study group while 6 in the control group (χ²=4.329, P<0.05). Conclusion Compared with traditional submucosal resection, individual tension plastic correction has advantages of less intra-operative bleeding and post-operative pain and fewer complications in the deviation of nasal septum treatment.

Laryngeal function-sparing surgery for pyriform sinus cancer: a retrospective analysis of 14 cases.

QIAN Xiaofei, ZHANG Suqin, CHEN Jianliang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  35-37.  doi:10.6040/j.issn.1673-3770.0.2015.049

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Objective To explore the approaches and indications of laryngeal function-sparing surgery for pyriform sinus cancer. Methods A total of 14 cases of pyriform sinus cancer were retrospectively reviewed, including stage Ⅰ (n=3), Ⅱ (n=5), Ⅲ (n=4) and Ⅳ (n=2). All patients received laryngeal function-sparing surgery, and then 40 to 55 Gy postoperative radiotherapy. Results During the follow-up of 5 years, all cases regained phonate function, and 12 cases' tracheal casings were removed. The 3-year and 5-year survival rate were 64.29% and 42.86%, respectively. Conclusion With careful preoperative evaluation, most patients with piriform sinus cancer can have normal laryngeal tissues preserved by delicate operation, and their larynx functions can be partially or completely restored with a variety of repair methods.

Transoral endoscopic dissection of parapharyngeal space.

ZHANG Baoying, LU Yongtian, LI Jianxing

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  38-41.  doi:10.6040/j.issn.1673-3770.0.2015.094

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Objective To investigate the transoral anatomic characteristics of parapharyngeal space. Methods A total of 5 fresh cadaver heads (including 1 injected cadaver head) were dissected to illustrate the transoral approach of parapharyngeal space anatomy. Results The superior constrictor muscle was the landmark to enter the prestyloid space. The stylopharyngeus and styloglossus muscles were critical marks which divided the parapharyngeal space into 2 parts. Posterior to these muscles and laterally to the superior constrictor muscle, the internal carotid artery, internal jugular vein, and lower cranial nerves were identifiable. Conclusion Our dissection emphasizes the role of the stylopharyngeus and styloglossus muscles. The lateral surface of the superior constrictor muscle is essential to protect the internal carotid artery.

Evidences from clinical epidemiological survey for allergic rhinitis patients complicated by bronchial asthma after tonsillectomy.

WANG Guifeng, FANG Wenhao, PAN Jinbin, WEI Maobin, WANG Xiaojie, LI Yunxia

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  42-44.  doi:10.6040/j.issn.1673-3770.0.2014.414

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Objective To explore the effect of tonsillectomy on patients with allergic rhinitis complicated with asthma. Methods A survey about allergic rhinitis severity, asthma starting age, disease severity and the medication control by patients themselves who were treated in the department of otorhinolaryngology, the 401 st hospital of PLA from 1990 to 2000 was carried out. Results A total of 1 249 allergic rhinitis patients completed the survey. The patients were divided into two groups: the tonsillectomy group(n=128) and the non-tonsillectomy group(n=1 121). Of the tonsillectomy group, the longitudinal allergic rhinitis rate was 46.88%, coucurrent asthma rate was 32.03%, asthma starting age was (32.4±7.63) years, moderate incidence rate of asthma was 43.9% and remission rate of asthma with drugs was 82.93%. Of the non-tonsillectomy group, the longitudinal allergic rhinitisrate was 18.20%, coucurrent asthma rate was 47.55%, asthma starting age was (19.88±6.39) years, moderate incidence rate of asthma was 43.90% and remission rate of asthma with drugs was 68.10%.The difference was statistically significant between the two groups(all P<0.05). Conclusion The tonsillectomy has a therapeutic effect on allergic rhinitis complicated with asthma.

Preservation or resection of the hyoid bone on aspiration after supraglottic horizontal partial laryngectomy.

WANG Shouxi, LIU Hezhen

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  45-47.  doi:10.6040/j.issn.1673-3770.0.2015.092

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Objective To investigate the effect of preservation or resection of the hyoid bone on aspiration after supraglottic horizontal partial laryngectomy. Methods A total of 39 patients(56 to 67 years old) with supraglottic laryngeal carcinoma (T₁-T₃) without cerebrovascular diseases, nervous system diseases and respiratory diseases were chosen as the observation objects, and of them, 19 patients were preserved the hyoid bone and 20 were removed the hyoid bone. Results The incision margin of all cases was negative. The phonation approached normal and the decannulation rate was 100%. Of the patients preserving the hyoid bone, 2 had mild aspiration(10.5%), 7 serious(36.8%) and 10 moderate(52.6%), and the restoration duration was (31±3) days. Of the patients removing the hyoid bone, 11 had mild aspiration(55.0%), 9 moderate(45.0%) and none serious, and the restoration duration was (15±2) days without aspirated pneumonia. Conclusion Removing the hyoid bone with supraglottic horizontal partial laryngectomy can make good use of the function of the tongue root to shelter glottis, which is an effective way to relieve the post-operation aspiration, shorten the restoration time and prevent or decrease the aspirated pneumonia.

Methods for exposure of the facial nerve in parotid gland surgery.

WANG Xiaoxia, YAO Xiaobao, LI Honghui, BAI Yanxia, ZHANG Shaoqiang, SHEN Zhen, LI Baiya

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  48-50.  doi:10.6040/j.issn.1673-3770.0.2015.028

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Objective To explore the parotid gland surgery in a safe and efficient way to expose the facial nerve. Methods A total of 810 benign parotid gland cases were retrospectively analyzed, they were respectively treated by the methods of total trunk, zygomatic branch, mandibular margin and buccal branch to locate the facial nerve. Results A total of 465 cases were treated by the total tunk method, 11 cases of them were not found with this method and then were found with other methods, and 3 cases of them were injuried the facial nerve trunk; 138 cases were exposured the facial nerve successfully with the zygomatic branch method; 74 cases were exposured successfully with the mandibular margin method, 8 cases of them had intra-operative injury; 133 cases were exposured successfully with the buccal branch method, 5 cases of them had intra-operative injury. Conclusion Parotid gland surgery at a fixed anatomic mark is good at searching the facial nerve. In according to the actual circumstances of the patients, surgeons should use comprehensive methods to expose the facial nerve in a safe and quick way.

The management of benign space-occupying lesion of the middle skull base via the endoscopic pterygopalatine space approaches.

ZHENG Chaopan, ZHOU Jingchun, HAN Ling, ZHANG Bo, MA Lingguo

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  51-54.  doi:10.6040/j.issn.1673-3770.0.2015.112

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Objective To discuss the surgical technique and indications of benign space-occupying lesion of the middle skull base via the endoscopic pterygopalatine space approaches. Methods Nine patients with benign space-occupying lesions of the middle skull base operated via the endoscopic pterygopalatine space approaches from May 2011 to December 2014 were retrospectively analyzed. The lesions included 3 schwannoma, 2 parasphenoide sinus cyst, 1 granulomatous vasculitis, 1 inflammatory pseudotumor, 1 fibroangioma and 1 fibrous dysplasia. Results The lesions were all removed. No recurrence happened during a 17-month follow- up on the average. There was no occurrence of cerebrospinal fluid rhinorrhea or meningitis in all patients. Five patients had obvious numbness in the maxillary nerve innervation area and 3 patients had mycteroxerosis after the operation, but these symptoms disappeared afterwards. Conclusion The management of benign space-occupying lesion of the middle skull base via the endoscopic pterygopalatine space approaches was reliable with minimal invasion and total removal of some benign lesions.

Allen's test to evaluate hand's collateral circulation in normal Chinese people.

CHEN Xi

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  55-57.  doi:10.6040/j.issn.1673-3770.0.2014.406

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Objective To evaluate hand's collateral circulation in normal Chinese people with Allen's test in preoperative assessment of radial forearm free flap application. Methods Objective Allen's test was performed using noninvasive oxygen saturation (SaO₂) and Plethysmogram(PLETH) to evaluate the collateral circulation of radial and ulner artery in 150 normal subjects, The average recovery time of blood oxygen saturation, and average recovery time of PLETH was recorded. Results The average recovery time of oxygen saturation and verage recovery time of PLETH were (4.3±1.2) and (3.8±1.5)s, respectively. Conclusion Objective Allen's test can provide a valuable reference for the clinical.

Resection of styloid process through the anterolateral side of tonsil aided by endoscopy.

HE Benchao, XU Bisheng, HU Jing, CHEN Xuqing, WANG Yu

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  58-59.  doi:10.6040/j.issn.1673-3770.0.2015.002

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Objective To investigate the effectiveness of resection of styloid process though the anterolateral side of tonsil aided by endoscopic. Methods 15 patients with Eagle's syndrome enrolled. Among them, 10 patients presented unilaterally but 5 patients bilaterally. All the patients underwent the resection of styloid process though the anterolateral side of tonsil endoscopically. Results All the patients were followed up for 3~12 months. 11 patients(15 sides) were cured, and 3 patients (4 sides) were improved markedly. Conclusion Resection of styloid process through the anterolateral side of tonsil under endoscopy can be performed intra-orallly. This approach helps not only avoid the complications after tonsillectomy, but also clearly identify the surrounding blood vessels, muscles, and nerves.

Clinical analysis of 56 cases of throat fungal infection.

WANG Xin, LIANG Guiling

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  60-61.  doi:10.6040/j.issn.1673-3770.0.2015.102

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Objective To investigate the etiology and treatment of throat fungal infection. Methods A total of 56 patients with throat fungal infection were examined with chest radiography, treponema pallidum antibodies, HIV related projects, routine examination of the laryngopharyngeal area and conventional electronic nasopharyngoscope examination. To determine the colony types, the yellow membrane in the throat was taken for pathological biopsy and HE staining. 5% sodium bicarbonate solution was used to gargle and antifungal drugs were administered. All patients were followed up for 1 to 6 months. Results All infections were controlled. Electronic nasopharyngoscope observed that mucosa returned to normal. Conclusion Throat fungal infection caused by overuse of broad-spectrum antibiotics and hormone can be cured with 5% sodium bicarbonate gargle. This method is affordable with reliable outcomes.

Effects of total intravenous anesthesia on the bleed volume during endoscopic sinus surgery.

WANG Honggeng, CHEN Dongsheng, LIN Qun, HUANG Fang, HONG Yuming, HUANG Jianqiang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  62-64.  doi:10.6040/j.issn.1673-3770.0.2015.034

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Objective To explore the effect of total intravenous anesthesia on the bleed volume during endoscopic sinus surgery. Methods A total of sixty adult patients(ASAⅠ-Ⅱ), agreed to be on electively endoscopic sinus surgery, were randomly divided into two groups(group A and group B, n=30 each). All patients were injected intravenously with fentanyl, propofol and cisatracurium during the induction of general anesthesia. During the maintaince stage of the general anesthesia, patients in group A were injected intravenously with propofol and patients in group B were inhalated with sevoflurane until 5 minutes before the end of the operation. All patients were monitored with arterial blood pressure, were hepervolumic diluted and were performed with controlled hypotention 15 minutes before the operation. The arterial blood gas, blood lactate and coagulation function were monitored 30 minutes before the operation(T₀), 30 minutes(T₁) and 90 minutes after the operation (T₂) and 30 minutes after the end of the operation(T₃). Bleed volume and operation duration were recorded at the end of the operation. Results Comparing with those at T₀, there was no significant difference in the arterial blood pressure, blood lactate and coagulation function at T₁, T₂ and T₃. Bleed volume in group A was few than that in group B(P<0.05). There was no significant difference in the operation duration between the two groups. Conclusion During the endoscopic sinus surgery with intravenous anesthesia, the bleed volume is few than that with inhalation anesthesia.

Isolation, culture, identification and adipogenic differentiation of orbital adipose-derived stromal cells in human.

ZHAO Pingqian, ZHANG Yu, YANG Wenlei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  65-68.  doi:10.6040/j.issn.1673-3770.0.2015.137

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Objective To investigate the method of isolation, culture and identification of human orbital adipose-derived stromal cells (hOADSCs) and it's ability of adipogenic differentiation in vitro. Methods The hOADSCs were isolated by tissue explant culture technique, then were primary cultured and subcultured in vitro. The second generation of hOADSCs was detached, and the expressions of cell surface antigen CD29, CD31, CD44 and CD45 were analyzed with flow cytometry to identify the cells. The hOADSCs were induced to be adipogenesis with the adipogenic induction medium in vitro and stained with oil red O. The morphology of the hOADSC was observed by phase contrast microscopy. The plating efficiency and doubling time of the hOADSCs were tested. The hOADSCs proliferation was detected by CCK-8, and the cell growth curve was made. Results The hOADSCs were isolated by tissue explant culture technique and exhibited a fibroblast- or spindle-like morphology. The hOADSCs grew rapidly after subculturing. The expression rate of cell surface antigen CD29, CD31, CD44 and CD45 was 99.0%, 1.5%, 99.1% and 1.2%, respectively. The hOADSCs were differentiated into adipocytes with the adipogenic induction medium in vitro and the intracellular lipid droplets were stained in red by oil red O. The plating efficiency and doubling time of the subcultured hOADSC were 92.6% and 1.98days, respectively. The hOADSCs could be subcultured for more than ten generations in vitro. Conclusion In this experiment, the hOADSCs were isolated, cultured by tissue explant culture technique and could be differentiated into mature adipocytes with the adipogenic induction medium in vitro.

Observation of collagen in PHEMA Keratoprothesis implanted into alkali burned rabbit corneas by picric sirius red staining.

BAI Hua, GUO Huiling, WANG Liqiang, HUANG Yifei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  69-73.  doi:10.6040/j.issn.1673-3770.0.2014.128

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Objective To observe the dynamic changes of type and distribution of collagen fiber in the porous skirt of new type one-piece keratoprosthesis (KPros) made of PHEMA implanted into the alkali burned rabbit corneas. Methods A total of 10 pieces KPros were implanted into the alkali burned rabbit corneas. The skirt of kpro was obtained after 2, 8, 16 and 22 weeks. The samples were treated with picric-sirius red staining and observed by polarizing microscopy. Results This material PHEMA allowed the cornea and surrounding tissue growing and forming a multi-site stable fiber-connections under polarized light after staining. The new organization within the pores was mainly type I collagen and its growth performance was that yellow-green type Ⅲ collagen become mature red type Ⅰ collagen in process and cells were active especially in limbus. Conclusion The dynamic changes of collagen observation, can be concluded that the PHEMA pores and the cornea shown the similar performance and consistent with normal rabbit corneal implant healing.

Application value of SonoLiver time-intensity curve in the diagnosis of ocular adnexal lymphoma and orbital benign tumor.

WU Li, CHEN Ying, ZHOU Yunyun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  74-76.  doi:10.6040/j.issn.1673-3770.0.2015.204

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Objective To investigate the application value of SonoLiver time-intensity curve in the ocular adnexal lymphoma and orbital benign tumor. Methods Retrospective analyses were conducted for thirty-five cases of ocular adnexal lymphoma and twenty cases of orbital benign tumor, which were all underwent the examination of contrast-enhanced ultrasonography (CEUS) and confirmed by pathology. SonoLiver software was used to get the time-intensity curve(TIC) and record the ultrasound contrast agent (UCA) reach time (AT), the rise time (RT), time to peak (TTP) and the maximun intensity (IMAX). Results RT in the ocular adnexal lymphoma(7.64±2.65)s was significantly shorter than that in the orbital benign tumor(10.60±4.84)s, and TTP in the ocular adnexal lymphoma(9.44±2.05)s was also significantly shorter than that in the orbital benign tumor(26.07±9.90)s (both P < 0.05); No statistical difference of AT and IMAX were found between the two groups(both P > 0.05). The enhancement pattern was different between the ocular adnexal lymphoma and the orbital benign tumor (P < 0.05). Conclusion There are some clinical values in the differential diagnosis of ocular adnexal lymphoma and orbital benign tumor by analysing SonoLiver CEUS parameters.

Application of stepped multi-model merged methodology in ENT clinical teaching for under-graduates.

LI Danfeng, CHEN Fuquan, SHI Li, CHEN Jun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  77-79.  doi:10.6040/j.issn.1673-3770.0.2014.349

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Objective To adapt clinical requirement and improve quality of teaching, we modify teaching mode like LBL, CBL or PBL. Methods We have used Stepped Multi-model Merged Methodology in ENT under-graduates for one year and evaluated this method with questionnaire surveys in Grade 2010 and with telephone in Grade 2009. Results In 36 students, 97.2% satisfied with departmental rotation examination, 91.7% considered that they can learn clinical knowledge roundly, and established clinical thinking fast. Students who are now working agreed that it was helpful for them to adapt to work rapidly. Conclusion Multi-model Merged Methodology makes students understand clinical easy-to-digest, learn knowledge systematically, and build clinical thinking fast.

Advances in the diagnosis of early laryngeal carcinoma and precancerous laryngeal lesions.

YAN Yu, ZHU Jiang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  80-85.  doi:10.6040/j.issn.1673-3770.0.2015.007

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In recent years, the approaches to diagnose early laryngeal carcinoma and precancerous lesions emerge in a diversified and multielement way, including molecular, imaging, endoscopic methods and so on. All the approaches mutually promote and influence on each other. This paper reviews these diagnostic methods and progress so as to guide the clinical work.

Primary nasal septal papillary adenocarcinoma of 1 case: a literature review.

LONG Meihui

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  86-87.  doi:10.6040/j.issn.1673-3770.0.2015.016

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Endoscopy and electrocoagulation for obstinate epistaxis in 102 adults.

LI Ping

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  88-89.  doi:10.6040/j.issn.1673-3770.0.2014.392

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Dermatomyositis combined with gastric cancer with hoarseness and dysphagia as the original symptoms 1.

HAO Jianhai, JI Limei, ZHANG Junyao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(4):  90-91.  doi:10.6040/j.issn.1673-3770.0.2014.326

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