Investigate of the learning curve of cochlear implantation / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the learning curve of cochlear implantation and its guiding significance for clinical surgery.</p><p><b>METHODS</b>A retrospective analysis of the clinical data of two otologists in early cochlear implant surgeries, including 98 cases of Dr. A and 54 cases of Dr. B.Statistics of the two doctors incidence of complications and operating time. Operation time as index were drawing a, b two groups of cases of scatter plot, the oscillating sine curve model Y = sin(X)-P/2 and logarithmic curve model Y = b1ln(X)+b0 curve fit were analyzed. Then, extract the early 90 cases of surgery by Dr. A which was divided into a, b, c three groups with 30 cases a group. The operating time and complications were further compared and analyzed(SPSS 16.0).</p><p><b>RESULTS</b>From the operation sequence,A and B physicians, early operation cases cost more operating time, and more complications.Learning curve before and after about 30 cases appeared inflection point, showing a rapid decline in period (learning phase) and slow decline period (consolidation phase) in two stages.Group contrast to Dr. A's early 90 consecutive cases, the operating time of Phase b and Phase c decreased significantly than Phase a (P(a-b) < 0.01, P(a-c) < 0.01), while there was no significant difference between group Phase b and Phase c (P(b-c) = 0.68), the complication rate of Phase b and Phase c decreased significantly than Phase a (P(a-b) < 0.01, P(a-c) < 0.01), while there was no significant difference between group Phase b and Phase c (P(b-c) = 0.15).</p><p><b>CONCLUSIONS</b>Our department of cochlear implantation followed the learning curve rule. The minimum number of cases that should accumulate in the learning phase needs about 30 cases.</p>

Electromyographic Study on Tensor Veli Palatini in Healthy Population / 听力学及言语疾病杂志

Objective To establish examination methods of electromyography (EMG) for tensor veli palatini (TVP) ,to obtain EMG values and EMG graphic patterns of TVP in normal healthy population .Methods A total of 20 healthy adults were selected for the study .Under the guidance of nasopharyngoscope ,especially designed elec-trode needles were inserted into different sites of TVP .All the 20 healthy adults were asked to perform series of swallowing and recorded the EMG values and EMG waveforms .Results At a scanning speed of 5 ms/div ,and with the TVP point as tie point ,the results of 20 healthy adults were obtained for 38 sides of TVP EMG .With the TVP contraction duration (0 .863 ± 0 .255 s) ,the peak voltage was produced by the contraction of 445 .100 ± 246 .808μV .The wave forms of EMG were considered as the interference .TVPs were observed bilaterally in synchroniza-tion with the contraction during swallowing .Action potential durations were 9 .142 ± 2 .178 ms ,and the amplitude of the action potential was 254 .260 ± 191 .544 μV .The action potential graphic configuration was multi -phasic with 2~3 waveforms .Conclusion This experimental study showed that when the TVP point was as tie point and the scanning speed was set at 5 ms/div record ,the results of action potentials were obtained more stable and clearer and the TVP normal values were also obtained for the normal population .

Plain X-ray for locations of intracochlear electrode arrays during cochlear implantation / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the position and shape of inserted electrode arrays by plain X-ray during cochlear implantation.@*METHOD@#Cochlear view of implanted electrode arrays by plain X-ray were observed during operation in 54 patients received cochlear implant.@*RESULT@#The image in cochlear view could provide the information about position and shape of inserted electrode arrays. The spiral-shape electrode arrays without distortion and folding were found in 52 cases. The complete insertion of intracochlear electrode in these patients were confirmed by surgery. Of 54 cases, the other 2 cases showed improper position and C-shape of intracochlear electrodes, one was partial insertion and the other was bending inside the cochlea. The bending electrode array was reinserted immediately during operation.@*CONCLUSION@#Routine plain X-ray after inserted electrode during operation was a best way of knowing the shape and depth of the electrode array, especial for the difficult cochlear implantation, and also could avoided anesthetization again.

The diagnosis and treatment of the simple congenital malformation of ossicular chain / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the diagnosis and treatment of the simple congenital malformation of ossicular chain.@*METHOD@#Curative effect analysis for 4 cases of treatment of simple congenital malformation of ossicular chain were performed in our department from June 2005 to August 2009, retrospectively. 4 patients underwent middle ear exploration and ossicular chain reconstruction were followed up for 1-4 years, and air conduction threshold of speech frequency(0.5, 1.0, 2.0 kHz) were detected, 15 dB increase of which were as the standard of successful operation.@*RESULT@#Three cases was abnormal incus, 2 cases were absence of instruction on the stapes footplates, and stapes footplates fixed, one case was absence of the incus. Hearing level had significantly improve after hearing reconstruction in 3 patients. The averaged postoperative air conduction threshold of speech frequency had 47 dB increase, bone conduction threshold have no change, while one case of hearing level without change. Tinnitus, vertigo, facial paralysis and other complications occurred were found in all the patients.@*CONCLUSION@#The congenital conductive hearing loss without external ear malformations should be suspected of congenital malformation of ossicular chain, which could be diagnosed by tympanic exploration. Ossicular chain reconstruction can improve the hearing effectively.

The exploration of TTAG method in determinating the states of eustachian tube function of healthy group / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the feasibility and validity of tubo-tymanoaerodynamicgraphy (TTAG) determinating the Eustachian tube function of health adult group.@*METHOD@#The ventilation function of Eustachian tube was measured by the TTAG method in health adult group (132 ears), the results and the graphs were also analyzed.@*RESULT@#The positive rate in health adult group using Valsalva method was 93.93% (124/132). The positive ears were divided into type I and type II, the mean value of nasopharynx press of type I and II has no significant differences (P>0.05), but the mean value of external auditory canal press had significant differences (P<0.01).@*CONCLUSION@#TTAG method has the clinical value in determinating the states of Eustachian tube function of health group.

The exploration of TTAG method in determinating the states of Eustachian tube functiong of healthy group / 临床耳鼻咽喉头颈外科杂志

Objective:To explore the feasibility and validity of tubo-tymanoaerodynamic graphy(TTAG)determinating the Eustachian tube function of health adult group.Mthod:The ventilation function of Eustachian tube was measured by the TTAG method in health adlut group(132 ears),the results and the graphs were also analyzed.Reslut:The positive rate in health adult group using Valsalva method was 93.93%(124/132).The positive ears were divided into typeⅠand typeⅡ, the mean value of nasopharynx press of type Ⅰand Ⅱ has no significant differences(P>0.05),but the mean value of external auditory canal press had significant differences(P<0.01).Conclusion:TTAG meathod has the clinical value in determinating the states of Eustachian tube function of health group.

Analysis on clinical and cell immunophenotype of primary extra-nodular non-Hodgkin′s lymphoma in head and neck / 中国耳鼻咽喉头颈外科

Objective:To report the characteristic of clinical manifestation and cell immunophenotype in cases with primary extra-nodular non-Hodgkin′s lymphoma(PE-NHL) in head and neck.Methods.One hundred and fifteen patients with PE-NHL in head and neck were reviewed,which were diagnosed by pathology in the pas ten years.The features of clinical manifestation and cell immunophenotype in these patients wre analyzed.Results:Twenty to forty years old was most common (42.0%) ages range in the group of patients with PE-NHL.Nasal cavity was the most commonly involved site (36.6%,42/115), next the PE-NHL respectively occurred in nasopharynx(26.1%,30/115),tonsilla(20.1%,24/115) and oral cavity (8.7%,10/115).Only in a few cases the PE-NHL occurred in oroharynx,laryngopharynx and larynx.The patients mainly showed the symptoms of primary lesion located.The lump,ulcer or both signs were observed on primary position,the lump was the most common sign.Cell immunophenotype resulte displayed 51.2% of the PE-NHL originating from T cells,48.8% originating from B cells.Most of nasal PE-NHL originated from T cells ,while most of tonsilla and oral PE-NHL originated from B cells.About half of nasopharyngeal PE-NHL originated from T cells,another half origiated from B cells.Conclusion:The PE-NHL in head and neck mostly occurred in nasal cavity ,then occurred in nasopharynx,tonsilla and oral cavity.The clinical manifestation in the patients with the PE-NHL lacked characteristic symptoms.Sometimes these PE-NHL were confused with other malignant tumours in primary position,which were easily made a misdiagnosis.Therefore discrimination and diagnosis have to be made by pathology and immunohistochemistry.

Confirmation of patulous eustachian tube syndrome by Tubo-tymanoaerodynamic graphy / 临床耳鼻咽喉头颈外科杂志

Objective: To compare the advantage of tympanogram, Morimitsu＇s method and Tubotymanoaerodynamic graphy (TTAG) in the confirmation of patulous eustachian tube syndrome. Method :Twenty ears with patulous eustachian tube syndrome diagnosed clinically were selected. The tympanogram, Morimitsu＇s method and TTAG were examined in these ears and the positive rate was estimated. Result:The confirmation of patulous eustachian tube syndrome by tympanogram,Morimitsu＇s method and TTAG was 5,12 and 20 ears in 20 ears with patulous eustachian tube syndrome. The positive rate was 25％,60％ and 100％ respectively. TTAG also was useful in following-up. Conclusion:TTAG is an important method for diagnosis and following-up in patulous eustachian tube syndrome.