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Table of Content

    16 June 2016 Volume 30 Issue 3
      
    Surgical management of pyriform sinus carcinoma via the glottis adjacent space approach.
    PAN Xinliang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  1-3.  doi:10.6040/j.issn.1673-3770.0.2016.232
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    Reconstruction of hypopharyngeal defects after ablation of advanced head and neck squamous carcinoma involving hypophaynx with pectoralis major myocutaneous flap.
    LI Xiaoming, SONG Qi, LI Hongxia, TAO Zhenfeng, SHEN Yupeng, XIAO Shufen
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  4-9.  doi:10.6040/j.issn.1673-3770.0.2016.233
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    Objective To explore the eligibility of using pectoralis major myocutaneous flap(PMF)to reconstruct major and complex defects in the hypopharngeal and cervical esophageal regions. Methods PMF with or without combinations of other reconstructive tissue flaps were used with some modifications to surgical techniques. Major or complex defects were caused in 59 patients after en bloc removal of advanced and recurrent hypopharyngeal and laryngeal cancers, which included partial and circumferential hypopharyngeal defects, and circumferential pharyngeal defects with complex soft tissue defects in the anterior neck. Results Single patch-on PMF was used in 26 cases, patch-on PMF with anterior vertebral skin graft in 4 cases, patch-on PMF with anterior neck skin graft in 2 cases, patch-on PMF with deltopectoral flap in 2 cases, tubed PMF in 16 cases, tubed PMF with deltopectoral flap in 4 cases, gastric pull-up plus PMF in 4 cases, and double-paddled PMF in 2 cases. Post-operative complications were encountered in 20 cases, which were managed properly. All patients were healed and restored their swallowing function, except one patient who died in hospital. Conclusion PMF is suitable for reconstruction of nearly all kinds of defects in hypopharyngeal and cervical esophageal regions, especially for those with complex soft tissue defects in the anterior neck.
    Preliminary clinical analysis of neo-adjuvant chemotherapy with nimotuzumab plus nedaplatin and fluorouracil in hypopharyngeal squamous cell carcinoma.
    DONG Pin, YING Xinjiang, CHEN Xinwei, DENG Zhihong, ZHANG Shaoqiang, YU Ziwei, JIN Bin, SUN Zhenfeng, XIE Jin, ZHU Jiangcai
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  10-14.  doi:10.6040/j.issn.1673-3770.0.2016.222
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    Objective To investigate the safety and efficacy of nimotuzumab combined with nedaplatinand and fluorouracil(5-FU)as neo-adjuvant chemotherapy in the treatment of hypopharyngeal squamous cell carcinoma. Methods Between July 2012 and December 2014, we performed initial treatment on 91 cases of hypopharyngeal squamous cell carcinoma with the nimotuzumab(300 mg/m2 day 1)combined with nedaplatin(90 mg/m2 day 1)and 5-FU(750 mg/m2 day1-5)as neo-adjuvant chemotherapy, with one cycle for 3 weeks. Two cycles were followed by surgery and radiation therapy. The primary endpoint was tumor response rate, pathological complete response rate, the rate of laryngeal preservation and chemotherapy related toxicity. Results The response rate of tumor was 86.8%(79/91)after two cycles of neo-adjuvant chemotherapy. Fifty-two patients(57.1%)got downstage, with T downstage in 47(51.6%)cases and N downstage in 20(22.0%)cases. Eighty-eight patients got surgery after the neo-adjuvant chemotherapy, of which 68 patients(77.3%)preserved laryngeal function. The pathological complete response was 8.8%(8/91)of the total. The toxicity was mild and manageable. There were 29 cases of neutropenia(31.9%), 26 cases of nausea/vomiting(28.6%). Conclusion Nimotuzumab plus nedaplatin and 5-FU regimen as neo-adjuvant chemotherapy was highly effective for improving the hypopharyngeal carcinoma patients’ tumor response rate and preserving their organ function, while the toxicities were well tolerable.
    Surgical treatment of hypopharyngeal cancer with cervical esophageal invasion.
    LI Wenming, WEI Dongmin, SUN Ruijie, QIAN Ye, LIU Dayu, XIE Guang, LEI Dapeng, PAN Xinliang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  15-19.  doi:10.6040/j.issn.1673-3770.0.2016.221
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    Objective To explore the best treatment plan and treatment experience of the cervical esophagus invasion of cervical esophagus. Methods From2001 to 2012, seventy-one patients with advanced hypopharyngeal cancer and cervical esophageal invasion were retrospectively reviewed to summarize several safe and effective treatment methods, including 64 males and 7 females. The medianage was 56.8 years old, ranged from 36 to77 years old.According to AJCC 2002 criteria, all the tumors were T4 stage and originated from the pyriform sinus(51), posterior pharyngeal wall(18), post cricoid area(2), there were 44 patient sincN0, 4 in cN1, 20 in cN2, 3 in cN3 and no distant metastasis. Precise preoperative evaluation was performed with computed tomography scan, barium swallow perspective and biopsy. All the patients received neck dissection, including both unilateral(57 patients)and bilateral(14 patients). Pharyngoesophageal defect reconstruction methods were: pectoralis major musculocutaneous flap in 22 patients, laryngotracheal flap in 11,pectoralis major musculocutaneous flap combined with split thickness skin graft in 6, stomach pulling-up or coloninterpositionin in 31 patients. Total laryngectomy was carried out in 31 patients.65 patients received radio therapy postoperatively(dose55-70 Gy). Results The cervical lymph node metastasis rate was 45.1%.In 28 patients whose laryngeal function was preserved, the trachea cannula was extracted in 19 patients, with the decanulation rate as 67.8%. A total of 37 patients underwent thyroidectomy, 14 cases of postoperative patients with pathologically confirmed thyroid invasion. The common complications after surgery with pharyngeal fistula in 12 cases, 2 cases of incision infection, anastomotic stenosis in 1 cases. The 3 years and 5 years disease-free survival rate in all patients were 43.7% and 23.9% which calculated by Kaplan-Meier methods. The 3 years and 5 years disease-free survival rate of laryngeal function preservation group were 50% and 28.6%, while in non-functionally preserved group were 39.5% and 20.9%. There was no significantly different between the two groups(χ2=1.244,P=0.265). Conclusion Combined therapy 山东大学耳鼻喉眼学报30卷3期 -李文明,等.下咽癌侵犯颈段食管的治疗 \=-was the best choice for hypopharyngeal cancer with cervical esophageal invasion. The continuity of the pharyngoesophagus was restored by laryngotracheal flap, pectoralis major muculocutaneous flap or with split thickness skin graft. Stomach trans-position or colon interposition was used while the defect of the esophagus was greater.All of those operation methods were safe and effective. Some patients with appropriate surgical procedures can retain the patients laryngeal function.
    Treatment experience of preservation of laryngeal function in surgical management of pyriform sinus carcinoma.
    SONG Xicheng, ZHANG Hua, LIU Zhonglu, WANG Yunqiang, WANG Yan, ZHANG Qiang, WANG Qiang, KANG Shasha, SONG Yipeng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  20-23.  doi:10.6040/j.issn.1673-3770.0.2016.262
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    Objective To investigate preservation and reconstruction of larynx function in surgical treatment of pyriform sinus carcinoma. Methods A retrospective analysis of 102 cases of pyriform cancer treated in June 2004 to October 2015 underwent surgeries with laryngeal functions preserved was carried out. There were 9 cases of stage Ⅰ, 11 cases of stage Ⅱ, 47 cases of stage Ⅲ and 35 stage Ⅳ, according to the 2002 UICC staging. Pharyngeal lateral wall approach, hyoid region approach and paraglottic space approach were chosen respectively to remove the tumor as per preoperative evaluation, followed by repairing of surgical defects and reconstruction of laryngeal and pharyngeal functions. 93 cases of postoperative radiotherapy were implemented. Results All patients recovered well after surgery except 1 patient with pharyngeal fistula and infection. All repairing materials of different methods survived and the average time of postoperative oral intake was 12.47 days. All patients retained good laryngeal functions with 95 decannulations and the 3-year and 5-year survival rates were 59.3% and 40.7% respectively. Conclusion Comprehensive preoperative investigations as laryngoscopy and radiological assessment may give good suggestions in selecting appropriate surgical approaches; good surgical approach may help provide good feasibility and visibility, and ensure complete removal of the tumors with safety margins; through the epiglottis flipping and/or thyroid reinforcement repairing methods, the incidence of accidental swallowing and pharyngeal fistula can be reduced; pyriform sinus carcinoma are found mostly in advanced stages, single treatment is often ineffective in controlling the lesion, and radiotherapy is necessary as a comprehensive treatment to improve the local control rate and survival rate. Appropriate surgical approaches and repairing methods can help surgeons to completely remove the tumor, and preserve or rebuild laryngeal and pharyngeal functions in managing chosen patients with pyriform sinus cancer.
    Bioinformatic screening of differentially expressed protein kinases and their inhibitors in hypopharyngeal cancer.
    HU Wenliang, ZHENG Yanqiu, CUI Xiaobo, CUI Yanru, SUN Yuanhao
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  24-28.  doi:10.6040/j.issn.1673-3770.0.2015.340
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    Objective To screen differentially expressed protein kinases and their inhibitors, in order to provide new targets for molecular therapy of hypopharyngeal cancer. Methods GEO database and SAM software were employed to screen the differentially expressed protein kinase genes in hypopharyngeal cancer. Human hypopharyngeal cancer FaDu cell line was cultured in vitro. Real-time PCR was used to prove the accuracy of microarray results. Based on KEGG database, the kinase-regulated pathways were identified. The inhibitors of such kinases were identified by using kinase-inhibitor database. Results A total of 3 protein kinase genes(PKC-β, CDK6 and CDC42)were identified(fold change≥2.0, P<0.05). Real-time PCR showed that the 3 kinase genes were differentially expressed in FaDu cells, which was consistent with the microarray results(P<0.05)Pathway analysis indicated that a complex pathway network was regulated by the 3 kinases. The results of inhibitor screening showed that 5 inhibitors regulated PKC-β, 4 inhibitors regulated CDK6 and 3 inhibitors regulated CDC42. There were less than 10 studies about the 4 inhibitors in cancer. Conclusion Three differentially expressed protein kinases(PKC-β, CDK6 and CDC42)are identified and they are able to promote the development of tumor. Their kinase inhibitors may play a potential anti-cancer role, which may provide a new target for molecular therapy of hypopharyngeal cancer.
    Clinical observation of anti-reflux treatment in patients with pharyngealforeign body sensation complicated with laryngopharyngeal reflux
    ZHOU Feng, WANG Xingjun, ZHAO Jun, ZHANG Shaobin
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  29-31.  doi:10.6040/j.issn.1673-3770.0.2015.389
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    Objective To observe the clinical efficacy of anti-refleux therapy in patients with pharyngealforeign body sensation complicated with laryngopharyngeal reflux. Methods A total of 104 patients were selected as study subjects, who had self-rating foreign-body sensation score>3 points, disease course≥1 months, and received continuous anti-reflux treatment for more than 8 weeks due to reflux symptom index(RSI)>13 points and reflux clinical presentation syndrome(RFS)>7 points after scoring. The rates of all reflux syndromes and signs of reflux clinical symptoms were analyzed, and clinical efficacy was evaluated. Results Of the 104 patients, most had reflux symptom hawking behavior(92/104,88.46%), with primary reflux signs being posterior commissurehypertrophy(97/104,93.27%), Erythema/congestion(89/104,85.57%), intra-throat sticky secretions(87/104,83.65%), ventriculuslaryngis obstruction(73/104,70.19%)and so on. After anti-reflux treatment, 61 were effective, with effective rate of 58.65%. Compared with treatment before, there was significant difference in RSI(t=1.975,P<0.05)but no significant difference was observed in RFS (t=1.258,P>0.05)after treatment. Conclusion Anti-reflux treatment is effective to patients with pharyngealforeign body sensation complicated with laryngopharyngeal reflux. As to patients with pharyngealforeign body sensation, laryngopharyngeal reflux should be considered if long-term treatment shows no significant efficacy.
    Analysis of the risk factors of proliferative laryngopharyngeal disease.
    HE Guijun, QIAN Xiaoyun, GU Yajun, LIN Chuanyao, SONG Panpan, GAO Xia
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  32-36.  doi:10.6040/j.issn.1673-3770.0.2015.491
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    Objective To investigate the risk factors of proliferative laryngopharyngeal disease(PLD). Methods A total of 471 patients with PLD were included in this retrospective study. Their general information, clinical data, reflux symptom index(RSI)and reflux fluiding score(RFS)were statistically analyzed. Results Smoking, alcohol, RSI, RFS and gastrosis were correlated with PLD(P<0.05), while age, sex and BMI were not correlated. Age, sex, smoking, alcohol and RFS score were significantly correlated with the nature of PLD(P<0.001), BMI was significantly correlated(P<0.05), while RSI score and gastrosis were not correlated. Logistic regression analysis indicated that age, gender, smoking, alcohol and RFS score were independent risk factors for the development of PLD(P<0.05). Conclusions The risk factors for PLD include smoking, alcohol, RSI, RFS and gastrosis. The benign or malignant nature of PLD is related to age, sex, smoking, alcohol, RFS and BMI.
    Influence of tracheal infection after total laryngectomy on pulmonary function and tumor recurrence rate in patients with laryngocarcinoma.
    JIN Shu
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  37-39.  doi:10.6040/j.issn.1673-3770.0.2015.449
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    Objective To explore the influence of tracheal infection after total laryngectomy on pulmonary function and tumor recurrence rate in patients with laryngocarcinoma. Methods A total of 276 patients with laryngocarcinoma were selected, in which 149 received total laryngectomy, and 127 received total laryngectomy plus neck lymph node dissection. Postoperative infection, pulmonary function and recurrence conditions of all patients were observed. Results Totally 26(9.42%)patients had postoperative infection, in which the infection rate of patients with total laryngectomy was 4.03%(6/149)whereas that of patients with total laryngectomy plus neck lymph node dissection was 15.75%(20/127), and there was significant difference(P<0.05). The infection rate was 2.11%(3/142)in patients with surgical duration <4 h, 11.76%(11/102)in patients with surgical duration < 4-6 h and 37.50%(12/32)in patients with surgical duration>6 h, and the rate of patients with surgical duration < 4-6 h was markedly lower than that >6 h(P<0.01). Compared with surgery before, forced expiratory volume in 1 second(FEV1)increased obviously while V25 reduced markedly in patients in postoperative tracheal infection group. The tumor recurrence rate was 34.62% in patients with tracheal infection, significantly higher than the 2.00% in those with non-infection(P<0.01). Conclusion Patients with laryngocarcinoma have certain improvement in pulmonary function and risk of infection and recurrence after total laryngectomy, so effective measurements should be conducted to reduce the infection rate and promote patients’ prognosis.
    Relationship between gastroesophageal reflux disease and laryngeal carcinoma: a meta-analysis.
    LI Zewen, GUO Junyu, ZHOU Jie, YAN Fubo, YANG Zhimin, DING Zhuhua
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  40-46.  doi:10.6040/j.issn.1673-3770.0.2015.411
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    Objective To evaluate the relationship between gastroesophageal reflux disease and laryngeal carcinoma with meta-analyses. Methods The published studies of the relationship between gastroesophageal reflux disease and laryngeal carcinoma were searched in the Pubmed、Embase、Web of Knowledge、CBM and CNKI databases(from the date of establishment of the databases to May 2015). The trails selection based on inclusion and exclusion criteria, the quality of the included studies was assessed and meta-analysis was performed with RevMan 5.3 and Stata 13.1 software. The OR value of included studies were calculated after heterogeneity test and publication bias was assessed by Harbord method. Results A total of 13 studies were recruited. The Meta-analysis showed the positive rate of gastroesophageal reflux disease was significantly higher in the laryngeal carcinoma group compared with the control group [OR=2.68, 95%CI(1.94, 3.70), P<0.000 01]. Conclusion Gastroesophageal reflux disease may be a significant risk factor for laryngeal carcinoma. However, given the heterogeneity of the published studies, future well-designed studies are needed.
    Anatomical and clinical evaluation of the endoscopic transoral transpharyngeal approach to the atlantoaxial.
    XIE Chang, YAN Bin, LI Jianxing, LU Yongtian
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  47-51.  doi:10.6040/j.issn.1673-3770.0.2016.015
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    Objective To evaluate the feasibility of endoscopic transoral transpharyngeal approach to the atlantoaxial. Methods Endoscopic transoral approach was performed in 5 cadaveric heads and necks. The atlantoaxial was measured with CT. Results (1) The range from clivus to C3 could be exposed by this approach, including atlas, axis, lateral mass, odontoid process and vertebral artery. (2) The anterior tubercle of the atlas could serve as a landmark leading to the endoscopic transoral atlantoaxis surgery. The arch could be drilled either from the tubercle to the lateral side or broken from the junction to the lateral mass. Endoscopic odontoid dissection should begin at the apex of the odontoid, and proceeded inferiorly. There was a “safe zone” in the front of atlantoaxis of transoral-transpharyngeal approach. (3) CT results showed: length of anterior arch of atlas 19.5±2.8 mm, the thickness of anterior tubercle of atlas 8.0±0.4 mm, atlas lateral horizontal diameter(left/right)12.7±2.3mm/12.7±1.6 mm, atlas lateral sagittal diameter(left/right)15.0±2.5 mm/15.3±1.4 mm, spacing of atlas transverse process the inside hole 47.2±1.6 mm, spacing of atlas lateral transverse process hole 60.4±1.4 mm, angle of odontoid 10.2±1.3°, spacing of axis transverse process the inside hole 29.2±1.7 mm, spacing of axis lateral transverse process hole 44.3±1.6 mm. Conclusion Endoscopic transoral transpharyngeal approach to the atlantoaxial is technically feasible, which provides a good exposure and the same decompressing size as conventional transoral-transpharyngeal approach. It is safe and minimal invasive, and can be widely applied in clinical practice.
    Experimental study on the construction of heterogeneous decellularized dermal matrix-free jejunal complex.
    CHANG Jiangyi, MA Lingguo, LI Jianyu, ZHOU Jingchun, ZHOU Zhou, ZENG Fanqian, XU Yang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  52-55.  doi:10.6040/j.issn.1673-3770.0.2015.308
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    Objective To study the construction of heterogeneous decellularized dermal matrix-free jejunal complex, in order to solve problem of intestinal secretion after the reconstruction of long-segment trachea with free jejunal graft. Methods A total of 10 adult mongrel dogs were involved. We cut the heterogeneous decellularized dermal matrix into suitable diameter, put it on the inner face of the jejunum whose mucous layer had been removed, and then used the Shape-memory Titanium-nickel Alloy stand to support it. On day 7, 14, 30, 90 and 180, we harvested the complex to observe the growth of epithelium with microscope. Results Of all 10 dogs, one dog died of intestinal adhesion and wound infection. The other 9 dogs lived to the end of the experiment. On day 7 and 14, we detected heterogeneous decellularized dermal matrix components, and part of free jejunal inner surface was squamous metaplasia. On day 30, 90 and 180, we did not detect any heterogeneous decellularized dermal matrix components, and almost all free jejunal inner surface was squamous metaplasia. Conclusion Heterogeneous decellularized dermal matrix with appropriate size could survive on the inner surface of the jejunum whose mucous layer had been removed and promote squamous metaplasia, thus inhibiting intestinal secretion. The Shape-memory Titanium-nickel Alloy stand could serve as a good support.
    Comparison of coblation, ultrasonic knife and conventional approach in tonsillectomy.
    ZHANG Liqing, YANG Cuifang, ZHOU Huaqun, LU Meiping, DONG Weida
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  56-60.  doi:10.6040/j.issn.1673-3770.0.2016.123
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    Objective To evaluate the advantages and disadvantages of coblation, ultrasonic knife and conventional approach in tonsillectomy. Methods A total of 117 cases in need of tonsillectomy were collected and divided into 3 groups: coblation tonsillectomy group(group A, n=39), ultrasound knife tonsillectomy group(group B, n=39)and the traditional tonsillectomy group(group C, n=39). The operation time, blood loss, postoperative sore throat situation, postoperative primary and secondary bleeding and so on were recorded and compared. Results The operation time was shorter, and intraoperative blood loss was less in group A and B than in group C(P<0.05). The operation time in group A [(9.92±4.04)min] was shorter than that [(15.86±1.36)min] in group B,(P<0.05). There was no difference in intraoperative blood loss between group A and B(P>0.05). The degree of the pain in the first three days after surgery in group A and in group B was significantly lower than that in group C(P<0.05), but no statistically significant differences were observed after three days(P>0.05). Postoperative throat pain in group A was lighter than that in group B, but there was no significant difference(P>0.05). Postoperative primary hemorrhage occurred in 1 case in group A and C, while secondary hemorrhage occurred in 1, 1 and 2 cases in group A, B and C, respectively. There was no significant difference in the time of pseudo-membrane defulvium among the three groups(P>0.05). Pharyngeal edema score 24 hours after operation in group A and group B was significantly lower than in group C(P<0.05), but there was no statistically significant difference between group A and group B(P>0.05). Conclusion Coblation tonsillectomy is the more safe and effective method, but its cost is relatively high. It is suitable for patients with good economic conditions and high quality of life. Ultrasonic knife tonsillectomy is suggested to be appropriate for patients with adhesive tonsillitis of long duration.
    Diagnosis and treatment of the third branchial cleft fistula: a clinical report of 6 cases and literature review.
    LI Qingming, WU Sien, HUANG Suhong, CAO Huotai, HUANG Suihua, YAO Tingting, LIU Qihong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  61-64.  doi:10.6040/j.issn.1673-3770.0.2016.041
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    Objective To investigate the clinical characteristics, diagnosis and therapy of the third branchial cleft fistula. Methods Clinical data of 6 cases of third barnchial cleft fistula were retrospectively reviewed, and related literatures were reviewed. Multi-slice spiral computerized tomography(MSCT)and fistula iodinated contrast media revealed the whole fistula and the opening of pyriform sinus of internalfistula. Third branchial cleft fistula was completely excised with functional neck dissection under general anesthesia. Results Of all 6 cases, 3 were misdiagnosed, 2 as neck abscess, and 1 as subacute thyroiditis. There was no recurrence during the follow-up of more than 10 months. Conclusion MSCT and fistula iodinated contrast media can reveal the whole fistula, which is accurate and simple for the diagnosis, and safe for the complete surgical resection of fistula. Functional neck dissection is an effective and safe surgical management for third branchial cleft fistula.
    Diagnosis and treatment of cervical necrotizing fasciitis: a report of 7 cases and literature review.
    CHEN Xiumei, SONG Xicheng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  65-67.  doi:10.6040/j.issn.1673-3770.0.2015.305
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    Objective To explore the clinical characteristic, diagnosis and treatment of cervical necrotizing fasciitis. Methods All 7 cases of cervical necrotizing fasciitis were diagnosed by CT and confirmed in operation. Of them, 2 underwent tracheotomy, neck incision and drainage operation, and the other 5 received neck incision and drainage operation. Postoperative flushing and anti-infection treatment were administered. Results Of all cases, 1 died and the other 6 were cured. During the follow-up of half a year, no relapse occurred. Conclusion For cervical necrotizing fasciitis cases, explorative operation should be timely applied. Incision and drainage of neck abscess can obtain a satisfactory effect and prevent serious complications.
    Participation of cAxin2 in the development of inner ear of chick embryo.
    ZHANG Xiaobing, DAI Fangping, HOU Yun, Brand-Saberi B
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  68-72.  doi:10.6040/j.issn.1673-3770.0.2015.456
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    Objective To observe the expression of the Wnt families negative regulator cAxin2 in the development of inner ear of chick embryo. Methods The fertilized white leghorn eggs were hatched and chick embryos were butchered in HH11-28 stages according to the Hamburger and Humilton(1951)staging criteria. The embroys were fixed and hybridized in situ and sectioned. Results Chick homolog gene, cAxin2, expressed in the otic cup beginning at stage HH14+ and exhibited a dynamic expression pattern during formation and further differentiation of the otic vesicle. Conclusion cAxin2 participate in inner ear development of Chick embryo.
    Non-surgical serialization treatment of unilateral Meniere disease in 48 cases.
    ZHANG Yunbo, XI Guoping, JIN Hongfang, WANG Caijun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  73-76.  doi:10.6040/j.issn.1673-3770.0.2015.423
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    Objective To explore the efficacy of treating Meniere disease by non-operative serialization through various listening stages. Methods Serialized treatment was conducted in 48 patients with unilateral Meniere disease according to the listening stages. In period Ⅰ, patients received regular diet control, blood vessel expansion, nerve nutrition and vitamin medication. In period Ⅱ, on the basis of conventional treatment, patients were injected with odium succinate 40 mg, once in 3 days for 3 times. If it was not effective, tympanostomy tube and tympanic cavity inflation were administered. In period Ⅲ, on the basis of regular treatment, patients underwent tympanic cavity perfusion after tympanostomy tube and injection of prednisolone sodium of 40 mg, once in 3 days for 3 times, and received inflation treatment in middle ear drum balloon. In period Ⅳ, on the basis of conventional treatment, patients received gentamicin 40 000 U+0.5%, sodium bicarbonate 0.5 mL and tympanic cavity injection once a week. The frequency of injection was commonly 2-3 times a week, determined by circumgyration, hearing changes and situations of tinnitus. For patients who had low vestibular apparatus function, rehabilitation training of vestibular function was provided. Patients’ vertigo, hearing, activity ability and tinnitus changes were followed up for 18-24 months. Results Vertigo was fully controlled in 12 cases, basically controlled in 33 cases, partially controlled in 3 cases, and the clinical effective rate was 93%. The hearing ability was improved to A level in 12 cases(>30 db or the frequency <20 db), to B level in 6 cases(15-30 db), to C level in 29 cases(0-14 db), and to D level in 1 case(improvement <0 db). The mobility was fully controlled in 16 cases(A level), basically controlled in 32 cases(B level), and the effective rate was 100%. The score of Tinnitus Handicap Inventory after treatment was significantly decreased(P<0.05). Conclusion Treatment of Meniere disease vertigo by non-operative serialization through different listening stages can achieve high control rate, and patients’ mobility is apparently improved. For patients in stage Ⅰ and Ⅱ, the tinnitus and hearing are significantly improved. For patients in all stages, tinnitus can be obviously improved. The method is simple and causes few side effects. It can avoid operation risks, and reduce the medical costs.
    IgG4-related disease:four cases report and a literature review.
    LIU Yue, ZHAO Xue, LIU Yan, JIN Chengxun, WEI Ning, JIN Chunshun, WANG Sanchun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  77-81.  doi:10.6040/j.issn.1673-3770.0.2016.065
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    Objective To explore the clinical features, pathological features and imaging manifestations of IgG4-related disease. Methods The clinical data of four cases of IgG4-related disease were analyzed and the related literatures were summarized. Results The average age was 55 years old. The proportion of male: female was 3∶1. 2 cases occurred in the submandibular gland, 1 in the eye socket and 1 in the facial region. There were no significant specificity, and the clinical manifestations were painless progressive swelling. Pathologic changes were lymphoid tissue and fibrous tissue hyperplasia, which had more plasma cell infiltration(IgG4 positive plasma cells more than 50/HPF, IgG4 positive plasma cells were greater than 40% IgG positive plasma cells). Inflammatory changes were lesions on imaging area. Conclusion IgG4 related disease is a rarely clinical disease, pathogenesis is unclear. Combined with clinical manifestations, serological detection, pathological features and imaging findings, diagnosis results are obtained, and timely accurate treatment can be carried out.
    Changes of pulmonary function and respiratory resistance in patients with allergic rhinitis and asthma after microwave treatment.
    YANG Meiyan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  82-84.  doi:10.6040/j.issn.1673-3770.0.2015.538
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    Objective To study the changes of pulmonary function and respiratory resistance in patients with allergic rhinitis and asthma after microwave treatment. Methods The pulmonary function of 43 patients were detected before and after treatment. In the microwave treatment, the power was 30 w, and starting time was 4 s. Multipoint solidification was performed on the submucosal inferior turbinate, forepart of middle turbinate and nasal hillock. Results The total effective rate was 100%, 30 cases were markedly improved(69.8%), and 13 cases were relieved(30.2%). No adverse reactions or complications were observed. The FEV1, FEV1%, and FEF75 improved significantly(P<0.05), while the FEF25 and FEF50 had no significant improvement(P>0.05). Conclusion Microwave treatment can effectively improve the pulmonary ventilation function and reduce respiratory resistance in patients with allergic rhinitis and asthma.
    The clinical study on the improved phacoemulsification.
    DENG Zhifeng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  85-88.  doi:10.6040/j.issn.1673-3770.0.2016.104
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    Objective To evaluate the safety and efficacy of the improved chop nucleus technique in phacoemulsification. Methods A total of 160 eyes with age-related cataract were divided into the improved chop nucleus phacoemulsification group and the conventional chop nucleus phacoemulsification group, each group had 80 eyes. The operation time, emulsifying time, energy and other data were recorded, and postoperative visual acuity, corneal edema, aqueous flare and other indicators were observed. Results By Mann-Whitney U test, there were significant difference between the two groups in operation time(P=0.000), emulsifying time(P=0.011)and energy(P=0.005). Also, there were significant difference in the best corrected visual acuity(BCVA)after surgery 1 d(P=0.003)and 3 d(P=0.005), in the corneal state after surgery 1 d(P=0.005), 3 d(P=0.004)and 7 d(P=0.044), and in the aqueous flare after surgery 1 d(P=0.004), 3 d(P=0.011)and 7 d(P=0.026). By χ2 test, the intra-operative complications and postoperative complications had no statistical significance. Conclusion The improved chop nucleus phacoemulsification compared with the traditional chop nucleus phacoemulsification for eye tissue leads to less damage, is a safe and effective surgery.
    Influence of long-term use of prostaglandin drugs on meibomian gland function and corneal structure in patients with primary open angle glaucoma.
    LI Dongmei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  89-92.  doi:10.6040/j.issn.1673-3770.0.2015.530
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    Objective To investigate the influence of prostaglandins(PGs)long-term use on meibomian gland function and corneal structure in patients with primary open angle glaucoma(POAG). Methods A total of 31 POAG patients(62 eyes)were include in this study, in which 15 cases without administration of prostaglandin drug were set as the control group; and 16 cases with long-term use of prostaglandin drugs were set as the observation group. Meibomian gland function, shape and cell density of corneal cells, status of subbasal nerve fiber bundles were compared between two groups. Results The density of basal cells, stromal cells and degree of neural distortion were significantly higher in observation group than those in the control group, and density of conjunctival goblet cell, number of branches to cornea subcutaneous nerve were significantly lower in observation group than those than the control group, with significant differences(P<0.05); there was no significnat difference in density of inflammatory cells, Langerhans cells and endothelial cell. neuronal density, and nerve luminosity variations between two groups(P>0.05). the incidence of MGD was 46.7% in the control group and was 71.9% in the observation group(P<0.05). Conclusion Long-term use of PGs may lead a meibomian gland dysfunction and damage to structure of the cornea in patients with glaucoma, including increased risk of MGD, changes in density of subcorneal cells and function of subbasal nerve fiber bundles.
    Effect of rh-bFGF on the level of glutamic acid in retinal tissue of rabbits with ischemia-reperfusion injury.
    SHAO Hongchao, GE Yanran
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  93-95.  doi:10.6040/j.issn.1673-3770.0.2015.517
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    Objective To explore the effect of recombinant human basic fibroblast growth factor(rh-bFGF)on the level of glutamic acid in retinal tissue of rabbits with ischemia-reperfusion injury. Methods Sixty-six white rabbits were divided into group A[retinal ischemia-reperfusion injury(RIRI)group, n=30], group B(RIRI+rh-bFGF, n=30)and group C(sham-operation group, n=6). Groups A and B were also assigned into 5 subgroups respectively 6, 12, 24, 48 and 72 h after ischemia-reperfusion injury, 6 rabbits in each group. The same dose of normal saline and rh-bFGF solution were respectively injected into the vitreous cavity of rabbits in groups A and B at the early stage of molding. The rabbits were killed and their eyeballs were taken out at five time points after molding. Puncture of anterior chamber was given in group C, and no other operations were given. The rabbits in group C were killed and their eyeballs were taken out. The changes of retinal pathomorphism were observed, and the contents of glutamic acid were detected. Results In group A, the retina was characterized by high edema, disordered levels and loose cell structure. Vacuole degeneration was present in retinal ganglion cells(RGC)and and the number of ganglion cells decreased. In group B, the retinal structure changes were similar to that in A group, but the damage was significantly milder than that in group A. In group C, the levels of retina were clear, the cells were arranged in parallel and retinal morphology was reguLar. RGC was reguLarly arranged in a single layer, and no vacuole degeneration occurred. 6, 12, 24, 48 and 72 h after ischemia-reperfusion injury, the contents of glutamic acid in groups A and B were dramatically higher than that in group C(P<0.01). When compared with group A, the contents of glutamic acid in group B decreased notably at different time points(P<0.01). Conclusion rh-bFGF has a protective effect on retinal injury in rabbits, and its mechanism may be related to the inhibition of cell apoptosis and decreased content of glutamic acid.
    The impact of indoor air pollutants and diet to allergic diseases.
    LIU Zhe, TENG Bo, WEN Lianji
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  96-102.  doi:10.6040/j.issn.1673-3770.0.2016.071
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    Recently, the prevalence of allergic disease increased rapidly. Common allergic diseases mainly include allergic rhinitis,allergic asthma and eczema. Clinical symptoms seriously affect the patients’ quality of life. Currently, some studies have defined the relation between indoor air pollutants and allergic diseases as well as that between diet and allergic diseases. The potential pathogenesis has become hotspot in recent years. This paper reviews the impact of several main indoor air pollutants and diet to allergic diseases. Potential mechanism also be elaborated in this review.
    Roles of multidrug resistance proteins P-gp and ABCG2 in laryngocatcinoma and their related signal pathways.
    SU Tiantian, ZHANG Jia, SUN Zhenfeng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  103-106.  doi:10.6040/j.issn.1673-3770.0.2015.469
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    Laryngocatcinoma is a type of malignant solid tumor, and chemotherapy plays an increasingly important role in its treatment, but multidrug resistance(MDR)has become the leading cause of chemotherapy failure. Researches have showed that P-gp and ABCG2 proteins are important in the MDR of laryngocatcinoma, P-gp may be positively or negatively correlated with ABCG2, and their related signal pathways(MAPK)are related to their expressions in tumors. However, how P-gp and ABCG2 are controlled and how to improve the effect of chemotherapy remain to be further investigated.
    Laryngeal tuberculosis of 8 cases.
    SONG Shenghua, JIANG Jinqin
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  107-108.  doi:10.6040/j.issn.1673-3770.0.2015.362
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    A report of craniopharyngioma misdiagnosed as sphenoid sinus cyst.
    ZHANG Jianwei, WANG Guoqing, NI Ze
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  109-110.  doi:10.6040/j.issn.1673-3770.0.2015.443
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    Excision of huge epiglottis cysts under side-door laryngoscope with larynx dynamic system in 46 cases.
    BI Zhi, XIAO Feng, ZHU Juanfen
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  111-112.  doi:10.6040/j.issn.1673-3770.0.2015.425
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    Penetrating injury of the eyeball with metal foreign body in the orbit: one case report.
    ZHAO Yun, ZHAO Hong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(3):  113-114.  doi:10.6040/j.issn.1673-3770.0.2016.017
    Abstract ( 791 )   PDF (1187KB) ( 582 )   Save
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