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    16 August 2016 Volume 30 Issue 4
      
    Allergen-specific immunotherapy as the first-line treatment for allergic rhinitis.
    CHENG Lei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  1-2.  doi:10.6040/j.issn.1673-3770.0.2016.349
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    Prospect and progress of allergic rhinitis.
    ZHANG Ruxin
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  3-6.  doi:10.6040/j.issn.1673-3770.0.2016.241
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    Clinical features and diagnosis of allergic rhinitis.
    YAN Aihui, HAN Jiali
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  7-9.  doi:10.6040/j.issn.1673-3770.0.2016.243
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    Drug treatment strategy for allergic rhinitis.
    ZHANG Gehua, LI Wenting
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  10-14.  doi:10.6040/j.issn.1673-3770.0.2016.280
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    Progress of immunotherapy for allergic rhinitis.
    LI Yong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  15-21.  doi:10.6040/j.issn.1673-3770.0.2016.278
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    Treatment of allergic rhinitis with traditional Chinese medicine.
    XIE Hui
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  22-25.  doi:10.6040/j.issn.1673-3770.0.2016.244
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    Study on single nucleotide polymorphisms of partial allergic rhinitis-associated haplotype module genes.
    TENG Weiqiang, CHEN Xiaoping, ZHANG Yan, ZHOU Enhui, YAO Wenhao, LI Li
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  26-29.  doi:10.6040/j.issn.1673-3770.0.2016.032
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    Objective To detect whether there exist allergic rhinitis-associated hapoltype module genes(SDAD1, CXCL10, CXCL11 and EoBL)and single nucleotide polymorphisms(SNP)on chromosome as well as whether these genes affect on SNP. Methods The blood sample DNA of patients with allergic rhinitis in hereditary background group and distribution group was extracted, and gene sequencing was conducted following polymerase chain reaction(PCR)primer design, synthesis and amplification. Results A total of 46 sites were detected in both groups, of which 34 had mutations, with total mutation rate being 78.3%. And there was significant difference in the gene mutation of allergic rhinitis between hereditary background group(66.67%)and distribution group(78.57%)(P=0.58). Conclusion SDAD1, CXCL9, CSCL10 and CXCL11 genes are expressed successively on chromosome haplotype modules in patients with allergic rhinitis, and SNP is extensively distributed on allergic rhinitis-associated genes, including SDAD1, CXCL10, CXCL11 and EoBL, but hereditary factors have insignificant influence on these mutations.
    Effects of interferon gamma on Eosinophil apoptosis and Eotaxin levels in nasal lavage fluid of allergic rhinitis rats.
    LI Qin, CHEN Yanlin, MA Yanyi, ZHANG Yongdong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  30-33.  doi:10.6040/j.issn.1673-3770.0.2016.162
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    Objective To explore the effect of interferon gamma(IFN-γ)on the apoptosis of Eosinophils and Eotaxin levels from nasal lavage fluid in allergic rhinitis(AR)rats. Methods AR model was established by the sensitizer of ovalbumin and aluminum hydroxide. The 40 rats were randomly divided into the control group(group A, n=10), the allergic rhinitis group(group B, n=10), the budesonide group(group C, n=10)and the IFN-γ group(group D, n=10). In days 31 to 38 after the establishment of AR rats, each rat of the group D was administrated by instillation of 1 μg(1 μg/50 μL)IFN-γ into each of the nasal cavities one time a day, while each rat of the group B was administrated by instillation of 50 μL phosphate buffer in the same way, and each rat of the group C was administrated by instillation of 50 μL(1.28 μg/μL)budesonide in the same way. In days 39, the nasal lavage fluid was obtained to measure the apoptotic percentage of eosinophils and the apoptotic ratios were analyzed by flow cytometry. The levels of Eotaxin were detected by enzyme-linked immunosorbent assay(ELISA). Results The percentage of EOS in nasal lavage fluid of group C and group D was evidently lower than that of group B(all P<0.01). The eosinophil apoptotic ratio in group C and group D was evidently higher than that in group B(all P<0.01). The levels of Eotaxin in nasal lavage fluid of group C and group D were evidently lower than those in group B(all P<0.01);Furthermore significantly negative correlation was observed between the percentage of EOS and apoptotic ratio in the nasal lavage fluid of group D (r=-0.769,P<0.05). While significantly positive correlation was observed between the percentage of EOS and Eotaxin in the nasal lavage fluid of group D (r=0.750,P<0.05). Conclusion IFN-γcan significantly reduce the eosinophil infiltration and increase eosinophil apoptosis. It can reduce the levels of Eotaxin so as to achieve the purpose of treating allergic rhinitis.
    Detection of serum total IgE and allergen-specific IgE in healthy adults and its significance.
    YUAN Yuan, WU Zhongfei, CHAO Changjiang, LU Meiping, TIAN Huiqin, CHENG Lei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  34-38.  doi:10.6040/j.issn.1673-3770.0.2016.259
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    Objective To explore the scientific significance and practical application of serum levels of total IgE(tIgE)and allergen-specific IgE(sIgE)in excluding allergen sensitization. Methods A total of 536 volunteers including 347 males and 189 females, aged 19-60 years with median age of 38 years old received the healthy physical examination were recruited in the study. All the subjects had no history and symptoms of allergic diseases as well as systemic diseases. Serum tIgE was detected by the capture enzyme-linked immunosorbent assay. The tIgE level ≤100 kU/L represented negative while >100 kU/L positive. Serum sIgE was assessed by means of the Phadiatop test using the fluoroimmunoassay. The Phadiatop class 0 means negative and class ≥1 positive. Results Serum level of tIgE among healthy adults was 1.14-1 703.70(median 37.18)kU/L, and it was significantly higher in males than in females(P=0.001). The negative and positive rates of serum tIgE were 72.52% and 27.48%, respectively. Serum level of sIgE(Phadiatop)among healthy adults was 0.01-59.50(median 0.05)kU/L, which had no significant significance between the male and the female(P=0.154). The negative and positive rates of Phadiatop were 82.09% and 17.91%, respectively. There were no statistically significant differences in serum tIgE and sIgE levels among different age groups(P=0.119 and P=0.225, respectively). The Spearman rank correlation coefficient between serum tIgE and sIgE levels was 0.683 with statistical significance(positive correlation, P<0.001). There were 368 subjects(94.85%)with negative Phadiatop and 20 subjects(5.15%)with positive Phadiatop in the serum tIgE negative subjects(n=388), while 75 山东大学耳鼻喉眼学报30卷4期 -袁源,等.健康成人血清总IgE和变应原特异性IgE检测及意义 \=-subjects(51.02%)with positive Phadiatop and 72 subjects(48.98 %)with negative Phadiatop in the serum tIgE positive subjects(n=147). Conclusion More than one fourth subjects among healthy adults have a serum tIgE level higher than 100 kU/L, while less than one fifth subjects have a sensitization to inhaled allergens. There is an obvious correlation between the serum levels of tIgE and sIgE. The serum tIgE level below 100 kU/L may have a clinical value to exclude allergen sensitization; however, the sensitized status may not be confirmed when the tIgE level is higher than 100 kU/L, and case history and clinical manifestations also should be considered.
    Analysis of allergen spectrum in 2 883 patients with allergic rhinitis in Liaoning area.
    TAI Xuhui, YANG Xin, ZHU Baoyu, CAO Hong, CHU Yanling, SHAN Xiaodong, JIANG Yu
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  39-42.  doi:10.6040/j.issn.1673-3770.0.2016.179
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    Objective To investigate the clinical distribution characteristics of the allergen spectrum in patients with allergic rhinitis in Liaoning area. Methods From January 2014 to December 2015,20 standardization allergens were used to determine 2883 patients with clinically suspected AR in our hospital. Serum specific IgE(sIgE), as the indicator of sensitive allergen spectrum distribution, was detected by EUROLINE immunoblot test. Results A total of 2 565 of 2 883(89.0%)patients presented positive reaction. Of them, the top three inhaled allergens were house dust mite/flour mite(68.9%), dog hair(37.3%)and cockroach(25.4% ); The top three food allergens were peanut(128.3%), egg(15.6%)and milk(14.3%). Conclusion House dust mite/flour mite and peanut are the most common inhaled and food allergens in AR patients in Liaoning area.
    Predictive biomarkers for dust mite specific immunotherapy in patients with allergic rhinitis.
    ZHOU Wencheng, YUAN Yuan, CHENG Lei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  43-49.  doi:10.6040/j.issn.1673-3770.0.2016.224
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    Objective To investigate the changes of serum total IgE(tIgE)and specific IgE(sIgE)levels in patients with allergic rhinitis(AR)one year after allergen-specific immunotherapy, and so as to explore the predictive biomarkers for therapeutic effects of subcutaneous immunotherapy(SCIT)and sublingual immunotherapy(SLIT). Methods Patients with moderate-to-severe persistent AR who completed one year of dust mite specific immunotherapy were enrolled in this study. The effectiveness of immunotherapy was evaluated by patient-reported outcomes. The changes of serum tIgE, Dp-sIgE and Df-sIgE levels were compared before and after immunotherapy, and these antibody levels were stratified analyzed based on the responders and nonresponders of treatment. The baseline serum IgE levels before immunotherapy were tested for correlation with clinical response to the treatment, and the best predictive biomarkers and cut-off value for discriminating between responders and nonresponders were estimated on the basis of the receiver operator characteristic(ROC)curve. Results The effective rate of the SCIT group(n=50)and the SLIT group(n=58)was 64% and 65.5% after one year immunotherapy, respectively. And there was no statistical significant difference between the two groups(P>0.05). Also, no significant differences in the levels of tIgE, Dp-sIgE and Df-sIgE were observed in both groups before and after immunotherapy(P>0.05). However, a significant decreased serum Dp-sIgE level was found in the responders of treatment in the SCIT group. The using of baseline serum Dp-sIgE/tIgE ratio > 11.95% as a biomarker of effective SCIT yielded a sensitivity value of 71.9% and a specificity of 83.3%. As for SLIT, the serum Df-sIgE levels > 27.95 IU/ml(grade 4)yielded a sensitivity value of 52.6% and a specificity of 85.0%. Conclusion Serum sIgE level before immunotherapy could be a useful biomarker for predicting response to the treatment. Generally, patients with higher levels of sIgE or sIgE/tIgE ratios may be more likely to achieve therapeutic effect.
    Efficacy and safety of subcutaneous immunotherapy with house dust mite extract for allergic rhinitis.
    TU Yanyi, SHI Li, ZHAO Li, JIN Peng, ZI Xiaoxue, LI Ang, JIN Yixuan, ZHI Lili
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  50-55.  doi:10.6040/j.issn.1673-3770.0.2016.292
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    Objective Investigate the efficacy and safety of 2-year subcutaneous immunotherapy(SCIT)with HDM extract for allergic rhinitis with/without asthma. Methods A total of 58 patients with HDM-induced AR(35 sensitized to HDM only and 23 sensitized to HDM and other allergens simultaneously)with/without asthma were included. Symptom scores, visual analogue scale and quality of life were assessed before and after 6, 12 and 24 months of SCIT. Local and systemic adverse events were recorded for safety. Results Symptom scores decreased significantly(P<0.05)after 6 months of immunotherapy for both AR and asthma, and continued to decline until the end of the treatment. There was no statistical difference(P>0.05)between monosensitized patients and polysensitized patients in symptom scores after 2-year SCIT. Marked improvements(P<0.05)in quality of life were also observed after 6, 12 and 24 months of SCIT. Most side-effects were local reactions, no serious adverse event was reported during the treatment. Conclusion For AR patients, especially accompanied with asthma, SCIT is an effective and safe treatment.
    Clinical effect of focused ultrasound in combination with nasal spray hormone in treating allergic rhinitis.
    ZANG Jian, LIU Qian, JIANG Xuejun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  56-59.  doi:10.6040/j.issn.1673-3770.0.2016.257
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    Objective To observe the therapeutic effect of focused ultrasound and nasal spray hormone in treating allergic rhinitis under nasal endoscopy. Methods After focused ultrasound treatment, the patients with allergic rhinitis were randomly divided into A and B two groups. Group A continued to use small dose of nasal spray hormone for 3 months, while group B as the control group without using nasal spray hormone. We interviewed the patients respectively before and at the 3 months, 1 year and 2 years after surgery. The visual analogue scale(VAS)was recorded. Results Compared with baseline, the VAS scores of the two groups were both significantly decreased(P<0.05)at postoperative 3 months, 1 year and 2 years. but with the time extension, the scores of group B were statistically significantly increased(P<0.05); No obvious difference was found at group A within 1 years follow-up, the difference was statistically significant at 2 year follow-up. Between group A and B there were statistically significant difference scores at postoperative 1 year and 2 years follow-up, the score of group A was lower. Conclusion For allergic rhinitis, the efficacy of focused ultrasound is significant, but it is decreased over time. If with postoperative small dose of nasal spray hormone, the long-term treatment effect is significantly improved.
    Analysis of the effect of Professor Xie Hui using warm needling therapy for allergic rhinitis.
    DOU Dou, LI Linglong, ZHANG Jin, CAO Liu, XIE Hui
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  60-62.  doi:10.6040/j.issn.1673-3770.0.2016.225
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    Objective To analyze the principle of the Warm Needling therapy for allergic rhinitis(AR). Methods From March 2013 to September 2015, a total of 36 patients with AR were treated by using needling on points of Xiaguan(ST7),Hegu(LI4),Baihui(DU20)and warm needling on Zusanli(ST36), once a week, three times as a course of treatment. Results There were 5 patients got significant results, 27 got marked effects, and 4 failed,the efficient was up to 89%. Conclusion By Inquiry the results and analysis the treatment, we conclude the principle of AR to be “tonify spleen Qi, ascending Yang and defending weiqi.”
    Screening analysis of fourteen hereditary deafness gene mutation in patients with Non-syndromic hearing loss in Shandong province.
    LIU Shuangshuang, NIU Yuping, SUN Yue, MI Zhaoyuan, SHI Guizhi
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  63-68.  doi:10.6040/j.issn.1673-3770.0.2015.528
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    Objective To screen the common causative sites responsible for hereditary deafness genes in Shandong and to clarify deafness gene mutation patterns in this region by a molecular epidemiological study, thus to provide a basis for further detection and clinical diagnosis of hereditary deafness. Methods Totally 845 cases of patients with non-syndromic hearing loss and 351 cases of normal hearing people without family history of hearing loss were selected. The targeted mutations were detected by the single-tube two-fluorescent PCR method, and the obtained PCR results were analyzed. Results In 845 hearing-loss patients, the positive rates of 235delC, 299_300delAT, 176_191del16, 35delG, 155delTCTG and 512insAACG in GJB2 gene were 19.1%, 6.7%, 0.9%, 0%, 0%, 0.5%, respectively; the positive rates of 538C>T and 547G>A in GJB3 gene were 0.1% and 0%, respectively; the positive rates of IVS7-2A>G, 2168A>G, 1174A>T and 1229C>T in SLC26A4 gene were 12.9%, 3.8%, 1.4% and 0.7%, respectively; the positive rates of A1555G and C1494T in mtDNA 12S rRNA gene were 3.9% and 0.1%. In normal hearing people, the carrier rates of 235delC, 299_300delAT in GJB2 gene and IVS7-2A>G, 2168A>G in SLC26A4 gene were 1.4%, 0.9%, 1.1% and 0.6%, respectively, while the carrier rates of all the other ten sites were 0%. Conclusion In Shandong province, the common mutation sites for hereditary deafness were as the following: 235delC, 299_300delAT, 176_191del16, 512insAACG in GJB2 gene; IVS7-2A>G, 2168A>G, 1174A>T, 1229C>T in SLC26A4 gene and A1555G in mtDNA 12S rRNA gene. Five of these nine sites, GJB2 gene 235delC, 299_300delAT, SLC26A4 gene IVS7-2A>G, 2168A>G and mtDNA 12S rRNA gene A1555G, showed relatively high frequencies of mutation and could be used as the hotspots in this screening project. This study can therefore be a direction for future screening of hereditary deafness gene mutations in Shandong province.
    Analysis on the relevant prognostic factors of sudden deafness and selection of course of treatment.
    MA Rongfeng, ZHU Fugao, SUN Meihong, FU Tao, ZHANG Xiaoheng, CAO Lin
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  69-74.  doi:10.6040/j.issn.1673-3770.0.2015.429
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    Objective To explore the relevant prognostic factors of sudden deafness and selection of course of treatment. Methods Theclinical data of 185 patients with sudden deafness(228 ears)treated in the Affiliated Hospital of Qingdao University were retrospectively analyzed. The influence of gender, age, lesion sides, concurrent symptoms, audiogram types, duration between onset and treatment, pure tone average of injury frequency and course of treatment on overall response rate(ORR)was analyzed. After screening the relevant factors, multi-factor binary Logistic regression analysis was applied. Results Among 228 ears, 144 ears were non-effective, 31 ears were effective, 23 ears were markedly effective, and 30 ears were healed. ORR was 36.8%. Single factor analysis showed that gender, age, audiogram types, duration between onset and treatment, pure tone average of injury frequency and course of treatment were closely related to ORR(P<0.05), but not to lesion sides and concurrent symptoms, such as vertigo, tinnitus and ear fullness(P>0.05). Multi-factor regression analysis displayed that gender, age,audiogram types, duration between onset and treatmentand course of treatment all had a certain correlation with ORR(P<0.05), but the pure tone average of injury frequency was not correlated with ORR(P>0.05). Conclusion The prognosis of female patients is better than male patients. With age growing and duration between onset and treatment prolonging, the ORR has the decreased tendency. The prognosis oflow-frequencydescending type isthe best,followed by the flat-type andcompletely deafness type, and the high-frequencydescending type is the worst. Early treatment can improve the clinical efficacy of sudden deafness, and the patients who failin the first course of treatment shouldcontinue to be treated for two courses of treatment.
    Bone ablation in middle ear with pulsed CO2 laser and Er:YAG laser: an experimental study.
    WANG Xiaoyan, ZHENG Yanqing, ZHENG Hao, YE Qing
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  75-79.  doi:10.6040/j.issn.1673-3770.0.2015.552
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    Objective To study the feasibility of bone ablation in middle ear with pulsed CO2 laser and Er:YAG laser in rabbit models, in order to provide a new and safe tool for fenestration operation in middle ear. Methods A total of 24 New Zealand rabbits were randomly divided into 3 groups: drill group, CO2 laser group, and Er:YAG laser group. The three tools were used to perform fenestration operation of middle ear. The feasibility of bone ablation, experimental phenomena, total operation time and light irradiation time, and opening efficiency were compared. The morphologic changes of adjacent tissues were observed with tissue slicing and HE staining after irradiation. Results All of the three approaches were suitable for fenestration operation of middle ear bone, with different operation time, but there was no statistical difference(P>0.05). The three groups had similar morphologic characteristics after fenestration. Conclusion Both pulsed CO2 laser and Er:YAG laser can ablate bone rapidly in the fenestration operation, which can serve as a new tool in otological surgeries besides electric drill.
    Application of titanium ossicular replacement prosthesis in open mastoidectomy with tympanoplasty for ossicular chain reconstruction.
    LIU Bin, JIANG Yuling, XIAO Xuping
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  80-83.  doi:10.6040/j.issn.1673-3770.0.2015.398
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    Objective To explore the effects of using titanium ossicular replacement prosthesis in open mastoidectomy with ympanoplasty. Method From January 2013 to March 2015, 65 cases with chronic suppurative otitis media and middle ear cholesteatoma were treated with open mastoidectomy and tympanoplasty. Ossicular chains were reconstructed by partial ossicular replacement prosthesis(PORP)or total ossicular replacement prosthesis(TORP). The clinical data of these cases were retrospectively analyzed. The hearing threshold of air conduction and air bone gap(ABG)were compared before and 1,3,6 months after surgery. Results After 6 months of operation, the pure tone average(PTA)and averaged ABG of patients with chronic suppurative otitis media or middle ear cholesteatoma were dropped compared with those before surgery, with significant difference(P<0.05). There were 39 ears with an ABG lower than 20 dB after operation. Conclusion The effects of using titanium ossicular replacement prosthesis in open mastoidectomy with tmpanoplasty is satisfied for patients with chronic suppurative otitis media or middle ear cholesteatoma. The surgical indication and technique, as well as perioperative management, should be considered to ensure the success of operation.
    Hyperbaric oxygen therapy for 9 cases of sudden hearing loss with large vestibular aqueduct syndrome.
    WANG Jiefeng, WANG Huige
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  84-85.  doi:10.6040/j.issn.1673-3770.0.2016.107
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    Objective To investigate the clinical efficacy of hyperbaric oxygen therapy in with sudden hearing loss patients with large vestibular aqueduct syndrome. Methods A total of 9 cases(11 ears)of sudden hearing loss with large vestibular aqueduct syndrome were treated with ten times of hyperbaric oxygen therapy in two weeks. Results The therapy was well tolerated. Pure tone audiometry revealed significant improvement after therapy. Conclusion All cases present good tolerance and significant effect. Hyperbaric oxygen therapy can be one of the therapeutic methods for sudden hearing loss patients with large vestibular aqueduct syndrome.
    Efficacy and associated factors of endoscopic sinus surgery on patients with chronic rhinosinusitis with or without nasal polyps.
    SU Yi, XIE Jinghua, PAN Xiaoli, ZENG Guoqing
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  86-89.  doi:10.6040/j.issn.1673-3770.0.2016.096
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    Objective To explore the efficacy and associated factors of endoscopic sinus surgery on patients with chronic rhinosinusitis(CRS)with or without nasal polyps. Method A total of 126 CRS patients with nasal polyps and 154 without nasal polyps were included and treated by endoscopic sinus surgery, then were follow up for 6 months. The efficacy, complications and quality of life were compared between the two groups, and the factors of efficacy were analyzed. Results There was no significant difference in efficacy and complication rate between the two groups(P>0.05); after treatment, physical health, physical role functioning, mental health, emotional role function, energy, and general health in quality of life questionnaire SF-36 were increased(P<0.05), emotional role function was significantly higher in patients with CRS without nasal polyps than that in patients with nasal polyps(t=-4.107, P<0.001); after treatment, the law of nasal irrigation(P<0.001, OR=0.456, 95%CI: 0.727-0.913)and the regular use of hormones(P=0.029, OR=0.645, 95%CI: 0.325-0.752)had a significant impact on the outcome. Conclusion There is no difference in efficacy and safety for endoscopic sinus surgery between the patients with CRS with and without nasal polyps, but without nasal polyps patients recover better emotional role function, the efficacy of CRS is also subject to the law whether postoperative nasal irrigation and row hormones, and therefore should pay attention to the postoperative clinical treatment.
    Analysis of clinical risk factors on the postoperative prognosis of chronic rhinosinusitis.
    XIE Zhaofeng, LIN Honghao
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  90-93.  doi:10.6040/j.issn.1673-3770.0.2015.527
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    Objective To analyze the related factors affecting the postoperative prognosis of chronic rhinosinusitis(CRS)patients, and to provide effective reference for the treatment of patients with CRS. Methods Ninety CRS patients in our hospital from May 2014 to November 2015 were randomly selected and confirmed by sinus coronal CT scan and nasal endoscopic examine. All patients underwent endoscopic sinus surgery after continuous glucocorticoid nasal spray(200 μg per diem)and anti-inflammation therapy for 3 days. The related factors affecting the surgical treatment effect were analyzed. Results Before surgery, patients had very serious symptoms of head pain, rhinobyon and postnasal drip, which were effectively improved after treatment. But there is no significant improvement in general discomfort and hyposmia symptom. There were marked differences between the postoperative visual analog scale(VAS)score and 24 weeks and 48 weeks after surgery. Patients with nasal polyps or not, the long-term use of nasal congestion or not, has the history of sinus surgery or not, adhere to the implementation of the comprehensive treatment after surgery or not were related factors affecting the postoperative prognosis. Conclusion Nasal endoscopic surgery is effective in the treatment of patients with CRS, and can effectively improve the clinical symptoms. Acquaintance with patients past history, detection of allergens and implementation of comprehensive therapy after surgery is very important to improve the surgical effect.
    Diagnostic value of plasma 1-3-β-D glucan for fungal rhinosinusitis.
    YU Pengju, XU Fenglei, YANG Jun, CHEN Wei, JIANG Manjie
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  94-97.  doi:10.6040/j.issn.1673-3770.0.2015.526
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    Objective To analyze the value of plasma 1-3-β-D glucan for diagnosis of fungal rhinosinusitis. Methods Patients with nasosinusitis underwent surgery treatment at our hospital from 2014 to 2015 were selected and divided into observation group(fungal rhinosinusitis)and control group(bacterial rhinosinusitis)according to the postoperative pathological diagnosis. Changes of 1-3-β-D glucan, C-reactive protein(CRP)and procalcitonin(PCT)in peripheral blood were compared. Results A total of 83 patients were enrolled, in which 41 cases were divided in observation group and 42 cases were divided in control group. Patients in observation group had a higher level of 1-3-β-D glucan than that of control group before surgery(P<0.05), but decreased significantly after surgery(P<0.05). Correlation analysis showed that, for patients in observation group, the levels of 1-3-β-D glucan had significant positive correlation with CRP(t=0.846, P=0.002)and PCT(t=0.701, P=0.002). ROC analysis showed that the 1-3-β-D glucan cut-off point value of 12.0 pg/mL, as used for the diagnosis of fungal rhinosinusitis, provided a sensitivity of 90.48%, a specificity of 95.12%, better than these of CRP and PCT. Conclusion Plasma 1-3-β-D glucan assay for diagnosis of fungal rhinosinusitis is reliable and it has potential to become a practical indicator for auxiliary preoperative diagnosis.
    Investigations on the clinical features and endoscopic sinus surgery for the elderly patients with fungus ball sinusitis.
    LIU Ying, JI Qing, FENG Xinrong, LIU Wen
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  98-100.  doi:10.6040/j.issn.1673-3770.0.2016.038
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    Objective To investigate the clinical characters of the elderly patients with fungus ball sinusitis, and assess the therapeutic effect of endoscopic sinus surgery and management for recurrence. Methods The clinical data of 60 cases were analyzed. All the patients were performed endoscopic sinus surgeries and Visual Analog Scale(VAS)and the endoscopic examination. Patients with post-operative recurrence were done the maxillary sinus irrigation. Results In this group, the main clinical symptoms were runny nose, stuffy nose, nasal odor, postnasal drip and drip with blood, and the common signs were the middle nasal meatus stenosis and mucosal swelling, purulent secretions or caseous matter attachment and nasal meat obstruction, 76.92 percent of the patients had typical CT features. Both the Visual Analog Scale(VAS)and the score of endoscopic examination after the surgery were significantly lower than those before the surgery(p-value <0.01). It took 6 months that the operated cavity fully recovered. 4 recurrent cases were under complete control through irrigation of maxillary sinus. Conclusion The clinical characters and nasal examination are different in elderly patients with fungus ball sinusitis, CT scanning has special value for diagnosis. Endoscopic sinus surgery is an efficient way for this disease and irrigation of the maxillary sinus plays an important role for post-operative recurrence.
    Changes of ocular hemodynamics after intravitreal ranibizumab injection in patients with wet age-related macular degeneration.
    ZHAO Lu, XIE Guoli, WANG Yanling
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  101-104.  doi:10.6040/j.issn.1673-3770.0.2015.481
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    Objective To evaluate the changes in retrobulbar blood flow by using color Doppler sonography in patients who had undergone a single intravitreal ranibizumab injection for wet age-related macular degeneration(wAMD). Methods 20 wAMD patients(20 eyes)who had undergone intravitreal 0.5 mg ranibizumab injection were enrolled in this study. The ophthalmic artery, central retinal artery and ciliary artery of both eyes of patients were evaluated by color Doppler sonography. Peak systolic velocity(PSV), end-diastolic velocity(EDV), and resistance index(RI)and pulsatility index(PI)values were calculated before injection, and after injection on day 7 and day 30. The differences of ocular hemodynamic parameters were analysed at different time points. Results In a comparison with the pre-injection values of PSV, EDV, RI and PI, the post-injection values at both 1 and 4 week showed no statistically significant difference in ophthalmic artery, central retinal artery and lateral posterior ciliary artery. Similarly, all the same parameters revealed no statistically significant difference in the un-injected healthy fellow eyes. Conclusion Intravitreal ranibizumab injection for wAMD does not cause a significant difference in the retrobulbar blood flow in either the injected eye or the fellow eye.
    Intravitreal injection of conbercept for macular edema secondary to retinal vein occlusion.
    YAN Xiaoteng, FENG Jun, KANG Xinle
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  105-108.  doi:10.6040/j.issn.1673-3770.0.2016.002
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    Objective To explore the effects of intravitreal injection of conbercept for macular edema(ME)secondary to retinal vein occlusion(RVO). Methods A prospective, continuity and uncontrolled clinical case analysis was used. Thirty cases(30 eyes)with ME secondary to RVO in our hospital from September 2014 to February 2015 were selected, in which 9 cases(9 eyes)were central retinal vein occlusion(CRVO)and 21 cases(21 eyes)were branch retinal vein occlusion(BRVO). All cases were treated with intravitreal injection of conbercept for 3 times and followed up for 6 months. Best corrected visual acuity(BCVA)and central macular thickness(CMT)were observed. Results In patients with BRVO, mean BCVA before treatment and 6 months after treatment were(0.77±0.24)logMAR,(0.27±0.19)logMAR, and CMT were(596.8±139.6)μm,(272.6±29.2)μm, respectively, the difference has statistical significance(t=4.483, P<0.05; t=7.189, P<0.05). In patients with CRVO, mean BCVA before treatment and 6 months after treatment were(0.87±0.55)logMAR,(0.43±0.2)logMAR, and CMT were(647.3±163.6)μm,(393.1±121.5)μm, respectively, the difference has statistical significance(t=2.288, P<0.05; t=7.189, P<0.05). Conclusion Intravitreal injections of conbercept is effective for ME secondary to RVO.
    Analysis of efficacy of corneal bandage lens after pterygium resection.
    SHENG Xia, CHEN Hui, DENG Hong, XIE Qing
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  109-112.  doi:10.6040/j.issn.1673-3770.0.2016.010
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    Objective To evaluate the effectiveness of corneal bandage lens after pterygium resection combined with autologous limbal stem cell implantation. Methods A total of 58 patients(62 eyes)with pterygium were selected and given pterygium resection combined with autologous limbal stem cell implantation. They were randomly divided into experimental group and control group, 29 patients(31 eyes)for each group. Experimental group was given corneal bandage lens on postoperative d1, while control group was treated with routine eye pad dressing. Eye conditions 1 d, 4 d, 7 d and 1 month after operation and recovery condition 9 months after operation were observed in both groups. Results There were significant differences between two groups in eye condition scales 1 d and 4 d after operation(P<0.05), but the differences were not significant 7 d and 1 month after operation(P>0.05). There was interaction between time and grouping factors(P<0.05). And 9 month after operation, there was no significant difference between two groups in recurrence rate(P>0.05). Conclusion Application of corneal bandage lens after pterygium resection has no significant influence on postoperative recurrence rate of pterygium, but can relieve the corneal discomfort, and increase patients comfort, so it is an simple, effective and suitable complementary therapeutic method deserving to be popularized.
    Inflammatory granuloma after bronchial foreign body surgery in 2 cases.
    WEN Xin, SU Jinzhu, WANG Juan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2016, 30(4):  113-114.  doi:10.6040/j.issn.1673-3770.0.2015.467
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