Clinical multi-center study on the treatment of sudden sensorineural hearing loss accompanied with feeling of ear fullness / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effect of drug treatment for patients with sudden sensorineural hearing loss (SSNHL) accompanied with feeling of ear fullness (FEF).</p><p><b>METHODS</b>A prospective clinical multicenter research was carried out from August 2007 to October 2011. SSNHL patients aged between 18 to 65 years old and accepted no medication were recruited, with a duration less than two weeks. The patients were divided into four types according to the hearing curve: type A was acute SSNHL in low tone frequencies, type B was acute SSNHL in high tone frequencies, type C was acute SSNHL in all frequencies, and type D was total deafness. Each type was subdivided into two groups by the accompaniment of SEF or not. And each type had four different treatment programs, based on the unified designed randomized table. All patients were followed up for four weeks from the initial examination.</p><p><b>RESULTS</b>A total of 1 024 cases with single side SSNHL were recruited in the study from 33 hospitals in China, including 565 cases accompanied with FEF (55.18%), and 459 cases without FEF (44.82%). By classification of audiogram, 205 cases were type A (20.20%), of whom 122 were accompanied with FEF (59.51%); 141 cases belonged to type B (13.77%), of whom 74 were accompanied with FEF (52.48%); 402 cases were type C (39.25%), of whom 229 were accompanied with FEF (56.97%); and 276 cases were classified as type D (26.95%), of whom 140 were accompanied with FEF (50.72%). No significant difference was observed in total effective rate between the SSNHL patients accompanied with FEF or not in four acoustic types (P > 0.05). Among four acoustic types, the clinical cure rate of patients accompanied with FEF in type A was 93.44%, ranking the first; followed by 84.28% for type C; 75.71% for type D; and 70.27% for type B, respectively.</p><p><b>CONCLUSIONS</b>The therapeutic effect for patients accompanied with FEF in type A is satisfactory. The presence of FEF do not impact the therapeutic effect for SSNHL patients.</p>

Langerhans cell histiocytosis of the temporal bone in children: 7 cases analysis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the clinical manifestations, diagnosis, therapy and prognosis of Langerhans cell histiocytosis (LCH) of the temporal bone in children.@*METHOD@#Seven children with LCH of the temporal bone n our hospital were retrospectively summed up from April 2009 to April 2014. The patients were followed up 1-5 years, their clinical manifestations, imaging findings, diagnosis, therapy and prognosis were studied. Correlation between clinical classifications and prognosis was also analyzed.@*RESULT@#Among the 7 patients, 4 were boys and 3 were girls. 5 cases belonged to the single system group and 2 cases belonged to the multisystem group. The most common clinical characters were temporal tumor, otorrhea, otalgia, hearing loss and granulation of external auditory canal. CT of the temporal bones showed extensive osteolytic destructions with diffuse soft tissure density, without border sclerotization. The cases were. received different therapies. Followed up for 1-5 years, 4 cases were regressive, 1 case kept stable, while 2 cases showed progressive. The two boys then received standard treatment combined steroids with vinblastine. The prognosis in the multisystem group was significantly different from the single system group (P < 0.05).@*CONCLUSION@#The clinical manifestations of LCH vary a lot. The diagnosis is based on histological and immunophenotypic examination of lesion tissue. The main therapy includs surgery, chemotherapy and radiotherapy. The prognosis of the single system group is much better than the multisystem group.

Change of CTR1 Expression after Round Window Niche Copper Sulfate and Cisplatin Infusion / 听力学及言语疾病杂志

Objective To study the expression of copper transport protein 1 in the inner ear of rat and the changes of CTR1 expression after those round window niche copper sulfate and cisplatin infusion .Methods 24 male wistar rats were randomly divided into 4 groups :Group I as the normal control group (nontreatment group);Group II as the round window niche cisplatin infusion group(0 .5 mg/ml);Group III as the round window niche cisplatin infusion group (1 mg/ml);group IV as the round window niche copper sulfate infusion (0 .02 mg/kg) .The CTR1 protein was detected by the immunohistochemical (IHC) otaining and Western-blot ,and the CTR1mRNA expres‐sion levels were detected by RT -PCR .Results The expression of CTR1 protein was observed in the cytoplasm and cell membrane of Corti organ cells ,spiral ganglion cells and stria vascularis in all groups .The average optical densi‐ties of CTR1 protein was a downward trend .The expression of CTR1 protein was observed in four different groups . The optical density analysis of CTR1 showed that the optical densities were 0 .532 ± 0 .031 ,0 .394 ± 0 .024 ,0 .234 ± 0 .030 and 0 .191 ± 0 .015 ,respectively .There was a downward trend ,and there were statistically differences among the groups (P<0 .05) .The CTR1 mRNA was observed in all groups .The optical density analysis of CTR1 mRNAshowed that the optical densities were 0 .508 ± 0 .035 ,0 .391 ± 0 .022 ,0 .240 ± 0 .02 and 0 .186 ± 0 .021 ,respective‐ly .It had a downward trend and were statistically differences among the groups (P<0 .05) .Conclusion The CTR1 protein was abundantly expressed in Corti organ ,spiral ganglion cells and stria vascularis of the cochlea .The round window cisplatin and copper sulfate infusion can change the expression of CTR1 proteins in inner ear .

Intratympanic therapy in the management of tinnitus / 临床耳鼻咽喉头颈外科杂志

Tinnitus is a common symptom which often becomes disabling, affecting the emotional and psychosocial dimensions of life. Nowadays, therapies for tinnitus vary greatly, none of which could give a satisfactory therapeutic effect however. Intratympanic therapy allows the generation of high concentration of drugs within the inner ear without systemic side effects. This review aims to introduce the commonly used medications and approaches for intratympanic management of tinnitus. Although different medications have been tested for their effects on tinnitus by intratympanic application, no breakthrough has been achieved so far. Consequently, the clinical use of specific medications for tinnitus has remained limited. A more widespread adoption of intratympanic management requires the development of specific medications for tinnitus, as well as proof of their safety and efficacy.

Study on clinical manifestations and treatment of primary cervical tracheal malignant tumor of children / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the clinical manifestations and treatment of the primary cervical tracheal malignant tumor of children.@*METHOD@#Five cases diagnosed as primary tracheal malignant tumor with fibrolaryngoscopy, CT scan and pathology were retrospectively analyzed and reviewed. Extraction of malignant tumor was performed with tracheoscopy and nasal endoscope after emergent tracheotomy below the tumor in 4 cases, and tracheotomy after intubation in 1 case. After operation, 4 children received radiotherapy, and 1 case received laser therapy add radiotherapy.@*RESULT@#Five cases were followed up for three to eight years, and no recurrence was found.@*CONCLUSION@#There was no specific manifestation in early tracheal malignant tumor, but it was critical and emergent during symptoms appear. Imaging examination was a very invaluable diagnosis method. Optimal and effective therapeutic protocol is tracheostomy under local anesthesia to keep upper airway patency followed by surgical extraction and radiotherapy. It was not appropriate to have tracheal wall resection for children.

Study on clinical manifestations and treatment of primary cervical tracheal malignant tumor of children / 临床耳鼻咽喉头颈外科杂志

Objective:To study the clinical manifestations and treatment of the primary cervical tracheal malig-nant tumor of children. Method:Five cases diagnosed as primary tracheal malignant tumor with fibrolaryngoscopy, CT scan and pathology were retrospectively analyzed and reviewed. Extraction of malignant tumor was performed with tracheoscope and nasal endoscope after emergent tracheotomy below the tumor in 4 cases, and tracheotomy after intubation in 1 case. After operation, 4 children received radiotherapy, and 1 case received laser therapy add radiotherapy. Result:Five cases were followed up for three to eight years, and no recurrence was found. Conclu-sion: There was no specific manifestation in early tracheal malignant tumor, but it was critical and emergent during symptoms appear. Imaging examination was a very invaluable dignosis method. Optimal and effective therapeutic protocol is tracheostomy under local anesthesia to keep upper airway patency followed by surgical extraction and radiotherapy. It was not appropriate to have tracheal wall resection for children.

Round window catheter placement with dexamethasone perfusion for intractable sudden sensorineural hearing loss / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the efficacy of round window catheter placement with dexamethasone perfusion for 13 patients with intractable sudden sensorineural hearing loss (SSNHL).@*METHOD@#Dexamethasone (2.5 mg) was perfused transtympanically through round window catheter by Micro-infusion pump. The perfusion was taken twice a day and continued for an hour each time, for a total of 7 days.@*RESULT@#Thirteen patients have been followed up for 1 month. Five of them (38.5%) were demonstrated a 17-54 dB improvement in pure-tone threshold average (PTA). The other 8 patients (61.5%) had no effect.@*CONCLUSION@#Round window catheter placement with dexamethasone perfusion is a cost-effective and useful treatment for SSNHL patients who had no effect through conventional therapy, although hearing thresholds of these patients had hardly improved to normal levels.

Diagnosis and management of lipogranuloma of the eyelids from nasal endoscopic surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To enhance the safety of nasal endoscopic surgery and decrease its complications of eyes.@*METHOD@#Three patients of chronic rhinosinusitis and nasal polyposis with lipogranulomas of the eyelids after nasal endoscopic surgery and nasal packing of petrolatum gauze were reported and analyzed, and their treatment results were presented during the last 2 years.@*RESULT@#The medial orbital wall injury occurred in all three patients during endoscopic sinus surgery. The patients developed an ipsilateral periocular swelling, eyelid hematoma and palpebral conjunctival edema during 2 to 3 hours after surgery. Nasal packs petrolatum gauze were removed 10-24 hours after surgery. The patients were discharged from hospital when periorbital swelling and eyelid ecchymoma disappeared, and nasal cavity obstruction was improved 6 to 8 days after surgery. The swelling and nodular mass of ipsilateral eyelids (one in left upper eyelid and two in right lower eyelid) were found 12-15 days after surgery, and their eye movement and eyesight were normal. Antibiotic and corticosteroid were administered for 3 4 weeks with only improvement in eyelid swelling. These masses of eyelids were completely excised through palpebral margin 1-6 months after surgery. The histopathological examination of the surgical specimens showed lipogranuloma. No recurrence and symptom of the eyes had been observed during 4-18 months follow up.@*CONCLUSION@#The lipogranuloma of the eyelid is a rare and late complication after nasal endoscopic surgery and nasal packing with vaspetrolatum gauze. The medial orbital wall injury and bleeding during surgery, and vaseline of nasal packing permeated into the eyelid are the direct causes of this complication. The application of petrolatum gauze should be avoided when the medial orbital wall trauma is identified. The complete excision of granulomas is a best effective therapy.

Diagnosis and surgical treatment of the carotid body tumors / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To enhance the cure rate and lower the complication rate and the mortality rate through summarizing the clinical features and experiences in diagnosis and therapy of carotid body tumor (CBT).@*METHOD@#Retrospectively analyzed the clinical data of 21 cases (23 sides) of CBT from 1995-2095 occurring in our hospital.@*RESULT@#The accurate diagnosis rates hy using digital subtraction angiography (DSA) and magnetic resonance imaging (MRI) were 100%. Seventeen cases (19 sides) accepted surgical operation with different kinds of procedures. The tumors of 8 cases were simplex isolated from the carotid artery. Both the tumour and the external carotid artery were resected in 9 cases. One case underwent resection of both the internal and external carotid artery and the tumour without carotid reconstruction. One case underwent resection of the internal, external carotid artery and the tumor with reconstruction of the internal carotid artery. No operative mortality was observed. The ventricular arrhythmia which had not been controlled pre-operation occurred in 1 case who was finally self-cured. One case had hoarseness and completely recovered in one week. and 1 case without carotid reconstruction had a frequent headache and gradually recovered in 5 months. The others had no complications.@*CONCLUSION@#OSA and MRI are the best methods for diagnosing CBT. Surgery is the first choice concerning the treatment of CBT. Accurate preoperative evaluation, correct therapeutic decision exquisite vascular surgical techniques can help to significantly decrease, even avoid the complications.

Study of blood dynamics of ophthalmic artery in patients with sudden sensorineural hearing loss using color doppler flow imaging / 临床耳鼻咽喉头颈外科杂志

Objective: To investigate the relationship between the pathogenesis of sudden sensorineural hearing loss (SSHL) and the disorder of blood circulation in inner ear. Method :Blood dynamics of the ophthalmic artery were studied quantitatively using color doppler imaging in 34 patients with SSHL. Result:Compared with 34 self-controls and 15 normal controls, 28 patients (82.4％) with SSHL had significantly lower blood flow velocities and higher resistance indices (P＜0.05),and there was no significant difference between the selfcontrol group and the normal control group (P＞0.05). Conclusion: The study suggested that the blood situations－the decreased blood flow velocities and perfusion and increased resistance of ophthalmic artery in patients with SSHL maybe play a role in the pathogenesis of SSHL.

Detection of Plasma Endothelins and Serum Nitric Oxide in the Patients with Sudden Sensorineural Hearing Loss / 中国医师杂志

Objective To investigate the roles of endothelins and nitric oxide in the pathogenesis of sudden sensorineural hearing loss(SSHL). Methods 26 patients with SSHL in Changsha area from October 2000 to April 2001, and 18 healthy subjects in the same period were enrolled in this study. Plasma endothelins level was detected by radioimmunoassay, and serum nitric oxide(NO) level was detected by cadmium-reduced spectrophotometry. Results The plasma endothelins level in the SSHL patients was significantly higher than that in the healthy subjects, and the serum NO level in the SSHL patients was significantly lower than that in the healthy subjects(P0.05). Conclusion The increase of ET level and the decrease of NO level may play an important role in the pathogenesis of SSHL, which may serve as an index to predict the hearing improving or not, but were not related to the degree of hearing loss.

Juvenile onset recurrent respiratory papillomatosis in 38 children / 中国耳鼻咽喉头颈外科

Objective:To evaluate the feature of juvenile onset recurrent respiratory papillomatosis (JORRP).Methods:Thirty-eight cases with JORRP were analyzed retrospectively from June,1986 to June,2000.Results:The average age was 3.5 years before diagnosis.Average 3.45 operations had been performed per patient .Of 38 cases ,eight had comlications of laryngeal dysfunction after operations.Peristomal and tracheal papilloma were spread in six of the nineteen cases with tracheotomies.Conclusion:JORRP is the most common laryngeal tumor in children. Most patients have frequent recurrences and multiple operations. Care should be taken to avoid damaging the normal laryngeal structure during surgical excision.

Evaluation of the effect of streptomycin perfusion of the labyrinth in the treatment of Meniere′s disease and endolymphatic hydrops / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the clinical effect of streptomycin perfusion of the labyrinth (SPL) inthe treatment of Meniere's disease. Method: 13 patients with Meniere′s disease and 3 patients with delayedendolymphatic hydrops (DEH) underwent SPL. The follow－up time was between 5 and 7 years (average 6.3years). Result:Vertigo was completely controlled in 9 patients, substantialy controlled in 4, limitedly controlledin 2 and not controlled in 1. Hearing was improved in 1 patients, stabilized in 5 and worse in 10. Tinnitus wasimproved in 3 patients, stabilized in 5 and worse in 8. Conclusion:SPL is a safe and effective method in thetreatment of Meniere′s disease and DEH, but the hearing may be insulted and tinnitus may be worse in somepatients.