Present status of the treatment for olfactory dysfunction / 中华耳鼻咽喉头颈外科杂志

Olfactory dysfunction is defined as decrease or loss of smell perception.This review systematically summarizes classification, etiology and diagnosis progress of olfactory dysfunction, and focuses on advancement in management of olfactory dysfunction, including pharmaceutical remedy, surgical treatment as well as olfactory training.Glucocorticoids play an important role in the treatment of olfactory dysfunction. Sodium citrate, vitamin A, and nonspecific phosphodiesterase inhibitors (theophylline, pentoxifylline) are promising drugs.Endoscopic paranasal sinuses surgery can improve the olfactory dysfunction caused by chronic sinusitis to some extent.Olfactory training has been proven to be effective for a variety of causes of olfactory dysfunction.

Nebulized glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction / 中国耳鼻咽喉头颈外科

OBJECTIVETo investigate the efficacy and safety of nebulizing glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction.METHODSPatients with postviral olfactory dysfunction were recruited in this study. All patients underwent T&T olfactory testing, sinonasal computer tomgraphy scanning, as well as magnetic resonance scanning of the olfactory pathway. Nebulizing glucocorticoid (pulmicort repulse) was inhaled once daily at the starting dose of 2 mg tapered to 1 mg after two weeks combined with olfactory training for 4 weeks. T&T olfactory testing were repeated after 4-week treatment.RESULTS Twenty four patients received teatment, with a mean age of 54 years old(range 37 to 81 years old), a mean olfactory dysfunction course of 2.20 months(range, 0.25-9 months). Of whom, 21 were anosmia, 3 were hyposmia. After teatment, complete recovery were achieved in 4 patients(16.7%), obvious improvement in 9 (37.5%), improvement in 5 (20.8%), no improvement in 6 (25.0%). No side effect and untoward effect were found.CONCLUSIONThe primmary outcomes suggest the efficacy and safety of nebulizing glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction.

A study of modified lateral pharyngoplasty for the treatment of obstructive sleep apnea hypopnea syndrome: primary outcomes analysis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To describe a modified lateral pharyngoplasty with partial transsection of levator veli palatine muscle in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and report the primary outcomes.@*METHOD@#Retrospective review was performed in sixty patients with OSAHS. All the patients underwent modified surgical procedures, including partial transsection of levator veli palatine muscle and high soft palatoplasty.@*RESULT@#The patients with a reduction of the AHI at least 50% were 6 (6/60, 10%). The patients with a reduction of the AHI at least 50% and a postoperative AHI < 20 were 44 (44/60, 73.3%). The patients with a postoperative AHI < 5 were 10 (10/60, 16.7%). Postoperative complications were postoperative bleeding in two cases (3.3%) and short-term velopharyngeal insufficiency in 10 cases (16.7%).@*CONCLUSION@#Lateral pharyngoplasty with partial transsection of levator veli palatine muscle provides a safe and effective procedure for selected OSAHS patients with oropharyngeal collapse as the main site.

Etiology and treatment of delayed epistaxis after endoscopic surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the etiology and management of delayed epistaxis after endoscopic surgery.@*METHOD@#To retrospectively analyze the clinical data of 11 cases for epistaxis after nasal endoscopic surgery. To compare their precipitating factors, their surgical approach, time and site of bleeding and management in order to find the intrinsic rules.@*RESULT@#The precipitating factors, bleeding sites and treatments varied among patients.@*CONCLUSION@#Delayed epistaxis after endoscopic surgery can not be neglected. There may be some precipitating factors. The surgical approach may be related to the bleeding site. It is better to treat the epistaxis using the endoscope to explore the bleeding site and to give corresponding intervention.

Application of mitomycin in laryngeal surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the application of mitomycin in laryngeal surgery.@*METHOD@#Retrospective analysis of the clinical data of 48 patients who had vocal cord lesion involving anterior commissure. The treatment of 30 patients treated with microsurgery and external application of mitomycin, while that of the others were only done with microsurgery.@*RESULT@#Among the 30 patients who were treated with microsurgery and mitomycin, only 2 patients of which showed slight adhesion of anterior commissure after surgery. While in the group of microsurgery, there were 6 patients who had adhesion of anterior commissure adhesion after surgery.@*CONCLUSION@#Mitomycin could prevent vocal adhesion after laryngeal surgery.

The management of space-occupying lesion of middle skull base involving sphenoid sinus by transnasal endoscopic surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the diagnosis and therapy of space-occupying lesion of middle skull base involving sphenoid sinus.@*METHOD@#A retrospective analysis was performed. Eighteen patients with extradural space-occupying lesion of middle skull base involving sphenoid sinus underwent transnasal endoscopic surgery.@*RESULT@#One case of primary empty sella turcica was misdiagnosed as sphenoidal sinus cyst. One case of fibrous dysplasia and one case of meningioma were all misdiagnosed as mycotic sphenoiditis. Total rate of misdiagnosis was 16.7%. Among the 18 cases, 17 cases underwent complete resection of the lesion, and only 1 case underwent major resection of the lesion. The amount of blood loss during surgery ranged between 100 ml and 2,500 ml. One case had bacterial meningitis which was cured after corresponding treatment. One case was blind in both eyes. And the other case died of pulmonary embolism.@*CONCLUSION@#Transnasal endoscopic surgery is feasible and practical to treat benign space-occupying lesion of sphenoidal sinus and extradural lesion of middle skull base involving sphenoidal sinus. Definite diagnosis, accurate location and careful operation are important to complete the surgery successfully.

The management of space-occupying lesion of middle skull base involving sphenoid sinus by transnasal endoscopic surgery / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the diagnosis and therapy of space-occupying lesion of middle skull base involving sphenoid sinus.Method:A retrospective analysis was performed. Eighteen patients with extradural space-occupying lesion of middle skull base involving sphenoid sinus underwent transnasal endoscopic surgery.Result:One case of primary empty sella turcica was misdiagnosed as sphenoidal sinus cyst. One case of fibrous dysplasia and one case of meningioma were all misdiagnosed as mycotic sphenoiditis. Total rate of misdiagnosis was 16.7%.Among the 18 cases, 17 cases underwent complete resection of the lesion, and only 1 case underwent major resection of the lesion. The amount of blood loss during surgery ranged between 100 ml and 2500 ml.One case had bacterial meningitis which was cured after corresponding treatment. One case was blind in both eyes. And the other case died of pulmonary embolism.Conclusion:Transnasal endoscopic surgery is feasible and practical to treat benign space-occupying lesion of sphenoidal sinus and extradural lesion of middle skull base involving sphenoidal sinus. Definite diagnosis, accurate location and careful operation are important to complete the surgery successfully.

Observation on serology and histology of patients with chronic hepatitis B after interferon treatment / 中华传染病杂志

Objective To investigate the changes in serology and liver histology of patients with chronic hepatitis B after interferon treatment. Methods Twenty four patients with chronic hepatitis B were enrolled in this research. Sera of patients were obtained before and after interferon treatment respectively. Liver biopsy was performed in each patient before and after treatment respectively. Serum ALT, HBsAg, HBcAg, HBeAg, HBV DNA and TIMP 1 were evaluated, as well as HAI(histological activity index), HBsAg, HBcAg, HBeAg, TIMP 1 and activated HSC in liver. Results The patients responded to interferon accounted for 7/24(37.5%). Compared with pretreatment, the serum HBV DNA and TIMP 1 decreased significantly( P

Expression of Aquaporins in the Inner Ear of Normal Guinea Pigs and Guinea Pigs with Endolymphatic Hydrops / 听力学及言语疾病杂志

Objective To study the expression of aquaporins(AQPs) in the inner ear of normal guinea pig and guinea pigs with endolymphatic hydrops, and to investigate the mechanism and significance. Methods The guinea pigs were divided into two groups randomly: model group and control group. The guinea pigs in model group were given desmopressing 4 ?g?kg-1?d-1 introperitoneally for 1 week, while the guinea pigs in control group were given saline. After one week, the expression of AQPs in the inner ears of all guinea pigs was evaluated.Results Expression of AQP0, 1, 2, 3, 5, 7 and 8 were found in the ears of normal guinea pigs. Weak expression of AQP0 was found in stria vascularis and spiral ganglion. The distribution of AQP1 consisted of cellular lining the bony labyrinth, fibrocytes lining in the endolymphatic duct and sac, cells under the basilar membrane, fibrocytes of the spiral ligament and the spiral limbus, Corti's organ, inner and outer spiral sulcus, stria vascularis, saccular and utricular wall, and spiral ganglion. AQP2 were found in stria vascularis, Corti's organ, spiral ganglion and endolymphatic sac. AQP3, 7 and 8 were distributed in a similar manner as the surrounding membranous labyrinth, including Corti's organ, inner and outer spiral sulcus, stria vascularis, fibrocytes of the spiral ligament and the spiral limbus, saccular and utricular wall, endolymphatic sac and spiral ganglion. AQP5 was found at Corti's organ, inner and outer spiral sulcus, spiral ganglion and fibrocytes in spiral ligment. The AQP2 in stria vascularis and endolymphatic sac was stronger in the inner ears with ELH than that in normal ears.Conclusion There are various AQPs in inner ears of normal guinea pigs, and their distributions are overlapping and without obvious regional specificity. Desmopressing induces the expression of AQP2 in the inner ears of guinea pigs. The results indicate that ELH may correlate to upregulation of AQP2, but the mechanism remains unclear.