Effect of tympanoplasty on wet ear with different mucosal status of tympanic cavity / 临床耳鼻咽喉头颈外科杂志

Objective@#A retrospective analysis of audiologic outcome and graft take rate on post-tympanoplasty with different middle ear mucosal conditions in wet ear. @*Method@#According to the characteristics of middle ear mucosal condition and residual eardrum, 80 cases with wet ear of chronic suppurative otitis media were divided into the hydrocele group, the swelling group and the granulation group. The factors in different groups, including gender, age, disease course, sides, size and location of perforations, destruction of ossicular chain and reconstruction methods were analyzed. Moreover, postoperative hearing improvement and graft take rate were compared among the three groups. @*Result@#There was no significant difference in gender, age, disease course, sides, size and location of perforations among the hydrocele group, the swelling group and the granulation group （P>0.05）. Overall, the postoperative average Air-Bone Gaps（ABG） were reduced in all wet ear patients after surgery （P<0.01）. The ABG was decreased from （25.5 ± 10.8） dB to（15.4 ± 9.4） dB in the hydrocele group, and decreased from （27.6 ± 8.7） dB to （15.2 ± 9.6） dB in the swelling group, and from （29.5 ± 7.7） dB to （17.2 ± 17.2） dB in the granulation group. The graft take rates were 90.0% in totally. There were no significant difference in graft take rates among the three groups, and 84.6% in the hydrocele group, 93.3% in the swelling group and 100.0% in the swelling group（P>0.05）. @*Conclusion@#Wet ear is not an absolute contraindication of tympanoplasty for chronic suppurative otitis media. Whether there was effusion, swelling or granulomatous hyperplasia in the tympanoplasty, the patients'hearing improved significantly after tympanoplasty, and the healing rate of the tympanoplasty did not decrease. Further basic and clinical studies are needed to standardize the timing of wet ear surgery, clarify the operative contraindication and elucidate the pathophysiological mechanism of eardrum healing.

Effect of tympanoplasty on wet ear with different mucosal status of tympanic cavity / 临床耳鼻咽喉头颈外科杂志

A retrospective analysis of audiologic outcome and graft take rate on post-tympanoplasty with different middle ear mucosal conditions in wet ear. According to the characteristics of middle ear mucosal condition and residual eardrum, 80 cases with wet ear of chronic suppurative otitis media were divided into the hydrocele group, the swelling group and the granulation group. The factors in different groups, including gender, age, disease course, sides, size and location of perforations, destruction of ossicular chain and reconstruction methods were analyzed. Moreover, postoperative hearing improvement and graft take rate were compared among the three groups. There was no significant difference in gender, age, disease course, sides, size and location of perforations among the hydrocele group, the swelling group and the granulation group （>0.05）. Overall, the postoperative average Air-Bone Gaps（ABG） were reduced in all wet ear patients after surgery （0.05）. Wet ear is not an absolute contraindication of tympanoplasty for chronic suppurative otitis media. Whether there was effusion, swelling or granulomatous hyperplasia in the tympanoplasty, the patients'hearing improved significantly after tympanoplasty, and the healing rate of the tympanoplasty did not decrease. Further basic and clinical studies are needed to standardize the timing of wet ear surgery, clarify the operative contraindication and elucidate the pathophysiological mechanism of eardrum healing.

Application of 3D printing in the flipped classroom in practice teaching of otolaryngology-head and neck surgery / 中华医学教育探索杂志

Objective@#To investigate the application of 3D printing in the flipped classroom in the practice teaching of otolaryngology-head and neck surgery.@*Methods@#A total of 68 medical undergraduates of the Grade 2013 in Air Force Medical University were divided into experimental group and control group, with 34 undergraduates in each group. The undergraduates in the experimental group received the teaching method of 3D printing in the with flipped classroom, and those in the control group received traditional teaching. The teaching effect was evaluated by questionnaire and examinations of basic knowledge and clinical skills, Independent-samples t test was used for between-group comparison with SPSS 20.0.@*Results@#Compared with the control group, the experimental group had significantly higher scores in theoretical examinations (34.79±2.20 vs. 31.73±3.12, t=4.676, P=0.000) and clinical skill examination (50.06±2.98 vs. 45.82±4.68, t=4.449, P=0.000). The questionnaire survey showed that among the 34 undergraduates in the experimental group, 31(91.2%) thought that the new teaching method could increase their learning interest, 33(97.0%) believed it could improve learning efficiency, 25(73.5%) believed the models obtained by 3D printing had good quality, 32(94.1%) felt that it could improve clinical skills, 28 (82.4%) thought it could enhance the interaction between students and teachers, and 29(85.3%) thought it did not bring extra burden.@*Conclusion@#The teaching method of 3D printing combined with flipped classroom in the practice teaching of otolaryngology-head and neck surgery can improve students' learning interest, academic scores, and clinical skills, and therefore, it holds promise for application in teaching.

Application of 3D printing in the flipped classroom in practice teaching of otolaryngology-head and neck surgery / 中华医学教育探索杂志

Objective To investigate the application of 3D printing in the flipped classroom in the practice teaching of otolaryngology-head and neck surgery. Methods A total of 68 medical undergraduates of the Grade 2013 in Air Force Medical University were divided into experimental group and control group, with 34 undergraduates in each group. The undergraduates in the experimental group received the teaching method of 3D printing in the with flipped classroom , and those in the control group received traditional teaching. The teaching effect was evaluated by questionnaire and examinations of basic knowledge and clinical skills, Independent-samples t test was used for between-group comparison with SPSS 20.0. Results Compared with the control group , the experimental group had significantly higher scores in theoretical examinations (34.79 ±2.20 vs. 31.73 ±3.12, t=4.676, P=0.000) and clinical skill examination (50.06 ±2.98 vs. 45.82 ±4.68, t=4.449, P=0.000). The questionnaire survey showed that among the 34 undergraduates in the experimental group, 31(91.2％) thought that the new teaching method could increase their learning interest, 33 (97.0％) believed it could improve learning efficiency, 25 (73.5％) believed the models obtained by 3D printing had good quality, 32 (94.1％) felt that it could improve clinical skills, 28 (82.4％) thought it could enhance the interaction between students and teachers, and 29(85.3％) thought it did not bring extra burden. Conclusion The teaching method of 3D printing combined with flipped classroom in the practice teaching of otolaryngology-head and neck surgery can improve students' learning interest, academic scores, and clinical skills, and therefore, it holds promise for application in teaching.

Decreased Expression of TRPV4 Channels in HEI-OC1 Cells Induced by High Glucose Is Associated with Hearing Impairment

PURPOSE: Previous reports have shown that hyperglycemia-induced inhibition of transient receptor potential vanilloid sub type 4 (TRPV4), a transient receptor potential ion channel, affects the severity of hearing impairment (HI). In this study, we explored the role of TRPV4 in HI using HEI-OC1 cells exposed to high glucose (HG). MATERIALS AND METHODS: HEI-OC1 cells were cultured in a HG environment (25 mM D-glucose) for 48 hours, and qRT-PCR and Western blotting were used to analyze the expression of TRPV4 at the mRNA and protein level. TRPV4 agonist (GSK1016790A) or antagonist (HC-067047) in cultured HEI-OC1 cells was used to obtain abnormal TRPV4 expression. Functional TRPV4 activity was assessed in cultured HEI-OC1 cells using the MTT assay and a cell death detection ELISA. RESULTS: TRPV4 agonists exerted protective effects against HG-induced HI, as evidenced by increased MTT levels and inhibition of apoptosis in HEI-OC1 cells. TRPV4 overexpression significantly increased protein levels of phosphorylated p38 mitogen-activated protein kinase (p-p38 MAPK), while TRPV4 antagonists had the opposite effect. Our results indicated that TRPV4 is a hyperglycemia-related factor that can inhibit cell proliferation and promote cell apoptosis by activating the MAPK signaling pathway in HEI-OC1 cells. CONCLUSION: Our results show that the overexpression of TRPV4 can attenuate cell death in HEI-OC1 cells exposed to HG.

Evaluation of Word Recognition Abilities in Children in 4-talker Babble Noise / 听力学及言语疾病杂志

Objective The aim of this study is to evaluate word recognition abilities in 4-talker babble noise (BN) in children with normal hearing (NH), and to explore the lexical effects, age on speech recognition ability in children.Methods Children of 3~6 years old with normal hearing (N=212)were participated in this study.One hundred and twenty-four children were performed under the quiet conditions,while 88 were performed in 4-talker babble noise.The standard-Chinese version of the lexical neighborhood test was used to assess spoken word recognition performance.The speech level was 70 dB SPL, and signal to noise ratio (SNR) was chosen 4 dB in BN.Results The correct scores of the NH children in quiet for the DE, DH, ME, and MH words were 96.45%±5.17%, 88.87%±7.73%, 91.90%±7.31% and 82.38%±7.95%, while the scores in BN were 85.34%±11.23%, 66.42%±11.08%, 68.81%±15.99% and 48.58%±12.81%, respectively.The word-recognition performance in BN was significantly poorer than that in quiet.The word recognition scores showed that the lexical effects were significant in the BN (P<0.05).Children scored higher with dissyllabic words than with monosyllabic words;easy words scored higher than hard words in both quiet and noisy environments.The word-recognition performance also increased with age in each lexical category in the 3-to 6-year-old NH children.Conclusion Age and lexical characteristics of words had significant influences on the performance of Mandarin-Chinese word recognition in BN.The lexical effects were more noticeable under noise listening conditions than in quiet.The word-recognition performance in noise increased with age in NH children of 3-to 6-years old in noise and had not reached adult-like performance at 6 years of age.

Video head impulse test in peripheral vestibular diseases / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVES</b>The function of the semicircular canal receptors and the pathway of the vestibulo-ocular reflex (VOR) can be diagnosed with the clinical head impulse test. The aim of the study was to investigate the horizontal VOR by means of video head impulse test in peripheral vestibular disorders.</p><p><b>METHODS</b>Using the vHIT, we examined horizontal semicircular canal VOR in a group of 55 patients and a control group of 20 healthy subjects. The group of patients included 10 cases of vestibular neuritis (VN), 6 cases of vestibular schwannoma (VS), 12 cases of Meniere's disease (MD), and 15 cases of bilateral vestibulopathy (BV), as well as 13 cases of idiopathic sudden hearing loss with vertigo (ISHL).</p><p><b>RESULTS</b>Instantaneous gains of 40 ms, 60 ms and 80 ms of horizontal VOR were 0.88 ± 0.17, 0.94 ± 0.13 and 0.96 ± 0.13, respectively. Regression gain at 60 ms was 0.99 ± 0.11, and asymmetry was 5.6 ± 3.5. Normal range of 60 ms instantaneous gain was > 0.73, normal range of regression gain was > 0.80. Abnormal vHIT was found in VS (100%), VN (90.9%), BV (86.7%), MD (40.0%) and ISHL (38.5%). Three conditions of refixation saccades occurred in cases with abnormal VOR: isolated covert saccades (12.5%), isolated overt saccades (45.0%) and the combination of overt and covert saccades (42.5%).</p><p><b>CONCLUSIONS</b>The vHIT detects abnormal VOR changes in the combination of gain assessment and refixation saccades. Since isolated covert saccades in VOR changes can only be seen with vHIT, peripheral vestibular disorders are likely to be misdiagnosed with the HIT.</p>

The MRI study of upper airway on obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the character of upper airway and to offer the reference for clinical treatment through observing the upper airway caliber and its corresponding pharyngeal wall of OSAHS patients by magnetic resonance imaging (MRI).@*METHOD@#The upper airway of 33 obstructive sleep apnea hypopnea syndrome (OSAHS) patients diagnosed by PSG were analyzed and compared by MRI. The cross-sectional area of the upper airway and thickness of lateral parapharyngeal wall were calculated. The cross-sectional area of the upper airway and thickness of lateral and posterior pharyngeal wall were also measured in 20 nonsnoring age-matched normal subjects selected as the control group.@*RESULT@#The cross-sectional areas of upper airway of OSAHS patients were smaller than that of the control. The Thickness of posterior pharyngeal wall and lateral pharyngeal wall of the retropalatal region, retroglossal region and epiglottal region were thicker in patients group than that of the control. The thickness and length of the palate in patients group were larger than that of the control. The cross-sectional areas of retropalatal region of OSAHS patients had negative correlation with apnea hypopnea index (AHI). There was also negative correlation between the retroglossal region cross-sectional area and the neck circumference.@*CONCLUSION@#Measurement of upper airway with MRI could observe the change of pharynx cross-sectional area and had reference value in guiding the clinical diagnosis and treatment.

Retrospective analysis of 1062 cases consulted by an otolaryngology chief resident / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To describe consultation practice patterns of an otolaryngology chief resident in China.@*METHOD@#The pattern and frequency of patient encounters during the Xijing Hospital of the Fourth Military Medical University otolaryngology residency program for one chief resident were retrospectively analyzed.@*RESULT@#A total of 1062 new inpatients were consulted during a 10-month period of otolaryngology residency, including emergency consultation for 467 cases (43.97%) and routine consultation for 595 cases (56.03%). The chief resident consulted an average of 28 new patients perweek. The most common diagnosis for an emergency consultation was epistaxis (279 cases, 59.72% of emergency consultation), characterized by disturbances of blood coagulation, hypertension, renal failure or liver failure, iatrogenic factors. The second cause was laryngeal obstruction and tracheotomy (113 cases, 24.19% of emergency consultation). There were 43 cases with foreign body in bronchus . For routine consultation on general internal medicine, chronic rhinitis and sinusitis (169 cases) was the most common disorder, followed by chronic pharyngitis, acute or chronic tonsillitis. For consultation on surgery, most cases were concerned about preoperative evaluations (67 cases) of the chronic otolaryngological disorders.@*CONCLUSION@#Consultation is an inimitable clinical practice and a challenge to otolaryngology residents. The chief residents should be prepared for the consultation practice. Accumulation of related data from consultation is necessary and helpful for chief residents.

The effect of pulmicort on pediatric chronic sinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the effective method in treatment of pediatric chronic sinusitis.@*METHOD@#Two hundred and ten children were clinically diagnosed as chronic sinusitis and randomly divided into three groups as pulmicort, rhinocort and routine treatment group, respectively. All the patients in different group were systemic treated by corresponding method for two weeks.@*RESULT@#The effective rates were 84% for pulmicort treatment group, 61% for rhinocort treatment group and 48% for routine treatment group, so the effective rate for the patients treated with pulmicort were significantly higher than that with either rhinocort or routine treatment.@*CONCLUSION@#Pulmicort can be used to treat pediatric chronic sinusitis with higher effective rate.