Research progress in therapeutic action of mesenchymal stem cell in allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

Allergic rhinitis (AR) is an allergic disease of nasal mucosa, currently the consensus has been reached that there is a Th1/Th2 imbalance in AR′s pathogenesis, meanwhile there are defects in the number and/or function of Treg cells. Mesenchymal stem cells (MSCs) have characteristics of multiple differentiation potential, low immunogenicity and immunomodulation function, which can be migrated and implanted into the nasal inflammatory mucosal, recovering the Th1/Th2 immune balance and up-regulate the Treg cells by immunomodulatory function to improve AR. For the present, the treatment of AR by MSCs is basically at the animal experiment stage. This paper reviews the progress of MSCs in AR′s treatment and provides a basis for the clinical treatment of MSCs.

The summary of experience and effect observation of cochlear implants in adults with different causes / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#This article summarizes the matters warranting consideration in adult cochlear implants before and after operation with different deafness causes and investigates the impact of etiological variables that affect hearing and speech ability rehabilitation after cochlear implantation.@*METHOD@#We retrospectively reviewed the preoperative data of 30 adults who have received cochlear implantation, switch on, and periodical post operative mapping. 'Nijmegen Cochlear Implant Questionnaire' was used for every patient during follow-up and test their hearing thresholds at one year after switched-on. The average score of every patient in the six aspects of questionnaire, along with the average hearing threshold, has been gathered.@*RESULT@#The average hearing threshold of every patient is lower than 35 dBHL. The average score of 28 patients is more than or equal to 75 in the basic sound perception, advanced sound perception as well as self-esteem. The average score of 26 patients is more than or equal to 75 in capacity for action. Besides, as for sociability and speech ability, the average score of 22 patients is more than or equal to 75.@*CONCLUSION@#Auditory perception can be greatly improved regardless of deafness causes, on the premise that appropriate candidate is selected. The primary disease should be brought under control before and after the operation. The influence of various causes to the language ability rehabilitation largely depends on the development of the language center at deafness onset. Self-esteem and social identity can be significantly enhanced after cochlear implantation in adult patients, particularly those with acquired deafness.

The Factors Affecting the Rehabilitation Efficacy after the Operation of Adults Cochlear Implantation / 听力学及言语疾病杂志

Objective We will discuss the related factors affecting the rehabilitation efficacy after the opera-tion of adults cochlear implantation .Methods Nijmegen Cochlear Implant Questionnaire'was adopted .There were questionnaire surveys on 29 adult patients with cochlear implantation .The individual scores and total scores of all subjects were collected together with the personal information ,including age ,bilateral effects and other factors . They were grouped in accordance with different grouping standards of different affecting factors .Results Compared to the communication manner of long -term hearing loss ,the rehabilitation efficacy of the group using lip -reading preoperatively was greater than the group using sign language or writing ;the rehabilitation efficacy of the group with the aggregate time of using CIs more than two years was superior to that similar group of less than two years , and the average P within the group of these two factors was 0 .05 .Conclusion Ages ,the bilateral deafness ,and auditory dep-rivation have no obvious effects on the rehabilitation efficacy after the operation .The patients with postlingual deafness can improve their hearing with proper rehabilitation .Lip-reading preoperatively has positive effects on the rehabilitation effica-cy after the operation ;the length of using CIs has become the major factor affecting the rehabilitation efficacy .

The study of risk factors of nasal septal perforation in rats / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the risk factors and interaction of nasal septal perforation (NSP) in rats.@*METHOD@#Animals (n=120) that underwent unilateral nasal obstruction using Merocel nasal packing or gelfoam with/without standard staphylococcus aureus inoculation were observed for the formation of NSP at 2, 3, 5, and 7 days after operation by endoscope system. Following sacrifice at 7 days, the obtained nasal secretions were prepared for bacterial culture. Experimental interventions were compared with normal controls (n=10).@*RESULT@#Perforation of nasal septum was observed in 80% of the animals accepted nasal obstruction using Merocel nasal packing with standard staphylococcus aureus inoculation in 3 days (P 0.05). There was a weak region in anteroinferior nasal septum in rats, which the almost NSPs located in. The position of NSP does not overlap Merocel.@*CONCLUSION@#The interaction of risk factors contributes to NSP. The occurrence of NSP mainly depends on the construction of nasal septum, while dysaemia is also necessary. Obstruction of nasal drainage and infection promote the development of NSP.

A verification study on the genes associated with laryngeal squamous cell carcinoma by cDNA microarray / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Our previous study revealed many genes differentially expressed in human laryngeal squamous cell carcinoma tissues (LSCC) and related adjacent normal tissues. We verificated the differentiated expressions of target genes, possibly related to LSCC. And these results can be foundations of further study of these target genes function.@*METHOD@#SENP1, CD109, Laminin alpha 2, Laminin alpha 3 were selected according to the cDNA microarray results. The expression of these genes mRNA and protein were detected by RT-PCR and Western blot in 12 cases of LSCC and related adjacent normal tissues.@*RESULT@#The mRNA expression of SENP1, CD109 and Laminin alpha 3 were significantly higher while Laminin alpha 2 were significantly lower in LSCC tissues than in corresponding adjacent normal tissues by Semiquantitative RT-PCR. Western blot analysis revealed SENP1, CD109 protein expression were significantly higher in LSCC tissues than in corresponding adjacent normal tissues.@*CONCLUSION@#SENP1, CD109, Laminin alpha 2 and Laminin alpha 3 may correlated with tumorigenesis and development of LSCC and can provide beneficial clue for study pathogenesis of LSCC in molecular level.

Expression and the correlation of AQP5, HIF-1alpha and VEGF in human nasal polyps / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To detect the expression of AQP5, HIF-1alpha and VEGF in human nasal polyps, and to observe the relationship of AQP5 with HIF-1a and VEGF, and to investigate their role in the pathogenesis of nasal polyps.@*METHOD@#Using the techniques of Real-time Quantitative Polymerase chain Reaction and Western blot, the expressions of AQP5, HIF-1alpha, VEGF mRNA and protein were examined. The specimens were obtained from patients underwent endoscopic surgery at the same time, including eighteen nasal polyps and ten inferior turbinate tissues.@*RESULT@#(1) The result of RT-PCR showed that the expressions of the AQP5 mRNA were lower in nasal polyps than those in inferior turbinate tissue (P 0.05); (2) According to the Western blot, there was no significant difference between the expression of AQP5 in nasal polyps and inferior turbinate tissues (P > 0.05); the expression of HIF-la or VEGF were higher in nasal polyps than those in inferior turbinate tissues (P < 0.05); (3) According to the Western blot, there was a positive correlation between the expression of AQP5 and that of HIF-1alpha (r = 0.633, P < 0.05), and the correlation was also existed between AQP5 and that of VEGF (r = 0.611, P < 0.05).@*CONCLUSION@#AQP5, HIF-1alpha, VEGF are all involved in the edema formation of nasal polyps. The changes of AQP5's distribution can cause accumulation of water in nasal polyps, HIF-1alpha, VEGF can induce new blood vessels and increase vasopermeability in nasal polyps; they have separate regulatory mechanism in edema formation, but might have some relationships in some ways.

Clinical evaluation of intratympanic methylprednisolone perfusion for intractable Meniere's disease / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the clinical efficacy of the intratympanic methylprednisolone perfusion for patients of intractable Meniere's disease (MD).@*METHOD@#Ten cases (10 ears), collected from Janu 2008 to Janu 2010, of intractable MD were studied retrospectively. The micro-catheter was placed into the tympanum of the affected ear, then methylprednisolone was imported into the tympanum once a day for 10 days. The average followed-up duration was (15. 4 +/- 5. 4) months after the perfusion. The treatment effect of vertigo, hearing loss and activity capacity was evaluated with Diagnostic Criteria for MD set by the Guiyang Meeting in 2006. The efficacy of tinnitus was analyzed by comparing the score of tinnitus handicap inventory (THI) before and after treatment.@*RESULT@#The vertigo was absolutely controlled in 7 patients (grade A), partially controlled in 2 patients (grade B) and no efficiency in 1 patient (grade C). The 2 patients in grade B had a vertigo again in 9 months and 11 months after intratympanic perfusion, respectively, while the frequency, severity and duration of their vertigo softened obviously. Puretone threshold average (PTA) at the affected frequencies was decreased to within the level of 20 dB in one patient and was improved more than 30 dB in another one (grade A), improved 15 dB to 30 dB in 4 patients (grade B), and improved less than 15 dB in the other 4 patients. The average score of THI was 48.80 +/- 7.25 and 41.9 +/- 7.78 before and after perfusion respectively. The ability capacity of all the 10 patients after treatment was as normal (grade A), i. e. All of them could lead an independent life. There was no irreversible tympanic perforation in the operated ear and there was no other complications left.@*CONCLUSION@#Intratympanic methylprednisolone perfusion through the micro-catheter is a safe and effective method for the intractable Meniere's disease.

Diagnosis and treatment of mycotic otitis media / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To diagnose the mycotic otitis media correctly and to explore the most adequate treatment for the disease.@*METHOD@#Thirty-six inpatients (39 ears) with mycotic otitis media in Nanjing Drum Tower Hospital from Jan. 2003 to Dec. 2007 were analyzed retrospectively. Morphous of the fungi, the methods and efficacies of the treatment were analyzed respectively.@*RESULT@#According to the fungal cultures, 27 ears were induced by mold fungus and 12 ears were induced by budding fungus. Among these 36 patients (39 ears), myringoplasty accompanied local antifungal cream were applied in one ear, mastoidectomy with canal wall down and/or tympanoplasty accompanied with oral antifungal medication were administrated in 35 ears, only oral antifungal drugs were used in 3 ears (the control ears of the bilateral mycotic otitis media, which was not treated by surgery). All of the patients were followed up for 3 to 36 months, otorrhea occurred in the patients who refused to oral antifungal medication for 3 weeks after the myringoplasty, then dry again by local antifungal cream, but otorrhea recurred 3 times within 2 years. Thirty-five patients (38 ears) acquired dry ear after surgery and/or oral antifungal drugs, but 2 of the 38 ears recurred separately at the fourth and sixth month after their surgeries, then dry again by irrigation with hydrogen peroxide and by administrating local antifungal cream for 3 weeks.@*CONCLUSION@#Otologists should elevate suspicion of mycotic otitis media when they meet patients with continuous otorrhea and patients who did not respond to the antibacterial treatment. The diagnosis based on microbiological findings, such as direct microscopy or fungal cultures should be done as soon as possible. If the otomycosis is decided, we suggest that topical treatment should be selected firstly, although most patients in present study were treated by surgery accompanied with oral antifungal medications. If there is obvious bone erosion, surgery is necessary to excise the pathological tissues, minificate the mastoid cavity and close the middle cavity in order to improve the hearing and prevent the infection from the outer ear.

Clinical study of the bone conduction thresholds before and after tympanoplasty in chronic suppurative otitis media / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the relative factors of the changes of preoperative and postoperative bone conduction thresholds in chronic suppurative otitis media.@*METHOD@#The preoperative and postoperative bone conduction thresholds were prospectively investigated in 45 patients with unilateral chronic suppurative otitis media after tympanoplasty. Preoperatively (within 3 days before operation), 10 dB or more depression of bone conduction threshold at least in consecutive 2 frequencies between 0.25 kHz and 8.00 kHz was considered to be significant. Similarly in the postoperative period (3 months after operation), 10 dB or more improvement or impairment of bone conduction threshold at least in consecutive 2 frequencies between 0.25 kHz and 8.00 kHz was regarded as significant.@*RESULT@#Thirty-five of 45 cases (77.8%) were found to have depressed bone conduction threshold before operation, 6 of 35 cases (17.1%) had improved bone conduction thresholds and 5 of 45 cases (11.1%) had depressed bone conduction thresholds after tympanoplasty.@*CONCLUSION@#In cases with chronic suppurative otitis media, successful results could be achieved after tympanoplasty disregarding air conduction threshold, the air-bone gap and deteriorated bone conduction threshold. Impairment of bone conduction thresholds could be induced by chronic suppurative otitis media itself and could also be induced by touching the ossicle chain crudely and by the noise of drilling during the operation.

The investigation of formant on different artistic voice / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the characteristic of formant-a very important parameter in the spectrogram of three types of artistic voice (western mode; Chinese mode; Beijing opera).@*METHOD@#We used MATLAB software to make the short-time Fourier transform and spectrogram analysis on the homeostasis vowel examples of the three types.@*RESULT@#The western mode had different representation "singer formant" (Fs) based on the voice part; the Chinese mode's notable features were that F1, F2, F3, were continuous and the energy of them changed softly; the Beijing opera had the common representation which was a very wide formant and there was soft transition between formants and various harmonic, besides it showed a similar component like the "Fs" (two formants connected normally).@*CONCLUSION@#Different artistic voice showed their own characteristics of the formant parameter in the spectrogram, which had important value on the identification, objective evaluation and prediction.

Expression and its significance of aquaporin 5 in nasal polyps with or without allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To confirm the expression and distribution of aquaporin 5 (AQP5) in nasal polyps.@*METHOD@#AQP5 were studied in 20 samples nasal polyp without AR (Group NAR) and 16 samples with AR (Group AR) with immunochemistric staging and its integrated light intensity and its grey step.@*RESULT@#(1) Hematoxylin and eosin staining showed that there was obvious inflammation reaction, a large quantity of glands hyperplasia and acidophils soaked in nasal polyps, especially those with allergic rhinitis. (2) Immunofluorescence technique showed that the distribution of AQP5 in the two groups was in accordance with that in nasal polyps on the whole. AQP5 expressed mainly in the membrane and cytoplasm of the epithelium of the glands, ducts and cilia. (3) The statistical analysis of the immunohistochemical staining showed that the integrated light intensity of AQP5 in Group AR (0.1675+/-0.006536) was obviously higher than that in the Group NARs nasal polyps (0.09343+/-0.001816). There was statistical significance between the two groups (t = -12.00, P<0.01). (4) The statistical analysis of the immunohistochemical staining showed that the grey step of AQP5 in Group AR (175.6+/-2.471) was obviously lower than that in the Group NAR's nasal polyps (206.2+/-0.9649). There was statistical significance between the two groups (t=12.46, P<0.01).@*CONCLUSION@#AQP5 is expressed in nasal polyp. Combined with the research before, it was conferred that the hypersecretion of glands and its character has a relationship with the high expression of AQP5 in nasal polyps, and nasal polyp with different symptom has different mechanism.

Diagnosis and therapy of choanal polyps from posterior ethmoid sinus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical feature, diagnosis and endoscopic surgery of choanal polyps (CP) from posterior ethmoid sinus.@*METHOD@#Eleven cases with CP from posterior ethmoid sinus treated by endoscopic endonasal surgery between January 2002 to June 2007 were retrospectively reviewed. Clinical manifestation, intranasal and intrasinus lesions, methods and attentions of endoscopic surgery and therapeutic effects were analysed.@*RESULT@#All cases were treated by endoscopic surgery and CP were found originated from posterior ethmoidal ostium. Lesions in posterior ethmoid sinus included 3 (27.3%) cyst, 5 (45.4%) polyp and 3 (27.3%) mucosal edema. No operation complications were observed. The follow-up period ranged from 6 months to 3 years (mean 1.2 years) and no recurrence was founded.@*CONCLUSION@#Most of CP originated from posterior ethmoidal ostium and its formation might be related to the cyst in the sinus. Endoscopic surgery represents a minimally invasive and highly successful procedure, complete removal of CP and lesions in the sinus can reduce the recurrence.

Effectiveness of Microresection Combined with Radiofrequency Ablation under Laryngoscope and Rigid Telescope for Laryngeal Precancerosis / 中国微创外科杂志

Objective To investigate the effectiveness of microresection combined with radiofrequency ablation under laryngoscope and rigid telescope for laryngeal precancerosis. Methods Fifty-one patients with laryngeal precancerosis, which was diagnosed pathologically, were treated with microresection combined with radiofrequency ablation under laryngoscope and rigid telescope. The patients were followed up for over 6 months. Results During a mean of 26-month follow-up (6 months to 4.5 years), 7 of the patients had recurrence (vocal cord leukoplakia in 3, atypical hyperplasia in 2, and laryngeal papilloma in 2); 4 had carcinomatous change (vocal cord leukoplakia in 1, atypical hyperplasia in 2, and laryngeal papilloma in 1);and 2 patients developed laryngeal web after surgical treatment for bilateral vocal cord leukoplakia. One month after the operation, the Jitter, Shimmer, and NNE were decreased significantly (P