Table of Content

16 February 2017 Volume 31 Issue 1

  

Clinical research on obstructive sleep apnea syndrome: still a long way to go.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  1-3.  doi:10.6040/j.issn.1673-3770.0.2017.063

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Localization diagnosis of obstructive sleep apnea hypopnea syndrome.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  4-7.  doi:10.6040/j.issn.1673-3770.0.2017.007

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The localization diagnosis of obstructive sleep apnea hypopnea syndrome(OSAHS)is important for selecting the appropriate surgical treatment, and improving curative effect. However, there still remains some confusion. Although there exist many commonly used localization diagnosis methods, including nose throat routine examination, endoscopy plus MULLER, upper-airway-esophageal continuous pressure measurement, upper-airway imaging examination, drug inducing sleep endoscopy, and so on, none of them can provide accurate evidence for surgical treatment or predict the outcome comparatively precisely. Based on relevant literature and the authors clinical experience and research, the author puts forward that elaborate localization diagnosis is not necessarily listed as a routine examination, and it applies only to cases with unknown causes or cases which need to be furthered studied. In the future, studies on the pathogenesis of OSAHS should be strengthened. The localization diagnosis is important, but what is more important is to detect the causes for airway stenosis and blockage, in order to develop more precise treatment plan, and achieve satisfactory outcomes by minimally invasive surgery.

The clinical features and treatment strategies of position-related OSAHS.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  8-12.  doi:10.6040/j.issn.1673-3770.0.2017.030

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According to the occurrence and severity of obstructive sleep apnea hypopnea syndrome(OSAHS)in different body positions, OSAHS can be classified into 2 types, position-related and non position-related, which have different clinical manifestations. At present, there are various treatments for these 2 types of OSAHS, and the therapeutic effects also vary. In this paper, we will review the clinical features and treatments of these 2 types of OSAHS.

Application of nasal cavity expansion surgery in the treatment of OSAHS and its clinical efficacy.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  13-17.  doi:10.6040/j.issn.1673-3770.0.2016.511

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As people have more awareness of the existence of multi plane stenosis in obstructive sleep apnea-hypopnea syndrome(OSAHS), nasal cavity expansion surgery has aroused more and more attention. This paper will review the pathophysiology of nasal obstruction and OSAHS, significance of expansion nasal OSAHS and nasal obstruction in patients with OSAHS, the significance of nasal cavity expansion surgery and its influence on nasal function, preoperative airway examination and evaluation of surgical indications, the timing of surgery, and curative effect of surgery.

Interpretation of the clinical practice guidelines for diagnostic testing for adult obstructive sleep apnea: an update for 2016. An American Academy of Sleep Medicine Clinical Practice Guideline.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  18-20.  doi:10.6040/j.issn.1673-3770.0.2017.084

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Relationship between vitamin D and obstructive sleep apnea hypopnea syndrome in children.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  21-26.  doi:10.6040/j.issn.1673-3770.0.2016.507

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Objective To investigate the clinical significance of detecting serum vitamin D level in children with obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods During June and Octorber 2016, 69 children with snoring were divided into the OSAHS group(n=47)and primary snoring(PS)group(n=22)according to the apnea-hypopnea index(AHI), and 70 healthy children without snoring served as controls. Venous blood was drawn from each child to measure the serum level of 25(OH)D, triglycerides(TG), total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C). Childrens behaviors were assessed with Conners Parent Symptom Questionnaire(PSQ). Results (1) The mean serum 25(OH)D level of the control, PS and OSAHS groups were 25.38±10.87 ng/mL, 22.00±7.84 ng/mL, and 17.92±6.32 ng/mL(F=9.458, P<0.001). There was significant difference between the OSAHS group and the control group(P<0.001), but no statistical difference between the PS group and the control group(P>0.05). (2) Non-obese children with OSA had significantly lower 25(OH)D level than non-obese children without OSA(P=0.001). There were no significant difference between obese children with OSA and non-obese children with OSA(P=0.566). (3) The 25(OH)D level of the OSAHS group showed positive correlation with anxiety(r=0.337, P=0.020), but no significant correlation with AHI, PSQ, TG, TC, HDL-C and LDL-C(r<0.5, P>0.05). Conclusion The level of serum 25(OH)D is significantly decreased in children with OSAHS, which may help to explore the pathophysiological changes of OSAHS.

Serum lipid changes in obstructive sleep apnea hypopnea syndrome patients underwent airway surgery.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  27-30.  doi:10.6040/j.issn.1673-3770.0.2016.197

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Objective To investigate the changes of lipid profiles in patients with obstructive sleep apnea hypopnea syndrome(OSAHS)before and after upper airway surgery, and to explore whether lipid detection can be used as an intuitive and effective way to evaluate the efficacy of surgery. Methods We performed a retrospective review of adult OSAHS patients who underwent surgery at Beijing Chaoyang Hospital during 2010 to 2013 with available perioperative serum lipid profiles, and selected the data of patients who did not use lipid-lowering medications during this period. We set up preoperative period, perioperativeperiod and follow-up period as three observation point. Results A total of 19 patients were enrolled. Preoperative blood lipid examination time was(12.5±5.6)months and the follow-up was(11.8±6.2)months.There was significant difference in total cholesterol serum(TC)levels and Lipoprotein(a)levels in OSAHS patients among the three observation periods(F_TC=9.03, P_TC=0.000 7; F_LP(a)=5.49, P_LP(a)=0.009). We set the perioperative period as the baseline. Both TC and LP(a)are significantly different when compare the preoperative and follow-upperiod to perioperative period(all P<0.05). Conclusion OSAHS with intermittent hypoxia can lead to blood serum lipids disorder, which can be improved with surgical treatment. TC and LP(a)are both sensitive indicator to hypoxia. Early detection and treatment of OSAHS are essential for the prevention and treatment of cardiovascular diseases. We suggest that more cardiovascular indicators should be explored to evaluate the effectiveness of surgery. 山东大学耳鼻喉眼学报31卷1期 -葛晓辉,等.手术对阻塞性睡眠呼吸暂停低通气综合征患者血脂代谢变化的临床观察 \=-

Efficacy and safety assessment of expiratory positive airway pressure rhinobyon for OSAHS therapy.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  31-37.  doi:10.6040/j.issn.1673-3770.0.2017.025

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Objective Evidence shows that CPAP therapy relying mainly on end-expiratory positive airway pressure(EEPAP)with OSAHS. Therefore, we designed expiratory positive airway pressure(EPAP)rhinobyon and made the efficacy and safety assessment. Methods Six volunteers were enrolled to measure the end-tidal carbon dioxide pressure(P_ETCO₂)while being treated by EPAP rhinobyon under different expiratory pressure. Fourteen OSAHS patients(AHI≥15/h by PSG)recruited were divided into two groups randomly and treated with CPAP and EPAP rhinobyon for a week respectively. After a week of washing out, the patients were applied with exchanged therapeutic methods for another week. The PSG was performed at the end of each week of treatment with device-on. Results There was no significant difference of P_ETCO₂ with EPAP therapies under different expiratory pressure and without any therapy(F=1.162, P=0.34). Among the 14 OSAHS patients in both groups, AHI decreased, minimum SaO₂ and mean SaO₂ increased significantly after treatment(P<0.001, respectively). There was no significant difference of the efficacy between EPAP rhinobyon and CPAP therapy(P=0.830, 0672, 0.649; P=0.473, 0.636, 0.667). Conclusion EPAP rhinobyon therapy was safe and reliable with significant efficacy for selected OSAHS patients. It could be promoted as the substitutive therapy for OSAHS in the future.

The significance of Epworth sleepiness scale and micro-arousal index in simple snoring.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  38-40.  doi:10.6040/j.issn.1673-3770.0.2016.466

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Objective To explore the significance of Epworth sleepiness scale(ESS)and micro-arousal index in simple snoring. Methods Polysomnography(PSG)recordings of 358 adults with simple snoring were divided into 3 groups according to ESS: mild group(n=286, ESS≤12), moderate group(n=43, 13≤ESS≤17)and severe group(n=29, 18≤ESS). The apnea hypopnea index(AHI), apnea index(AI), hypopnea index(HI), the lowest oxygen saturation(LSaO₂), micro-arousal index(MAI), and body mass index(BMI)were compared. Results The differences in AHI, AI, HI, LSaO₂ and BMI were not significant among the 3 groups(P>0.05). Significant differences were observed in MAI between mild and severe groups, moderate and severe groups(U=-8.030, -5.604, P<0.05, respectively). ESS was significantly correlated to MAI(r=0.331, P<0.05). Conclusion MAI and ESS are important to evaluate the severity of simple snoring.

Investigation of the consistency of sources of snoring sound induced by simulated snoring and drug-induced sleep endoscopy in patients with snoring.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  41-44.  doi:10.6040/j.issn.1673-3770.0.2016.436

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Objective To investigate the consistency of the sources of snoring sound induced by simulated snoring and drug-induced sleep endoscopy in simple snores(SS)and mild obstructive sleep apnea/hypopnea syndrome(OSAHS). Methods A total of 40 cases diagnosed as either SS or mild OSAHS by polysomnography(PSG)underwent simulated snoring and drug-induced sleep endoscopy successively. The vibration of soft tissue of upper airway was observed with fiberoptic laryngoscope. Results Under simulated snoring condition and drug-induced sleep endoscopy, there were different vibrations in the pharynx. The McNemar statistical results showed that there was no significant difference between simulated snoring and drug-induced sleep endoscopy in determining the vibration of soft palate and epiglottis/tongue base(P=0.774, 0.077), while there was very significant difference between the two methods in determining the vibration of the lateral phaynged wall(P=0.002). Under these two conditions, there was no significant difference in the incidence rates of vibration of both soft palate and epiglottis/tongue base(P=0.770, 0.110), while the incidence rate of vibration of lateral pharyngeal wall was much higer under drug-induced sleep endoscopy than that under simulated snoring(P=0.005). Conclusion Compared with drug-induced sleep endoscopy, simulated snoring is relatively reliable in determination of soft palate vibration, slightly inferior for epiglottis/tongue base, but is unreliable in the determination of lateral pharyngeal wall vibration.

Effects of rosiglitazone on oxidative stress and cognitive function in mice exposed to intermittent hypoxia.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  45-49.  doi:10.6040/j.issn.1673-3770.0.2017.027

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Objective To study the effects of PPAR gamma agonist rosiglitazone on the oxidative stress and cognitive functionon in mice exposed to intermittent hypoxia. Methods Sixty healthy male ICR mice were randomly divided into: the normoxic control group(UC group, n=12), the intermittent hypoxia group(IH group, n=12), the low dose of rosiglitazone intervention group(1 mg/kg ROS+IH group, n=12), the middle dose of rosiglitazone intervention group(3 mg/kg ROS+IH group, n=12), and the high dose of rosiglitazone intervention group(9 mg/kg ROS+IH group, n=12). IH group and groups treated with rosiglitazone were exposed to intermittent hypoxia cabin with discontinuous gas, eight hours each day. After four weeks intervention, mice were divided into two parts. The MDA and SOD assay kits were used to measure MDA and SOD concentration of mice in part one and Morris water maze test was used to detect the learning and memory function of the remaining mice. Results Compared with the UC group, the MDA concentration increased(P<0.05)and the SOD concentration decreased(P<0.05)in the IH group; compared with IH group, MDA concentration of the groups treated with rosiglitazone decreased in a dose-dependent manner(P<0.05)and SOD concentration increased. Compared with group UC, the average escape latency became longer, the times of crossing the platform and the time percentage spent in the platform quadrant reduced in the IH group; compared with the IH group, average escape latency shortened, frequency of crossing the platform and the percentage of time spent in platform quadrant increased in the 9 mg/kg ROS+IH group(P<0.05). Conclusion PPAR gamma agonist-rosiglitazone can improve the oxidative stress damage and cognitive dysfunction induced by intermittent hypoxia in mice.

Modified UPPP with low-temperature plasma tongue volume reduction and selective nasal cavity expansion for moderate to severe OSAHS: short-term efficacy and safety evaluation.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  50-54.  doi:10.6040/j.issn.1673-3770.0.2016.490

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Objective To explore the clinical efficacy, safety and value of modified uvulopalatopharyngoplasty(UPPP)versus low-temperature plasma and selective nasal cavity vasodilatation with tongue volume reduction in the treatment of moderate and severe obstructive sleep apnea hypopnea syndrome(OSAHS). Methods The clinical data of 164 patients with moderate or serious OSAHS treated during Octorber, 2013 and May, 2016 were retrospective analyzed. According to the different surgical approaches, patients were divided into two groups: the observation group(n=82)and the control group(n=82). Patients in the observation group received modified UPPP versus low-temperature plasma and selective nasal cavity vasodilatation with tongue volume reduction, while patients in the control group underwent routine UPPP and nasal cavity vasodilatation. The clinic efficacy, operative complications, postoperative relapse and other indexes of the two groups were compared. Results Six months after surgery, the general effective rate of the observation group and control group was 81.7% and 62.2%, respectively, with statistically significant difference(P<0.05). One year after surgery, the general effective rate of the observation group and control group was 75.6% 山东大学耳鼻喉眼学报31卷1期 -怀德,等.低温等离子辅助改良腭咽成形联合舌减容和鼻腔扩容术对中重度OSAHS的近期疗效和安全性评价 \=-and 51.2%, respectively, with statistically significant difference(P<0.05). Fewer complications occurred in the observation group than in the control group. Conclusion The efficacy of modified UPPP plus low-temperature plasma and selective nasal cavity vasodilatation with tongue volume reduction can produce satisfactory clinical outcome for patients with moderate or severe OSAHS.

Meta-analysis of the uvulopalatopharyngoplasty(UPPP)and modified UPPP for obstructive sleep apnea hypopnea syndrome.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  55-63.  doi:10.6040/j.issn.1673-3770.0.2017.047

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Objective To assess the efficacy of various soft palate surgeries for obstructive sleep apnea hypopnea syndrome(OSAHS). Methods Clinical studies of the soft palate surgical procedures for OSAHS were searched in databases including Cochrane, MEDLINE and PubMed, from their inception to October, 2015. References of the selected studies then underwent retrospective review and citation retrieval. Two reviewers independently screened the articles according to the predefined inclusive and exclusive criteria, and then extracted necessary data and evaluated quality of the included studies. A meta-analysis was performed using RevMan 5.1.0. Results A total of 20 self-controlled trials or RCTs involving 631 patients(88% males)were finally included. Quality evaluation was conducted independently by the two reviewers and crosschecked. Polysomnograph was adopted as a diagnostic criterion, but subjective assessment was used often for the evaluations of obstructive sites. Meta-analyses showed a significant improvement in apnea hyponea index(AHI), lowest saturation(LSAT)and Epworth sleepiness scale score(ESS). Sensitivity analysis indicated that these results were stable. Conclusion High-quality studies as well as objective indicators for the evaluation of obstructive sties are still needed. The soft palate surgeries are effective in reducing AHI and ESS, and enhancing LSAT. To date, no evidence has suggested one surgical approach is more effective than the others.

Surgical procedures and application of uvulopalatopharyngoplasty and its modified methods in patients with obstructive sleep apnea.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  64-69.  doi:10.6040/j.issn.1673-3770.0.2017.036

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The stenosis soft palate level is common in patients with obstructive sleep apnea syndrome(OSA)and uvulopalatopharyngoplasty(UPPP)is the classic method to relieve the obstructive sites. This review mainly describes surgical procedures of UPPP and its modified methods and theirs efficacy in the treatment of OSA.

Obstructive sleep apnea and cancer: a review.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  70-74.  doi:10.6040/j.issn.1673-3770.0.2016.533

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Several studies have recently demonstrated that patients with obstructive sleep apnea(OSA)have a high prevalence of cancer and cancer-related mortality. A large number of animal experiments and clinical studies have further confirmed that OSA can be involved in tumorigenesis and progression. The mechanism may involve oxidative stress, systemic inflammation, sympathetic outflow, immune dysfunction, exosomes, hypoxia-inducible factor(HIF), and so on.

Clinical efficacy of Tiebifu Granule in the treatment of deafness with iron deficiency.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  75-79.  doi:10.6040/j.issn.1673-3770.0.2016.190

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Objective To explore the clinical efficacy of Tiebifu Granule in the treatment of deafness with iron deficiency. Methods A total of 217 cases with iron deficiency including 163 cases of unilateral deaf and 54 cases of bilateral deaf were screened from 1 214 cases of sensorineural deafness and randomly divided into 2 groups: Tiebifu Granule group(n=109, taking Tiebifu Granule for 2 months)and control group(n=108, taking vitamin B1, mesylate, or methycobal for 2 months). The average threshold and serum ferritin were observed 1-3 days before medication, and 1 month and 2 months after taking medicine. Results One month after taking medicine, the serum ferritin level returned normal in 71.6% and 10.2% cases in the Tiebifu Granule group and control group, while the rate increased to 89% and 13.9% two months after taking medicine, showing significant difference between the two groups(P<0.001). The total effective rate of Tiebifu Granule group and control group was 52.3% and 22.2%, respectively, with significant difference between the two groups(P<0.001). Relevance between hearing improvement and serum ferritin increase was found in the Tiebifu Granule Group, but not in the control group. Conclusion Tiebifu Granule can effectively treat sensorineural deafness with iron deficiency.

Application of three-dimensional technology in the reconstruction of orbital wall defects in malignant tumors of maxillary sinus.

J Otolaryngol Ophthalmol Shandong Univ. 2017, 31(1):  80-84.  doi:10.6040/j.issn.1673-3770.0.2016.410

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Objective To assess the effect of three-dimensional(3D)technology in the reconstruction of orbital walls defects in malignant tumor of maxillary sinus. Methods A total of 6 patients suffering from malignant tumors of maxillary sinus with destruction of orbital walls who received surgical treatment in our department were enrolled. Before operation, all patients received computed tomography(CT). A resin stereo model of the affected orbital wall was printed with 3D printing technique, based on which a titanium mesh was modeled. The performed titanium mesh was then implanted into the defect area of orbital wall for reconstruction. Orbital volumes and globe projections were evaluated with clinical and CT examinations to assess the recovery of orbital walls. Results All 6 cases came through the operation successfully. During operation, the performed titanium mesh did not require reshaping and pruning. It fit bone bed surrounding the defect closely. Clinical and CT examinations 3 months after surgery showed successful reconstruction of orbital wall in all cases without serious complications. During the follow-up of 6 to 30 months, no recurrence occurred. Enophthalmos was corrected to less than 3mm. No clinical enophthalmos could be observed. Single quadrant diplopia occurred in one patient. The differences of orbital volumes and globe projections between the affected and unaffected orbits were both statistically insignificant(both P>0.05). Conclusion With exact reconstruction of anatomic shape and orbital volumes, 3D preformed titanium mesh is suitable for the repair of surgical orbital defect in sinus malignant tumor.

A study of laser-assisted tympanostomy in the treatment of 20 cases of secretory otitis media.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  85-87.  doi:10.6040/j.issn.1673-3770.0.2016.113

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Objective To evaluate the efficacy of laser-assisted tympanostomy in the treatment of secretory otitis media. Methods A total of 20 cases(25 ears)of secretory otitis media were treated with laser perforation, combined with oral antibiotics, hormone and other drugs. Results Of all 25 ears, 17 were healed after one perforation, 4 after two perforations, and 4 ears received tube insertion after perforation failed. The effective rate of perforation was 84%(21/25). Conclusion Laser-assisted tympanostomy is effective, simple and repeatable for secretory otitis media.

Exploration of diagnostic strategy for atypical PSC-BPPV with negative DHM.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  88-90.  doi:10.6040/j.issn.1673-3770.0.2016.055

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Objective To explore the diagnostic strategy of atypical posterior semicanal benign paroxysmal positional vertigo(PSC-BPPV)with negative Dix-Hallpike maneuver(DHM). Methods The diagnostic course of 55 cases of atypical PSC-BPPV with negative DHM was retrospectively reviewed. Epley maneuver was performed bilaterally and its effectiveness was observed. The early confirmed diagnostic rates according to positive DHM and Epley maneuver were compared. Results The confirmed diagnostic rate according to positive DHM and bilateral Epley maneuver were 35.6% and 100.0%, respectively. Conclusion Compared with positive DHM, bilateral Epley maneuver is more effective in the early diagnosis of PSC-BPPV, which can also avoid missed diagnosis of bilateral PSC-BPPV.

Clinical manifestation and treatment of orbital complications following acute rhinosinusitis in children.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  91-94.  doi:10.6040/j.issn.1673-3770.0.2016.195

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Objective To investigate the clinical manifestation and treatment methods of orbital complications following acute rhinosinusitis in children. Methods The clinical data of 16 children with orbital complications secondary to acute rhinosinusitis were retrospectively analyzed. After diagnosis, all the children were treated with drugs. For the children with impaired vision due to orbital cellulitis complicated by optic neuritis, emergency operation was performed. If the symptoms of children with subperiosteal abscess of the orbit were not improved after administration of drugs, the surgery was conducted immediately. Results Among 16 children, 7 with subperiosteal abscess of the orbit were cured by sinus opening plus drainage for subperiosteal abscesses. Of the 2 with impaired vision due to orbital cellulitis complicated by optic neuritis, one had the vision recovered, while the other only had light sensation. Seven children with orbital cellulitis and preseptal cellulitis were also cured after administration of drugs. Conclusion Orbital complications following acute rhinosinusitis in children are characterized by complicated clinical manifestations and rapid progression, so they should be diagnosed and treated as soon as possible. The ophthalmologists and paediatricians should attach more importance to orbital complications owing to the presence of their initial symptoms around eyes. Both orbital cellulitis and preseptal cellulitis can be cured after administration of drugs, and surgery should be performed as soon as possible if subperiosteal abscesses and orbital cellulitis complicated by optic neuritis occur.

Efficacy of recombinant human epidermal growth factor in prevention of radioactive oral mucosa inflammation and acute radiation dermatitis for nasopharyngeal carcinoma.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  95-99.  doi:10.6040/j.issn.1673-3770.0.2016.203

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Objective To observe the efficacy of recombinant human epidermal growth factor(rhEGF)in prevention of radioactive oral mucosa inflammation and acute radiation dermatitis of nasopharyngeal carcinoma(NPC). Methods A total of 50 NPC patients(5 stage Ⅱ, 32 stageⅢ and 13 stage Ⅳa)in the department of radiation oncology of our hospital hospitalized from January 2014 to December 2015 were randomly divided into the experimental group(n=26)and the control group(n=24).The two groups were treated with intensity modulated radiation therapy on the whole course, 6 weeks a radiotherapy cycle. The control group was given cisplatin single agent chemotherapy, and every 7 days for a cycle, 5 to 6 cycles. On the basis of the treatment of the control group, the experimental group was treated with combination of rhEGF(oral spray and neck skin smear gel)in the same period of the treatment. Short-term efficacy of the two groups was evaluated with complete remission, partial remission, stable disease and progression disease. The toxicity and side-effects were evaluated by the National Cancer Institute Common Toxicity Criteria(NCI-CTC). Results The short-term efficacy of the two groups was basically equivalent(P>0.05). No patients died in the two groups due to the toxic side effects, and the main toxicities in the two groups were gastrointestinal toxicity, myelosuppression and abnormal liver function. All patients had happened radioactive oral mucosa inflammation and acute radiation dermatitis of the neck which level was over grade Ⅰ. The incidence of radioactive oral mucosa inflammation and acute radiation dermatitis of the neck over grade Ⅱ level in the experimental group(42.31% and 11.54%)were significantly lower than those of the control group(70.83% and 41.67%)(P=0.042, 0.035). Conclusion The method of combination radiotherapy and chemotherapy with rhEGF in the treatment of NPC can effectively reduce the incidence of 山东大学耳鼻喉眼学报31卷1期 -于斌,等.重组人表皮生长因子预防鼻咽癌放射性口腔黏膜炎和急性放射性皮炎的疗效观察 \=-toxicity and side-effects of radioactive oral mucosa inflammation and acute radiation dermatitis of neck which caused by radiotherapy and chemotherapy.

Foreign body induced cervical abscess in 3 cases and literature view.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  100-102.  doi:10.6040/j.issn.1673-3770.0.2016.341

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Objective To explore the clinical characteristics, diagnosis and treatment of cervical abscess caused by foreign bodies. Methods Clinical data of 3 cases of cervical abscess caused by foreign body treated during 2012 and 2015 were retrospectively analyzed, and 49 similar cases were reviewed. Results Of the 49 cases, 48 received surgical treatment, and 46 had foreign bodies removed; 1 case received conservative treatment. Complications such as respiratory arrest occurred in 17 cases. All reported cases were cured. Conclusion Cervical abscess caused by foreign bodies is a critical condition with many complications. The key steps involve detecting and removing foreign bodies based on the history and imaging studies, and draining the abscess as soon as possible.

The aqueous levels of TNF-α and IP-10 in different kinds of glaucoma and their correlation.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  103-106.  doi:10.6040/j.issn.1673-3770.0.2016.201

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Objective To investigate the aqueous levels of tumor necrosis factor-α( TNF-α)and interferon-inducible protein-10( IP-10)in glaucoma and the correlation of them. Methods A total of 27 glaucoma patients were recruited and set as the glaucoma group, and another 28 cataract patients with normal intraocular pressure were also selected as the control group. Aqueous fluid of those patients were collected, and the detection of the concentrations of TNF-αand IP-10 was carried out using the cytometric bead array. The outcomes were further analyzed by SPSS 13.0. Results The mean concentrations of TNF-α and IP-10 in eyes with glaucoma were 2.57±0.82 pg/mL and 990.15±766.84 pg/mL respectively, significantly higher than those of eyes with cataract(P=0.003). In subgroup analysis, the concentration of TNF-α in eyes with acute angle closure glaucoma(AACG)was higher than eyes with chronic angle closure glaucoma(CACG); The concentration of IP-10 in the AACG group was higher than that in the CACG and the control group. Besides, the level of IP-10 was positively correlated with the level of TNF-α(r=0.841, P<0.001). Conclusion TNF-α and IP-10 may play important role in the pathogenesis of glaucoma, and different pathogenesis may lead to different level of inflammatory response. The level of IP-10 was positively correlated with TNF-α.

Causes of non-traumatic vitreous hemorrhage and effects of surgical treatment.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  107-109.  doi:10.6040/j.issn.1673-3770.0.2016.208

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Objective To analyze the causes of non-traumatic vitreous hemorrhage and the therapeutic effect of vitrectomy. Methods From January 2015 to December 2015, 229 patients(243 eyes)hospitalized for non-traumatic vitreous hemorrhage were enrolled in the retrospective analysis. Cause compositions, surgical procedures and prognosis of patients with non-traumatic vitreous hemorrhage were analyzed respectively. Results Proliferative diabetic retinopathy(PDR,134 eyes, 55.56%), retinal vein occlusion(RVO, 77 eyes, 32.37%)and rhegmatogenous retinal detachment(RD, 5 eyes, 5.80%)were the main causes of non-traumatic vitreous hemorrhage. There was significant difference in visual acuity before and after vitrectomy(P<0.05). Conclusion PDR, RVO and RD were the main causes of non-traumatic vitreous hemorrhage. Vitrectomy is an effective method for the treatment of vitreous hemorrhage.

Clinical observation on the treatment of BRVO-ME by the combination of laser therapy with Ranibizumab intravitreal injection.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  110-113.  doi:10.6040/j.issn.1673-3770.0.2016.328

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Objective To explore the clinical efficacy of branch retinal vein occlusion secondary macular edema(BRVO-ME)treated with Ranibizumab intravitreal injection combined with grille laser photocoagulation(GLP). Methods A total of 135(135 eyes)BRVO-ME cases were divided into 3 groups: simple drug group(n=45), simple laser group(n=45), and combined treatment group(n=45). The simple drug group received Ranibizumab intravitreal injection only. The simple laser group received GLP only. The combined treatment group received Ranibizumab intravitreal injection first, and then GLP 1 week after. The best corrected visual acuity(BCVA), central macular thickness(CMT), and intraocular pressure(IOP)of the 3 groups were observed. Results Three months after treatment, BCVA and CMT of all groups were significantly different(P<0.05). The combined treatment group had significantly lower BCVA and CMT than the other 2 groups in postoperative month 1, 2 and 3(P<0.05). During the treatment, no increased IOP was observed(P>0.05). No postoperative infection, vitreous hemorrhage, bacterial endophthalmitis or other adverse reactions occurred. Conclusion Ranibizumab intravitreal injection combined with GLP is safe and effective in the treatment of BRVO-ME, which can reduce the CMT, relieve macular edema, and improve visual acuity.

Endoscopic dacryocystorhinostomy.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  114-118.  doi:10.6040/j.issn.1673-3770.1.2016.11

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The situation of optical coherence tomography in the diagnosis of non-arteritic anterior ischemic optic neuropathy.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  119-122.  doi:10.6040/j.issn.1673-3770.0.2016.451

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Non-arteritic anterior ischemic optic neuropathy(NA-AION)is a common disease which caused blindness among the middle-aged and old people. The clinical manifestations of NA-AION include sudden blurred vision or defect of visual field which often happens in the early morning or after short break, and the defect of visual field usually connects to physiological blind spots. At present, the examinations of fundus and visual field, fundus fluorescein angiography(FFA)and visual evoked potential(VEP)are helpful in the diagnosis of NA-AION. In recent years, optical coherence tomography(OCT)has been widely used in the diagnosis and treatment of NA-AION due to its characteristics of non-invasiveness, higher safety and resolution, rapid scanning, three-dimensional reconstruction and stratification analysis. In this article, the diagnostic situation and clinical significance of OCT in NA-AION was reviewed.

The pathogenesis of RVO and anti-VEGF treatment for its macular edema.

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(1):  123-126.  doi:10.6040/j.issn.1673-3770.0.2016.454

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RVO is a common retinal vascular disease. Macular edema is one of major cause to induce visual damage. With the application of anti-VEGF drug in clinic, macular edema can be reduced and vision is improved. The essay mainly summarized the epidemiologies and mechanisms of retinal vein occlusion and the treatment of macular edema with anti-VEGF reagents.