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In order to improve the teaching quality of stomatology standardized residency training, the method of PDCA cycle quality management was tried, and 8 stomatology teachers were evaluated by 4 rounds of improvements. The evaluation included theoretical knowledge teaching satisfaction, operational skills teaching satisfaction, teaching level, teacher quality assessment, teaching quality supervision group evaluation and other indicators. The comprehensive teaching ability of all the teachers recruited in this study was significantly improved after 12 months of PDCA cycle training. The results suggest that the application of PDCA cycle helps stomatology teachers to provide high quality training to residents and provide the reference for the management of clinical teaching.
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OBJECTIVE To explore the CT and MRI appearances of otogenic sigmoid sinus thrombophlebitis(SST) and abscess. METHODS The HRCT, plain MRI, magnetic resonance venography(MRV), enhanced MRI findings in 11 patients with otogenic SST were retrospectively analyzed. RESULTS On CT, the bony wall of sigmoid sinus was eroded in 10 cases (10/11), and air bubbles were found in or around sigmoid sinus in 4 cases. On plain MRI, sigmoid sinus flow void effect disappeared in all 11 cases. SST manifested as high signal on T2W1 in all 11 cases, and as low signal on T1WI in 2 cases, isointense signal on T1WI in 6 cases, high signal on T1WI in 3 cases. Contrast enhancement MRI showed enhancement in wall of venous sinus, but venous sinus thrombosis did not enhanced, but showed as irregular filling defect or empty triangle. MRV showed that involved venous sinus was not visualized. CONCLUSION CT can show the erosion of the bony wall of sigmoid sinus which may indicate the SST; and if air bubbles are found around or in the sigmoid sinus, the abscess around or in the sigmoid sinus should be doubted. Conventional MRI combined with MRV are effective and noninvasive methods in the diagnosis of SST.
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The vegetative state is a complex condition with unclear mechanisms and limited diagnostic, prognostic, and therapeutic methods. In this study, we aimed to explore the proteomic profile of tears from patients in a traumatic vegetative state and identify potential diagnostic markers using tears-a body fluid that can be collected non-invasively. Using iTRAQ quantitative proteomic technology, in the discovery phase, tear samples collected from 16 patients in a traumatic vegetative state and 16 normal individuals were analyzed. Among 1080 identified tear proteins, 57 were upregulated and 15 were downregulated in the patients compared to the controls. Bioinformatics analysis revealed that the differentially-expressed proteins were mainly involved in the wound response and immune response signaling pathways. Furthermore, we verified the levels of 7 differentially-expressed proteins in tears from 50 traumatic vegetative state patients and 50 normal controls (including the samples used in the discovery phase) using ELISA. The results showed that this 7-protein panel had a high discrimination ability for traumatic vegetative state (area under the curve = 0.999). In summary, the altered tear proteomic profile identified in this study provides a basis for potential tear protein markers for diagnosis and prognosis of the traumatic vegetative state and also provides novel insights into the mechanisms of traumatic vegetative state.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Biomarkers , Metabolism , Chromatography, Liquid , Enzyme-Linked Immunosorbent Assay , Eye Proteins , Metabolism , Mass Spectrometry , Persistent Vegetative State , Metabolism , Proteome , Proteomics , ROC Curve , Tears , MetabolismABSTRACT
OBJECTIVE To summarize surgical treatment effects and to discuss surgical strategy for Small acoustic neuroma.METHODS The clinical data of 26 patients with small acoustic neuroma treated with surgery in our department were analyzed retrospectively.25 patients with preoperative hearing grading of C and D received the labyrinthine approach acoustic neuroma resection,and 1 patient with preoperative hearing grading of B received middle fossa approach acoustic neuroma resection.The preoperative and postoperative hearing level,incidence of tinnitus,balance disturbance and weakness of facial muscles were analyzed retrospectively.The control and recurrence of the tumor,the incidence of complications were recorded.RESULTS Total resection was achieved in 25 cases (96％),and in 1 cases achieved sub total resection due to the fact that the tumor was too adhesive to the facial nerve The follow-up time ranged from 6 months to 7 years with 7 cases lost contact.No deaths nor intracranial infection were encountered.Cerebrospinal fluid rhinorrhea was found in 1 cases after the operation and eustachian tube blockage was performed.All patients(100％) had their facial nerve reserved and 16 patients (88％) had their cochlea nerve reserved.17patients(89.5％) had intact facial nerve function and 2 patients suffered from level Ⅲ facial nerve paralysis (House-Brackmann grade) post operatively.6 patients suffered from vertigo pre-operatively and 5 of them reported disappearance of vertigo after the surgery.Of the 13 patients who did not have vertigo before the surgery,1 patient complained sense of dizziness and unsteady walking post-operatively.5 patients (33.3％) reported disappeared or alleviated tinnitus,8 patients (53％) had the same degree of tinnitus and 2 patients reported worsened tinnitus post-operatively.For patients who did not have tinnitus before the surgery,no tinnitus was reported post-operatively.CONCLUSION treatment strategy for small acoustic neuroma requires personalized setting based on the age of the patient,the combined systemic disease,the severity of the symptoms and the growth rate of the tumor.For patients without practical hearing,the tumor could be removed with labyrinthine approach,and the integrity of the cochlear nerve should be preserved as far as possible,for further reconstruction of hearing ability and cochlear implantation.
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Objective To evaluate the effects of facial nerve reconstruction surgery by reviewing the clinical information and follow-up results of 42 cases.Methods The clinical data of 42 patients who were diagnosed as facial schwannoma and received tumor resection and facial nerve reconstruction simultaneously from January 2004 to December 2015 in our department were studied.The surgeries included anastomosis between the two faical nerves(3 cases), facial nerve transplantation(4 cases), Hypoglossal/masseteric-facial nerve anastomosis(27 cases) and cross-facial nerve graft(8 cases).We evaluated the facial nerve function using H-B grade and Fisch score post-operation (1 week, 3 months,6 months and 1 year after surgery).Results The Fisch scores were significantly different between 1 week and 3 months, 3 months and 6 months post-operation for patients received cross-facial nerve graft.The facial nerve function became better as time went by.While there were no difference between 6 months and 1 year post-operation.On the other hand, the scores were significantly different between 6 months and 1 year post-operation for patients received hypoglossal/masseteric facial nerve anastomosis.Conclusion Most patients received tumor section and facial nerve reconstruction simultaneously could gain good results, it took a long time for the facial nerve function to return to a stable state and some of them were still in recovering 1 year after surgery.
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OBJECTIVE To study the effect of stapes footplate fixation of on the middle ear transfer function. METHODS A finite element model of stapes footplate fixation was developed by changing the Young's module after constructing a normal adult finite element ear model, which was developed based on a normal temporal bone scanning data using Micro-CT. The displacement at the umbo of tympanic membrane and at the center of the stapes footplate were calculated under certain sound pressure. RESULTS In case of stapes footplate fixation, compared with the normal data, the displacement at the center of stapes footplate was reduced significantly (-47 dB), but which was mild at the umbo of tympanic membrane. CONCLUSION The stapes footplate fixation ear model in this study showed an obvious displacement reduction of the stapes footplate. Further study using fresh temporal bone is necessary.
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OBJECTIVE@#To investigate the feasibility of the treatment of otosclerosis using laser stapedotomy with mini incision in the external auditory meatus.@*METHOD@#Thirteen patients(15 ears) with otosclerosis evidence on clinic history. They were all operated using the laser assisted stapedotomy by mini incision in external auditory meatus because of the wide straight canal. Laser resection the tendo musculistapedius and anterior and postrior arch, breaking the articulatioincudostapedia, removing the stapes superstructure, making a hole of 6mm diameter in the rear of stapes footplate by laser drilling, implanting the corresponding length Piston artificial ossicle.@*RESULT@#All the surgeries were successful and the operation time was about one hour. There was only one patient manifested vertigo and nausea after the operation. But the symptoms improved three days later after the expectant treatment. All the incisions were healed in the externals. There was significant difference between the preoperative and postoperative PTA. The air conduct improved in every frequent and the bone conduct improved in 1 kHz, 2 kHz and 4 kHz.@*CONCLUSION@#Laser assisted stapedotomy by mini incision in the external auditory meatus in patients having wide straight canal with otosclerosis can shorten the operation time, minimize the tissue damage, fasten the healing of the incision and reduce the complications postoperatively. In addition, the mini incision is beauty and easy to nurse.
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Humans , Ear Canal , General Surgery , Lasers , Otosclerosis , General Surgery , Postoperative Complications , Postoperative Period , Prostheses and Implants , Stapes , Stapes Surgery , Treatment OutcomeABSTRACT
OBJECTIVE@#To investigate the effect of vibrant sound bridge implantation in microtia whose reconstructive external auditory canal occurred atresia.@*METHOD@#Three cases (2 males and 1 female) of microtia had underwent hearing reconstruction operation (Include the external ear canal reconstructive surgery and tympanoplasty). The age ranged from 15 to 18 years and the average age was 17 years. All the 3 cases suffered from conductive hearing loss with the air-bone gap ranging from 51.6 to 65.0 dB HL and the average value being 56. 3 dB HL. All the 3 cases underwent vibrant sound bridge implantation, including the floating mass transducer implanted in the head of stapes in 2 cases and in the niche of round window in 1 case.@*RESULT@#The postoperative hearing level improved from 21.6 to 52.5 dB HL with an average of 32.2 dB HL. There were no complications such as vertigo, tinnitus and facial paralysis.@*CONCLUSION@#Through vibrant sound bridge implantation, the hearing level of microtia whose reconstructive external auditory canal occurred atresia was improved effectively.
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Adolescent , Female , Humans , Male , Congenital Microtia , General Surgery , Ear Canal , General Surgery , Hearing Loss, Conductive , General Surgery , Hearing Tests , Ossicular Prosthesis , Plastic Surgery Procedures , Methods , TympanoplastyABSTRACT
OBJECTIVE@#To describe the HRCT appearances of congenital inner ear malformations with cerebrospinal fluid leakage.@*METHOD@#Conducted a retrospective case review. The subjects comprised 11 patients who were decisively confirmed by HRCT and exploratory tympanotomy. The result of temporal bone computed tomography scans (HRCT) were analyzed.@*RESULT@#Inner ear malformations were classified into 4 types according to HRCT findings. There were 4 patients with cochlear aplasia, 2 patients with common cavity anomaly, 2 patients with IP-I anomaly, and 3 patients with IP- II anomaly. Eight patients had defects in the lamina cribrosa of the internal auditory canal. The development and aeration in the mastoid of involved ears was normal. Soft tissues were seen near the oval window in all involved ears.@*CONCLUSION@#HRCT image has an important value in the diagnosis and treatment of inner ear malformations with cerebrospinal fluid leakage.