Dynamic changes of vestibular autorotation test in patients with unilateral vestibular dysfunction during rehabilitation / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the dynamic changes of vestibular autorotation test (VAT) before and after vestibular rehabilitation treatment in patients with unilateral vestibular hypofunction (UVH). Methods: A retrospective study was carried out,48 patients who were diagnosed with UVH and under vestibular rehabilitation in department of otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2019 to January 2021 were enrolled. Among them, there were 21 males and 27 females, with an average age of 46.9 years old, including 25 cases of Meniere's disease, 13 cases of sudden deafness with vertigo and 10 cases of vestibular neuritis. The course of disease ranged from 5 days to 10 years. Demographic characteristics, detailed case data and routine examination were collected for the patients. The horizontal gain/phase, vertical gain/phase, and asymmetry of VAT at different frequencies before and after vestibular rehabilitation were collected. The absolute value of the difference between the measured value of 2.0-5.9 Hz before and after rehabilitation and the standard value were statistically analyzed. Results: Before vestibular rehabilitation, the incidence of abnormal gain was 62.5% (30/48), the incidence of abnormal phase was 56.3% (27/48), and the incidence of asymmetry was 16.7% (8/48). After 4-6 weeks of vestibular rehabilitation, the incidence of gain abnormality was 22.9% (11/48), the incidence of phase abnormality was 31.3% (15/48), and the incidence of asymmetry was 12.5% (6/48).The horizontal gain at frequency of 2.0-3.9 Hz showed statistically significant difference compared with before vestibular rehabilitation (P<0.05), and the horizontal gain at frequency of 4.3-5.9 Hz showed that there was no significant difference (P>0.05); the horizontal phase at 5.9 Hz showed that the difference was statistically significant (P=0.043), and there was no significant difference before and after rehabilitation treatment at 2.0-5.5 Hz (P>0.05); the vertical gain at 4.3 Hz showed the difference was statistically significant (P=0.020), and the remaining frequency showed no significant difference (P>0.05); No frequency of asymmetry and vertical phase showed the difference before and after rehabilitation was statistically significant (P>0.05). Conclusion: VAT can be used to monitor the change trend of multiple frequency bands before and after vestibular rehabilitation in UVH, in order to provide reference for the formulation of personalized rehabilitation strategies.

Modified titration intratympanic gentamicin injection for unilateral intractable Ménière's disease / 华中科技大学学报（医学）（英德文版）

This study looked into the efficacy of a modified titration protocol of intratympanic gentamicin injection (ITG) in the patients with unilateral intractable Ménière's disease (MD). Modified titration protocol of ITG at a low dose (20 mg/mL) was administered to 10 patients with definite unilateral intractable MD. After initial first two fixed ITGs on weekly basis, the patients might or might not be given any more injections, depending on the appearance of unilateral vestibular loss (UVL). ITG was terminated if the patients satisfied the criteria of UVL. All patients were followed-up for at least two years. The effects of ITG on the vertigo attack, functional level scores and postural balance were evaluated. Of the 10 cases, 8 showed the sign of UVL after receiving initial two ITGs and were not given any more intratympanic injections, and the other 2 patients were administered three ITGs. A two-year follow-up revealed that complete and substantial vertigo control was achieved in 9 cases, and limited vertigo control in 1 patient. Hearing level was lowered in 2 patients. The posture stability and functional level scores were improved. Our study showed that the modified titration protocol of ITG at a low dose could effectively control vertigo in patients with unilateral intractable MD.

Combined flap of postauricular musculo-periosteal and ear canal skin flap with bone paté for mastoid obliteration and canal wall down mastoidectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the long-term outcome and clinical value of modified radical mastoidectomy with mastoid obliteration using pedicled combined flap of postauricular musculo-periosteal and ear canal skin flap in conjunction with bone paté.</p><p><b>METHODS</b>During 2 years from April 2003 to March 2005, 71 otitis media patients (71 ears) with cholesteatoma were subjected to this kind of operation.</p><p><b>RESULTS</b>The follow-up period was more than 2 years. The period of complete reepithelialization ranged from 3 weeks to 1.5 months, with the mean period of 29 days. All of the patients, treated by the described method of operation had a dry, disease-free mastoid of ear.</p><p><b>CONCLUSIONS</b>Mastoid obliteration with pedicled combined flap of postauricular musculo-periosteal and ear canal skin flap in conjunction with bone paté, had the advantages as follows: (1) Healing of the mastoid cavity in a short time. (2) Better reepithelialization of the obliterated mastoid cavity. (3) No need of skin grafting in the mastoid cavity. (4) High rate of the dry ear in postoperation. (5) nearly no need of the mastoid cavity cleaning postoperatively.</p>

SiRNA expression cassettes targeting VEGF effectively inhibit the growth of laryngeal squamous cell carcinoma cell lines / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the effects of siRNA expression cassettes (SECs) targeting VEGF in vitro on cultured Hep-2 cells, the observation of the expression of VEGF, the screening of the best interference sequences, and the exploration of the application of RNA interference on tumor gene therapy in the future.</p><p><b>METHODS</b>On the basis of the principle of target sequence of siRNA, four interference sequences of VEGF were designed, and the downstream gene-specific primers of the SECs were synthesized. The RNAi transcription kit used U6 RNA-based polymerase III promoter and modified terminator for high level, precise siRNA expression inside target cells. The Hep-2 cells was transfected in growth period of index with the PCR products of the four sites separately, and began to observe and measure the results of RNA interference in 48 hours.</p><p><b>RESULTS</b>The transfected 1366-site cells created, turned into the round shape and began to shed off, whereas morphology of the cells of other groups had not obviously changed. Performing the agarose gels electrophoresis with RT-PCR products, compared with the contrast groups, some cells VEGF mRNA of 1366-site were suppressed obviously, the ratio of OD was 0. 05 while the expression of VEGF of the cell of other groups had not obviously changed. Western blot revealed that VEGF expression was decreased obviously post transfection using 1366-site SECs. Flow cytometry showed that apoptosis rate of 1366-site transfected cells is 43%, and apoptosis rate of the rest three site transfected cells scarcely changed. Similar results were obtained in three independent experiments.</p><p><b>CONCLUSIONS</b>The study suggested that siRNA expression cassettes (SECs) targeting VEGF 1366-site can effectively inhibit the growth laryngeal squamous cell carcinoma cell lines (Hep-2).</p>