Mapping the modulating effect of transcutaneous auricular vagus nerve stimulation on voxel-based analyses in patients with first-episode major depressive disorder: a resting-state functional magnetic resonance imaging study

Introduction: Seed-based analysis has shown that transcutaneous auricular vagus nerve stimulation (taVNS) can modulate the dysfunctional brain network in patients with major depressive disorder (MDD). However, the voxel-based neuropsychological mechanism of taVNS on patients with first-episode MDD is poorly understood. The objective of this study was to assess the effects of an 8-week course of taVNS on patients with first-episode MDD. Methods: Twenty-two patients with first-episode MDD accepted an 8-week course of taVNS treatment. Resting-state functional magnetic resonance imaging (rs-fMRI) scans were performed before and after treatment. Voxel-based analyses were performed to characterize spontaneous brain activity. Healthy controls (n=23) were recruited to minimize test-retest effects. Analysis of covariance (ANCOVA) was performed to ascertain treatment-related changes. Then, correlations between changes in brain activity and the Hamilton Depression Rating Scale (HAM-D)/Hamilton Anxiety Scale (HAM-A) remission rate were estimated. Results: Significant group-by-time interactions on voxel-based analyses were observed in the inferior ventral striatum (VSi) and precuneus. Post-hoc analyses showed that taVNS inhibited higher brain activity in the VSi, while upregulating it in the precuneus. Functional connectivity (FC) between the VSi and precuneus decreased. Positive correlations were found between the HAM-D remission rate and changes in brain activity in the VSi. Conclusion: taVNS reduced the FC between VSi and precuneus by normalizing the abnormal spontaneous brain activity of VSi in first-episode MDD patients.

Incidence and prognosis of olfactory and gustatory dysfunctions related to infection of SARS-CoV-2 Omicron strain: a national multi-center survey of 35 566 population / 中华耳鼻咽喉头颈外科杂志

Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.

Analysis and management of delayed cerebrospinal fluid rhinorrhea after invasive pituitary adenoma surgery / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the related factors and treatments of delayed cerebrospinal fluid rhinorrhea (CFR) after invasive pituitary adenoma (IPA) surgery. Methods: One hundred and forty-two patients with IPA treated in Tianjin Huanhu Hospital from January 2014 to January 2019 were analyzed retrospectively, including 62 males and 80 females, aging from 38 to 67 years. The clinical data of patients before and after operation were collected. All patients with postoperative CFR underwent endoscopic CFR repair. During the operation, residual or recurrent pituitary adenomas were resected, the dura around the leak was enlarged and the necrotic tissue was removed. For those who still had fluid leakage after repair, the necrotic tissue was cleaned up, the leakage was filled and reinforced under endoscopy. Endoscopic rhinorrhea repair was performed if necessary. The cerebrospinal fluid leak was repaired with multi-layer materials. The related risk factors of delayed CFR after operation were analyzed. SPSS 19.0 software was used for statistical analysis. Results: Among the 142 patients in this group, 64 cases underwent total tumor resection and 78 cases underwent non-total tumor resection. They were followed up for 6 to 72 months. Thirty-one cases had delayed CFR, with an incidence of 21.83%, and occurred between 1 and 5 years postoperatively, with an average of 2.4 years. All 31 patients with delayed CFR underwent endoscopic CFR repair. The nasal endoscopy was rechecked at 2 weeks, 1 month, 3 months and 6 months after operation. Twenty-eight patients were repaired successfully after 1 operation, while 2 patients after 2 operations and 1 patient after 3 operations. These patients were followed up for 6 to 60 months, and no CFR occurred again. Univariate analysis showed that the degree of tumor resection, recurrence, size, texture, postoperative radiotherapy and operator experience were the risk factors of delayed CFR (all P<0.05). Multivariate analysis showed that the degree of tumor resection and recurrence were the highest independent risk factors for postoperative CFR, and tumor size, texture, postoperative radiotherapy and operator experience were the independent risk factors in this study. Conclusions: Delayed CFR after IPA is related to the degree of tumor resection, recurrence, size, texture, postoperative radiotherapy and the operator experience. It is necessary to completely remove the tumor under endoscope, to expand resection of the dura and necrotic tissue around the leak, to repair the defect with multi-layer materials, to follow-up closely and to repair timely after operation.

Analysis on endoscopic endonasal approach combined with the frontotemporal orbitozygomatic approach under the microscope for skull base tumor with intra and extra-cranial involvement / 中华耳鼻咽喉头颈外科杂志

Objective: To evaluate the application of combination use of endoscopic endonasal approach combined with the frontotemporal orbitozygomatic approach microscopically in skull base tumor with intra and extra-cranial involvement. Methods: A total of 7 patients (4 males and 3 females, aging from 27 to 65 years old, with a medium age of 48) undergone complicated skull base surgeries via endoscopic endonasal approach combined with the frontotemporal orbitozygomatic approach microscopically from May 2016 to January 2018 were reviewed respectively. The patients included 2 cases of recurrent invasive pituitary adenoma, 3 cases of basal skull meningiomas, 1 case of clivus chondrosarcoma, and 1 case of recurrent nasopharyngeal carcinoma. The lesion extensively infiltrated nasal cavity, extending to the paranasal sinus, bilateral cavernous sinus, sellar region, suprasellar, superior clivus, temporal lobe, pterygopalatine fossa, infratemporal fossa and important intracranial vessels. All the 7 patients were treated under general anesthesia by endoscopic endonasal approach combined with frontotemporal orbitozygomatic approach under the microscope. Total excision rate, intraoperative and postoperative complications and postoperative curative effect were observed. All of them were followed up for 6 to 12 months. The Glasgow Outcome Scale (GOS) was used to evaluate the prognosis. Result: Total tumor removal was performed in 5 cases, subtotal removel in 2 cases. There was no complication during the operation. Postoperative severe complications occurred in 2 cases, including 1 case of cerebrospinal fluid rhinorrhea and intracranial infection, which was cured by lumbar cistern drainage and intrathecal injection; 1 case occurred oculomotor nerve paralysis, which recovered during follow-up. Postoperative complications occurred in 1 case of trochlear nerve dysfunction, 2 cases of facial numbness, and 1 case of tinnitus. During follow-up, all patients recovered to varying degrees. There was no bleeding and death after the operation. No tumor recurred during the follow-up period. All patients were recovered well with GOS grade Ⅳ-Ⅴ. Conclusions: Endoscopic transnasal approach combined with microscopic frontotemporal orbitozygomatic approach can remove tumors in one stage, reduce surgical complications and improve surgical effect. It has good application prospects and is suitable for excising complex intracranial and extracranial communicating tumors of widely involving sellar, clivus and petrous apex area.

Magnetic resonance imaging characteristics and differential diagnosis of common sellar cystic lesions / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate magnetic resonance imaging (MRI) characteristic and differential diagnostic keypoints of common sellar regional cystic lesions with the purpose of improving differential diagnostic accuracy.@*Methods@#In total, 174 cases of the pathologically diagnosed cystic lesions in sellar region between March 2016 and June 2019 were included in the current retrospective analysis. These cases included Rathke′s cleft cyst (n=68), craniopharyngioma (n=48), pituitary adenoma (n=56) and arachnoid cyst (n=2) in the sellar region. The position, texture and morphology of leisions, signal of cystic and solid part, invasion of surrounding tissues and maximum diameter of cysts on the MRI images were evaluated and compared between different groups. SPSS 25.0 software was used for statistical analysis.@*Results@#There were several specific changes on several MRI sequences in Rathke′s cleft cysts, craniopharyngioma and pituitary adenoma groups. For Rathke′s cleft cysts, round shape, rare polycystic structure, lack of solid part and maximum diameter of cysts which was significantly less than that of craniopharyngioma and pituitary adenoma groups ((17.37±6.12) mm vs (30.29±13.51) mm vs (28.18±11.13) mm, t value was 6.680, 5.838, respectively, all P<0.05), were favorable diagnostic criteria. While, the intracystic nodules were mostly found in craniopharyngioma. There was no high signal intensity in cystic wall on T1WI and T2WI of pituitary adenoma. MRI signal of arachnoid cyst in sellar region was basically the same as CSF signal, with low signal intensity on T1WI and DWI, high signal intensity on T2WI, without enhanced signal.@*Conclusions@#Common sellar regional cystic lesions showed characteristic manifestations on different MRI sequences. Valuable information in the morphology, MRI signal intensity, maximum diameter measurements may improve accuracy of differential diagnosis for sellar regional cystic lesions.

Application of three-dimensional printing technology in the surgical treatment of nasal skull base tumor / 中华耳鼻咽喉头颈外科杂志

Objective@#To explore the application value of three dimensional (3D) printing technique in the surgical treatment of nasal skull base tumor.@*Methods@#Seven patients with complicated skull base tumors admitted in Department of Otorhinolaryngology Head and Neck Surgery and Department of Neurosurgery of Tianjin HuanHu Hospital from Mar. 2017 to Feb. 2018 were selected. According to three sets of DICOM data of patients obtained from enhanced spiral CT scanning, navigation MRI scanning and CT angiography (CTA) magnetic navigation, data information of skull, blood vessel and tumor were extracted and reconstructed with different segmentation methods. The assembly and integration were achieved in the same coordinate system to form 3D visual composite virtual models. Combined with 3D printing technology, 3D visual composite virtual models were substantialized, and were applied for preoperative surgical strategy making and intraoperative reference.@*Results@#Virtual models of the nasal skull base of 7 patients were reconstructed successfully and 3D 1∶1 entity models were produced. The models demonstrated the relationship among the skull, tumors, and adjacent blood vessels.Seven cases were successfully performed.@*Conclusion@#3D virtual model of composite nasal skull base and its dissection model based on 3D printing technology can guide the medical staff to develop and perfect the operation scheme.

Olfactory functional magnetic resonance imaging in patients with mild cognitive impairment / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze the activation of brain regions associated with olfactory in patients with mild cognitive impairment (MCI) by olfactory functional magnetic resonance imaging (fMRI). @*Methods@#Twenty six patients with MCI were compared with twenty six controls in the dementia center of Tianjin HuanHu hospital in terms of olfactory function T&T testing, the differences between the activation of the whole brain and region of interest associated with olfactory (bilateral primary olfactory cortex(POC), bilateral hippocampus, bilateral orbital frontal gyrus) by olfactory stimulator using event correlation design for olfactory fMRI scanning. To analyze the correlation between the number of activator in POC and the threshold of olfactory discriminate as well as the severity of cognitive impairment.SPSS 19.0 software was used for the statistical analysis. @*Results@#T&T olfactory testing revealed that MCI patients had higher scores than controls (3.57±1.29 (±s) vs 1.02±0.35, t=4.372, P<0.05). The activation range of whole brain in MCI patients was less than controls (pleasant odor (po) 147.36±21.45 vs 323.11±39.76, unpleasant odor (upo) 201.86±24.93 vs 447.73±57.22, tpo=4.241, tupo=5.365, both P<0.05). The activation range of whole brain in inhaling unpleasant odor was more than pleasant odor in controls (447.73±57.22 vs 323.11±39.76, t=3.936, P<0.05). The number of activator in ROIawo in MCI patients was less than controls (pleasant odor (po) 51.0[8.0, 109.0](M[P25, P75]) vs 135.0[21.0, 321.5], unpleasant odor (upo) 65.0[6.0, 158.0]vs 205.0[36.5, 491.0], Zpo=-2.199, Zupo=-2.216, both P<0.05). The number of activator in POC in MCI patients was less than controls (pleasant odor (po) 19.0[4.0, 35.5]vs 46.0[9.0, 118.5], unpleasant odor (upo) 26.0[2.0, 51.0]vs 79.0[17.5, 189.0], Zpo=-1.898, Zupo=-2.167, both P<0.05). The number of activator in POC was negatively correlated with olfactory discriminate threshold in MCI patients (rpo=-0.415, rupo=-0.409, both P<0.05). The number of activator in POC was positively correlated with MoCA in MCI patients (rpo=0.289, rupo=0.296, both P<0.05). @*Conclusion@#Olfactory fMRI can objectively assess the olfactory function in MCI, it is a imaging indicator with neuropsychological tests for detection in MCI, the number of activator in POC can reflect the severity of MCI.

Relationship of Albumin Levels with the Prognosis and Severity of Illness among Elderly Sepsis Patients / 现代检验医学杂志

Objective To investigate the relationship of albumin levels with the prognosis and severity of illness in elderly sep-sis patients.Methods This was aretrospective study.108 elderly sepsis patients were enrolled from October 2014 to Decem-ber 2015.All patients were divided into survivors group (83 cases)and death group (25 cases)based on the 28-day progno-sis.The differences of clinical data and laboratory were compared between two groups.According to the albumin levels,all patients were divided into three groups,normal albumin group (≥35 g/L,24 cases),and mild hypoproteinemia group (28 g/L≤ALB<35 g/L,52 cases)and severe hypoproteinemia group (<28 g/L,32 cases),respectively.The mortality rate was compared in the groups.Spearman Correlation Coefficient was used to analyze ALB and other factors.Results In all 108 pa-tients,the 28-day mortality rate was 23.1%,and 77.8% of the patients with hypoproteinemia.ALB level [31.7 (28.3~35.7)g/L vs 25.8 (21.7~31.8)g/L,P<0.001]and Hb [128 (110~140)g/L vs 102 (84~132)g/L,P=0.015]in death group were significant lower than that in survival group.Meanwhile,APACHE II scores [20 (18~23)vs 22 (19~24),P=0.015]and SOFA score [6 (5~6)vs 6 (6~7),P<0.001]were higher than that in survival group.The mortality decreased with the increase of ALB level (43.8% vs 21.2% vs 0%,P<0.05).ALB had a negative correlation with APACHEⅡ score (r=-0.190,P=0.049)and coma (r=-0.311,P=0.001),and had a positive correlation with Hb (r=0.449,P<0.001).Conclusion The incidence of hypoproteinemia was high in elderly sepsis patients.ALB level was associated with prognosis and severity of illness among the patients.

Olfactory bulb volume in patients with posttraumatic olfactory dysfunction / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze the correlation between olfactory bulb(OB) volume and olfactory function in patients with posttraumatic olfactory dysfunction.@*Methods@#Forty patients with posttraumatic olfactory dysfunction were compared with forty controls in terms of olfactory function T&T testing, OB volume assessed with magnetic resonance imaging (MRI). SPSS 17.0 software was used to analyze the data.@*Results@#T&T olfactory testing revealed that patients with posttraumatic olfactory dysfunction had higher scores than controls(3.47±0.63 vs.1.39±0.19, t=4.317, P<0.05). Both men and women with posttraumatic olfactory dysfunction were affected by the same extent of olfactory loss(3.52±0.66 vs.3.43±0.61, t=0.896, P>0.05). Both men and women as controls were affected by the same extent of olfactory loss(1.41±0.20 vs.1.38±0.17, t=1.073, P>0.05). OB volume of left side in patients with posttraumatic olfactory dysfunction were (36.15±3.16)mm3, right side were (39.28±3.76)mm3, average OB volume were (37.55±3.42)mm3; OB volume of left side in controls were (81.74±5.87)mm3, right side were (83.58±6.13)mm3, average OB volume were (82.59±5.99)mm3; OB volumes were lower in patients with posttraumatic olfactory dysfunction as compared with controls(t value were 4.815, 4.837 and 4.825, all P<0.01). Average olfactory discriminate threshold was negatively correlated with average OB volume in posttraumatic olfactory dysfunction and controls(r value was-0.582, -0.564, both P<0.05). Average olfactory discriminate threshold was positively correlated with impairment degree in patients with posttraumatic olfactory dysfunction(r value was 0.472, P<0.05), average OB volume was negatively correlated with impairment degree in patients with posttraumatic olfactory dysfunction(r value was -0.397, P<0.05)@*Conclusions@#The OB volumes are lower in patients with posttraumatic olfactory dysfunction as compared with controls. The OB volume is correlated with olfactory function. Impairment degree in patients with posttraumatic olfactory dysfunction is accordance with olfactory function lowering degree. Megnetic resonance imaging can be used as a supplementary diagnostic tool for patients with posttraumatic olfactory dysfunction.

Immune checkpoint inhibitor therapy in advanced head and neck cancer / 中华耳鼻咽喉头颈外科杂志

Immune checkpoint inhibitor therapy, which targets regulatory pathways in T cells to enhance antitumor immune responses, improves the life quality of cancer patients and has joined the ranks of surgery, radiation, and chemotherapy to become a major choice for cancer therapy. Over the past few years, multiple exciting results have been obtained on checkpoint inhibitor therapy in advanced head and neck cancer. However, questions such as patient selection and biomarkers for assessing the therapy are largely unsolved. Herein, we briefly review recent findings in checkpoint inhibitor therapy for advanced head and neck cancer. We will also discuss possible mechanism, safety, combination therapy, and side effects for the therapy. Checkpoint inhibitor therapy has led to important clinical advances and will provide a new weapon against cancer.

Curative effect of Eucalyptol on the treatment of chronic rhinosinusitis / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the curative effect of Eucalyptol on the treatment of chronic rhinosinusitis (CRS). METHODS CRS patients were randomly divided into treatment group (conventional medications plus Eeucalyptol) and control group (conventional medications). The therapeutic effect of Eucalyptol were objectively and subjectively evaluated after treatment. RESULTS Evaluation at 3, 6 and 12 month after treatment, we found that the curative effect of the treatment group was better than that of the control group. There was a significant difference. CONCLUSION Eucalyptol as a kind of mucus dissolving medication, it has good treatment effect for CRS and is worth popularizing.

Recent Advances in Mitochondrial Proteomics / 分析化学

Mitochondria play a central role in the regulation of cellular energy metabolism, bio-synthesis and cell death. Dysfunction of mitochondria can lead to many diseases. Mitochondrial proteomics provides important theoretical foundation for a systematic understanding of the biological functions of mitochondria, studying the mechanisms of mitochondria-related diseases, and promoting the research and development of mitochondria-targeting drugs. The methodologies, recent technology development, and characteristics and applications of mitochondrial proteomics were reviewed and the challenges and prospects were also discussed.

Olfactory function in patients with idiopathic Parkinson's disease / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the correlation between olfactory bulb (OB) volume with depth of olfactory sulcus (OS) and olfactory function in patients with idiopathic Parkinson's disease (IPD).</p><p><b>METHODS</b>One hundred patients with IPD between January 2011 to December 2013 in Tianjin Huanhu Hospotal were compared with one hundred controls in terms of olfactory function T&T testing, OB volume and depth of OS assessed with Magnetic resonance imaging (MRI). One hundred IPD patients were investigated and estimated H-Y degrees, UPDRS, MMSE, MoCA. SPSS 13.0 software was used to analyze the data.</p><p><b>RESULTS</b>T&T olfactory testing revealed that IPD patients (3.0 ± 0.3) had higher scores than controls (1.3 ± 0.2, t = 2.537, P < 0.01). Both men and women with IPD were affected by the same extent of olfactory loss (t = 0.893, P > 0.05). Both men and women as controls were affected by the same extent of olfactory loss(t = 1.184, P > 0.05). OB volume of left side in IPD patients was (34.25 ± 5.14) mm(3), right side was (35.79 ± 5.28)mm(3), average OB volume was (35.28 ± 5.21) mm(3); OB volume of left side in controls was (47.38 ± 6.47) mm(3), right side was (47.75 ± 6.51) mm(3), average OB volume was (47.53 ± 6.49) mm(3); OB volume were lower in IPD patients as compared to controls (t value were 2.876, 2.747, 2.798, all P < 0.01). OS depth study revealed no statistical difference between IPD patients and controls (t value were 0.914, 0.987, 0.951, all P > 0.05). Olfactory discriminate threshold was negatively correlated with average OB volume in IPD patients and controls (r value were -0.537,-0.526, both P < 0.05); was no correlated with average depth of OS (r value were -0.142, -0.157, both P > 0.05). There was relation between the average OB volume and UPDRS III, UPDRS, the degree of H-Y in IPD patients (r value were 0.312, -0.419, -0.358, all P < 0.05). However the average OB volume was not related to the course of disease (r = -0.089, P > 0.05).</p><p><b>CONCLUSIONS</b>The OB volume is lower in IPD patients as compared to controls, the depth of OS have no significant changes in IPD patients; The OB volume is correlated with olfactory function, the depth of OS is not correlated with olfactory function; Olfactory function lower degree is accordance with serious degree in IPD patients, is not accordance with the course of disease.</p>

Analysis on influencing factor of the complications of percutaneous dilational tracheotomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To Analyze the influence factors on the complications of percutaneous dilational tracheotomy.</p><p><b>METHODS</b>Between August 2008 and February 2014, there were 3 450 patients with the indications of tracheotomy accepted percutaneous dilational tracheostomy, mainly using percutaneous dilational and percutaneous guide wire forceps in these cases. Statistical analysis was performed by SPSS 19.0 software on postoperative complications, the possible influence factors including age, gender, etiology, preoperative hypoxia, obesity, preoperative pulmonary infection, state of consciousness, operation method, operation doctor and whether with tracheal intubation.</p><p><b>RESULTS</b>Among 3 450 patients, there were 164 cases with intraoperative or postoperative complications, including postoperative bleeding in 74 cases (2.14%), subcutaneous emphysema in 54 cases (1.57%), wound infection in 16 cases (0.46%), pneumothorax in 6 cases (0.17%), mediastinal emphysema in 5 cases (0.14%), operation failed and change to conventional incision in 4 cases (0.12%), tracheoesophageal fistula in 2 cases (0.06%), death in 3 cases(0.09%).Obesity, etiology, preoperative hypoxia, preoperative pulmonary infection, state of consciousness and operation method were the main influence factors, with significant statistical difference (χ(2) value was 0.010, 0.000, 0.002, 0.000, 0.000, 0.000, all P < 0.05). Gender, age, operation doctor and whether there was the endotracheal intubation were not the main influence factors. There was no significant statistical difference (P > 0.05).</p><p><b>CONCLUSION</b>Although percutaneous dilational tracheostomy is safe, but the complications can also happen. In order to reduce the complications, it is need to pay attention to the factors of obesity, etiology, preoperative hypoxia, preoperative pulmonary infection, state of consciousness and operation method.</p>

A correlation study on olfactory bulb volumes with ages and olfactory function in healthy adults / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the correlation between olfactory bulb (OB) volumes and ages, as well as OB volumes and olfactory function in healthy adults.</p><p><b>METHODS</b>One hundred healthy subjects, without any diseases which might cause smell dysfunction were selected to participate in this study. The ages of the subjects ranged from 20 to 70, with the mean age of 42.6 ± 4.8. These subjects were scaned for olfactory function by T&T testing, OB volumes assessed with Magnetic resonance imaging (MRI). The correlation between OB volumes and ages as well as OB volumes and olfactory function in healthy adults was analyzed. SPSS 13.0 software was used to analyze the data.</p><p><b>RESULTS</b>The left and right OB volumes of men were (84.65 ± 7.11) mm(3) and (87.79 ± 7.57) mm(3), average OB volume was (86.14 ± 7.37) mm(3). The left and right OB volumes of women were (69.58 ± 4.72) mm(3) and (71.43 ± 5.29) mm(3), average OB volume was (70.22 ± 5.02) mm(3). OB volume study revealed no statistical difference between the left and right OB volumes of men (t = 1.024, P > 0.05). OB volume study revealed no statistical difference between the left and right OB volumes of women (t = 0.987, P > 0.05). OB volumes were lower in women as compared with men (t value were 3.742, 3.869 and 3.814, all P < 0.01). OB volumes were negatively correlated with ages in the subjects (r value were -0.588, -0.523, both P < 0.01). Olfactory discriminate threshold was negatively correlated with OB volumes in the subjects (r value were -0.624, -0.587, both P < 0.01).</p><p><b>CONCLUSIONS</b>This study revealed no statistical difference between the left and right OB volumes in healthy adults. OB volumes were lower in women as compared with men. As age went up, OB volume would become smaller. As olfactory function went down, OB volume would become smaller. OB volumes were expected to be a gauge of olfactory function.</p>

Acute pituitary apoplexy treatment through endoscopic endonasal transsphenoidal surgery / 中国耳鼻咽喉头颈外科

OBJECTIVETo discuss the operative techniques of endoscopic endonasal transsphenoidal surgery and perioperative management for treatment of acute pituitar y apoplexy (PA).METHODS A retrospective analysis was conducted on the clinical data of 51 pathologically diagnosed acute PA after transsphenoidal endoscopic endonasal resection at the TianJin HuanHu hospital between January 2000 and December 2013. There were 28 males and 23 females,with median age of 47 and disease course of 4h-7d.The typical clinical manifestations included headache, visual interference and pituitary dysfunction. CT scan, MRI scan and endocrinological examinations were performed in all cases before operation. Glucocorticoids were used during perioperatve period, The postoperation symptoms and the results follow-up visit after operation were recorded. RESULTS The tumors were totally removed in 42 cases and sub-totally removed in 9 cases without operative death and serious complications. The follow-up period was 1 year to 14 years. Of 47 patients with headaches before the operation, all patients were resolved after the operation; In 38 patients with sight disturbance before the operation,the sight was recovered very well in 34 patients after the operation. The visual field was recovered very well in all patients. Of 28 patients with endocrine disturbance before the operation, 22 were improved in endocrine symptom after the operation. No patient recurred.CONCLUSION The endoscopic endonasal transsphenoidal operation is safe and effective for treatment of acute PA.Appropriate perioperative management is important for the success of operation.

Olfactory bulb volume and depth of olfactory sulcus in olfactory dysfunction patients after upper respiratory tract infection / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the correlation between olfactory bulb (OB) volume, depth of olfactory sulcus (OS) and olfactory function in patients with olfactory dysfunction after upper respiratory tract infection.</p><p><b>METHODS</b>One hundred patients with olfactory dysfunction after upper respiratory tract infection (patient group) were compared with one hundred normal controls in terms of olfactory function T&T testing, OB volume and depth of OS assessed with magnetic resonance imaging (MRI). T&T testing and MRI were performed again after a year in patient group and the results were compared. SPSS 13.0 software was used to analyze the data.</p><p><b>RESULTS</b>T&T olfactory testing revealed that the patient group had higher scores than controls (t = 4.014, P < 0.05). Both men and women in patient group were affected by the same extent of olfactory loss (t value was 0.892, P > 0.05). Both men and women in control group were affected by the same extent of olfactory loss (t value was 1.011, P > 0.05). OB volume of left side in patient group was (38.14 ± 4.31) mm³, right side was (38.72 ± 4.22) mm³, average OB volume was (38.47 ± 4.27) mm³; OB volume of left side in controls was (51.65 ± 6.30) mm³, right side was (51.98 ± 6.34) mm³, average OB volume was (51.81 ± 6.32) mm³; OB volume was lower in patient group as compared with controls (t value were 4.233, 4.267 and 4.249, all P < 0.01). OS depth study revealed no statistical difference between patient group and control group (t value were 0.901, 0.948 and 0.927, all P > 0.05). Olfactory discriminate threshold was negatively correlated with OB volume in patient group and control group (r value were -0.598, -0.512, both P < 0.05) Olfactory discriminate threshold was not correlated with the depth of OS (r value were -0.152, -0.174, both P > 0.05). Olfactory discriminate threshold and OB volume were not correlated with the persistent time of the dysosmia in patient group (r value were -0.121, 0.139, both P > 0.05). Among 100 olfactory dysfunction patients after upper respiratory tract infection, when followed-up, 24 showed increased in OB volume and olfactory function after a year, but no statistical difference was found with the first time (t value were 0.894, 0.914, 0.942 and 0.931, all P > 0.05). The other 76 patients showed no significant changes of OB volume and olfactory function.</p><p><b>CONCLUSIONS</b>The OB volume was lower in patient group as compared with normal controls, the depth of OS showed no significant changes in patient group. The OB volume was correlated with olfactory function, the depth of OS was not correlated with olfactory function; Olfactory function had not correlated with the persistent time of the dysosmia in patient group.</p>

Olfactory function in patients with Alzheimer' disease / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the relationship between olfactory bulb (OB) volume, depth of olfactory sulcus (OS) and olfactory function in patients with Alzheimer' disease (AD).@*METHOD@#Fifty patients with AD patients and 50 healthy subjects were examined by olfactory function T&T testing, OB volume and depth of OS assessed with Magnetic resonance imaging (MRI).@*RESULT@#T&T olfactory testing revealed that AD patients had higher scores than control group (1.50 ± 0.17, 2.80 ± 0.31, P 0.05). Olfactory discriminate threshold was negatively correlated with average olfactory bulb volumes (r = -0. 711, P 0.05) in AD patients.@*CONCLUSION@#The OB volume were lower in AD patients as compare to controls, the depth of OS has no significant changes in AD patients; The OB volume is correlated with olfactory function, the depth of OS is no correlated with olfactory function. Cognitive impairment degree in AD patients is accordance with the lower degree olfactory function. The olfactory loss may be the earlier period and objective diagnosis indicator for AD patients.

Surgical treatment of pituitary apoplexy through endoscopic endonasal transsphenoida / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the transsphenoidal endoscopic endonasal approach for the surgical treatment of pituitary apoplexy (PA).@*METHOD@#A retrospective analysis was conducted over the clinical data of 42 pathologically diagnosed of PA after transsphenoidal endoscopic endonasal approach for the resection. CT scan, MRI scan and endocrinological examinations were performed in all case before operation. Glucocorticoids were used during perioperatve period. The postoperation symptoms and the results follow-up visit after operation were recorded.@*RESULT@#The tumors were totally removed in 36 cases and subtotally removed in 6 cases. In follow-up period from half a year to 13 years, headaches were resolved in 100%, visual interference were resolved in 91.9%, pituitary dysfunction were resolved in 77.3%. Without operative death and serious complications. No patient recurred.@*CONCLUSION@#We concluded that the transsphenoidal endoscopic endonasal approach is a safe, effective and microsurgery treatment of PA.

Rhino-orbito-cerebral mucormycosis: report of 9 cases / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To present the clinical characteristics and combination therapy of rhino-orbito-cerebral mucormycosis.</p><p><b>METHODS</b>The clinical data of 9 patients with rhino-orbito-cerebral mucormycosis treated between January 2008 and January 2013 were analyzed retrospectively. The clinical features, diagnosis, pathological characteristics, surgical technique and combination therapy were summarized. All the patients were treated with nasal endoscopic surgery and combined drug therapy.</p><p><b>RESULTS</b>Nine patients were under the state of systemic immunosuppression. Two patients died of intracranial infection. One patient with the symptom of headache was first alleviated after treatment, with visual acuity recovered partially, but this patient died 4 months later due to recurrence of mucormycosis and intracranial infection. Two patients with headache recovered after treatment, the visual acuity recovered to the hand movement, endoscopic examination of surgical cavity was clean and epithelialized, with no recurrence, still alive 5 years up to now. The symptom of headache in another 4 patients disappeared after treatment, visual acuity improved significantly, endoscopic surgical cavity was clean, follow-up with no recurrence, survived more than 2 years, and were still in the treatment of primary disease.</p><p><b>CONCLUSION</b>Rhino-orbito-cerebral mucormycosis is a serious chance infectious disease under the state of systemic immunosuppression, the development is rapid and the mortality rate is high, early diagnosis and combined treatment with nasal endoscopic surgery is necessary.</p>