ABSTRACT
Objective: To explore the clinical relationship between auditory neuropathy [AN] and nervous system diseases
Methods: A total of 134 AN patients who were treated in our hospital from December 2011 to April 2016 were selected. Then 120 cases [240 ears] with complete data of pure tone audiometry and acoustic immittance test were selected as an AN1 group, which was compared with 30 patients [49 ears] with general sensorineural hearing loss [SHL] in regard to the results of pure tone audiometry and acoustic immittance test. On the other hand, 79 cases [158 ears] of the 134 patients with complete data of DP otoacoustic emission test were selected as an AN2 group, which was compared with 30 normal subjects [60 ears] regarding the results of DP otoacoustic emission test
Results: Increases in the pure-tone hearing threshold by air conduction of AN1 group significantly exceeded those of SHL group at 0.125 and 0.25 kHz [low frequency] [P<0.05]. The former group had significantly lower values at 1.0, 2.0 kHz [moderate frequency] and 4.0, 8.0 kHz [high frequency] [P<0.05]. Of 134 patients, 14 [19 ears] had evoked V wave upon auditory brainstem response, whereas no waves after I wave were evoked in other tested ears. Distortion product [DP] otoacoustic emissions could all be evoked. AN2 group had significantly higher amplitudes of DP-gram than those of normal control group at 0.5 and 0.7 kHz [low frequency] [P<0.05]. Except for three cases of unsteady walking and 10 of dizziness, others did not suffer from typical symptoms of vertigo attack. As to caloric test-induced electronystagmograms, there were 30 bilaterally normal cases [75.0%], one case of left-side semicircular canal paresis [25%] and nine cases of bilateral semicircular canal paresis [22.5%]. Four patients with other nervous system diseases were complicated with AN. Other nervous system disorders included three cases of optic nerve atrophy and 7 of lower limb nerve damage
Conclusion: According to characteristic hearing dysfunction, AN may occur in the afferent pathway of acoustic nerve, probably accompanied by the pathological changes of efferent nerve in the olivocochlear system inside the brainstem
ABSTRACT
Objective To explore the effect of ginkgo biloba injection combined with alprostadil to hearing recovery,immunoglobulin level and hemorheology indexes of patients with sudden deafness.Methods 82 cases of sudden deafness patients collected in the first affiliated hospital of Wenzhou medical university from September 2015 to July 2014 were divided into control group(n=41) and experimental group(n=41) according to the random number table method.Control group were treated with 10μg alprostadil injection, added to 100 mL 0.9% saline infusion, intravenous drip, one time per day.Experimental group was given ginkgo biloba injection 20 mL, added to 500 mL 5% glucose intravenous drip on the basis of control group, one time per day.The clinical curative effect and hearing degree of recovery of two groups were observed after two weeks.Serum immunoglobulin A ( IgA ) , immunoglobulin G( IgG) , immunoglobulin M( IgM) levels were tested by automatic biochemical analyzer.The whole blood viscosity, plasma viscosity, red cell pressure product and red cell aggregation index were tested by blood viscosity analyzer.Results Two weeks after treatment, the total effective rate of experimental group was 92.68%, higher than 70.73% of the control group(χ2 =6.609,P=0.010).The tinnitus, aural fullness, vertigo and hearing recovery in experimental group was significantly higher than that of the control group, and the pure tone hearing threshold in experimental group was lower than the control group(P <0.05).After treatment, serum IgA, IgG and IgM levels were all decreased, and those indexes of experimental group were all significantly lower than those of control group(P<0.05).The whole blood viscosity, plasma viscosity, red blood cell hematocrit and red blood cell aggregation index were decreased, and those indexes of experimental group were all significantly lower than that of the control group( P <0.05).Conclusion The therapy of ginkgo biloba injection combined with alprostadil can reduce the tone of sudden deafness hearing threshold, promote the recovery of hearing, decreased in patients with immune globulin protein and hemorheology indexes, and improve clinical curative effect.
ABSTRACT
OBJECTIVE@#To evaluate the efficacy of combined modality therapy for advanced hypopharyngeal carcinoma in order to improve the curative effect of hypopharyngeal carcinoma.@*METHOD@#Seventy-six male patients with the stage III - IV hypopharyngeal carcinoma were treated with postoperative combined modality. Of all the 76 cases, 44 were treated with postoperative radiotherapy, and the other 32 treated with chemoradiotherapy concurrently.@*RESULT@#Kaplan Meier analysis indicated that the overall 5 survival rates of patients treated with postoperative radiotherapy was 25.9%, and that of patients treated with postoperative chemoradiotherapy was 27.8%. There was no significant difference between the two groups (P>0.05). Three and five years relapse-free survival rates of the patients treated with postoperative radiotherapy were 36.0%, 22.5%, and those of the patients treated with postoperative chemoradiotherapy were 68.0%, 45.3%. Significant difference was calculated between the two groups (P0.05).@*CONCLUSION@#For advanced hypopharyngeal carcinoma, postoperative chemoradiotherapy yielded satisfactory relapse free survival and laryngeal function preservation rate which was superior to that of postoperative radiotherapy. Also the treatment toxicities were not increased.