ABSTRACT
<p><b>OBJECTIVE</b>To analyze the efficacy of Methylprednisolone hemisuccinate intratympanic injection for refractory noise induced deafness.</p><p><b>METHODS</b>One hundred and twenty cases (215 ears) of noise induced deafness were treated with either hormone group (107 ears) or with non hormone group (108 ears). Following prior interventions, 145 ears went on to receive intratympanic Methylprednisolone hemisuccinate injection twice a week.</p><p><b>RESULTS</b>After Intratympanic therapy, the total effective rate was 46.2%. 32 of 71 ears (45.1%) demonstrated hearing improvement in hormone group and 35 of 74 ears (47.3%) in non hormone group. The difference was statistically insignificant (P = 0.788).</p><p><b>CONCLUSION</b>Intratympanic therapy appears to provide additional treatment benefits for patients with refractory noise induced deafness who have been treated with prior interventions. The outcome is not affected by pretreatment with hormone.</p>
Subject(s)
Humans , Glucocorticoids , Therapeutic Uses , Hearing Loss, Noise-Induced , Drug Therapy , Hearing Tests , Injection, Intratympanic , Methylprednisolone Hemisuccinate , Therapeutic Uses , Noise , Treatment OutcomeABSTRACT
OBJECTIVE@#To investigate the postoperative application of nasopharyngeal airway (NPA) in rhinogenous obstructive sleep apnea hypopnea syndrome (OSAHS) patients, so that to observe the parameters including vital signs of the patients and evaluatethe value of clinical application and reliability of NPA.@*METHOD@#A total of 216 patients diagnosed as rhinogenous OSAHS were randomly assigned to experimental group (setting NPA, 112 cases) and control group (not setting NPA, 104 cases) according to whether NPA was placed in the nasal cavity postoperatively. ECG, oxygen saturation and hemodynamics were monitored for 24 h postoperatively. The pharyngeal pain and discomfort, low oxygen saturation and hemodynamics were compared between these two groups. The subjective assessment and clinical symptoms were compared between the two groups using visual analogue scale (VAS).@*RESULT@#The experimental group showed better relief of nasal obstruction, nasal pain, headache, dry pharynx, insomnia and pain while taking out nasal packing compared with control group, where the differences were statistically significant (P < 0.01). In the experimental group, the level of LSa2O2 (P < 0.05), HR (P < 0.01), SBP (P < 0.05), DBP (P < 0.01), MAP (P < 0.01) and RPP (P < 0.01) was significantly lower than in the control group.@*CONCLUSION@#The postoperative application of nasopharyngeal airway in rhinogenous OSAHS patients could help to keep nasal patency and avoid the upper airway obstruction, which exhibited good safety and compliance. The nasopharyngeal airway can reduce patients' discomfort and improve hyoxemia, ensuring hemodynamic stability.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Nasopharynx , Postoperative Care , Respiration, Artificial , Methods , Sleep Apnea, Obstructive , TherapeuticsABSTRACT
BACKGROUND: Partial soft palate, uvula and the otiose soft tissue of lateral pharyngeal wall are resected in traditional uvulopalatopharyngoplasty. Although the syndrome can be improved, the complications, such as velopharyngeal insufficiency, cicatricial contration of pharyngeal cavity, can occur in some patients, furthermore, the prostecdtive efficacy is below the mark.OBJECTIVE: To investigate efficacy of the dilatation of oropharyngeal and nasopharyngealisthmus in uvulopalatopharyngoplasty treating obstructive sleep apnea hypopnea syndrome.DESIGN: A case-control observation.SETTING: The Affiliated Municipal Hospital of Medical College, Qingdao University.PARTICIPANTS: The patients who were hospitalized for snoring, apnea, breathing obstruction and somnolence were selected from the Sleep Respiratory Disorder Diagnosis and Treatment Center in the Affiliated Municipal Hospital of Medical College of Qingdao University from July 2001 to February 2006. We ascertained that the obstruction located at pharynx oralis, no hypertrophy of lingual root, and made a definite diagnosis of OSAHS by polysomnogram. The apnea hypopnca index (AHI) was ≥ 5 times per hour. Among 216 patients, there were 159 males and 57 females aged older than 25 years.METHODS: The patients were treated by modified UPPP which maintained the normal anatomic form of pharyngeal cavity, reserved the uvula, performed oblique straight incision along palatoglossal arch to soft palate, and avoided the incision of inverse U type. Palatoplasty and pharyngoplasty could extend the oropharyngeal isthmus and nasopharyngeal isthmus thoroughly.MAIN OUTCOME MEASURES: ① The survey of effect in the near future: Defined the pain without pain-killer as pain lightly, or as pain heavily inversely. If the lateral wall of oropharynx could remain the designed morphous, it was a good henosis; it was a bad henosis inversely. ② The survey of effect in a long term: According to the statement of the patients themselves. Estimated whether the patients had postoperative complications, such as backstreaming in nasal cavity, pharyngeal foreign body sensation, etc. Assessed if the patients had sleep apnea according to the observation of the family member and the monitoring of PSG. And ascertained whether the pharyngeal cavity had approached to normal structure by the examination of oropharynx.RESULTS: All 216 patients were involved in the final analysis. ① Of the 216 subjects, there were 156 patients who needed pain-killer (72%), and 60 Patients need not (26%). The lateral pharyngeal wall of 136 subjects was smooth (63%), and the other 80 were splited partly (37%). There were no complications such as breath holding, backstreaming in the nasal cavity. ② The survey of longdated postoperative effect: The 216 patients were followed up for 6 mouths.There was no deglutitive bucking, open rhinolalia. A total number of 84 patients (39%) had pharyngeal foreign body sensation. The syndrome of sleep apnea disappeared in 169 patients, and the other 47 patients still had the syndrome,but improved than before. In 203 patients (94%), the postoperative morphous of oral cavity were content, and the other 13 patients (6%) were not content. ③ The statistical significance of the preoperative and postoperative result of PSG monitoring of the 216 patients with OSAHS existed and the difference was significant [AI: 35.45±16.42, 12.75±9.62; HI:19.39±9.86, 17.43±10.15; AHI: 54.29±18.13, 28.31 ±16.23; the average low saturation of blood oxygen: (83.58±7.96) %,(85.53±8.18) %; the average saturation of blood oxygen: (91.98±3.29) %, (93.01±3.02) %, P ＜ 0.05].CONCLUSION: The modified uvulopalatopharyngoplasty indicates that this approach not only extend the nasopharynx cavity, but also avoids the postoperative complications. The patients have markedly improved symptoms.