The Protecting Effects of the Technique on the Chorda Tympanic Nerve in Middle Ear Surgery / 听力学及言语疾病杂志

Objective To investigate the different exposure and treatment methods for the chorda tympanic nerve in middle ear surgery, and discuss the surgery techniques and the feasibility of the chorda tympanic nerve protection.Methods From September 2013 to March 2016, 155 cases of middle ear surgeries at Zhujiang hospital were included in this study, including 24 cases of type I tympanoplasty, 6 cases of atticotomy and type I tympanoplasty, 22 cases of atticotomy and type II tympanoplasty, 23 cases of canal-wall-up mastoidectomy and tympanoplasty,74 cases of canal-wall-down mastoidectomy and tympanoplasty, 6 cases of stapedotomy.The conditions of exposure and protection of the chorda tympanic nerve in the operation were compared, and their taste function at 3 days to 1 months postoperatively through questionnaires were evaluated.Results The preservation rate of the chorda tympanic nerve was up to 89.03%(138/155).There were 17 cases of chorda tympanic nerve injuries, of which 15 cases suffered hypogeusia with the rate being 88.2%(15/17).In 126 cases of the complete protection of the chorda tympanic nerve, 13 of them appeared hypogeusia at 10.3% (13/126), but they recovered within 1 months postoperatively.One case of delayed facial paralysis occurred in 16 days postoperatively, and recovered completely after 2 weeks of treatment with glucocorticoids.There was a significant difference in the incidence of postoperative abnormal taste between the complete protection of the chorda tympanic nerve and fracture during operation.Conclusion According to the different position and exposure of chorda tympanic nerve, the individual measures should be taken in middle ear surgery to protect the chorda tympanic nerve.

Clinical analysis of cochlear implants related inflammatory reaction / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#This article discusses the clinical features and treatment methods of the inflammatory reaction associated with cochlear implants, and analyzes the possible pathogenesis and related factors.@*METHOD@#We retrospectively analyzed postoperative inflammation cases from February 2002 to October 2013 among 825 cochlear implantation patients. Their symptoms, signs and treatment processes and outcomes were described and summarized.@*RESULT@#Incidence of implants related inflammatory reaction was 1.58%. The onset time ranged from 2 months to 11 years post-operatively. There were 6 cases of implants related non-infectious inflammation, with an incidence of 0.73% (6 of 825). Post auricular swelling and subcutaneous non-infectious discharge were found in all these 6 cases. Pressure dressing with bandage and steroid, antihistamine medications was effective. There were 7 cases of post auricular infection, with an incidence of 0.85%, resulted from flap trauma or acute otitis media. Antibiotics and drainage was used for them to treat the infection, and rotation scalp flaps were used to cover the exposed device. Five of these cases were cured but cochlear implants had to be removed out in the other 2 cases of staphylococcus aureus infection.@*CONCLUSION@#Cochlear implantation surgery is safe and effective for profound deafness. However, the implants-related non-infectious and infectious inflammatory reaction impacts the effect of cochlear implants, even lead to removal of the implants.

The inhibitory effect of FA-MNP-MMP-9-ASODN nanocomposite on nasopharyngeal carcinoma in vitro / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the inhibitory effect of FA-MNP-MMP-9-ASODN nanocomposite on nasopharyngeal carcinoma (NPC) HNE-1 cell in vitro.@*METHOD@#To observe the MMP-9 mRNA and protein expression levels, proliferation ability, cell apoptosis and invasion ability of HNE-1 cell 48 hours after FA-MNP-MMP-9-ASODN transfection by RT-PCR, Western-blot, MTT assay, flow cytometry and Matrigel invasion test.@*RESULT@#MMP-9 mRNA and protein expression in HNE-1 cell of FA-MNP-MMP-9-ASODN group was significantly decreased compared to control group and nonsense sequence group of FA-MNP-MMP-9-NSODN. At the same time, for the HNE-1 cell in FA-MNP-MMP-9-ASODN group, growth inhibition rate was about 35.66%, proliferation activity significantly decreased compared to the control group and the nonsense sequence group, cell cycle was also inhibited, cell apoptosis rate was about 12.60%, the apoptosis rate was significantly higher than that in the control group and the nonsense sequence group. Invasion assay showed that the transmembrane cells in FA-MNP-MMP-9-ASODN group were about 21.00, significantly lower than that in the control group and the nonsense sequence group.@*CONCLUSION@#By inhibiting the expression of MMP-9, FA-MNP-MMP-9-ASODN nanocomposites could reduce NPC cell proliferation and invasion ability, and promote apoptosis, it had a good inhibitory effect in vitro.

The impact of malleus processing in ossicular chain reconstruction on the therapeutic effect in patients with tympanosclerosis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the effect of different malleus treatments on the postoperative efficacy in the tympanosclerosis patients receiving ossicular chain reconstruction.@*METHOD@#Fifty-nine patients (62 ears) with tympanosclerosis were treated by ossicular chain reconstruction. All the patients were divided into three groups, including malleus removal group (A, 24 ears), retaining only the malleus handle group (B, 18 ears) and the intact malleus group (C, 20 ears). All the patients were followed up 3 months pre-operation, 3 months and 1 year post-operation by audiometric measurement (the average hearing threshold at 0.5, 1.0, 2.0 kHz HI). Tympanic membrane was examined by ear endoscope.@*RESULT@#The pre-operation mean air bone gap (ABG) in these groups were 40.07 +/- 77.56 dB, 37.31 +/- 76.45 dB, and 36.75 +/- 76.72 dB, among which the difference had no statistical significance (P > 0.05). At 3 months after operation, the ABG in all cases was improved at 0.5, 1 and 2 kHz. The difference of ABG improvement among these three groups had no statistical significance (P > 0.05). One year after surgery, the ABG of the three groups were decreased by 17.92 +/- 9.28 dB, 16.76 +/- 5.19 dB and 10.58 +/- 7.38 dB respectively. The hearing improvement in group C is less than the other two groups (P = 0.03, P = 0.016). The difference of hearing improvement between group A and group B had no statistical significance(P > 0.05). Group A and group B each have one case of tympanic membrane perforation and artificial ossicle falling off.@*CONCLUSION@#The operating processes of malleus in ossicular chain reconstruction of patients with tympanosclerosis were introduced. In terms of short-term efficacy, the three groups showed no significant difference. However, the long-term efficacy of the patients in the group A and group B were better compared with the group C.

FA-MNP-MMP-9-ASODN complex construction and the study of its FA molecular targeting ability / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To construct FA targeted magnetic nanocomplex (FA-MNP-MMP-9-ASODN) loading matrix metalloproteinase 9 (MMP-9) antisense oligonucleotide (ASODN) and evaluate its targeting capacity and efficiency of gene transfection to folate receptor (FR) positive NPC.@*METHOD@#FA-MNP-MMP-9-ASODN was constructed by MMP-9-ASODN coupling with FA-MNP prepared by our research team through the aldehyde-ammonia condensation reaction. To analyze the feasibility of ASODN coupling with nanocarrier agarose gel electrophoresis. Two kinds of HNE-1 and CNE-2 cells and implanted tumors phagocytosis of FA-MNP-MMP-9-ASODN were observed by MRI on tumor-bearing nude mice, iron staining and TEM. To analyze gene transfection of the vector by observing FITC in the cell.@*RESULT@#The electrophoresis results revealed ASODN successfully coupling with FA-MNP. HNE-1 cell can effectively ingest the nanocomposite,with more FITC in the cell, but CNE-2 cell had not uptake for the nanocomposite, with no FITC in the cell. By comparing with CNE-2 tumor, HNE-1 tumor also can efficiently swallow the nanocomposite.@*CONCLUSION@#FA-MNP-MMP-9-ASODN nanocomplex is constructed successfully with good FA targeting ability and gene transfection.

Applied anatomy of facial recess and posterior tympanum related to cochlear implantation / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the related parameters of temporal bone structure in the surgery of cochlear implantation through facial recess approach so as to offer a theoretical reference for the avoidance of facial nerve injury and the accurate localization.@*METHOD@#In a surgical simulation experiment, twenty human temporal bones were studied. The correlation parameters were measured under surgical microscope.@*RESULT@#Distance between suprameatal spine and short process of incus was (12.44 +/- 0.51) mm. Width from crotch of chorda tympani nerve to stylomastoid foramen was (2.67 +/- 0.51) mm. Distance between short process of incus and crotch of chorda tympani nerve was (15.22 +/- 0.83) mm. The location of maximal width of the facial recess into short process of incus, crotch of chorda tympani nerve were (6.28 +/- 0.41) mm, (9.81 +/- 0.71) mm, respectively. The maximal width of the facial recess was (2.73 +/- 0.20) mm. The value at level of stapes and round window were (2.48 +/- 0.20 mm) and (2.24 +/- 0.18) mm, respectively. Distance between pyramidalis eminence and anterior round window was (2.22 +/- 0.21) mm. Width from stapes to underneath round window was (2.16 +/- 0.14) mm.@*CONCLUSION@#These parameters provide a reference value to determine the position of cochlear inserting the electrode array into the scale tympani and opening facial recess firstly to avoid potential damage to facial nerve in surgery.

Clinical analysis and prognosis of acute pyelonephritis in children / 中华临床感染病杂志

Objective To analyze the clinical characteristics and prognosis of acute pyelonephritis (APN) in children.Methods A retrospective analysis was performed in 230 pediatric patients with APN admitted from January 2009 to December 2010.The clinical characteristics,etiology,drug-resistant and prognosis were reviewed,and logistic regression analysis was performed to identify the risk factors of renal scarring after APN.Results Among 230 patients with APN,93 were boys and 137 were girls with a malefemale ratio of 1∶ 1.47.Ninety-nine patients were younger than 1 year with a male-female ratio of 1.30∶1 ;75 patients were 1 to 5 year with a male-female ratioof 1 ∶ 2.75 ; 56 patients were older than 5 year with a male-female ratio of 1∶2.29.A total of 106 strains were detected,in which 91 strains were Gram-negative bacteria,13 strains were Gram-positive bacteria and 2 strains were fungus.The most frequent bacteria were Escherichia coli (65 strains,61.32％),Klebsiella pneumonia (13 strains,12.6％) and Enterococcus faecium (9 strains,8.49％).Forty-four strains of Escherichia coli produced ESBLs,and all of them were resistant to ampicillin,part of them resistant to cephalosporin,compound sulfamethoxazole and aztreonam,but all were sensitive to amikacin,amoxicillin/clavulanic acid,nitrofurantoin,and imipenem.Renal emission computed tomography (ECT) was performed again in 52 children who were followed up for 6-12 months,in which 31 cases (59.62％) developed renal scar,and 21 cases (40.38％) were recovered.Abnormalities in urinary system or vesicoureteric reflux were identified as the risk factors for renal scarring after APN (OR =6.89,P ＜ 0.05).Conclusions The incidence of APN in children drops with age,which is frequently in the males younger than 1 year,and in the females older than 1 year.Escherichia coli is the most frequent pathogen of APN in children,and most strains are multidrug resistant.Children with abnormalities in urinary system or vesicoureteric reflux are prone to develop renal scarring.

Applied anatomy of scala tympani inlet related to cochlear implantation / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the related parameters of the temporal bone structure for determining the position of implanting electrode into the scala tympani in cochlear implantation surgery through the facial recess and epitympanum approach.</p><p><b>METHODS</b>In a surgical simulation experiment, 20 human temporal bones were studied and measured to determine the related parameters of the temporal bone structure.</p><p><b>RESULTS</b>The distance 5.91∓0.29 mm between the short process of the incus and the round window niche, 2.11∓0.18 mm between the stapes and the round window niche, 6.70∓0.19 mm between the facial nerve in the perpendicular paragraph and the round window niche, 2.22∓0.21 mm from the pyramidal eminence to the round window, and 2.16∓0.14 mm between the stapes and the round window. The minimal distance between the implanting electrode and the vestibular window was 2.12∓0.19 mm. The distance between the cochleariform process and the round window niche was 3.79∓0.17 mm. The position of the cochlear electrode array insertion into the second cochlear turn was 2.25∓0.13 mm under the stapes. The location of the cochlear electrode array insertion into the second cochlear turn was 2.28∓0.20 mm inferior to the pyramidal eminence.</p><p><b>CONCLUSION</b>These parameters provide a reference value to determine the different positions of cochlear electrode array insertion into the scale tympani in different patients.</p>

Therapeutic effect of modified surgery for cystic lymphangioma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the surgical treatments of cystic lymphangioma and their curative effect.@*METHOD@#A retrospective review of 12 patients (9 males, 3 females) of cystic lymphangioma was performed, with the age ranged from 1 to 35 (median age was 11). Six patients were born with cervical cyst, three patients had symptoms in childhood, and 3 in adolescence. Ten patients underwent modified operation, that is the extracapsular dissection performed under direct vision after open cystic, from July 1998 to March 2008, a patients who had operative procedure in other hospital with recurrence and a 1 year child received local injection of bleomycin A 5.@*RESULT@#Cystic lymphangioma were complete excised in 10 surgical patients, without any complication like nerve injury. One of the two patients who received injection was lost in follow-up, and the other was still in follow-up with the tumor basically eliminated.@*CONCLUSION@#Surgery is the primary treatment of cystic lymphangioma. Modified operative method is helpful to complete resection of lymphangioma and the protection of surrounding tissues.