Clinical research on nasal endoscopic surgery for rhinogenous optic function damage / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the surgical treatment of rhinogenous optic function damage (ROFD) through transnasal endoscopic approach.</p><p><b>METHODS</b>Twenty-three patients (25 eyes) with ROFD were retrospectively reviewed. All patients were operated on through transnasal endoscopic approach, and 9 patients underwent endoscopic optic nerve decompression.</p><p><b>RESULTS</b>Four patients had bilateral pansinusitis, 6 patients had unilateral posterior ethmoidal sinusitis and sphenoiditis. One patient had frontal and ethmoidal sinusitis. Five patients had fungal sinusitis occurred in the sphenoid sinus and unilateral posterior ethmoid sinus. Two patients had unilateral pyocyst and cyst of the sphenoid and ethmoid sinus. The preoperative visual acuity preoperative were as follows: 2 patients (2 eyes) no light perception (NLP), 6 patients (7 eyes) hand movement (HM), 7 patients (7 eyes) fingers counting (FC) less than 20 cm and 8 patients (9 eyes) were vision impaired in different degree. One patient (1 eye) was ophthalmoptosis, direct and indirect light reflex vanished. Three patients (3 eyes) diplopia, 2 patients (2 eyes) abduction paralysis, 3 patients (3 eyes) defect of visual field. One patient ptosis of upper lid. The visual acuity postoperative: 2 eyes failed, 10 eyes cured;13 eyes improved from HM or FC to FC (30-60 cm).</p><p><b>CONCLUSIONS</b>The endoscopic sinus surgery combined with appropriate medical therapy are effective to ROFD. Patients who suffered from severe visual damage and either unresponsive or intolerant to medical treatment should be administrated endoscopic sinus surgery including endoscopic optic nerve decompression.</p>

Changes of amino acid concentrations in the rat medial vestibular nucleus following unilateral labyrinthectomy / 生理学报

To understand the neurochemical mechanisms underlying the vestibular compensation, we determined the levels of amino acids such as aspartate, glutamate, glutamine, glycine, taurine, alanine in the medial vestibular nucleus (MVN) following unilateral labyrinthectomy (UL), by using in vivo brain microdialysis and high-performance liquid chromatography technique. Rats were pretreated by infusing 2% lidocaine 1.2 mL or 10 mg arsanilic acid into the tympanic cavity to obstruct uni-periphery vestibular organ, and then the levels of amino acids were determined in MVN of normal control and ipsilateral or contralateral lesional (ipsi-/contra-lesional) rats. In the control experiment, the levels of aspartate, glutamate, glutamine, glycine, taurine, and alanine were (6.15 +/- 0.59), (18.13 +/- 1.21), (33.73 +/- 1.67), (9.26 +/- 0.65), (9.56 +/- 0.77) and (10.07 +/- 0.83) pmol/8 muL sample, respectively. The concentrations of aspartate and glutamate decreased, while the concentration of taurine increased in the ipsi-lesional MVN of rats 10 min after infusing 2% lidocaine into middle ear to obstruct uni-periphery vestibular organ. Whereas the concentration of glutamate increased, the concentrations of glycine and alanine decreased in the contra-lesional MVN, accompanied by imbalances of glutamate, glycine and alanine in the bilateral nuclei. In contrast, the levels of glutamate and alanine decreased, the level of glutamine increased in the ipsi-lesional MVN, and the level of glutamate decreased in the contra-lesional MVN of rats 2 weeks after infusing 10 mg arsanilic acid into the tympanic cavity to obstruct uni-periphery vestibular organ. Furthermore, the level of glutamine in the ipsi-lesional MVN was obviously higher than that in the contra-lesional MVN. These results demonstrate that an imbalance of different amino acids appeared in bilateral MVN after UL, and this imbalance decreased after the development of vestibular compensation. Whereas the imbalance of glutamine release in bilateral nuclei appeared after vestibular compensation.

Changes of glutamate and taurine released in the medial vestibular nucleus following acute hypotension / 生理学报

In order to understand whether some special amino acids in the medial vestibular nucleus (MVN) of rats are involved in the regulation of blood pressure, we used microdialysis technique and high performance liquid chromatography (HPLC) to measure the changes of glutamate and taurine in this central area. Acute hypotension was induced by hemorrhage from the femoral artery. It was observed that the basal release of glutamate and taurine in the MVN was stable about 90 min after the beginning of microdialysis. The basal release of glutamate was (18.96 +/- 0.27) pmol/sample (8 mul), and that of taurine was (7.73 +/- 0.05) pmol/sample (8 mul). Glutamate release increased (P<0.05) and taurine release reduced (P<0.05) in the MVN in the hemorrhage-induced acute hypotensive rats. Nevertheless, these changes were not observed in the hemorrhage-induced acute hypotensive rats which were pretreated by infusing 2% lidocaine into the middle ear or 100 mg arsanilic acid into the tympanic cavity. These results suggest that the hemorrhage-induced acute hypotention can influence the activity of the neurons in the MVN by the afferent impulses from vestibular organ, and that some special amino acid transmitters in the MVN are involved in this process.