Multi-center study of clinical treatment on the flat type of sudden hearing loss / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of different treatment options for the flat type of sudden hearing loss.</p><p><b>METHODS</b>Prospective, multi-center clinical study was carried out using internationally used standardized clinical research method. Patients with the flat type of sudden hearing loss between 18 and 65 years old, within two weeks duration, and without any medical treatment were recruited. Treatment options were randomly selected according to the designed random table.</p><p><b>RESULTS</b>From August 2007 to October 2011, 402 patients with the flat type of sudden hearing loss who met the criteria (account for 39.26% of the total number of patients) from the 33 hospitals were collected; the total effective rate was 82.59%, and no significant difference was detected between different treatments, (χ(2) = 10.95, P = 0.28). In the 402 cases, 139 were cured (34.58%); 118 were markedly improved (29.35%); 75 were effective (18.66%); 70 were invalid (17.41%).</p><p><b>CONCLUSIONS</b>The therapeutic efficacy of flat type of sudden hearing loss overall is good; the treatment of improving the inner ear blood rheology and/or reducing blood fibrinogen has clinical significance; the therapeutic efficacy of using glucocorticoid systemically is good as well; there is no obvious difference between combination and single medication.</p>

Pathological features and clinical managements of nasopharyngeal angiofibroma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the pathological features of nasopharyngeal angiofibroma (NA) and the principles for clinical managements.</p><p><b>METHODS</b>Thirty-five patients with NAs were treated in First Affiliated Hospital of Fujian Medical University from Oct. 1981 to May 2007. The pathological changes, sites of origin, causes of intraoperative bleeding and the experiences of managements were retrospectively analysed. Using Fish stage: 6 cases were in stage I, 8 cases were in stage II, 17 cases were in stage III, 4 cases were stage IV. Two cases via endoscopic surgery, 2 cases via palatal approach, 19 cases via midfacial degloving approach, 9 cases via lateral rhinotomy approach, 3 cases via craniofacial combined approach.</p><p><b>RESULTS</b>In nasal cavity and paranasal sinus, the tumor was covered by squamous or columnar epithelium. The tumor extensions such as in pterygopalatine fossa and infratemporal fossa were covered by fibrous pseudocapsule. All cases of this series originated in the lateral wall of posterior portion of the nasal cavity. Fifteen of thirty-five cases confidentially originated near sphenopalatine foramen. Large and thick vessels in the pedicle region were the exact sites of serious intraoperative bleeding. Thirty-one cases were totally removed. Four cases were subtotal resected. Visual loss revealed in 6 cases, 4 cases visual acuity improved postoperatively. Three cases revealed postoperative dry eye due to surgical involvement of the sphenopalatine ganglion.</p><p><b>CONCLUSIONS</b>nasopharyngeal angiofibroma is covered by epithelium or pseudo-capsule, it does not infiltrate the surrounding tissue. Dissecting along the surface of tumor might decrease bleeding and facilitate removal of tumor. An ideal surgical management should be done according to actually size and image examination, to the greatest extent keeping normal facial appearance. Attention should be paid to the complications such as visual loss and dry eye.</p>