Value of pathogenic diagnosis of 18F-FDG PET/CT imaging in non-traumatic unilateral vocal cord paralysis / 中华核医学与分子影像杂志

Objective@#To evaluate the diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging in non-traumatic unilateral vocal cord paralysis (UVCP) and compare the radioactive uptake in different lesions.@*Methods@#Clinical data of 62 patients (49 males, 13 females; age: (61.7±12.8) years) with non-traumatic UVCP (43 cases of left vocal cord paralysis and 19 cases of right) admitted to Ji′an Hospital from January 2016 to December 2018 were analyzed retrospectively. Pathological results, imaging or follow-up results were considered as the standard of final diagnosis. The diagnostic efficacy of PET/CT imaging for the primary cause was analyzed. The maximum standardized uptake values (SUVmax) of vocal cord in patients with different etiology were compared by independent-sample t test.@*Results@#According to the final diagnosis, the primary causes of UVCP were as follows: malignant tumors (n=44), inflammation (n=16), glomus jugulare tumor (n=1) and idiopathic UVCP (n=1). The diagnostic accuracy of PET/CT imaging for the primary cause was 90.32%(56/62): 44 cases were correctly diagnosed as malignant tumors, while 11 cases as inflammation, and 1 case as glomus jugulare tumor. Among 62 patients, 29 patients had increased SUVmax in the affected side (direct invasion group; further divided into tumor group (n=12) and non-tumor group (n=17)), and other 33 patients had increased SUVmax in the healthy side (indirect invasion group). SUVmax of the affected vocal cord in direct invasion group was higher than that in the healthy side (9.97±5.21 vs 2.43±0.62; t=8.14, P<0.01). The differences between affected side and healthy side in the tumor group (14.92±3.91 vs 2.84±0.54) and the non-tumor group (6.48±2.48 vs 2.14±0.50) were statistically significant (t values: 9.94, 7.93, both P<0.01). In the indirect invasion group, SUVmax in the affected side of vocal cord was significantly lower than the healthy side (1.89±0.35 vs 6.97±2.63; t=11.44, P<0.01). There were significant differences in radioactive uptake between affected side of direct invasion group and healthy side of indirect invasion group (t=2.86, P<0.01), affected sides of tumor group and non-tumor group (t=7.46, P<0.01), affected side of tumor group and healthy side of indirect invasion group (t=6.07, P<0.01). But the radioactive uptake difference between affected side of non-tumor group and healthy side of indirect invasion group was not statistically significant (t=0.51, P>0.05).@*Conclusions@#18F-FDG PET/CT imaging has high diagnostic value in pathogenic diagnosis of non-traumatic UVCP. The different radioactive uptake of vocal cords in the affected side and the healthy side provides more accurate etiological information for clinical analysis.

Value of pathogenic diagnosis of 18F-FDG PET/CT imaging in non-traumatic unilateral vocal cord paralysis / 中华核医学与分子影像杂志

Objective To evaluate the diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging in non-traumatic unilateral vocal cord paralysis (UVCP) and compare the radioactive uptake in different lesions.Methods Clinical data of 62 patients (49 males,13 females;age:(61.7±12.8) years)with non-traumatic UVCP (43 cases of left vocal cord paralysis and 19 cases of right) admitted to Ji'an Hospital from January 2016 to December 2018 were analyzed retrospectively.Pathological results,imaging or follow-up results were considered as the standard of final diagnosis.The diagnostic efficacy of PET/CT imaging for the primary cause was analyzed.The maximum standardized uptake values (SUVmax) of vocal cord in patients with different etiology were compared by independent-sample t test.Results According to the final diagnosis,the primary causes of UVCP were as follows:malignant tumors (n=44),inflammation (n=16),glomus jugulare tumor (n =1) and idiopathic UVCP (n =1).The diagnostic accuracy of PET/CT imaging for the primary cause was 90.32％ (56/62):44 cases were correctly diagnosed as malignant tumors,while 11 cases as inflammation,and 1 case as glomus jugulare tumor.Among 62 patients,29 patients had increased SUVmax in the affected side (direct invasion group;further divided into tumor group (n =12) and non-tumor group (n =17)),and other 33 patients had increased SUVmax in the healthy side (indirect invasion group).SUVmax of the affected vocal cord in direct invasion group was higher than that in the healthy side (9.97±5.21 vs 2.43±0.62;t=8.14,P＜0.01).The differences between affected side and healthy side in the tumor group (14.92±3.91 vs 2.84±0.54) and the non-tumor group (6.48±2.48 vs 2.14±0.50) were statistically significant (t values:9.94,7.93,both P＜0.01).In the indirect invasion group,SUVmax in the affected side of vocal cord was significantly lower than the healthy side (1.89±0.35 vs 6.97±2.63;t =11.44,P＜0.01).There were significant differences in radioactive uptake between affected side of direct invasion group and healthy side of indirect invasion group (t =2.86,P＜0.01),affected sides of tumor group and non-tumor group (t=7.46,P＜0.01),affected side of tumor group and healthy side of indirect invasion group (t=6.07,P＜0.01).But the radioactive uptake difference between affected side of non-tumor group and healthy side of indirect invasion group was not statistically significant (t =0.51,P＞0.05).Conclusions 18F-FDG PET/CT imaging has high diagnostic value in pathogenic diagnosis of non-traumatic UVCP.The different radioactive uptake of vocal cords in the affected side and the healthy side provides more accurate etiological information for clinical analysis.

Evaluation of Neck Lymph Node Metastasis on Contrast-Enhanced Ultrasound: An Animal Study

OBJECTIVES: To assess the performance of contrast-enhanced ultrasound (CEUS) intended to differentiate hyperplastic from malignant neck lymph nodes in an animal model. METHODS: Twenty-four New Zealand rabbits were randomly divided into two groups: neck lymph node metastasis group (12 rabbits) and reactive hyperplastic lymph node group (12 rabbits). Tongue VX2 carcinoma with cervical lymph node metastasis was induced in 12 rabbits by injecting VX2 carcinoma suspension into the left tongue submucosa. Hyperplastic neck lymph nodes were induced by injecting egg yolk in the submandibular region of the rabbits in hyperplastic group. CEUS were performed in both groups before and after intravenous administration of SonoVue. The site, number, echogenicity, longitudinal and transverse nodal dimensions, patterns of enhancement of the neck lymph nodes were observed and recorded. RESULTS: In both groups only one lymph node was found in the left (tumor) side of the neck. CEUS found 12 of 12 metastatic lymph nodes in metastasis group, and diagnosed 11 of 12 lymph nodes as metastatic. Histopathologic analysis revealed metastatic lesions in all 12 rabbits, each with one lymph node, and all 12 lymph nodes in hyperplastic group is inflammation lymph nodes. All 12 cases in the hyperplastic group showed centripetal homogeneous enhancement while in the metastasis group one case showed centripetal homogeneous enhancement, three cases showed centrifugal heterogeneous enhancement, and eight cases showed diffused heterogeneous enhancement. Only one lymph node was dissected on the left side of the neck in each rabbit in both groups. CONCLUSION: CEUS can play a role in discriminating metastatic from hyperplastic lymph nodes in head and neck carcinoma.

Effect of dexamethasone on the expression of Tregs in allergic rhinitis mice / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the effect of dxamethasone (DEX) on the expression of Tregs in allergic rhinitis (AR) mice, and explore the mechanism of glucocorticoid in the treatment of AR.@*METHOD@#AR murine model was established by sensitization and challenge with OVA, besides intervention treatment with DEX was carried out in AR model. The behavior observation was used to evaluate the improvement effect of DEX on AR symptoms. The morphological characteristics of nasal tissues were observed by HE staining after fixation and decalcification. The mononuclear cells were obtained by grinding spleens, and the total RNA was extracted for reverse transcriptase polymerase chain reaction to investigate the level of mRNA expression of Foxp3. The changes of CD4+ Foxp3+ Tcells in spleen of mice were analyzed by flow cytometry.@*RESULT@#BALB/c mice received OVA sensitization followed by OVA intranasal challenge, the frequencies of sneezing and nose-scratching increased significantly in AR group (44. 50 ± 5. 61 and 72. 94 ± 8. 76) compared with control group (12. 68 ± 1. 87 and 26. 76 ± .2. 89), P<0. 01; The frequencies decreased significantly in DEX group (26. 04 ± 3. 93 and 56. 79 ± 5. 64), P< 0. 05 compared with AR group. The continuity of nasal mucosa ciliated columnar epithelium in AR group was destroyed and appeared to be repaired in DEX group. Inflammatory cells infiltration was also markedly decreased by DEX treatment. The proportion of CD4+ Foxp3+ T cells in AR group (3. 89 ± 0. 39)% decreased, P<0. 01 vs control group (4. 63 ± 0. 15) %. DEX treatment induced production of Tregs (6. 89 ± 0. 49)%, P<0. 05 vs control group. DEX significantly increased the expression of Foxp3 mRNA (P<0. 05) compared with AR and control group.@*CONCLUSION@#DEX reduce upper airway allergic inflammation effectively, which may be mediated by promoting the expression of Foxp3 and inducing the amplification of Tregs in vivo.

Effect of jieminqufeng decoction on cyclic nucleotides from the rats of allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the curative effect of Jieminqufeng decoction to the rats of allergic rhinitis and study the mechanism by which it treats allergic rhinitis.@*METHOD@#Forty wistar rats were divided into 4 groups at random. There are Jieminqufeng decoction group, cetirizine group, model control group and normal control group. The rats of allergic rhinitis were established with ovalbumin. We surveyed the behavioral changes of rats, searched eosinophilic granulocytes in the nasal secretion, detected the contents of cAMP and cGMP in the blood plasma and nasal mucosa.@*RESULT@#The model control group had typical symptoms of allergic rhinitis and the eosinophilic granulocytes could be found more frequently. The contents of cAMP and cAMP/cGMP rose in the blood plasma and nasal mucosa (P < 0.01). However, the changes of jieminqufeng decoction group were small.@*CONCLUSION@#The jieminqufeng decoction is an effective drug to allergic rhinitis. Its possible mechanism is that it changes the contents of cAMP and cGMP, lessens inflammatory reaction and blocks up the allergy.

Study on changes of face superficial sensory function and its relating factors after intracranial surgery of trigeminal nerve / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore changes of facial sensory function after intracranial surgery in the treatment of idiopathic trigeminal neuralgia (TN) and their possible reasons.@*METHOD@#Fifty-six patients of TN receiving trigeminal microvascular decompression (MVD) or nerve combing or coagulation surgery by post-sigmoid approach from 2006 to 2008 were observed. Their sensory score of pain, temperature and tactile were recorded before and 1 week after surgery. These scores as well as status of neurovascular conflict in trigeminal sensory root were analyzed and potential reasons were discussed.@*RESULT@#Nineteen (33.9%) cases had normal facial sense after surgery and 37 (66.1%) cases had a decreased sensation. Sensory scores of each divisions 1 week after surgery were significantly lower than those before surgery (P 0.05 respectively), while the pain sensory had obvious difference (P < 0.01). In the third division the descend score of pain and temperature in the lateral portion was lower than that of the medial portion (P < 0.05), but tactile score had not differences. In all 56 patients, 45 had neurovascular conflict and 26 of them had a decreased facial sense. While in 11 cases without responsible vessel, their facial sense were all abnormal. In the abnormal sensory group, the ratio of conflict vessel presenting at caudal, middle and rostral end of sensory root is 42.3%, 26.9% and 30.8% respectively. In normal sensory group, 63.2% cases had rostral conflict vessel and only 5.3% had caudal conflict vessel.@*CONCLUSION@#Intracranial surgery of trigeminal nerve results different changes of superficial sensation on the different portion of the face. In addition to direct injury, stretching of the sensory root (especially at root entry zoon) is an important possible responsibility of postoperative sensory hypesthesia.

To study the clinical valuation of different operation methods in treatment primary trigeminal neuralgia by retrosigmoidal approach / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the clinical valuation of different operation methods in treatment primary trigeminal neuralgia by retrosigmoidal approach.@*METHOD@#The clinical data of 165 cases with primary trigeminal neuralgia were studied, all head MRI(B-FFE) examination was made before surgery. According to patients' face sensation and cerebellopontine angle conditions, different operation methods were choose.@*RESULT@#Among of 165 cases, 7 cases with face numbness and sensory loss symptom before surgery, were treated with partial rhizotomy of trigeminal sensory root and nerve combing and all cured, followed-up study 3.5 to 5.0 years and no relapse and face sequelae is same as before; 145 cases with blood vessel compression and no face sequelae were treated with microvascular decompression and nerve combing of trigeminal nerve sensory root, 144 cases were cured and 1 case relieve, 15 cases with herpes simplex were cured after 1-2 weeks, 4 cases with oral lips or tongue numbness were cured after 1-3 months. Followed-up study 3 to 5 years,3 cases relapse and after second same operation methods cured. Among of 13 cases without face sequelae, 5 cases with artery compression were not suit to microvascular decompression and 8 cases without blood vessel compression. All these cases were treated with surface coagulation and nerve combing of trigeminal nerve sensory root, 2 cases with herpes simplex were cured after one week. Followed-up studying of 3.2 to 5.0 years, one case relapse, All 13 cases were cured and no neuralgia relapse and no severe sequelae. Among the 165 cases, two cases died of hemorrhage cephalon in operation or postoperation.@*CONCLUSION@#It is a safe and effective way to choose different methods combine to treat primary trigeminal neuralgia according to patients' face sensation and cerebellopontine angle conditions, but the risk of operation should not be ignored.

Superficial layer coagulation of trigeminal sensory root in treatment of trigeminal neuralgia / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the clinical value of superficial layer coagulation of trigeminal sensory root in the treatment of trigeminal neuralgia. METHODS The clinical data of 5 cases with trigeminal neuralgia were studied. Head MRI (B-FFE) examinations were made before surgery and operations were performed via retrosigmoidal approach. One case with left facial pain showed 3 arteries with offsets crossing and compressing the left trigeminal nerve. Among 4 cases with right facial pain,3 cases had an artery compressing the right trigeminal and the nerve were distorted and moved from its original site,one case with an artery going with trigeminal nerve sensory root branchlets. All cases were no indications for microvascular decompression and thus were treated with surface coagulation of trigeminal nerve sensory root. RESULTS Pain disappeared instantly after operation and facial sensory were retained. All cases were followed up for 2.4 to 5 years and no recurrences were found. CONCLUSION Superficial layer coagulation of trigeminal sensory root is a safe and effective method for the treatment of trigeminal neuralgia.

Effects of Jieminqufeng decoction on the histomorphological changes of nasal mucosa in rats with allergic rhinitis / 中国耳鼻咽喉头颈外科

OBJECTIVE To observe the curative effect of Jieminqufeng decoction to the rats with allergic rhinitis. METHODS Fourty Wistar rats were randomly divided into 4 groups. There were Jieminqufeng decoction group (A),cetirizine group (B),model control group(C) and normal control group (D). The rats with allergic rhinitis were established with ovalbumin. The behavioral changes of the rats were observed. The histological and cellular morphological changes were studied with light microscope and transmission electron microscope. RESULTS The model control (C) group had typical symptoms of allergic rhinitis. By light microscope and transmission electron microscope,a lot of eosinophilic granulocytes were found in nasal mucosa. The mucosal cells were lost or destroyed. However,the histological and cellular morphological changes of nasal mucosa in Group A,B were similar to that in Group D. CONCLUSION The Jieminqufeng decoction is an effective drug to treatment of allergic rhinitis. It can decrease the aggregation and activation of eosinophilic granulocytes,lessen inflammatory reaction and block up the allergy.

Analysis of 7064 Cases of Neonatal Hearing Screening / 听力学及言语疾病杂志

Objective To analyze the results in neonatal hearing screening,and then to make diagnosis and intervention for neonates with hearing problems as soon as possible.Methods From January 2004 to December 2008,7 064 newborns at Shanghai East Hospital received hearing screening by distortion product oto-acoustic emissions (DPOAE) 2～4 days after birth.Re-screening tests were performed for infants who failed the initial screening 42 days after birth.Those newborns who failed again received further audiologic diagnostic evaluations 3 months afterwards.Results Among 7 064 cases screened,out of 6 412 normal newborns,579 (9.03%)failed the initial screening,and 38 (7.41%)failed re-screening.129 cases of the other 652 (19.79%) newborns in NICU failed the initial screening,and 20 cases (18.69%) failed re-screening.There were statistical differences between the passing rates of the two groups (P