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    20 November 2018 Volume 32 Issue 6
      
    Editorial
    Treatment of throat tumors with CO2 laser
    Zhigang HUANG
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  1-3.  doi:10.6040/j.issn.1673-3770.1.2018.022
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    Invited Review
    Treatment of epiglottic carcinoma by transoral laser microsurgery
    Ming LIU
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  4-7.  doi:10.6040/j.issn.1673-3770.1.2018.020
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    Transoral supraglottic laryngectomy(TSL) is a transoral approach of microscopic-laser-assisted resection of tumors that has the advantages of less injury, less complications, and faster recovery after operation. At present, it is being used as one of treatments for T1 and T2 supraglottic carcinoma. We have described the history and operative procedure of TLM for treatment of epiglottic carcinoma in this paper.

    Progress in the treatment of recurrent respiratory papillomatosis using a CO2 laser
    Wenbin LEI,Qihong LIU
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  8-12.  doi:10.6040/j.issn.1673-3770.1.2018.014
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    Recurrent respiratory papillomatosis (RRP) is one of the most common benign epithelial tumors of the upper respiratory tract and is characterized by frequent relapse. However, the necessary frequency of procedures places a large economic burden on individual patients and their families, as well as society. In fact, surgery is still the most important treatment. CO2 lasers, which have benefits such as precision, minimal scarring, and little bleeding, are likely to completely remove the tumors. The submucosal dissection of RRP using a CO2 laser was demonstrated to be efficacious. Thus, the procedure is worthy of clinical promotion and application.

    Original Articles
    Evaluate the curative effect of CO2 laser in treatment of laryngeal carcinoma
    Wenming LI,Dongmin WEI,Ye QIAN,Shengda CAO,Ya XU,Dayu LIU,Xinliang PAN,Dapeng LEI
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  13-17.  doi:10.6040/j.issn.1673-3770.1.2018.025
    Abstract ( 338 )   HTML ( 23 )   PDF (1634KB) ( 143 )   Save
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    Objective

    To evaluate the curative effect of CO2 laser in the treatment of laryngeal carcinoma.

    Methods

    A retrospective analysis of 152 cases of early laryngeal carcinoma treated with laser surgery between 2011 and 2014 was conducted. Among all cases, 11, 102, 31, and 8 were Tis, T1a, T1b, and T2 cases, respectively.

    Results

    After the CO2 laser treatment, patients were discharged within 1-3 days. There were no complications, such as dyspnea and tracheotomy, during the perioperative period. The long-term pronunciation quality was satisfactory. The follow-up period was 4-8 years. The recurrence rate of glottic carcinoma was 8.2% (147 cases). Two patients had salvage surgery with CO2 laser. Six patients had salvage partial laryngectomy and four cases total laryngectomy. The five-year overall survival rate was 96.6%. Five cases of supraglottic carcinoma were followed up for 5 years without recurrence.

    Conclusion

    CO2 laser surgery is a minimally invasive, effective, and safe procedure for early laryngeal carcinoma. Satisfactory exposure, good surgical skills, and appropriate surgical indications are fundamental for the success of CO2 laser treatment.

    Therapeutic effect of partial laryngectomy with CO2 laser in the treatment of bilateral vocal cord paralysis
    Dayu LIU,Ruijie SUN,Xuexin LI,Zhen JIANG,Jianlin YUE,Yun LIN,Dapeng LEI,Xinliang PAN
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  18-21.  doi:10.6040/j.issn.1673-3770.1.2018.024
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    Objective

    To evaluate the effect of endoscopic carbon dioxide laser partial arytenoidectomy in the treatment of bilateral vocal cord paralysis.

    Methods

    Twenty-six patients diagnosed with bilateral vocal cord paralysis and hospitalized at the Qilu Hospital of Shandong University to undergo endoscopic carbon dioxide laser partial arytenoidectomy between January 2010 and June 2017 were included in this retrospective study. And evaluate the decannulation rate, hospitalization time, times of surgery, complication rate.

    Results

    All patients were discharged from the hospital within 7 to 10 days after surgery following satisfactory recovery of their swallowing function. No severe laryngeal edema, aspiration, apnea, and/or bleeding were observed in the postoperative period. The rate of decannulation was 88%, while the re-intervention rate was 36%. 52% of the patients did not perceive any considerable impairment in their voice quality compared to pre-operative voice quality.

    Conclusion

    Endoscopic carbon dioxide laser posterior cordectomy and partial arytenoidectomy is a reliable method for the treatment of bilateral vocal cord paralysis. The key factor for improving the rate of decannulation is regulating the formation of granulation tissue and scars.

    Experimental study on the repair of canine laryngeal defect by nickel-titanium alloy stent and double-pedicled fascial flap
    ZHENG Chaopan, MA Lingguo, ZHOU Jingchun, YAN Min, MAI Jiahao, ZHONG Shiru, ZENG Xiaoyan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  22-25.  doi:10.6040/j.issn.1673-3770.0.2018.137
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    Objective To explore the outcome of repairing a laryngeal stent and unilateral large-scale tissue defect with a nickel-titanium alloy stent and double-strap ribbon myofascial flap in beagle dogs. Methods Ten beagle dogs were used. One-half of the right thyroid cartilage plate and corresponding acoustic chamber tissue were removed. A nickel-titanium alloy stent was fixed to the right thyroid cartilage plate stump. The right pedicle ribbon myofascial flap was placed into the throat cavity and sutured to the acoustic chamber tissue and thyroid cartilage stump, completely wrapping the stent. After the operation, the wounds on the laryngeal surface and healing of the nickel-titanium alloy stent into the surrounding tissue were regularly observed. Results Of the 10 experimental dogs, 1 died of extensive subcutaneous and mediastinal emphysema. Nine dogs recovered well without breathing difficulties. At 1, 7, and 14 months after the operation, there was a small amount of granulation in the larynx wound, which disappeared in March and June; subsequently, the wound surface in the laryngeal cavity was smooth. Conclusion Nickel-titanium alloy stents and double-strapped myofascial flaps can be used to repair and reconstruct a wide range of defects in canine laryngeal stents and tissues. When the surgical method is properly selected, superior results can be obtained.
    Measurement of canine vocal fold intrinsic tension using weights suspension method
    XU Hongming, CHEN Shumei, JIANG Yugang, LI Xiaoyan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  26-29.  doi:10.6040/j.issn.1673-3770.0.2018.278
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    Objective To measure the intrinsic tension of central part canine vocal fold. Methods Weights suspension method was employed to stretch the excised canine vocal fold(including the entire five-story structure)to its' original length, using the weights mass to evaluate the intrinsic vocal fold tension. Major geometrical parameter of the canine vocal folds were measured and compare to those reported by literatures to assess the reliability of the samples. Results The average weights mass used to stretch the suspended vocal fold sample was 22.06 g. Vocal fold tension was showed to have no correlational relationship with the weight of experimental canines. Major geometricalparameterof these canine vocal folds correspond with those reported by literatures. Conclusion The intrinsic tension of middle part canine vocal fold which is necessary in establishing vocal fold finite element model can be measured by weights suspension method.
    Effect of MicroRNA-24 on the proliferation, migration, invasion, and apoptosis of LSCC cells
    XU Li, WANG Zhiyi, CHEN Wei, XUE Fei, ZHANG Yong, CHENG You, JI Junfeng, CUI Pengcheng, JIANG Manjie
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  30-37.  doi:10.6040/j.issn.1673-3770.0.2018.021
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    Objective The effect of miR-24 on the proliferation, migration, invasion, and apoptosis of LSCC cells was examined. Methods After constructing Hep-2 and AMC-HN-8 cells to overexpress miR-24 by cell transfection, the proliferation of Hep-2 and AMC-HN-8 cells was detected by MTT assay and a cloning assay. A scratch test and Transwell assay were conducted to detect cell migration and invasion abilities, and the effect on apoptosis was analyzed by using flow cytometry analysis. Results After cell transfection, qRT-PCR confirmed upregulation of miR-24 in Hep-2/miR-24 and AMC-HN-8/miR-24 cells. MTT and colony formation assays showed that upregulation of miR-24 significantly reduced the proliferation of LSCC cells. Additionally, the capacity for colony formation in Hep-2/miR-24 and AMC-HN-8/miR-24 cells was significantly reduced compared to that of control cells. The scratch test and Transwell assay showed that the migration and invasion ability of miR-24 were significantly reduced. Flow cytometry showed that overexpression of miR-24 significantly enhanced apoptosis in LSCC cells. These results suggest that miR-24 inhibits the proliferation, invasion, and metastasis and increases the apoptosis of LSCC cells. Conclusion Abnormal expression of miR-24 is closely related to properties of LSCC cells. miR-24 inhibits the proliferation and migration and enhances the apoptosis of LSCC cells.
    Association between Helicobacter pylori and laryngeal squamous cell carcinoma
    WANG Kuirong, RAO Lihua, LI Zhuan, DUAN Bingzhi
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  38-42.  doi:10.6040/j.issn.1673-3770.0.2018.202
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    Objective To examine the association between Helicobacter pylori and laryngeal squamous cell carcinoma(LSCC). Methods Between March 2016 and February 2018, 124 patients were randomly enrolled in this study, including 71 with LSCC and 53 with vocal cord polyps and epiglottic cysts. The expression of H.pylori in tissues was detected with polymerase chain reaction(PCR)technique, and serum H.pylori IgG was detected using enzyme-linked immunosorbent assay(ELISA). The expressions of RASSF1A and FHIT in tissues were detected using immunohistochemistry(IHC)and PCR. The expressions of RASSF1A and FHIT in FaDu cells under H.pylori co-culture conditions were detected using PCR and western blot tests. Results The H.pylori-positive rates in LSCC and control groups were 71.83%(51/71)and 26.42%(14/53)(P<0.001). Six patients(11.76%)only had H.pylori infection in tumor tissues, 24(47.06%)only had infection in adjacent cancer tissues, and 21(41.18%)had H.pylori infection in both tumor and adjacent cancer tissues (P<0.05). Positive rates for H.pylori IgG antibody were 78.87%(56/71)and 64.15%(34/53)in LSCC and control groups(P=0.069). H.pylori infection was a risk factor for LSCC by univariate logistic regression analysis(odds ratio [OR]=7.09, 95% confidence interval [CI]: 3.11-17.28, P<0.001). H.pylori infection was an independent risk factor for LSCC by multivariate logistic regression analysis(OR=6.94, 95% CI: 2.87-15.31, P<0.001). Mann-Whitney tests showed no statistically significant differences in H.pylori infection according to different lesion sites, T stages, and TNM stages(P>0.05). The expressions of RASSF1A in LSCC tissues with and without H.pylori infection were 4.46±1.93 and 8.78±1.82(P<0.05)using IHC. The expressions of FHIT in LSCC tissues with and without H.pylori infection were 7.52±1.69, 2.86±1.15(P<0.05)using IHC. The expressions of RASSF1A mRNA in LSCC tissues with and without H.pylori infection were 0.74±0.10 and 0.19±0.06(P<0.05)using quantitative real-time(qRT)-PCR. The expressions of FHIT in LSCC tissues with and without H.pylori infection were 0.42±0.10 and 1.16±0.12(P<0.05)using qRT-PCR. The expressions of RASSF1A mRNA in FaDu cells under H.pylori co-culture conditions(30∶1, 100∶1, 300∶1)were 0.20±0.08, 0.43±0.10, and 1.41±0.08, and FHIT mRNA expressions were 1.26±0.22, 0.70±0.13, and 0.18±0.10 by qRT-PCR. The expressions of RASSF1A mRNA in FaDu cells under H.pylori co-culture conditions(30∶1, 100∶1, 300∶1)were 0.53±0.12, 0.59±0.10, and 1.07±0.14, and FHIT mRNA expressions were 0.69±0.11, 0.42±0.14, and 0.28±0.09 by Western blotting. Conclusion There is significant evidence that H.pylori is present in the mucosa of laryngeal tissues in LSCC. H.pylori may be an important risk factor for the development of LSCC by regulating RASSF1A and FHIT expression.
    Clinical analysis of 68 cases of multiple primary cancers of head and neck
    HUANG Fang, WEI Guifang, HUANG Sicheng, HUANG Xiangqin
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  43-47.  doi:10.6040/j.issn.1673-3770.0.2018.329
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    Objective To summarize and analyze the incidence of multiple primary cancers(MPCs)of the head and neck region in patients hospitalized in the otolaryngology department. Methods Retrospective analysis of the clinical data of 68 patients with head and neck MPCs was conducted using SPSS 21.0. Results Overall, 648 cases of malignant tumors were found in 8758 patients treated in the same period. Among them, 68 cases were diagnosed with MPC with an occurrence rate of 0.78%. The annual occurrence rate of MPC during 2014-2017 was 0.72%, 0.72%, 0.77%, and 0.86%, successively, and showed an upward trend. The MPC group included 61 males and 7 females, and the proportion of males was higher than that in a single primary cancer group. There were 62 cases of double cancer, 6 of triple cancer, 35 of synchronous carcinoma, and 33 of metachronous carcinoma. Forty-four patients had a previous history of smoking/drinking, and male smokers/drinkers were significantly higher than females(χ2 = 6.40, P=0.006). Hypopharyngeal cancer accounted for the highest incidence of MPC(23.81%), followed by oral cancer(14.71%)and laryngeal cancer(9.33%). The most common primary cancer associated with oral cancer, hypopharyngeal cancer, and laryngeal cancer was esophageal cancer. There were 45 cases(66.18%)that presented the second cancer in less than 5 years after the first. Twenty-two patients had received radiation/chemotherapy, and these patients had a higher proportion of metachronous MPC(χ2 = 18.64, P<0.001). Conclusion The highest incidence of MPC in the head and neck in consecutive order is hypopharyngeal, oral, and laryngeal cancer. There is a high possibility of head and neck cancer presenting in combination with upper gastrointestinal cancers, such as esophageal cancer. It has been suggested that gastroscopy be listed as a routine examination both pre-operatively and at follow-up. Commonly, the interval between the second and first cancer was less than 5 years; hence, the first 5 years of follow-up and long-term regular follow-up should be fortified after radiotherapy for malignant tumors. MPC should be considered when devising a radiotherapy program, and special attention should be paid to the radiation protection of the surrounding tissues and organs.
    Analysis of clinical and pathological features of 84 patients with primary head and neck lymphoma
    LIU Dingding, QIAN Xiaoyun, LIU Yongze, GAO Xia
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  48-51.  doi:10.6040/j.issn.1673-3770.0.2018.274
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    Objective To evaluate the clinical and pathological features of primary head and neck lymphoma. Methods The medical records of 84 patients with primary head and neck lymphoma were retrospectively analyzed with respect to age, sex, tumor location, clinical manifestations, pathological types, and prognosis. Results Among all patients, 45(53.6%)were males and 39(46.4%)were females, with a male:female ratio of 1.15∶1 and age range of 19-80 years. There were 80 cases(95.2%)of non-Hodgkins lymphoma and 4(4.8%)of Hodgkins lymphoma. Among the 80 cases of non-Hodgkins lymphoma, 39(48.7 %)were primary diffuse large B-cell lymphoma(DLBCL)and 21(26.3%)were natural killer/T-cell(NK-T)lymphoma. A wide range of sites were affected with the following incidence: 28 cases(33.3%)of the neck, 26 cases(30.9%)of the nasal sinuses, 14 cases(16.7%)of the tonsils, and 7 cases(8.3%)of the base of the tongue. Primary in the cervical lymph nodes and Waldeyer lymphatic ring was mainly DLBCL, primary in the nasal cavity and sinus with NK/T cell lymphoma. The 1-year and 5-year survival rate of NK-T-cell lymphoma of the head and neck was 90% and 47.6%, respectively, while that of DLBCL of the head and neck was 97.3% and 58.3%, respectively. Conclusion Although the incidence of primary head and neck lymphomas is high, the clinical and imaging features are not specific. It is necessary to perform early histopathological examination to reduce instances of missed diagnosis as well as avoid misdiagnosis.
    Diagnostic value of detection of pepsin in the saliva for laryngopharyngeal reflux
    TAO Yanli, YUAN Tiejun
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  52-55.  doi:10.6040/j.issn.1673-3770.0.2018.219
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    Objective To determine whether detection of pepsin in the saliva could be useful for diagnosing laryngopharyngeal reflux(LPR). Methods Twenty-five patients having LPR with reflux symptoms index scale(RSI)>13 and a reflux symptoms index scale(RFS)>7 were selected. Pepsin levels were measured by protease-labeling prior to treatment. Patients were treated with esomeprazole along with 2.5% sodium bicarbonate atomization inhalation therapy. Two months after completion of treatment, the RSI, RFS, and pepsin in the saliva were measured again. Results Out of 25, 12 salivary samples were positive and 13 were negative before treatment. PPI test results were positive in 10 cases and negative in 15 cases after treatment. The results of saliva pepsin test and PPI test were both positive in 9 cases and negative in 12 cases. One case had a positive result in the PPI test, and 3 cases had positive results in the salivary pepsin test. The diagnostic criteria for this study included a positive result on PPI test, and a sensitivity and specificity of 90.00% and 80.00%, respectively, in the detection results of pepsin. All 25 patients were able to complete the entire investigation and treatment course. The symptoms improved in 19 cases, while they did not significantly improve in 6 cases. The scores of the RSI scale before and after treatment were 19.84±3.96 and 7.00±2.84 respectively, with the difference being statistically significant(P<0.001). Signs obviously improved in all 25 cases. The RFS scale score before and after treatment was 14.08±3.51 and 5.44±3.07 respectively, with the difference being statistically significant(P<0.001). Conclusion The detection of pepsin in the saliva can be used for the diagnosis of LPR.
    Clinical effect of Yunpi Huatan Tongqiao decoction on pediatric snoring disease and immune function
    YU Yuejin, GU Jingwen, HUANG Wei, LI Pei, HU Hua, HAO Yanan, FAN Yongjiang, GAO Yiyi
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  56-59.  doi:10.6040/j.issn.1673-3770.0.2018.307
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    Objective To study the clinical effect of activating spleen treatment of nasal prescription on pediatric snoring disease and immune function. Methods Sixty consecutive subjects with pediatric snoring disease were enrolled from May 2016 to December 2017 and divided randomly into control and observation groups, each group comprising of 30 cases. Patients in the control group underwent resective surgery and those in the observation group were administered activating spleen treatment of nasal prescription. The total duration of treatment was 3 months, following which the difference in size of the tonsils were assessed. TCM syndrome scores, the clinical efficacy rate before and after treatment in the two groups, and immunologic parameters including IgA, IgG, and IgM levels in peripheral venous blood were evaluated by ELISA. Results The size of the tonsils was smaller in both groups after treatment with significant reduction in size being observed in the control group(P<0.05). The size of the tonsils was within the normal range in the observation group. Lower post-treatment TCM syndrome scores were observed in the two groups with no statistically significant difference(P>0.05). The efficacy rate was not significantly different between the two groups(P>0.05). Post-treatment, the levels of IgA, IgG, and IgM remained unchanged in the two groups(P>0.05). Conclusion Both treatments, nasal prescription for activation of spleen and resective surgery, can provide comparable clinical effect in cases of pediatric adenoidal hypertrophy with no effect on immune function.
    Invention and application of subjective visual vertical and horizontal examination software
    ZHANG Yuzhong, WEI Xinyu, LI Yingqi, CHEN Zichen, XU Yong, CHENG Ying, GAO Ying, CHEN Feiyun, HU Juan, XU Min, ZHANG Qing
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  60-63.  doi:10.6040/j.issn.1673-3770.0.2018.313
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    Objective To develop software to examine the subjective visual vertical(SVV)and subjective visual horizontal(SVH). These parameters are mainly used to determine the symmetry and dominant side of bilateral otolith function, evaluate the static compensation state of otolith function, and guide vestibular rehabilitation. Methods The SVV/SVH software was developed and combined with a visual reference barrel device, and used in a dark examination room to collect data from 80 healthy volunteers to determine the normal reference range. This study was a cross-sectional study. Results In the 80 healthy volunteers, the average deviation of the SVV examination ranged from -3.00° to 3.00°. The mean(± standard deviation)was -0.29(±1.42)°. The mean deviation of SVH ranged from -4.00° to 3.50°. The mean value(± standard deviation)was -0.38(±1.84)°. Conclusion The 95% normal reference ranges of the SVV and SVH measured using the software were -3.13 to 2.55° and -4.06 to 3.30°, respectively. The software and equipment can be used to evaluate the functional status of the otolith. Combined with other vestibular examinations, such as vestibular-evoked myogenic potentials, caloric test, and video head impulse test, the software can be used to comprehensively evaluate the patients vestibular function and vestibular compensation status and guide vestibular rehabilitation.
    Effect of vestibular rehabilitation on residual dizziness in elderly patients with benign paroxysmal positional vertigo
    DING Jian, LIU Yiming
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  64-68.  doi:10.6040/j.issn.1673-3770.0.2018.290
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    Objective To examine the therapeutic effect of vestibular rehabilitation on residual dizziness after successful canalith repositioning maneuvers in elderly patients with benign paroxysmal positional vertigo(BPPV). Methods Between January 2015 and December 2017, we treated 86 patients with nystagmus that resolved within 3 days after successful canalith repositioning maneuvers and 86 patients with residual dizziness after treatment. Using a random table method, patients with residual dizziness were divided into 43 cases in an observation group and 43 in a control group. Both groups were treated with dioxetine mesylate, and the observation group also received vestibular rehabilitation training. Both groups were treated for 7 days. The curative effect was compared, using The Berg Balance Scale(BBS)score, the Vestibular Symptom Index(VSI)score, and the Dizziness Handicap Inventory(DHI)score. Results The efficacy rate in the observation group(95.35%)was higher than that in the control group(72.09%)(P<0.05). The BBS score in the observation group before treatment was 7.39±1.24 and increased to 49.81±4.56 after treatment. The BBS score in the control group before treatment was 7.61±1.27 and increased to 39.62±3.21 after treatment. The score in the control group was higher than that in the control group(P<0.05). The VSI score in the observation group before treatment was 32.78±2.41 and decreased to 24.87±3.28 after treatment. The VSI score in the control group before treatment was 32.54±2.39 and decreased to 28.46±2.80 after treatment. The score in the control group was lower than that in the control group(P<0.05). The DHI score in the observation group before treatment was 76.44±6.57 and decreased to 30.81±3.24 after treatment. The DHI score in the control group before treatment was 76.36±5.82 and decreased to 42.36±4.67 after treatment. The score in the control group was lower than that in the control group(P<0.05). Conclusion Vestibular rehabilitation is effective for residual dizziness in elderly patients with BPPV.
    Clinical observation of 40 cases of tympanic membrane perforation treated with auricular endoscopic cartilage ring and cartilage membrane repair
    ZHOU Qing, LIU Xiongguang, WU Changlin, YE Xiaowu
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  69-72.  doi:10.6040/j.issn.1673-3770.0.2018.203
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    Objective To investigate the curative effect of endoscopic tragus cartilage ring perichondrium myringoplasty. Methods Eighty patients(80 ears)with tympanic membrane perforation were randomly divided into observation(endoscopic ear cartilage perichondrium composite ring repair)and control groups(temporalis fascia myringoplasty using an operating microscope), with 40 cases in each group. Clinical indexes, efficacy, tympanic membrane healing rates, hearing recovery, and the incidence of postoperative complications were compared between the two groups. Results The operative time and the amount of bleeding in the observation group were lower than those in the control group(P<0.05). The total efficacy rate in the observation group was higher than that in the control group(P<0.05). The tympanic membrane healing rate in the two groups was not statistically different after 1, 6, and 12 postoperative months(P>0.05). There was no significant difference in hearing recovery between the two groups after 1, 6, and 12 months(P>0.05). There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05). Conclusion Use of endoscopic ear tragus cartilage ring perichondrium myringoplasty to reduce postoperative bleeding shortens the operative time and healing rate, with good clinical curative effect, and can improve hearing, making it clinically useful.
    Dose-dependent effects of exogenous IL-17A on airway inflammatory responses in mice with allergic rhinitis
    JIANG Xiaodan, DONG Qingzhe, DANG Zhihong, LI Shenling, MIAO Yu, ZHAO Han, ZHANG Niankai
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  73-78.  doi:10.6040/j.issn.1673-3770.0.2018.365
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    Objective To evaluate the effects of different doses of exogenous Interleukin-17A(IL-17A)on airway inflammatory responses in mice with allergic rhinitis. Methods Forty-eight BALB/c female mice were assigned randomly to six groups(A, B, C, D, E, and F), with eight mice per group. Groups D, E, and F received intraperitoneal OVA injection and nasal challenge, normal saline(NS), and different doses of IL-17A(100 ng and 500 ng)one hour before nasal challenge, respectively. Groups A, B, and C received intraperitoneal NS injection and nasal challenge, NS, and different doses of IL-17A(100 ng and 500 ng)one hour before nasal challenge, respectively. Nasal symptoms were assessed at 4 weeks. Serum, nasal lavage fluid(NLF), and nasal tissue were collected. Eosinophils in NLF were measured using Diff-Quik staining. IL-6 and IL-10 levels in serum and NLF were measured using enzyme-linked immunosorbent assay(ELISA). Mast cells in nasal mucosa were measured using toluidine blue staining. Results All mice in group D had a symptom score of greater than five points, demonstrating that the model was successful. Groups A, B, C, D, E, and F had average scores of 1.5(1.0-2.8), 2.0(1.0-3.0), 2.5(2.0-3.0), 7.0(6.3-8.0), 3.0(2.3-3.8), and 8.0(7.0-8.8), respectively. Rubbing times and number of sneezes were lower in group E than in group D(H=21.375, P=0.033, H=20.250, P=0.049). Levels of IL-6 in the serum and NLF were higher in group D than in group A(H=25.750, P=0.004; H=20.688, P=0.047). IL-10 levels in the serum and NLF were lower in group D than in group A(H=22.875, P=0.016; H=20.625, P=0.048). There were no significant differences in IL-6 levels in the serum and NLF between group E and group A(H=19.875, P=0.068; H=8.125, P>0.999). IL-10 levels in the serum were higher in group E than in group D(H=27.062, P=0.002). IL-6 levels in the serum and NLF were higher in group F than in group A(H=22.250, P=0.008, H=28.688, P=0.001). There were no significant differences in IL-10 levels in the serum and NLF between group F and group D(H=13.062, P=0.930; H=0.500, P>0.999). Eosinophils in the NLF were more abundant in group C than in group A(H=20.688, P=0.047). The number of eosinophils in group E was significantly lower than that in group D(H=21.188, P=0.037). There was no significant difference in the number of eosinophils in group F compared with that in group D(H=2.875, P>0.999). Mast cells in the nasal mucosa were more abundant in group D than in group A(H=27.188, P=0.002). The number of mast cells in the nasal mucosa was lower in group E than in group D(H=20.938, P=0.042). There was no significant difference in the number of mast cells between group F and group D(H=1.188, P>0.999). Conclusion 500 ng of exogenous IL-17A led to a modest proinflammatory effect in normal mice. Treatment with 100 ng exogenous IL-17A in mice with allergic rhinitis can protect against allergic airway inflammation.
    Clinical features and treatment of juvenile ossifying fibroma of the nasal cavity and sinuses
    HAN Yang, YANG Xiaojian, TANG Lixing, WANG Pengpeng, ZHANG Jie, GE Wentong
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  79-83.  doi:10.6040/j.issn.1673-3770.0.2018.327
    Abstract ( 439 )   PDF (1745KB) ( 110 )   Save
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    Objective To analyze the clinical features of juvenile ossifying fibroma in the nasal cavity and sinuses and discuss the treatment. Methods From May 2015 to December 2017, 6 children(4 boys, 2 girls)with ossification fibroma of the nasal cavity and paranasal sinuses were selected with ages ranging from 2 months to 12 years 6 months, with a median age of 6 years and 2 months. The tumors occurred in the maxillary sinus(1 case), ethmoid sinus(3 cases), sphenoid sinus(1 case)and frontal sinus(1 case). All the children were treated via surgery. One case showed the involvement of the optic nerve in the tumor. Nasal endoscopy-mediated partial resection of the tumor was performed to preserve the childs eyesight. Six months after the operation, the optic nerve was found to be involved in the optic nerve and the skull base was extensively involved. The second partial resection of the tumor was performed under nasal endoscope after recurrence of the tumor involving a wider area, 6 months after the operation. During the third operation, the right nasal incision combined with nasal endoscope-mediated partial resection of the ossification fibroma of nasal sinuses was performed. All other children underwent endoscopic resection of tumors, except for one, whose age was 2 months and was not examined via computed tomography(CT). Metronic FUSION ENT Image Guidance System-based electromagnetic navigation technique was used to locate the tumor margin. Another case was treated with interventional angiography and embolization 1 day before nasal endoscopy because the tumor was located in the sphenoid sinus and had definite nourishing vessels. All the patients were followed up with regularly using nasal endoscopy and sinus CT. Results The pathological classification of 6 cases was as follows: sandy gravel in 5 cases and trabecular shape in 1 case. The average follow-up time was 2.2 years. There was one incidence of recurrence for which partial resection of the tumor was performed, and the patient survived with the tumor after the operation. No recurrence or complications were found in the other children during the follow-up period, and the primary symptoms were effectively alleviated. Conclusion Osteofibroma of the nasal cavity and paranasal sinuses has the characteristics of invasive growth and easy recurrence after operation, and surgery is the only effective treatment. Endoscopic sinus surgery with image navigation has been deemed suitable for children.
    Clinical effect of combination therapy of sodium hyaluronate and recombinant bovine basic fibroblast growth factor on dry eye after phacoemulsification
    TU Xuefeng
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  84-87.  doi:10.6040/j.issn.1673-3770.0.2017.509
    Abstract ( 357 )   PDF (428KB) ( 116 )   Save
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    Objective To analyze the effect of sodium hyaluronate(SH)and recombinant bovine basic fibroblast growth factor(r-bFGF)on tear film of dry eye after phacoemulsification surgery. Methods Among patients diagnosed with dry eye within one month of phacoemulsification surgery who presented to our hospital between July 2014 and June 2017, 96 cases(102 eyes)were randomly divided into a treatment group(48 cases, 50 eyes)and a control group(48 cases, 52 eyes). All enrolled patients underwent dry eye examination and grading. The control group was administered 0.1% SH, while the treatment group was treated with eye drops containing SH and r-bFGF. After one month of treatment, all patients underwent dry eye-related examination and grading again. Results No statistically significant differences were observed in any of the indexes between the two groups before initiating treatment. After treatment, the Schirmer I test results, non-invasive tear film break-up time, tear meniscus height, corneal fluorescein staining and ocular symptoms scores of the treatment group were significantly better than those of the control group, with a statistically significant difference. Difference in the tear film lipid layer scores between the treatment and control groups was not statistically significant. Conclusion SH combined with r-bFGF has a significant effect on dry eye after phacoemulsification surgery.
    Clinical study of conbercept in the treatment of proliferative diabetic retinopathy
    LIU Wanzhi, CHEN Jun, FAN Changchun
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  88-91.  doi:10.6040/j.issn.1673-3770.0.2018.005
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    Objective To investigate the effect of preoperative prophylactic injection of conbercept into the vitreous cavity on proliferative diabetic retinopathy(PDR)and to analyze the factors influencing prognosis. Methods A retrospective analysis was performed on 40 patients(54 eyes)with PDR who underwent vitrectomy from January 2015 to June 2017. Of these, 20 patients(26 eyes, the observation group)received preoperative prophylactic intravitreal injection of conbercept and 20(28 eyes)without treatment were in the control group. The surgical outcomes and prognosis were compared between the 2 groups. Prognosis was evaluated according to the effect on visual improvement, and prognostic factors were analyzed using single and multiple factor analysis. Results The duration of surgery in the observation group was much shorter than in the control group. The incidence of iatrogenic perforation or intraoperative bleeding and the need for intraoperative electrocoagulation or silicone oil filling were much less in the observation group than in the control group, and the differences were statistically significant. There was no significant difference in macular thickness between the 2 groups before surgery. After surgery, the macular thickness in the observation group was much less than that in the control group, with a statistically significant difference. There was no significant difference between the 2 groups in the rate of retinal repositioning, postoperative vitreous reaccumulation, and recovery of visual acuity. Higher preoperative glycated hemoglobin levels and higher preoperative macular thickness were independent risk factors for prognosis. Conclusion Preoperative prophylactic intravitreal injection of conbercept can improve the effect of vitrectomy for PDR patients, and can help reduce complications. However, this measure had no obvious effect on recovery of visual acuity.
    Clinical study of compaq combined with laser in the treatment of retinopathy of prematurity
    GUO Bao, ZHANG Deyong
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  92-97.  doi:10.6040/j.issn.1673-3770.0.2018.272
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    Objective To observe the clinical effect of treatment with Compaq, laser, and a combination for the treatment of retinopathy of prematurity(ROP). Methods Sixty-three children(126 eyes)with ROP treated in our hospital from February 2016 to December 2017 were randomly divided into three groups of 21 patients(42 eyes)using the envelope method. Laser photocoagulation treatment group was treated with laser photocoagulation alone, compaq treatment group was treated with compaitcept glass cavity injection alone, and combined treatment group was treated with compaitcept glass body cavity injection and laser irradiation combined with laser photocoagulation. The clinical effects observed in the three groups were compared, and the indices related to the retinal electroretinogram and changes in the equivalent spherical mirror and astigmatism were analyzed. Complications and follow-up results were analyzed during and after treatment. Results The rate of controlled disease in laser photocoagulation treatment group, compaq treatment group and combined treatment group was 71.43%, 66.67% and 95.24%(H=5.694, P=0.058). Regarding the amplitude of the flash electroretinogram(F-ERG)reaction, the amplitude of the b-wave, the cone-rod mixed maximum response a- and b-waves, there was significant difference between the above three groups(all P<0.05). Regarding the F-ERG response latency, peak mixed rod-cone response a- and b-wave, there was significant difference between the above three groups(all P<0.05). Regarding myopia, high myopia, astigmatism, and high astigmatism, there was significant difference between the above three groups(all P<0.05). The incidence of complications was 23.80%, 19.04% and 14.28%(χ2=0.618, P=0.432)in laser photocoagulation treatment group, compaq treatment group and combined treatment group. During the follow-up period, the recurrence rate of ROP in laser photocoagulation treatment group, compaq treatment group and combined treatment group was 33.33%、28.57% and 4.76%. The recurrence rate of ROP in laser photocoagulation treatment group and compaq treatment group significantly higher than that in combined treatment group(all P<0.05). Conclusion Treatment with Compaq combined with laser is effective and safe for the treatment of ROP.
    Protective effect of puerarin on the optic nerve in rats with chronic intraocular hypertension
    LIU Bei, LÜ Bochang, ZHU Zhongqiao, SUN Jianhua
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  98-103.  doi:10.6040/j.issn.1673-3770.0.2018.319
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    Objective To observe the protective effect of Puerarin on optical nerve in rats with chronic intraocular hypertension. Methods Sixty Sprague-Dawley rats were randomly divided into the sham operation, model control, and puerarin groups by the random number table method. Each group contained 20 rats, and the right eye was used as the experimental eye. Chronic intraocular hypertension was established in the model control and puerarin groups by scleral vein cautery; in the sham operation group, the conjunctiva was cut. Puerarin was injected intraperitoneally into rats in the puerarin group(10 mL/kg), while 0.5 mL saline was injected intraperitoneally into rats in the sham operation and model control groups, both before the operation and once daily after the operation for 4 weeks. Intraocular pressure was measured before the operation and 1 day, 3 days, 1 week, 2 weeks, 3 weeks, and 4 weeks after the operation. Rat eyeballs and optic nerve specimens were prepared at 4 weeks after the operation. The retinal thickness was measured by hematoxylin-eosin staining. Ultrastructural changes in optic nerve axons in rats were observed by transmission electron microscopy. The expression of p-AKT and AKT proteins in the retina was analyzed by western blotting. Results There were significant differences with respect to changes in intraocular pressure before and after the operation in the model control and puerarin groups(Fpuerarin=448.22, P<0.001; Fmodel=450.86, P<0.001). There was a significant difference in the intraocular pressure among the three groups at 4 weeks after the operation(F=520.88, P<0.001). At 4 weeks after operation, there were significant differences among the three groups in retinal thickness(F=441.29, P<0.001), in the number of myelinated nerve fibers (F=1 344.31, P<0.001), and in the ratio of p-AKT to AKT(F=90.22, P<0.001). Conclusion Puerarin has a protective effect on the optic nerve in rats with chronic intraocular hypertension.
    Narrow-band imaging in diagnosis and treatment of tumors of the pharynx and larynx
    CHEN Lixiao, JIANG Rui, YU Ziwei
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  104-108.  doi:10.6040/j.issn.1673-3770.0.2018.174
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    Malignant tumors of the pharynx and larynx have low clinical incidence, and are often terminal when discovered, with a low 5-year survival rate. The early detection of malignant tumors is a serious challenge for otolaryngologists. White-light electronic laryngoscopy has been the most commonly performed examination of the pharynx and larynx. With advances in technology, narrow-band imaging(NBI)electronic laryngoscopy now enables earlier detection of malignant tumors of the pharynx and larynx in contrast to that with ordinary white light laryngoscopy. The ability to demonstrate capillary loop morphology in the mucous membranes and submucous membranes of the throat makes minimally invasive treatment possible. NBI also plays a significant role in postoperative follow-up. This paper reviews the application of NBI in the management of tumors of the pharynx and larynx, and examines the origins, principles, advantages, disadvantages, and prospects for clinical application.
    A case of external auditory canal adenoid cystic carcinoma invading the middle ear and temporal lobe, with cervical lymph node metastasis
    HE Jian, QIAN Liting, GAO Jin
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  109-111.  doi:10.6040/j.issn.1673-3770.0.2017.424
    Abstract ( 277 )   PDF (4525KB) ( 111 )   Save
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    One case report of nasal septum neurofibroma
    LI Lingling, JIANG Yan, CHEN Min, ZHAO Lijuan, ZHANG Shengnan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  112-113.  doi:10.6040/j.issn.1673-3770.0.2018.104
    Abstract ( 338 )   PDF (293KB) ( 107 )   Save
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    Cervical necrotizing fasciitis with neutropenia: a case report
    JIANG Qingyun, LI Hong, XIA Jiyan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  114-116.  doi:10.6040/j.issn.1673-3770.0.2017.490
    Abstract ( 258 )   PDF (1730KB) ( 105 )   Save
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    A case of trifocal intraocular lens implantation in patients with over-long axial cataract
    WANG Daoguang, LIU Dongmei, BI Hongsheng
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  117-118.  doi:10.6040/j.issn.1673-3770.0.2017.371
    Abstract ( 305 )   PDF (1019KB) ( 144 )   Save
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    A case of aseptic endophthalmitis after YAG laser
    WANG Jing, LI Bin, ZHANG Hui
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  119-120.  doi:10.6040/j.issn.1673-3770.0.2017.376
    Abstract ( 313 )   PDF (290KB) ( 88 )   Save
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    A case of mucosa-associated lymphoid tissue lymphoma initiating in conjunctiva
    ZHANG Jingyi, WANG Wenyi, ZHANG Qingquan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2018, 32(6):  121-122.  doi:10.6040/j.issn.1673-3770.0.2018.159
    Abstract ( 311 )   PDF (1762KB) ( 121 )   Save
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