Table of Content

16 December 2015 Volume 29 Issue 6

  

Application of MSCT multimodal 3D reconstruction in the assessment of temporal bone structures and cochlear implantation

WANG Yihong, LI Ruiyu, CHEN Cailong, WANG Xiaoyan, LIN Meifu, ZHOU Shuo

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  1-4.  doi:10.6040/j.issn.1673-3770.0.2015.270

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Objective To investigate the application and value of MSCT multimodal three-dimensional (3D) reconstruction in cochlear implantation. Methods ① The membranous structures with 3D imaging of cochlea, vestibular, semicircular canal and temporal bone transparent imaging were constructed with a double threshold reconstruction technique, where the anatomical relationship between ossicles, inner ear and temporal bone were displayed. ② The facial nerve reconstruction displayed the path of the facial nerve. The ultrastructure showed the facial nerve, facial nerve recess, posterior wall of the external auditory canal and the structure of chorda tympani nerve and neighboring structures. ③ The distance between promontory plane vertical segment of the facial nerve and chorda tympani nerve was measured. Results Of the 83 patients recruited in this study, 11 had inner ear malformation. Of them, 2 had Mondini malformation, 2 had semicircular canal malformation, 2 had common cavity malformation, 1 had internal auditory canal stenosis, and 4 had enlarged vestibular aqueduct. The distance between normal structure of cape plane vertical segment of the facial nerve and chorda tympani nerve was 0.27±0.057 cm at the left-side and 0.28±0.068 cm at the right-side. An intact structure of the implanted electrodes was clearly showed in 5 patients in the post-operative examination. Conclusion The 3D multimodal reconstruction technique is useful in providing ultrastructure imaging of the middle and inner ear, which is important for surgeons in pre-and post-operative evaluations of the success and potential risk factors for performing cochlear implantation.

lidocaine combined with retroauricular injection of gastrodine in the treatment of idiopathic tinnitus

DI Guohua, LIU Junru, ZHAO Yanxiang, GAO Yingkai

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  5-7.  doi:10.6040/j.issn.1673-3770.0.2015.253

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Objective To explore the clinical efficacy of lidocaine combined with retroauricular injection of gastrodine in the treatment of idiopathic tinnitus. Methods A total of 90 cases of idiopathic tinnitus were randomly divided into treatment group and control group. The treatment group was treated by two simultaneous methods. The first method used intravenous drip of drugs to nurture nerves and to improve blood circulation in the inner ear. The other one was to combine 2% lidocaine with retroauricular injection of gastrodine. The control group received the first treatment only. One course of treatment lasted for 14 d. All patients were followed up for 3 months. Results The total efficacy of treatment group and control group was 84.44% and 55.56%, respectively. After 3-month of follow-up, the total efficacy of treatment group and control group was 82.22% and 55.11%, respectively. There was statistical difference between the statistics (P<0.05). No obvious adverse effects were observed. Conclusion Combination of 2% lidocaine and gastrodine injection is simple and effective in the treatment of idiopathic tinnitus.

The middle ear cerumen gland tumor of three cases and review of the literature

LÜ Dan, YANG Hui, YIN Rui, GU Deying, ZHENG Yitao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  8-12.  doi:10.6040/j.issn.1673-3770.0.2015.227

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Objective To analyze the clinical and pathological feature, therapy and outcome of ceruminous gland tumor of the middle ear. Methods We reviewed the clinical findings of three cases with ceruminous gland tumor from November 2006 to October 2014. Results Follow up to December 2014, one patient was diagnosed ceruminal adenoma who have been followed up for more than 6 years, there were no recurrence. One case with ceruminous carcinoma who received surgery and radiotherapy was relapsed during after followed up one year, and he accepted surgery and radiotherapy, after about 2 years the patient with suspected relapse.One case was diagnosed adenoid cystic carcinoma, and she received treatment with P53. However, she was relapsed after 1 year, and she received surgery and postoperative radiotherapy. Follow up for more than 9 months, considered that the tumor recurrence and metastasis to the brain. Conclusion The early diagnosis of ceruminous gland tumor is difficult, and easy to relapse, the diagnosis relies on clinical characteristic, imaging studies and histopathologic appearance.The treatment method and prognosis depends on tumor types, ceruminous adenoma is mainly treated with surgery, ceruminal adenocarcinoma and adenoid cystic carcinoma should adopt comprehensive treatment based on surgery.

Application of pedicle temporal muscle flap in the treatment of secondary radical mastectomy

LI Dongfang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  13-16.  doi:10.6040/j.issn.1673-3770.0.2015.183

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Objective To explore the clinical application of mastoid cavity packing by retroauricular pedicle fascia-temporalis muscle flap in secondary open radical mastoidectomy. Methods A total of 20 patients (20 ears) who had undergone open radical mastoidectomy received secondary open radical mastoidectomy due to long-time wet seepage of their ears. Of them, 10 received open radical mastoidectomy (RM) and 10 received open radical mastoidectomy with mastoid packing operation (CWDM). All CWDM operations adopted retroauricular pedicle fascia-temporalis muscle flap mastoid cavity packing. Results All cases were followed up for 2 years. The average time of ear drying was (58.4±4.45)d and (29.6±2.37)d in RM group and CWDM group, respectively. The average return visit frequency was (17.1±2.33) and (6.1±1.52) times in RM group and CWDM group, respectively. One case in the RM group had wet ear continuously. There was no wet ear and relapsing after operation in the CWDM group. CWDM group had a shorter ear drying time and lower return visit frequency than the RM group (P<0.001). Conclusion CWDM is superior to RM in ear drying time, return visit frequency and relapsing after operation and other indicators. The mastoid cavity packing by retroauricular pedicle fascia-temporalis muscle flap has a good effect.

Surgical strategies and techniques in the management of refractory cerebrospinal fluid otorrhea

ZHANG Bin, LI Feng, ZHANG Liangwen, YANG Yang, ZHU Shugan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  17-21.  doi:10.6040/j.issn.1673-3770.0.2015.272

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Objective To explore the surgical strategies and techniques in the management of refractory cerebrospinal fluid (CSF) otorrhea. Methods Combined subtemporal trasnscranial and transmastoid approach was performed to repair the middle cranial fossa defects in 11 patients with posttraumatic CSF otorrhea. Results (1) Mastoid probe was not required in 5 cases. Due to comminuted fractures of mastoid process, 2 cases needed titanium plate fixation before the bone flaps were removed. In the other 4 cases with serious mastoid fracture, the pieces were collected and refilled back to the defect, and fixed together with longissimus by biological glue. (2) The brain tissues herniation and/or exposed mastoid mucosa via large skull base defects were observed intraoperatively in 6 cases. (3) The ossicular chain was intact in 3 cases, disappeared in 2 cases, and not inspected in 4 cases; the otosteon (malleus) was missed in 2 cases. No recurrence was recorded during the follow-up of 2-11 years. Conclusion (1) A combined supra-infratentorial approach, with an incision incorporating both the middle skull base and mastoid process, is advisable for the management of CSF otorrhea with complex fractures, especially with unstable fractures involving the mastoid process. (2) Postoperative rhinorrhea could be prevented by tamponade of tympanic cavity, especially, the eustachian tube, in addition to obliteration of the external auditory canal during surgical repair of CSF leaks in patients with complex fractures and hearing loss. (3) Inadvertent injury to petrous segment of the internal carotid artery should be avoided during surgical manipulations near tympanic cavity and eustachian tube.

Clinical significance of grading low middle fossa tegmen plate with high-resolution computed tomography

SUN Xiaowei, LI Dongmei, DOU Fenfen, ZHANG Zihe, ZHANG Jianji, DING Yuanping, SHI Li

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  22-25.  doi:10.6040/j.issn.1673-3770.0.2015.209

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Objective To observe the effect of high-resolution computed tomography (HRCT) grading of low middle fossa tegmen plate on the elimination of diseased tissue in epitympanum and to investigate the grading standard of low middle fossa tegmen plate. Methods The CT images obtained from 87 chronic otitis media (COM) cases were subjected to coronal reconstruction. A horizontal tangent L1 at the highest point along the upper wall of external auditory canal, a horizontal tangent L2 at the highest point of the semicircular canal structure, and a horizontal tangent L3 at the lowest point along the middle fossa tegmen plate were created to measure the distance between L1 and L2, L1 and L3, and to calculate the r value (b/a). The r value was used to divide the low middle fossa tegmen plate into five grades: non-low, mild, moderate, severe, and absolute low. Pre-operative evaluation and postoperative results were compared. Results Surgeons had different opinions on the r value: (1) If r < 1/4, the low middle cranial fossa cover identified by the Radiation Department could not be accepted. (2) If 1/4 ≤ r < 1/3, the low middle cranial fossa cover identified by the Radiation Department could be accepted, but it was not mentioned in the operation record. (2) If 1/3 < r ≤ 1/2, wearing was found at the bottom wall of the middle fossa tegmen plate upon clearing the diseased tissue, and the operation would be affected because of bleeding. (4) If 1/2 < r ≤3/4, the surgeons were able to identify the low middle fossa tegmen plate before operation; but some cases' back wall of the external auditory canals could be preserved after the diseased tissue in the epitympanum was cleared. (5) If r > 3/4, the surgeons experienced difficulty in finding the trum tympanicum and pathway behind the ear because the low middle fossa tegmen plate wore down the back wall of external auditory canal. Conclusion The r value can be used to divide the low middle fossa tegmen plate into five grades: non, mild, moderate, severe, and absolute low. Mild grade has no effect on the removal of lesions,moderate grade makes the removal of lesions difficult, severe grade requires destruction of the back wall of external auditory canal, and absolute low grade means wearing down of the back wall of external auditory canal is inevitable.

Anatomy of lacrimal sac to endoscopic transnasal dacryocystorhinostomy

WANG Gang, HU Jinwang, TAO Wei, WU Changsong, WEI Pingcun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  26-28.  doi:10.6040/j.issn.1673-3770.0.2015.210

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Objective To provide anatomical localization for endoscopic transnasal dacryocystorhinostomy. Methods Twelve adult cadavers(24 sides) were studied on the projection anatomy of lacrimal sac on the lateral wall of nasal cavity. Sixty-two patients (85 sides) with chronic dacryocystitis and nasolacrimal duct obstruction were treated by endoscopic transnasal dacryocystorhinostomy. Results Fifteen adult cadavers sides (62.5%) lacrimal sac upper bound were higher than the insertion of middle turbinate, 9 adult cadavers sides (37.5%) lacrimal sac upper bound were lower than the insertion of middle turbinate. During a post-operative follow-up of 6 months, 50 patients (70 sides 82.3%) were cured, 8 (9 sides 10.6%) had improvement, and 4 (6 sides 7.1%) were invalid. The total efficiency was 92.9%. Conclusion Upper bound of the lacrimal sac was 0.7 cm up the insertion of middle turbinate .Lower bound of the lacrimal sac was 0.3 cm under the insertion of middle turbinate. After bound of the lacrimal sacs was front of the uncinate.

Evaluation the significance of antibiotics in septoplasty peri-operation duration

FU Yafeng, FENG Xiaolian, LIN Meifang, LONG Chaoqing

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  29-30.  doi:10.6040/j.issn.1673-3770.0.2015.197

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Objective To study the real necessity of antibiotics in septoplasties. Methods A total of 180 patients underwent septoplasty and were randomly divided into group A (n=60), group B (n=60) and group C (n=60). Group A was without antibiotics, group B and group C were respectively given cephradine(3.0 g) or cefamandole (1.5 g) both in the anesthesical induction and post-operatively for 3 days. Results There were 6 cases(10.0%) infected in group A, 7 cases(11.7%) infected in group B, and 5 cases(8.3%) infected in group C. The infection rate had no significant difference in the three groups (χ²=0.370, P=0.831). Conclusion In peri-operative period of septoplasty, routine prophylactic use of antibiotics can not reduce the incidence of post-operative infection.

Relationship between the expression of EGFL7 in nasopharyngeal carcinoma and the invasion and metastasis of tumor

ZHAO Yanlian, LU Yongtian, YANG Jihong, ZHANG Juan, MIAO Fangfang, LI Jieping

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  31-35.  doi:10.6040/j.issn.1673-3770.0.2015.307

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Objective To study the expression of epidermal growth factor-like domain 7(EGFL7) in nasopharyngeal carcinoma(NPC), and to investigate its correlation with microvessel density(MVD) and lymphatic vessel density(LVD) and its relationship with the invasion and metastasis of NPC and its possible mechanism. Methods The immunohisto chemical method was used to detect EGFL7 expression of 40 cases of nasopharyngeal carcinoma and 20 cases of nasopharyngitis; MVD and LVD were detected by antibody CD31 and D2-40 antibody for immunohistochemistry in the experimental and control groups, and to analyze the correlation of EGFL7 expression and tumor grade and MVD and LVD. Results The experimental group and the control group were of EGFL7 expression, but in the experimental group EGFL7 expression rate was higher than that of control group (P<0.05); EGFL7 expression and MVD was positively correlated in the experimental group, but LVD did not; in the experimental group, lymph node metastasis of LVD was significantly higher than those without lymph node metastasis of (P<0.05); in the experimental group, EGFL7 expression had no correlation with patient gender, age and EB virus antibody (P>0.05) but had some correlation with clinical stage and lymph node metastasis(P<0.05). Conclusion EGFL7 has no dual function on blood vessels and lymphatic vessels, it only expresses in endothelial cells and nasopharyngeal carcinoma cells. EGFL7 is closely associated with the growth and invasion and metastasis of nasopharyngeal carcinoma (NPC), it may become one of the markers reacting nasopharyngeal carcinoma metastasis and prognosis.

Expression of tumor suppressor in lung cancer 1 in laryngeal squamous cell carcinoma and its significance

LI Fu, ZHAO Shuyou

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  36-38.  doi:10.6040/j.issn.1673-3770.0.2015.202

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Objective To investigate the correlation of tumor suppressor in lung cancer 1 (TSLC1) and laryngeal squamous cell carcinoma, in order to provide a theoretic basis of oncogenesis, diagnosis and treatment of laryngeal cancer. Methods Paraffin-embedded specimens were collected from 45 cases of laryngeal squamous cell carcinoma, 8 of which had lymphatic metastasis. Another 20 specimens from normal adjacent tissues served as controls. The expression of TSLC1 was detected with immunohistochemical staining (PV-6000). The relation between TSLC1 expression and other clinicopathological parameters was analyzed with SPSS 10.0. Results The positive expression of TSLC1 was 17/45 (37.8%) in specimens of laryngeal squamous cell carcinoma, which was significantly lower than in specimens of normal adjacent tissues (15/20, 75%), (χ²=7.68, P<0.01). Loss of TSLC1 expression was correlated with the clinical stage, tumor differentiation and lymph node metastasis (χ²=4.15, 6.11, 4.11, P<0.05), but not correlated with patients' age, gender, or location of primary laryngeal carcinoma (χ²= 0.25, 0.09, 1.0, P>0.05). Conclusion Loss of TSLC1 expression is frequently observed in laryngeal squamous cell carcinoma, which is significantly correlated to the clinical stage, tumor differentiation and lymph node metastasis. The down-regulation of TSLC1 expression may correlate with the occurrence and invasion of laryngeal squamous cell carcinoma, but more studies are needed to verify the hypothesis.

Foreign bodies in children's bronchus: an analysis of 2000 cases

GAO Ying, WANG Zhenghui, CHANG Huimin, WU Caiqin, KOU Xiaohui, XU Min

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  39-42.  doi:10.6040/j.issn.1673-3770.0.2015.303

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Objective To investigate the clinical characteristics, diagnosis and treatment of tracheobronchial foreign bodies in children. Methods Clinical data of 2 000 cases of tracheobronchial foreign bodies in children were retrospectively analyzed, including children's age, diagnosis, type and site of foreign bodies, imaging examination, type of anesthesia and surgical approach. Results Of all cases, 72.5% occurred in children aged 1-3; 82.5% foreign bodies were plant-based; 52.4% foreign bodies were found in the right main bronchus; 98.7% result of 3D reconstruction of CT was confirmed, which was significantly higher than that of chest X-ray (82%, P<0.01). After operation, 1 985 cases were cured, of which 1 976 cases received general anesthesia and 9 received local anesthesia; 15 cases died. Conclusion There is high incidence of tracheobronchial foreign bodies in children. Timely diagnosis, accurate imaging examination, and timely surgical treatment can effectively reduce the misdiagnosis rate and mortality. Positive and effective health promotion is the key to prevent the occurrence of tracheal foreign bodies in children.

Clinical analysis of sorts and causes of complications of tracheotomy: a report of 1,063 cases

WANG Junxi, YU Guodong, CHEN Qianmei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  43-44.  doi:10.6040/j.issn.1673-3770.0.2015.257

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Objective To explore the causes of complications of tracheotomy and precautionary measures. Methods Clinical data of 1,063 patients who underwent tracheostomy were retrospectively reviewed. Results The overall rate of complication was 2.73%, including bleeding in 13 cases (1.22%), casing out in 6 cases (0.56), subcutaneous emphysema in 4 cases (0.38%), intraoperative suffocation in 2 cases (0.188%), pneumomediastinum in 1 case (0.094%), drug allergy in 1 case (0.094%), and tracheoesophageal laceration in 1 case (0.094%). One patient died during operation due to pneumothorax. Conclusion There are various sorts of complications of tracheotomy and the causes are complicated.

Diagnosis of foreign bodies in the cervical esophagus by CT scan and treatment options

LI Yongtuan, XIU Haibo, WANG Ningning, XIN Lu

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  45-48.  doi:10.6040/j.issn.1673-3770.0.2015.186

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Objective To investigate the role of CT scan as an optimal approach in the diagnosis of foreign bodies in the cervical esophagus, and to explore the different treatment options based on the scan results. Methods Clinical data of 179 patients admitted to our department due to upper esophageal foreign body during May 2011 and Oct. 2014 were retrospectively analyzed. All cases had symptoms of dysphagia, swallowing obstruction and pain. The diagnosis of upper esophageal foreign body was confirmed via X ray or HRCT examination. The foreign bodies were removed with different methods based on results of CT scan. Results The foreign bodies were removed with rigid esophagoscope under general anesthesia in 68 cases, with electronic gastroscope under topical anesthesia in 60 cases, with lateral neck incision in 10 cases, with 16# Foley catheter under no anesthesia in 12 baby patients. Another 29 patients with fishbone received no treatment because the foreign bodies and symptoms disappeared within 12 hours. Conclusion Eating too fast or being absent-minded during dinner are the major causes of esophageal foreign bodies. Correct evaluation of the nature, size, position of the foreign bodies, and damage they might do to patients, as well as timely management are key to treat cervical esophageal foreign bodies and avoid complications.

Clinical analysis of laryngeal amyloidosis in supragolttic portion: report of 3 cases and literature review

CHEN Wu na, GAO Xingqiang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  49-51.  doi:10.6040/j.issn.1673-3770.0.2015.195

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Objective To explore the clinical characteristics and treatment of laryngeal amyloidosis (LA) likely to be misdiagnosed as laryngeal malignancy in supragolttic portion. Methods The three patients with LA in supragolttic portion received carbon dioxide (CO₂) laser operation with microscopic laryngoscopy to remove the lesions. Relevant clinical data were analyzed. Results All patients recovered clinically. During the follow-up of one to two years, no recurrence occurred. Conclusion LA shows no specific clinical manifestation, whereas it can be confirmed by positive reaction of Congo red staining of pathological section. CO₂ laser operation with microscopic laryngoscopy is effective in treating LA.

Application of low temperature radiofrequency volumetric tissue reduction in infant lingual thyroglossal duct cyst

MIAO Gangyong, XIAO Xuping, TAN Zhiqiang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  52-55.  doi:10.6040/j.issn.1673-3770.0.2015.289

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Objective To evaluate the effectiveness of low temperature radiofrequency volumetic tissue reduction in the treatment of infant lingual thyroglossal duct cyst. Methods Clinical data of 9 infantswith respiratory distressdue tolingual thyroglossal duct cysttreated during 2012 to 2014 by low temperature radiofrequency volumetric tissue reductionwere retrospectively analyzed, and relevant literature was reviewed. Results All operations were successful.Nopostoperative haemorrhage, pharyngalgia,dysphea or other complicationswere observed.No respiratory distress recurred1 year after surgery. Conclusion Low temperature radiofrequency volumetric tissue reduction is a promising management for infant lingual thyroglossal duct cyst, whichhas advantages of shortoperation time, minimal trauma, and fewcomplications.

The experiment of SIRT1 on against oxidative stress to retinal pigmented epithelium cells

LI Langen, WEI Wei, ZHANG Yufeng, Geriletu, YANG Jia, ZHANG Yanmei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  56-59.  doi:10.6040/j.issn.1673-3770.0.2015.215

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Objective To observe the protection role of the sirtuin 1 (SIRT1) towards the retinal pigmented epithelium(RPE) cells following exposure to oxidative stress. Methods The rates of proliferation and apoptosis, levels of intracellular reactive oxygen species(ROS) and cell senescence of RPEs, induced by oxidants (H₂O₂), were evaluated. Results The results revealed a down-regulation of SIRT1 expression during oxidative stress. Furthermore, SIRT1 activator resveratrol (RSV) and inhibitors nicotinamide (NA) were respectively treated on RPE cells following exposure by H₂O₂ intervention; the expression of SIRT1 gene were detected by RT-PCR technology after RNA interfering on SIRT1. The experiments indicated that cell proliferation, apoptosis and ROS levels were significantly different compared with the control group after intervention by H₂O₂, and cell senescence were significantly increased; NA was significantly increased the toxicity of H₂O₂, however RSV had the opposite anti-cytotoxicity of H₂O₂; RT-PCR analysis showed that SIRT1 levels were significantly reduced. Conclusion These results therefore suggested that down-regulation of SirT1 expression during oxidative stress, further investigation indicated that SIRT1 protected RPEs from oxidative stressinduced damage. Appropriate increase of the activity of SIRT1 may be a therapeutic strategy to delay AMD.

Postoperative pain and corneal irritation after surface corneal refractive surgery

CUI Changxia, TAO Xiangchen, ZHU Wei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  60-63.  doi:10.6040/j.issn.1673-3770.0.2015.205

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Objective To investigate the postoperative pain and corneal irritation after superficial corneal refractive surgery by different surgical procedures. Methods A total of 600 cases (1 200 eyes) of surface corneal refractive surgery were divided into 3 groups according to different operation methods as photorefractive keratectomy group (PRK group), laser epithelial keratomileusis group (LASEK group) and epipolis laser in-situ keratomileusis group (Epi-LASIK group). The pain index and corneal irritation among the three groups were compared. Results On day 1 after surgery, there was no statistical difference in the pain index and corneal irritation between PRK group and LASEK group, but there was statistical difference between Epi-LASIK group and the other two groups. On day 2 and 3 postoperatively, there was statistical difference between the PRK group and the other two groups, but there was no statistical difference between LASEK group and Epi-LASIK group. One day 5 after surgery, there was no difference among the three groups. Conclusion The pain after surface corneal refractive surgery is the major factor of postoperative discomfort for patients. Postoperative pain index and corneal irritation are different for different operation methods.

Immunosuppressive treatment for non-infectious uveitis and its effect on cytokines

WANG Zengzhi

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  64-67.  doi:10.6040/j.issn.1673-3770.0.2015.259

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Objective To explore the effect of immunosuppressive treatment on noninfectious uveitis and to analyse its influence on cytokines. Methods A total of 57 patients with non-infectious uveitis treated in July 2012 to October 2012 were enrolled in this study. Based on different immunosuppressant drug ingredients, they were divided into the experimental group(hormones) and the control group(hormone preparations). Results ① The immunoglobulin Ig-A, G and C3, 4 were significantly higher in the experimental group than in the control group; ③ The greatest impact on cytokines is glucocorticoid, followed by anti-metabolites drugs, alkylating agent, T cell inhibitors, and biological preparations. Conclusion The effect of non-infectious uveitis with immune inhibitors, can effectively improve disease cure rate, of which the effect of glucocorticoid best, therefore, glucocorticoid is a wide range of drugs in the treatment of infective uveitis.

Evaluation of meibomian gland dysfunction after phacoemulsification surgery

LIU Zhao, WU Changrui, GAO Ning

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  68-70.  doi:10.6040/j.issn.1673-3770.0.2015.201

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Objective To evaluate meibomian gland dysfunction after phacoemulsification surgery. Methods Fifty-eight eyes of 58 patients underwent phacoemulsification and were evaluated the OSDI, lid margin abnormalities, superficial punctate keratopathies (SPK), tear film break-up time (BUT), Schirmer test, lower tear meniscus height, depth, and area using anterior segment optical coherence tomography, and meibum expressibility pre-operatively and at 1 month and 3 months post-operatively. Results The OSDI were worse at 1 month and 3 months post-operatively (10.7±7.9, 25.7±7.9, 27.9±12.1, P<0.05 and P<0.05, respectively). Lid margin abnormalities were significantly increased (1.6±1.0, 2.0±1.2, 2.5±0.9, P<0.05 and P<0.05, respectively) and BUT decreased post-operatively (6.6±3.1, 4.3±1.9, 4.1±2.2, P<0.05 and P<0.05, respectively). Meibum expressibility decreased at 3 months post-operatively (1.8±0.9 vs 2.2±0.7, P<0.05); however, SPK, lower tear meniscus height, depth and area and the Schirmer test did not significantly change post-operatively (P>0.05). Conclusion Meibomian gland function may be altered without accompanying structural changes after phacoemulsification surgery.

Effect of glycosylated hemoglobin on dry eye in patients with type 2 diabetes mellitus

WANG Luping, WU Xinyi

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  71-73.  doi:10.6040/j.issn.1673-3770.0.2015.312

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Objective To evaluate the effect of glycosylated hemoglobin on dry eye in patients with type 2 diabetes mellitus. Methods A total of 140 patients with type 2 diabetes mellitus were collected and divided into two groups: poor in glucose control group (n=70) and good in glucose control group (n=70), according to the level of glycosylated hemoglobin A1c (HbA1c). All patients were inquired about dry eye svndrome and received the examinations as follows: Schirmer I test (SIt), tear break-up time (BUT) and corneal fluorescein staining (FL). Results The elderly and male patients of poor in glucose control group showed higher incidence of dry eye syndrome than that of good in glucose control group, showing a significant difference between two groups (P<0.05). The elderly patients of poor in glucose control group showed lesser SIt and faster BUT than controls (P<0.05); there were no differences among SIt, BUT in young and middle patients of two groups. HbA1c level was positively correlated with dry eye svndrome, and negatively correlated with SIt, BUT. Conclusion The HbA1c level was correlated with dry eye in elderly patients with type 2 diabetes mellitus. It has great clinical value by controlling the glycosylated hemoglobin levels on patients with type 2 diabetes mellitus.

Effectiveness and safety of retinal photocoagulation in combination with vitrectomy for proliferative diabetic retinopathy

HU Xinmiao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  74-77.  doi:10.6040/j.issn.1673-3770.0.2015.203

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Objective To investigate the effectiveness and safety of retinal photocoagulation(RP) in combination with vitrectomy in treatment of proliferative diabetic retinopathy(PDR). Methods The clinical data of 79 patients (79 eyes) with PDR treated by RP and vitrectomy in our hospital during March 2010 to March 2014 were retrospectively analyzed. Results In a follow-up of 12 months after the operation, 61 eyes (77.22%) improved their post-operative visual acuity, 15 eyes (18.99%) had the same vision and 3 eyes (3.80%) had deterioration. After vitrectomy of 1 month, 2 eyes had the iop elevated over 30 mmHg, 1 eye had neovascular glaucoma (NVG), and 1 eye had retinal detachment. After vitrectomy of 3 months, 2 eyes had fro vitreous hemorrhage again. After vitrectomy of 12 months, 2 eyes had silicone oil emulsification occurred secondary glaucoma. Conclusion Angiography after vitrectomy can be targeted to treat RP. It can avoid excessive photocoagulation and can prevent photocoagulation insufficiently, improves in vision at the same time with few complications and high safety, is an effective method for PDR.

An investigation of the standard of classification of retinal hemorrhage in full-term normal delivery newborns according to digital wide-angle retinal imaging device RetCam-3

WANG Yacong, GENG Shaohui, LI Yantao, WANG Yufang, ZHANG Hong, ZHANG Tingting, ZHANG Jiajia, ZHANG Wei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  78-81.  doi:10.6040/j.issn.1673-3770.0.2015.274

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Objective To probe the classification of retinal hemorrhage(RH) in vaginal delivery term newborns according to digital wide-angle retinal imaging device(RetCam-3 ). Methods A total of 1 021 healthy full-term normal delivery newborns(2 042 eyes)were enrolled in this study.A digital wide-angle retinal imaging device(RetCam m) was used to examine the subjects at about 3 days after birth. Newborns with RH were reexamined after three, four and six weeks. RH was classified according to the location of RH and degree of hemorrhage in macular by RetCam-3. Results In 1 021 cases of newborns,retinal hemorrhages were found in 165 infants(17.14%).Within these 165 infants,155 infants(16.16%)wereⅠdegree retinal hemorrhage, 9 infants(0.88%) were Ⅱdegree retinal hemorrhage and 1 infant (0.01%) was Ⅲ degree retinal hemorrhage. The average time of second stage of labor in newborns without RH was 49.81±5.3 minites. The average time of second stage of labor in newborns with RH was 51.13±6.12 minutes. Newborns with RH had longer second stage of labor than those without RH. The difference was statistically significant (t=2.839, P=0.005). Conclusion According to the result of RetCam-3 of 2 042 eyes, we classify RH in degreeⅠ,Ⅱ and Ⅲ. RH of DegreeⅠis located in the superficial retina and resolves itself within three weeks after birth. RH of DegreeⅡ is located in the superficial retina including macular and resolves itself within six weeks after birth. RH of Degree Ⅲ is located ahead of retina including macular and does not resolve itself within six weeks after birth.Prolonged second stage of labor may play roles of risk factor in retinal hemorrhage.

5% Sodium Bicarbonate Injection and Nystatin Tablets mixture gauze for treating fungal otitis externa mycotica in 156 cases

ZHU Jiangbin, SUN Xiuqin, NAN Bingwei, HAO Zongsheng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  82-83.  doi:10.6040/j.issn.1673-3770.0.2015.265

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A patient of esophageal foreign body accompanied by pneumothorax was cured by thoracic closed drainage and removal of foreign bodies by esophagoscopy

LI Zhaosheng, XU Zhenyue, SHEN Weilin, HUANG Qianjin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  84-86.  doi:10.6040/j.issn.1673-3770.0.2015.156

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Effect of continuous Z type nasalseptalsutureand nasalpackingfor patients with chronic sinusitis and nasal septum deviation

LIU Guoqi, MA Pan, WANG Huihui, LIU Xiaochen

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  87-89.  doi:10.6040/j.issn.1673-3770.0.2015.249

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Hemostatic effect of preventive suture ligation in tonsillectomy

DONG Shiliang, ZHAN Mingming

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(6):  90-91.  doi:10.6040/j.issn.1673-3770.0.2015.282

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