Development of the mastoid air cells and its relationship to Ménière's disease / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the fundamental pathological anatomy and possible pathogenetic factors of Ménière's disease(MD), we compared the types of mastoid air cells between the MD group and the control group.</p><p><b>METHODS</b>The MD group had 113 ears and the control group had 100 ears. Temoral bone CT scanning was performed in all the subjects. The types of mastoid air cells were determined by surgical findings and imaging data. All the mastoid air cells were divided into diploetic type, gasified type and sclerosis type. Analysis of the proportion of different types and the statistical analysis were performed between the two groups.</p><p><b>RESULTS</b>51.4% (57/113) in the MD group and 18.0% (18/100) in the control group were diploetic type mastoid, the difference was significant (χ(2) = 24.476, P < 0.001). The gasified type was 43.4% (49/113) in the MD group and 77.0% (77/100) in the control group, the difference was significant (χ(2) = 24.843, P < 0.001). The sclerosis type was 6.2% in the MD group and 5.0% (5/100) in the control group, and there was no statistical significance (χ(2) = 0.142,P > 0.05).</p><p><b>CONCLUSIONS</b>The mastoid air cells are dysplasia in MD patients, and it may be one of the fundamental pathological anatomy. The long-term ventilation and drainage disorder and recurrent inflammation attack may play an important role in occurrence, development and prognosis of MD.</p>

Analysis of the effectiveness in patients who were treated with a course of drugs for sudden deafness which was present for at least three weeks / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate and analyze the significance of a course of glucocorticosteroids and other drugs for the treatment of patients with sudden deafness present for at least three weeks.</p><p><b>METHODS</b>A retrospective review was done on 48 patients (58 ears) with sudden deafness present for at least three weeks or more, who were admitted to the Department of Otorhinolaryngology, Peking University People's Hospital from November 2002 to July 2010. The patients were divided into three groups by the type of hearing threshold. The different treatments were used in the three groups. The SPSS 17.0 software was used to analyze the data.</p><p><b>RESULTS</b>In patients with a low tone hearing loss (6 ears), 83.3% improved. For patients with a high tone loss (22 ears) 31.8% improved. For a flat tone hearing loss (30 ears) 36.7% improved. For patients with a hearing loss more than one year (12 ears) there was improvement in 58.3% (7 ears) of the patients. In 9 ears which had a flat tone hearing loss of 90 dB or greater before treatment, 77.8% (7 ears) improved with 33.3% (3 ears) having a significant improvement. In 21 ears which had a hearing threshold was under 90 dB, 14.3% (3 ears) improved.</p><p><b>CONCLUSIONS</b>In the treatment of patients with sudden deafness which was longer than 21 days the treatment was significant, especially for those who had a 90 dB or greater flat-tone type hearing threshold before treatment. Even though the hearing loss was more than a year in some patients there was still a benefit from treatment.</p>

Analysis of sub-typing in full-frequency sudden deafness / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the relationship between the sub-typing of full-frequency sudden deafness and its effect in treatment.</p><p><b>METHODS</b>A series of 87 cases that have full-frequency sudden deafness were studied from Aug, 2005 to Mar, 2008. All cases were treated with methylprednisolone, Batroxobin and Xueshuantong.</p><p><b>RESULTS</b>Based on the frequency of hearing loss, the objectives were divided into sudden-drop-down type and slow-drop-down type. The effective percentage and significant effective percentage in sudden-drop-down type were 84.4% (27/32) and 68.8% (22/32), respectively. The effective percentage and significant effective percentage in slow-drop-down type were 52.7% (29/55) and 32.7% (18/55), respectively. Slow-drop-down type showed a higher effective and significant effective percentage respectively (P < 0.01). According to the degree of hearing loss, objectives were divided into flat-type and profound-type. The effective percentage and significant effective percentage in flat-type were 73.3 % (44/60) and 53.3 % (32/60) respectively. The effective percentage and significant effective percentage in flat-type were 44.4% (12/27) and 29.6% (8/27) respectively. The flat-type showed a higher effective (P < 0.01) and significant effective percentage (P < 0.05) for treatment.</p><p><b>CONCLUSIONS</b>The sudden deafness needs a further classification. According to the frequency of hearing loss, it can be divided into sudden-drop-down and slow-drop-down type. According to the degree of hearing loss, it can be divided into flat-type and profound-type. It would be appropriate to using 90 dB(average hearing threshold) as a criteria for the classification of hearing loss.</p>

Different pathogenesis of benign paroxysmal positional vertigo from the nystagmus during particle repositioning maneuver / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the nystagmus during particle repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV), and verify different pathogenesis of benign paroxysmal positional vertigo (BPPV).</p><p><b>METHODS</b>The chief complains, nystagmus during positioning test and particle repositioning maneuver (PRM) were recorded in detail from 66 PC-BPPV cases during Dec.2007 and Apr.2008, and verifying possible pathogenesis of BPPV was based on nystagmus.</p><p><b>RESULTS</b>Of all 66 PC-BPPV cases, the four positions of PRM were found in 24 cases presented upward torsional nystagmus at the second or third position, 21 cases presented negative nystagmus except the first position, 7 cases presented intensity horizontal nystagmus during PRM and 14 cases presented downward nystagmus at the second or third position during PRM. Of all 66 cases, 78.8% of them were accord with canalithiasis and cupulolithiasis while the other may be related with otolith organ or nerve disease.</p><p><b>CONCLUSIONS</b>Besides canalithiasis and cupulolithiasis, part of BPPV may be related with otolith organ or nerve disease.</p>

Prognosis and treatment of sudden sensorineural hearing loss with total and severe all frequency hearing loss / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the treatment and prognosis of sudden sensorineural hearing loss (SSHL) with total and severe all frequency hearing loss.</p><p><b>METHODS</b>Sixty-two patients diagnosed as SSHL (0.25, 0.5, 1, 2, 4 kHz pure tone average > or = 56 dB) were studied from January 2003 to October 2006, in which 18 of them were treated with Xueshuantong (Panax notoginseng saponins) while 19 of them treated with steroid and Xueshuantong, and 25 of them treated with steroid, DF-521 and Xueshuantong.</p><p><b>RESULTS</b>The hearing improvement rate of the patients treated with Xueshuantong was 22.2% (4/18) while the patients treated with steroid and Xueshuantong was 57.9% (11/19) and the patients treated with steroid, DF-521 and Xueshuantong was 68.0% (17/25). The good improvement rate of the patients treated with Xueshuantong was 5.6% (1/18) while the patients treated with steroid and Xueshuantong was 36.8% (7/19) and the patients treated with steroid, DF-521 and Xueshuantong was 60.0% (15/25). Over hearing improvement was significantly better in patients treated with steroid, defibrinogenation and Xueshuantong than in those treated with Xueshuantong only (P < 0.05). The patients of total hearing loss had a significantly higher vertigo rate and worse therapy effect.</p><p><b>CONCLUSIONS</b>The combined therapy include high-dose corticosteroids and defibrinogenation therapy is effective for the patients with total deafness and severe all frequency hearing loss. The prognosis of patients with total hearing loss was poor.</p>

Immunohistochemical discrimination of aggressivity between the cholesteatoma from different positions / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate whether the cholesteatoma from different positions have different biological characteristics.</p><p><b>METHODS</b>The expression of the Ki-67 and collagen IV in 19 specimens of cholesteatoma were stained immunohistochemically using the SP method, according to the origin of the specimens, include 7 cases from the epitympanum, 8 cases from tympanic sinus and 4 cases from the out acoustic canal. According to the severity of the inflammation in the perimatrix, the inflammation group included 7 cases, the non-inflammation group included 8 cases.</p><p><b>RESULTS</b>The average count was the same between the cholesteatoma from epitympanum and tympanic sinus. And the count of the cholesteatoma in the middle ear was also the same to the cholesteatoma from the out acoustic canal. But even from the same sample, the cholesteatoma from the positions with severe inflammation in the perimatrix count much higher, and the difference was statistically significant. Collagen IV had been found to localized in the basic membrane. In some specimens the staining of the collagen IV was not continuous.</p><p><b>CONCLUSIONS</b>The results suggested that it was the severity of inflammation in the perimatrix influenced the differences, but not the origins of the cholesteatoma.</p>