Table of Content

24 October 2007 Volume 21 Issue 5

  

Articles

Reconstruction for advanced hypopharyngeal carcinoma and laryngeal recurrent carcinoma

DONG Pin,LI Xiao-yan,TU Li-qiang,MENG Qing-hong,WANG Sang,XIE Jin,JIANG Yan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  385-387 . 

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Objective:To explore how to repair the hypopharyngeal and cervical defects after carcinoma removal in patients with hypopharyneal carcinoma of the advanced stage and laryngeal recurrent carcinoma. Method:36 cases of recurrent laryngeal carcinoma were treated. The defects of 18 cases were repaired with pectoralis major flaps, of 4 with deltopectoralis skin flaps, of 2 with stomach replaced esophagus and of 12 with the flap shift from thoraces to cover the dead space. Also 16 cases of late hypopharyngeal and eight cases of cervical esophageal carcinoma were treated in this study. The defects of 1 case was repaired with jejunal interposition, of 8 with laryngeal mucosal flaps from the uninjured side, of 8 with laryngotracheal interpositions, of 2 with pectoralis major flaps, of 2 with stomach replaced esophagus,and of 1 with a free antebrachial flap.Results: No one died during the operations and no reconstructed tissue necrosis happened after the operations. All flaps survived. In cases repaired with laryngeal mucosal flaps, only 1 with pre-operational radiotherapy suffered from pharyngeal fistula. 1 case was repaired with a pectoralis major flap and 1 with a stomach replaced esophagus suffered from a pharyngeal fistula. All patients could intake semi-fluid after healing. Followed up for 9 to 84 months, 14 patients had dysphagia but still could intake semifluid. Conclusions:All kinds of ways to reconstruct the defect of hypopharynx are good in different aspects and have different indications. Location of the tumor and size of the defects are the most important factors for choosing the reconstruction method. Also, complications should be decreased.

Expression and significance of p21, p73 and PTEN in multiple primary cancers of the head and neck

HUANG Fang,ZHU Cong-yue

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  388-392 . 

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Objective: To investigate the effects of p21, p73 and PTEN expressions in multiple primary cancers of the head and neck. Method: Expressions of p21, p73 and PTEN were determined by the S-P immunohistochemical technique in 42 samples of multiple primary cancer tissues, 42 cases of marched single cancer tissues of the head and neck, and 30 cases of normal epithelial tissues of the head and neck. Results: Positive expression rates of p21, p73 and PTEN in multiple primary cancer tissues and single cancer tissues of the head and neck were 69.05％, 57.14％, 71.43％ and 76.19％, 40.48％, 76.19％, respectively, and those in normal epithelial tissues were 96.66％, 13.33％ and 100.00％. The loss expression rates of p21 and PTEN and the over-expression rates of p73 in multiple primary cancer tissues and single cancer tissues of the head and neck were all significantly higher than those in normal epithelial tissues(P＜0.05), but no significant differences were found between multiple primary cancer tissues and single cancer tissues. Conclusion: The loss of expression of p21 and PTEN and the upregulated expression of p73 may play important roles in tumor genesis of multiple primary cancer and single cancer of the head and neck, but no differences have been found till now between multiple primary cancer and single cancer.

Long-term curative effect of the KTP laser for laryngeal carcin

SUN Xin,JI Wen-yue

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  393-395 . 

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Objective: To evaluate the long-term curative effect of the KTP laser in the treatment of laryngeal carcinoma. Methods: A retrospective analysis of 108 laryngeal carcinoma cases treated with KTP laser surgery under a selfretaining laryngoscope in our hospital from 1997 to 2001 were carried out. 87 cases were the glottic type T1a,17 T1b, 2T2 and 2 were supraglottic. Results: Among the 101 followed-up cases, 3 relapsed and 4 had metastasis. 7 cases failed an follow-up. Conclusion: Laser is reliable in the treatment of early-stage laryngeal carcinoma. After the operations the vocal function is well retained. The recurrent cases can also receive treatment.

Relationship between upper airway CT measurements and apnea hypopnea indexes of patients with obstructive sleep apnea hypopnea syndrome

JIANG Xiao,CHEN Bin,YI Hong-liang,YIN Shan-kai,SU Kai-ming

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  396-399 . 

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Objective To investigate the relationship between upper airway CT measurements and apnea hypopnea indexes of patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods The pharynxes of 42 patients with OSAHS were scanned by CT during normal respiration and deep inspiration. CT measurements were made in crosssection areas with their corresponding sagittal and transverse diameters, and their pharyngeal collapsibility was also determined. Results （1） The smallest crosssection area of OSAHS was at the velopharyngeal level. (2) At the velopharyngeal level CT measurements were negatively correlated with AHI during normal respiration and deep inspiration, and at the tonguepharyngeal level CT measurements were negatively correlated with AHI during deep inspiration in moderate and serious OSAHS. (3) The collapsibility of different pharynx levels was not correlated with AHI in all cases. Conclusions The collapsibility of different pharynx levels has no correlation with AHI.

Effect of uvulopalatopharyngoplasty on high sensitive C-creative protein in the serum of patients with obstructive sleep apnea hypopnea

WENG Yong-cai,LIU Ji-xiang,WANG Lin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  400-403 . 

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Objective To explore the effects of uvulopalatopharyngoplasty(UPPP) on high sensitive C-creative protein(hs-CRP) in serum of patients with obstructive sleep apnea hypopnea syndrome(OSAHS). Method Before and three months after the operations, serum hs-CRP was determined in the experimental group (n=20) and two control groups. Result The serum level of hs-CRP in OSAHS patients was significantly higher than that of the control groups and it was significantly decreased three months after UPPP. Conclusion UPPP can obviously decrease the level of hs-CRP of OSAHS patients; therefore it reduces the incidence of cardiovascular disease of OASHS patients.

Effect of plasma radio-frequency at a low temperature for 60 patients with obstructive sleep apnea hypopnea syndrome

LIU Hong-jun,ZHANG Ai-fen,LINa,LIU Ai-qin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  404-406 . 

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Objective To investigate and study the clinical effect of plasma radiofrequency ablation (RFA) at a low temperature in treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Infraturbinal, soft palate, uvula and tongue base were channeled using ENTec-CobatorTM plasma surgical instruments,which was made by the Arthrocare Company, USA in all 60 cases. Nocturnal polysomnography（PSG）and fibroptic laryngoscope examination were performed on before and after the operations. Different operations were based on different obstruction planes under local anesthesia: ① only RFA on the infraturbinal, soft palate, uvula and tongue base; ② RFA after tonsillectomy plus partial resection of the soft palate and uvula; ③ gradual RFA after tonsillectomy for the unbearable patients; ④ RFA accompanied with nasal septum deviation and polyps resection under endoscopy. Results Symptoms of all patients were alleviated or vanished: the apnea time was remarkably reduced, all patients were vigorous in the daytime, the free margin of the soft palate was elevated, the uvula was shortened, the volume of the tonsil was remarkably reduced, and the pharyngeal space was significantly expanded. No complications occurred during and after the operations. The mean AHI of OSAHS patients decreased and the mean lowest SaO2 increased after the operations (P＜0.01); in general, 18 cases were cured, 28 patients showed an excellent effect, 10 cases showed a good effect and 4 cases had no effect after 6 months, whereas 15, 25, 13, and 7 respectively after 12 months. The effect rate was 93.33%（56/60）and 88.33%（53/60）, respectively. Conclusion Plasma radiofrequency ablation (RFA) is an effective method for obstructive sleep apnea hypopnea syndrome (OSAHS) and it is simple, microtraumatic, safe and accessible and can be popularized in clinical work, but its longterm effect is unclear.

Modified uvulopalatopharyngoplasty for obstructive sleep apnea hypopnea syndrome

WANG Yan-wei,XIN Lu,YUAN Yong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  407-410 . 

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Objective To modify uvulopalatopharyngoplasty(UPPP). Methods 263 patients with obstructive sleep apnea hypopnea syndrome(OSAHS) were treated with modified UPPP. In the operations, the uvula was reserved, the fat tissues of the palatine velar cleft were dissected and palatoplasty and pharyngoplasty were carried out. All patients was determined by polysomnography(PSG) before the operations and 6 months after the operations to assess the surgical outcome statistically. Results All patients were involved in this analysis. (1) 197(74.9%) patients did not need painkillers after the operations and 66(25.1%) needed painkillers. The lateral pharyngeal wall was smooth in 168(63.9%)cases and was partly split in 95(36.1%) cases. There were no complications such as breath holding or backstreaming in the nasal cavity after the operations. (2) All were followed up for more than 6 months and no deglutitive bucking or open rhinolalia were found. 95(36.1%) patients had pharyngeal foreign body sensation. Syndromes of sleep apnea disappeared in 189 (71.9%) patients and were alleviated in the other 74(28.1%) patients. In 252(95.8%)patients, the postoperative morphous of the oral cavity was content. (3) The PSG results were statistically significant between the pre-operative and post-operative for 263 patients（P＜0.05). Conclusions The modified UPPP not only extends the nasopharynx cavity but also avoids postoperative complications and improves the effects of UPPP. 

Effect of adenoidectomy on sleep architectures in children with adenoidal hypertrophy

ZHU Juan-fen,FENG Yong-gang,GU Xiao-feng,BI Zhi

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  415-416 . 

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Objective To evaluate the changes of sleep architecture in children with adenoidal hypertrophy after adenoidectomy. Methods From January 2003 to October 2006, polysomnography (PSG) was performed on 120 children with adenoidal hypertrophy before and after adenoidectomy. Various polygraphic parameters describing the macrostructure of sleep and the microstructure of sleep were analyzed . Results The S1 and S2 stages were not significantly changed after adenoidectomy(P>0.05), and the SWS and REM stages increased in ratio (P>0.05). But the arousals index before adenoidectomy was higher than that after adenoidectomy (6.3±0. 4 vs 2.8±0.3，P<0.01) and the SaO2 before operations was lower than that after operations （70.3±1.3 vs 93.4±1.4） (P<0.01). 〖WTHZ〗Conclusions There are no significant differences in the macrostructure of sleep after adenoidectomy. Improvement of the microstructure of sleep in children with adenoidal hypertrophy is the physiopathological basis of clinical relief after adenoidectomy.

Combined therapy for recurrent secretory otitis media with residual adenoids

JI Jian-li,SUN Wen-hai,LI Da-jian,LIU Xin-yi,ZHANG En-dong,LIU Yan,SUN Cai-bo

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  417-419 . 

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Objective To explore the effects of combined therapy for recurrent secretory otitis media with residual adenoids. Method A total of 29 ears of recurrent secretory otitis media (20 patients) were subjected to endoscopic adenoidectomy combined with pharyngotympanic tube catheterization and systemic medication between 2004 and 2007. Results Followed up for 6 months to 3 years, 26 ears (17 cases, 89.7%) were cured, 1 ear (1 case, 3.4%) was improved and 2 ears (2 cases, 6.9%) were unchanged. The total validity rate was 93.1%. Conclusion Combined therapy is effective for treating recurrent secretory otitis media with residual adenoids.

Surgical excision with compression buttoning for pseudo-cysts of the auricle

CAI Chang-ping,Siow Jinkeat, Samuel Yeak

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  420-422 . 

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Objective To evaluate the effects of surgical excision with compression buttoning on pseudocysts of the auricle. Methods 30 patients were selected for surgery during the past two years. A helical incision was made and a skin flap was well raised beyond the boundary of the raised anterior cartilage segment of the pseudocyst. The affected perichondrium was carefully excised along the margins. The skin flap was returned to its original position and closed with simple running 5/0 Vicryl(r) rapide sutures. A pair of sterilized buttons on the anterior and posterior surfaces of the auricle was used to sandwich the raised skin flap onto the cartilage. The buttons and sutures were removed on the fifth and eighth postoperative days. Results All recovered well following excisions and compression buttonings of the pseudocyst. No recurrence and complications developed. Conclusion Treatment options are varied. Surgical excision with compression buttoning yields an excellent result without recurrence. It is advised to be the first choice in the management of pseudocysts of the auricle.

BFGF prevents Cisplatin induced hair cell death and Caspase-9 activation in rat cochlea in vitro

LI Shu-na,WANG Xiao-yu,JIANG Xue-jun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  423-426 . 

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Objective Cisplatin of different concentrations can induce hair cell death in the cochlea. To explore if the bFGF of different concentrations prevents ciplatin induced hair cell death and the expression of caspase-9. Method Basilar membranes were cultured and the number of hair cells and the expression of caspase-9 were determined by immunofluorescent staining. Results Cisplatin of 15μg/ml induced the maximal hair cell death, when it was equal to or higher than 100ng/ml, bFGF could well prevent ciplatin induced hair cell death. Conclusions Hair cell death induced by cisplatin is concentrationdependent. BFGF can prevent ciplatin induced hair cell death, which is related to the expression of caspase-9.

Comparison between proliferation activity and apoptosis activity of epithelial cells in nasal polyps

LIN Xing-qiang,WANG Hui-ge,SHEN Zhi-zhong,ZHANG Yan,YE Hui-jie,YANG Dan-na

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  430-432 . 

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Objective To investigate the status of the balance between proliferation and apoptosis of epithelial cells in nasal polyps and to explore its pathogenic significance. Methods Expressions of PCNA were determined for 29 cases of nasal polyps in the treatment group and 11 cases of normal inferior turbinates in the control group by immunohistochemical staining. The apoptosis cells in site were determined by the TUNEL technique. Results ① Both the PCNA positive index（PIPCNA）and the apoptosis index（AI）of epithelial cells in nasal polyps were prominently higher than those in normal inferior turbinates（30.02±5.89, 5.33±2.79, respectively）(P＜0.01). However, the PIPCNA/AI ratio of epithelial cells in nasal polyps（1.95±0.66） was lower than that in normal inferior turbinates（6.93±3.32）(P＜0.01).② The PIPCNA of epithelial cells in nasal polyps (53.60±11.10) was prominently higher than the AI of epithelial cells in nasal polyps（29.48±8.20）(P＜0.01). Conclusions Both proliferation actability and apoptosis actability of epithelial cells in nasal polyps are increasing, and the latter is of a large increasing range, but the proliferation rate of epithelial cells in nasal polyps, taking one with another, is still higher than the apoptosis rate, resulting in an increasing cell accumulation accompanied by overproliferation of epithelial cells in nasal polyps.

Inferior nasal concha flipping for mycotic maxillary sinusitis under a rhinoendoscope

SONG Xi-cheng,WANG Qiang,ZHANG Hua,WANG Yan-mei,SUN Yan,CHEN Xiu-mei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  433-435 . 

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Objective To explore the treatment method for mycotic maxillary sinusitis. Methods 32 patients hospitalized from June 2003 to June 2006 were treated by an inferior nasal concha flipping pathway. All patients are characterized with a fully occupied maxillary antrum cavity, and the pathological tissues could not be completely removed through middle or sub. 19 patients featured bone destruction or absorption to different degrees. All patients underwent rhinoendoscope surgeries. The inferior nasal concha was partly cut off 0.5 cm from the anterior adhering point, and the hamular process and the tissues around the opening of maxillary sinus as well as the tissues of the inferior nasal meatus were removed. The inferior nasal concha was made into a banded tissue flap with the pedicle at the rear, and then based on the situation, it was flipped backwards or upwards exposing the fields of view in the operations. Using 0°, 30° and 70° endoscopes, the disordered tissues in the endo-inferior part of maxillary cavity were erased using a curette, and the lacrimal canal in the front end and the sphenopalatine artery were well preserved. After complete removal of the disordered tissues, the inferior nasal concha was repositioned, and the anterior incisions were sutured or glued. Results All disordered tissues were completely removed and no recurrence was found after a followup of 1 to 4 years. 5 patients complained about dry nasal cavities and after a nasal douche their symptoms disappeared in 15 to 30 days. 3 months after the operations no complaints about dry nasal cavities or headache were found. No nasal synechia, angusty or necrosis were found. Conclusions Inferior nasal concha flipping can reduce trauma, avoid labiogingval incisions and provides an expansive field of view. Especially when it comes to the management of the endoinferior part of the maxillary antrum, the pathway can be discharged through the middle meatus. The pathway also provides an expansive field of view for postoperative recheck and management for relapse. By preserving the structure and volume of the inferior nasal concha, the sequel of dry nasal cavity, incrustation and headache are decreased. 

Relationship between variations of dissection and chronic sinusitis

DONG Jin-ye,LI Na,SHI Guang-gang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  436-438 . 

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Objective To investigate the correlation between variations of dissection and chronic sinusitis. Methods 286 patients with chronic sinusitis and 100 normal persons were selected as the experimental and control groups. Variations of dissection were analyzed by preoperative computed tomography of nasal sinuses and by endoscopy. Result Chronic sinusitis correlated with septal deformity, uncinate process shift and hypertrophy, pneumation and paradoxical curvature of the middle turbinate, ethmoid bulla, agger nasi cell and Haller′s cell. Conclusion Variations of dissection, especially of the septal deformity are risk factors for chronic sinusitis.

Middle ear function of patients with chronic sinusitis

JI Xiao-bin,WANG Lei,YANG Gui-mei,MENG Qing-xiang,XIE Jing-hua,WU Xiao-zhong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  439-442 . 

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Objective To investigate the effects of chronic sinusitis on middle ear function. Methods 53 patients with chronic sinusitis and 10 healthy controls were involved in this study. All were determined by the acoustic immitance audiometer and pure tone audiometry. Results （1）A type was determined in 33 patients (62.26%), As type in 4 patients (7.55%), B type in 2 patients (3.77%), and C type in 14 patients (26.42%). 35 patients (66.04%) had normal air hearing threshold, 16(30.19%) had a little deafness and 2 (3.77%) had middle deafness.（2）There were significant differences between the chronic sinusitis and the controls, among stages in As, B and C types tympanograms, were peak pressure, acoustic stapedius reflex and gradient. But statical compliance showed no change. （3）There were significant differences between the chronic sinusitis and the controls, and among stages in air hearing threshold of each frequency of chronic sinusitis. Conclusions As the stage of chronic sinusitis proceeds, both abnormal tympanograms and the acoustic stapedius reflex vanishing greatly grow, and as the peak pressure trends to negative, the gradient raises, though the statitical compliance shows no or few changes, the hearing impairment is heavier than before.

Expression of angiopoietin-2 and its clinical significance on Juvenile nasopharyngeal angiofibroma

WU Xian-min,LI Zhi-chun,ZHANG Sheng,YI Zi-xiang,LIN Gong-biao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  443-445 . 

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Objective To investigate the expression of angiopoietin-2(Ang-2) in Juvenile nasopharyngeal angiofibroma(JNA) and its relationship with vascularization and dilatancy growth. Methods Expression of Ang-2 was determined in 30 cases of JNA and 20 cases of chronic inflammation tissues of the pharynx nasalis by immunohistochemistry. Vascular endothelial cells were marked by CD34 and the microvessel density (MVD) was also determined in the above tissue specimens. Results The positive rate of Ang-2 protein was 76.67% in JNA， which was higher than that in chronic inflammation tissues of the pharynx nasalis. The positive rate of Ang-2 proteins was 90％ in stages Ⅲ-Ⅳ， which was obviously higher than that in stagesⅠ-Ⅱ. The expression rate of CD34 in JNA was lower than that in chronic inflammation tissues of the pharynx nasalis（P<0.05）. Conclusions Ang-2 participates in the vascularization of JNA and has some relatioge and tumor′s dilatancy growth.

Pathogenesis and treatment of vasomotor rhinitis

CUI Zhe-zhu,HAN Yu,YE Hui,JIANG Xian,CUI Chun-lian,JIN Shun-ji

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  446-448 . 

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Objective To investigate the pathogenesis and therapy of vasomotor rhinitis. Method One hundred and seventysix patients with vasomotor rhinitis were randomly divided into three groups: the autonomic nerve regulation group (n=62 ), the laser therapy for single inferior turbinate group (n=50) and the drug therapy group (n=64). Results The effect of laser therapy for the single inferior turbinate group was better than that of the autonomic nerve regulation group, but there was no significant difference between the two groups statistically. The effect of laser therapy for the single inferior turbinate group and the autonomic nerve regulation group was better than that for the drug therapy group (P=0.004, P= 0.041). Conclusion Laser therapy for the single inferior turbinate and autonomic nerve regulation are all effective for vasomotor rhinitis. Vasomotor rhinitis is probably caused by regional vegetosis of the nasal mucosa.

Odontogenic paranasal fistula: a report of six cases

WANG Yong-fu,ZHANG Qing-quan,ZHANG Jie

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  449-450 . 

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Objective To explore the diagnosis and treatment of apicitis of the maxillary canine complicated with paranasal fistula. Methods The clinical data of 6 patients with apicitis of the eye tooth complicated with paranasal fistula were retrospectively analysed. No abnormality was found in the nasal CT or X-ray images. 4 patients were misdiagnosed as osteomyelitis of the maxilla， infectionus ofsebaceous cyst or basal cell carcinoma. 2 patients underwent dental filming and were finally diagnosed as paranasal fistula. In the operations, all were locally ectomized and sutured, the diseased teeth were pulled out, and the raw surfaces of the root tip were scoraped to clean the focus of infection. Results The prospo-cut of all 6 cases ended up with primary healing, and after 2 to 10 years follow-up, no recurrence was found. Conclusions Paranasal fistula may be caused by odongenic diseases and so stomatological examination is necessary for minimizing the misdiagnosis rate. 

Diagnosis and treatment of the congenital first branchial cyst and fistula

LU Yong-tian,MIAO Bei-ping,XU An-ting

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  456-458 . 

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Objective To explore the diagnosis and treatment of the congenital first branchial cyst and fistula. Method The clinical data of 18 patients with first branchial cyst and fistula were retrospectively analyzed. Results Among them, 10 had first branchial fistulas, of which the external blind fistula was between the earlobe and mastoid process and 6 patients， of which the internal blind fistula located in the boundary of bone and cartilage was in the posterior and lower wall of the external auditory meatus. 8 patients had a branchial cleft cyst, in which the cyst was located in the posterior earlobe in 4 patients, the mandibular angle in 2 patients and the fascia of the parotid gland in 2 patients. All cysts and fistulas were surgically removed. 16 patients were followed up and they thoroughly recovered. Conclusions Congenital first branchial cleft cyst and fistula are rare in the clinic and are easily misdiagnosed and mistreated. Definite diagnosis before operation depends on imaging. The key to cure the diseases is a reasonable operative procedure and complete surgical resection is important for avoiding recurrence.

Clinical application of MSCT three-dimensional reconstruction in the diagnosis of tracheobronchial foreign bodies

LIU Li-ting,LIU Dan,LI Hui,QIU Yi-zhou

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  459-461 . 

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Objective To investigate the value of the CT 3D in the diagnosis of tracheobronchial foreign bodies. Methods 30 patients suspected of having tracheobronchial foreign bodies were subjected to HRCT scanning and 3D reconstruction. Images by HRCT and those under the stiff bronchoscope were compared to analyze the value of reconstruction. Results All 30 patients gained clear images. Foreign bodies were found at the same position shown by CT and operations in 23 patients, while they were moved in one, and they were negative in 3 patients examined by CT. One showed false negative images. Stiff bronchoscopy proved that one had a left bronchiostenosis and the other had inhalant bronchitis. Conclusions MSCT and imaging retro-processing techniques are valuable in judging tracheobronchial foreign bodies.

Combined treatment on keratosis of the larynx

YU Chong-xian,ZHANG Kun-ling,LIU Ye-hai

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  462-464 . 

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Objective To explore effective therapies for keratosis of the larynx, a pre-malignant precursor of squamous cell carcinoma. Methods From 2000 to 2003, 30 patients with keratosis of the larynx were given combined therapies which were mainly anticornification drugs, ancillary drugs, humidification treatment and surgery. Results All the patients were followed up from 1 to 5 years. Complete remission was observed in 25 of 30 patients (83.3%), partial response was seen in 1 patient and recurrence in 2. Meanwhile progression to carcinoma occurred in 2 cases. Conclusions These combined therapies have advantages of easy procedure, good effect and minor injury for keratosis of the larynx.

Laser-assisted subepithelial keratectomy for the correction of high myopia

LIU Mei-guang,WANG Chuan-fu,TAO Xiang-chen,MU Guo-ying

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  465-467 . 

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Objective To investigate the effect of laserassisted subepithelial keratectomy（LASEK）for the correction of high myopia. Methods LASEK was performed on 54 eyes of 27 myopia patients. The preoperative mean spherical (MSE) was -6.00～-14.00D, average（-8.75±1.27）D. Postoperative uncorrected visual acuity(UCVA), refractive power, time of epithelial healing and corneal haze were all recorded. Patients were followedup for 6 months. Results No serious complications occurred. The epithelium was healed in a mean （3.71±0.26）d. 3 days after the operations, the UCVA≥0.5 was found in 88.9%(48/54) and ≥0.8 in 35.2% (19/54). 7 days after the operations, the UCVA≥0.5 was found in 100%(54/54) and ≥0.8 in 87.0% (47/54). 6 months after the operations the UCVA was equal with or better than the preoperative best corrected visual acuity (BCVA). 1, 3 and 6 months after the operations, corneal haze was found in 13 eyes（24.1%）, 7 eyes（13.0%） and 2 eyes（3.7%）respectively but it was below grade 2 and had no effect on visual acuity. Conclusion LASEK is a safe, effective, stable and predictable surgery for myopia.

Rigid gas permeable contact lens for refraction reconstruction of ammetropia after penetrating keratoplasty

TAO Xiang-chen,LI Xin,WANG Zhen,MU Guo-ying

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  468-470 . 

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Objective To investigate the safety, efficacy and characteristics of rigid gas permeable contact lens (RGPCL) for correction of ammetropia after penetrating keratoplasty. Methods 23 eyes of 19 patients after penetrating keratoplasties were fitted with RGPCL. Among them, 2 had spherical posterior surface designs, 17 had aspherical designs and 4 had special keratoconus designs. The status was in a flat and three points fitting. All were followed up for six to thirtyseven months. Results All patients achieved visual acuity over 0.5 and 14 even equal or over 0.8, which was significantly different from the best corrected visual acuity with glasses. After wearing RGP, the K value decreased from 47.18±4.92D to 45.69±3.04D and corneal astigmatism from 6.53±2.26D to 3.95±1.87D（P＜0.05）. There were no significant changes in corneal endotheliu. No significant epithelial or corneal complications were observed during the follow up period. Conclusions RGPCL is ideal for refraction reconstruction of ammetropia after penetrating keratoplasty. Both flexible and continuous wearing are safe. It is easier to achieve an ideal fitting state with the aspherical design and special posterior surface design.

Modification of endostatin with low molecular weight heparin and its angiogenesis effects on rabbit corneas

ZHU Wei,TAO Xiang-chen,LI Xin,YUAN Zhong-fang,MU Guo-ying

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  471-473 . 

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Objective To investigate the modification of endostatin (ES) with low molecular weight heparin (LMEH) and its inhibitory effects on corneal neovascularization（CNV）. Methods ES was modified with LMWH by a chemical method. The rabbit CNV model was made with alkali burning. LMWHES(group 1)， ES (group 2) and normal saline(control group) were subconjunctivally injected. Results The blood vessel was shorter and smaller in group 1 than in the other two groups(P<0.05) and the expression of VEGF in group 1 was also significantly lower than that of the other two groups(P<0.05). Conclusions LMWHES can effectively inhibit the growth of CNV and is superior to ES.

Occasion choice and efficacy of vitrectomy treatment for proliferative diabetic retinopathy

CHEN Fang,ZHUANG Chao-rong,ZHAO ming,YE dong-sheng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2007, 21(5):  474-476 . 

Abstract ( 2139 )   PDF (139KB) ( 1234 )   Save

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Objective To explore the occasion choice and efficacy of vitrecto my for treatment of proliferative diabetic retinopathy(PDR). Methods 186 patients (242 eyes) with PDR were enrolled in this study. Panretinal photocoagulation (PRP) was performed on 123 eyes and vitrectomy on 119 eyes. All were followed up for 6 to 40 months. Results After vitrectomy, visual acuity was improved in 78.4% eyes of the Ⅳ and ⅤPDR groups and 43.7% of the Ⅵ PDR group. After PRP, visual acuity was improved in 80.8% eyes of theⅣ PDR group and 58.2% of the Ⅴ PDR group. For Ⅴ PDR patients without vitreous hemorrhage, the effective rate of vitrectomy treatment was 78.9% while of PRP it was 58.2%. The main operative complication was iatrogenic retinal holes and the postoperative complications were vitreous rehemorrhage, retinal detachment and neovascular glaucoma. Conclusion A suitable operative occasion is important for patients with PDR to ensure good visual acuity.