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1.
Article in Chinese | WPRIM | ID: wpr-936233

ABSTRACT

Objective: To establish a three-dimensional model of middle ear-eustachian tube based on Chinese digital visual human dataset, and the deformation and pressure changes of the middle ear-eustachian tube system after eustachian tube opening are simulated by computer numerical simulation. Methods: The first female Chinese Digital Visual Human data was adopted. The images were imported by Amira image processing software, and the images were segmented by Geomagic software to form a three-dimensional model of middle ear-eustachian tube system, including eustachian tube, tympanum, tympanic membrane, auditory ossicles, and mastoid air cells system. The 3D model was imported into Hypermesh software for meshing and analysis. The structural mechanics calculation was carried out by Abaqus, and gas flow was simulated by Xflow. The tissue deformation and middle ear pressure changes during eustachian tube opening were numerically simulated by fluid-solid coupling algorithm. Several pressure monitoring points including tympanum, mastoid, tympanic isthmus, and external auditory canal were set up in the model, and the pressure changes of each monitoring point were recorded and compared. Results: In this study, a three-dimensional model of middle ear-eustachian tube and a numerical simulation model of middle ear ventilation were established, including eustachian tube, tympanum, mastoid air cells, tympanic membrane, and auditory ossicles. The dynamic changes of the model after ventilation could be divided into five stages according to the pressure. In addition, the pressure changes of tympanum and tympanic isthmus were basically synchronous, and the pressure changes of mastoid air cells system were later than that of tympanum and tympanic isthmus, which verified the pressure buffering effect of mastoid. The extracted pressure curve of the external auditory canal was basically consistent with that of tympanometry in terms of value and trend, which verified the effectiveness of the model. Conclusions: The numerical simulation model of middle ear-eustachian tube ventilation established in this paper can simulate the tissue deformation and middle ear pressure changes after eustachian tube opening, and its accuracy and effectiveness are also verified. This not only lays a foundation for further research, but also provides a new research method for the study of middle ear ventilation.


Subject(s)
China , Ear, Middle , Eustachian Tube , Female , Human Body , Humans , Middle Ear Ventilation
2.
Article in Chinese | WPRIM | ID: wpr-936171

ABSTRACT

Objective: Using propensity score matching method(PSM) to investigate the clinical effect of surgical plus radio(chemo)therapy and non-surgery chemoradiotherapy treatment strategies for advanced tonsillar squamous cell carcinoma. Methods: A retrospective analysis was conducted on the clinical data of 324 patients diagnosed with advanced tonsillar squamous cell carcinoma and treated in Peking Union Medical College Hospital from 2000 to 2018, confirmed by pathology and without distant metastasis. Survival analysis was performed using Kaplan-Meier estimates, the Cox proportional hazards model, and propensity score matching(PSM). Results: Of the 324 patients, 102 were treated with non-surgery chemoradiotherapy treatment strategies and 222 with surgical plus radio(chemo)therapy treatment. Cox multivariate analysis showed that the non-surgery treatment group had a favorable prognosis than the surgical treatment group, however, these outcomes were not significantly different [overall survival(OS): adjusted Hazard Ratios(aHR): 0.92, 95% confidence interval(CI): 0.60-1.42; disease-specific survival(DSS): aHR: 0.71, 95%CI: 0.43-1.20; disease-free survival(DFS): aHR: 0.82, 95%CI: 0.53-1.28]. The new patient cohort consisted of 102 subpairs after PSM. There were no significant differences between two groups(OS: aHR: 0.85, 95%CI: 0.51-1.40; DSS: aHR: 0.62, 95%CI: 0.35-1.11; DFS: aHR: 0.80, 95%CI: 0.49-1.33). Conclusion: Our findings indicate that patients with non-surgical treatment do not have significantly better survival outcomes compared to surgical treatment group, while non-surgical treatment has advantages in improving the quality of life of patients, so comprehensive treatment based on radiotherapy and chemotherapy may be recommended for advanced tonsillar squamous cell carcinoma.


Subject(s)
Carcinoma, Squamous Cell/therapy , Chemoradiotherapy , Humans , Quality of Life , Retrospective Studies , Tonsillar Neoplasms/therapy
3.
Article in Chinese | WPRIM | ID: wpr-942453

ABSTRACT

Objective: By summarizing the technical points and therapeutic outcomes of combing infratemporal fossa approach (IFA) and internal carotid artery (ICA) reconstruction for the colossal skull base tumor invading ICA in petrous bone, the clinical application value was discussed. Methods: Five patients (2 males, 3 females,aging from 27 to 55 years old) who received surgeries between July 2015 and May 2017 for lateral skull base pathology involved petrous ICA using technique combined IFA and pre-reconstruction, were reviewed. Results: Among the five patients, three were paraganglioma of head and neck, one was carotid aneurysms, and one was recurrent adenoid cystic carcinoma (ACC). The median tumor size in the largest cross-section was 60 mm × 51 mm (range, 28 mm × 22 mm-72 mm × 58 mm). Complete excision was achieved with IFA and ICA reconstruction. The median blood loss volume was 1 000 ml (range, 600-2 500 ml). Four cases showed no new long-term neurologic sequelae, while one showed hemiplegia due to graft vessel occlusion. Except for the one with ACC having facial nerve cut, others achieved good facial nerve function of HB grade Ⅰ to Ⅱ during 3 to 12 months, follow-up. No tumor recurrence was observed over the median duration of follow-up for above 36 months (range, 36-58 months). Conclusion: For lesions involved superior part of ICA, which is unable to separate from ICA, IFA and ICA reconstruction can achieve complete excision.


Subject(s)
Adult , Carotid Artery, Internal/surgery , Female , Humans , Infratemporal Fossa , Male , Middle Aged , Neoplasm Recurrence, Local , Petrous Bone/surgery , Skull Base/surgery , Skull Base Neoplasms/surgery
4.
Article in Chinese | WPRIM | ID: wpr-873106

ABSTRACT

Objective::To clone the complementary deoxyribonucleic acid (cDNA) of auxin/indole acetic acid protein (Aux/IAA) from Glycyrrhiza glabra (GgARPI) and analyze its sequence by bioinformatics. Method::RNA was extracted from fresh root of G. glabra, the cDNA sequence of GgARPI gene was cloned by reverse transcription polymerase chain reaction (RT-PCR), then sequencing and bioinformatic analysis were performed. Result::The GgARPI cDNA sequence with the full length of 686 bp was obtained from G. glabra. The full open reading frame (ORF) was 585 bp, encoding 194 amino acid residues. The bioinformatic analysis showed that the protein coded by GgARPI was a stable hydrophilic protein, with a relative molecular weight of 21.95 kDa and isoelectric point of 6.85.It contained no signal peptides or transmembrane domain. Its secondary structure mainly consisted of random coil. An Aux/IAA superfamily was included in the conversed domain. Homology analysis indicated that it had a close evolutionary relationship with leguminous plants, and a distant evolutionary relationship with monocotyledon, such as Setaria italica. Conclusion::GgARPI cDNA sequence is successfully cloned from G. glabra for the first time, which will lay a foundation for studying the function of GgARPI and explaining the molecular regulatory mechanism of biosynthesis of glycyrrhizic acid in G. glabra.

5.
Article in Chinese | WPRIM | ID: wpr-873000

ABSTRACT

Objective::To clone the cDNA sequence of UDP-glucose 4-epimerase (UGE) in Glycyrrhiza glabra and analyze its sequence, so as to explore the potential relationship between the UGE gene and the molecular regulatory mechanisms of glycyrrhizic acid biosynthesis. Method::The cDNA sequence of UGE was cloned from the root of G. glabra by reverse transcription polymerase chain reaction (RT-PCR), then sequenced and analyzed by bioinformatics software. Results::A GgUGE cDNA sequence with the full length of 1 121 bp was obtained. The open reading fame (ORF) of GgUGE was 1 053 bp, encoding 350 amino acid residues. The GgUGE cDNA sequence was submitted to GenBank, and the accession No. was MK638908. Sequence analysis showed that GgUGE was an unstable hydrophilic protein, its average relative molecular weight was 39.02 kDa, and isoelectric point was 6.13. It contained no signal peptides or transmembrane domains. Its secondary structure mainly constituted of α-helix and had a conversed domain of UDP-glucose 4-epimerase superfamily. The homologoue analysis showed that the cDNA and amino acid sequences of GgUGE had the closest evolutionary relationship to Leguminosae and relatively distant evolutionary relationship to Salicaceae. Conclusion::In this study, GgUGE cDNA sequence is successfully cloned from G. glabra for the very first time, which will provide reference for studying the function of GgUGE and explaining the molecular regulatory mechanisms of glycyrrhizic acid biosynthesis in G. glabra.

6.
Acta Pharmaceutica Sinica ; (12): 646-658, 2018.
Article in Chinese | WPRIM | ID: wpr-779919

ABSTRACT

Chinese pharmacopoeia stipulates that the content of liquiritin in licorice slices should be no less than 0.5%. However, there are lots of unqualified licorice slices in the herbal medicine markets. Due to the important role of functional gene polymorphism in secondary metabolism, this study attempts to analyze the influence of chalcone synthase (CHS) gene polymorphism on liquiritin biosynthesis and find out the unique haplotypes in licorice samples with high or low content of liquiritin, and to provide a basis for further analysis of molecular mechanism in flavonoid biosynthetic pathway. The contents of the 4 main flavonoids (liquiritin, isoliquiritin, liquiritigenin, isoliquiritigenin) in 60 licorice samples were assayed by HPLC and the results were analyzed by Spearman and χ2 tests. The contents of the 4 main flavonoids were related to each other and obviously different in different original plants. They were highest in Glycyrrhiza uralensis samples and lowest in Glycyrriza inflate samples. Five G. uralensis samples with the highest liquiritin contents and five G. inflate samples with the lowest liquiritin contents were selected to clone the CHS cDNA sequences. 336 CHS cDNA sequences with a full length of 1 175 bp were obtained, 249 variable sites (141 missense mutation sites) were found, and 137 haplotypes were determined. 130 variable sites were found in the 336 CHS amino acid sequences and 102 types were determined. AA-3 is the major type of CHS in licorice, AA-35 is the special major type of CHS in the group with high flavonoids contents and AA-36 is the special major type of CHS in the group with low flavonoids contents. The mutation sites between AA-35 and AA-36 are I/V at 193 and V/T at 229. Discovery Studio 2.5 analysis of the three-dimensional structure of the CHS protein shows that the valine at site 229 of AA-35 is combined with malonyl-CoA. Homology analysis indicates that the homology of CHS among different species is low. This study is significant for identification of the unique haplotypes in licorices with high or low content of liquiritin and guiding the further molecular breeding of high-quantity licorice.

7.
Basic & Clinical Medicine ; (12): 1042-1045, 2018.
Article in Chinese | WPRIM | ID: wpr-694033

ABSTRACT

Objective To explore SECTRA 3D real-time reconstruction of virtual simulation technology in the anat-omy teaching of otolaryngology. Methods Eighty medical students who have received traditional class teaching of otolaryngology anatomy joined the SECTRA 3D real-time reconstruction class to study the major anatomic knowledge of otolaryngology. Questionnaires and exams were provided for them before and after the SECTRA 3D real-time re-construction class. Results The test scores were 79.19±10.39 before 3D class and 87.69±10.25 after 3D class. After teaching, the scores improved significantly.Conclusions Application of SECTRA real-time reconstruction of 3D virtual simulation technology in otolaryngology anatomy teaching, can help medical students to master the ana-tomical knowledge better than the traditional class teaching and can stimulate their interests to learn otolaryngology anatomy.

8.
Basic & Clinical Medicine ; (12): 878-881, 2018.
Article in Chinese | WPRIM | ID: wpr-694002

ABSTRACT

Objective To apply three-dimensional(3D) printing techniques to the clinical anatomy teaching of otolar-yngology. Methods We reconstructed the three-dimensional models of temporal bones and paranasal sinuses based on CT scan data,and divided them into sub-models according to several interested planes on CT scan. Sub-models were printed with 3D printer.The CT images of interested planes were printed by normal printer and pasted to the appropri-ate sub-models. We also checked the accuracy of the anatomy models. Results We successfully made the digital and 3D printing models of temporal bones and paranasal sinuses. The CT scan images were compounded to the models. The key anatomy structures outside and inside of the temporal bone and paranasal sinuses can be shown clearly and exactly on the models. Conclusions The 3D printing models help the medical students to understand and master the clinical anatomy and radiology knowledge of otolaryngology as a supplement for traditional teaching methods.

9.
Basic & Clinical Medicine ; (12): 874-877, 2018.
Article in Chinese | WPRIM | ID: wpr-694001

ABSTRACT

Objective To investigate the application of standardized patients in the department of otolaryngology. Methods Two otolaryngology scripts were designed and four standardized patients were trained. Ten students were offered standardized patients teaching twice. Students' and clinical teachers' feedback, as well as objective grading for each student were analyzed. Results The performance scores for all the standardized patients were o-ver 4 points(1-5 points). Standardized patients and clinical teachers have a high degree of consistency in grad-ing the students. 70%(7/10) of the students considered standardized patients' immediate comment as the most benefits. Conclusions Well trained standardized patients are competent for the role of an actor,evaluator and in-structor in teaching and assessing students. The standardized patients as a teaching component should be promoted in otolaryngology.

10.
Article in Chinese | WPRIM | ID: wpr-301456

ABSTRACT

<p><b>OBJECTIVE</b>To assess the effectiveness and safety of intratympanic versus systemic steroid therapy in the initial treatment of idiopathic sudden hearing loss.</p><p><b>METHODS</b>An extensive search of the literature was performed in Pubmed and other available database from January, 1980 to November, 2011. After filtering by the criteria of Cochrane Collaboration, a meta-analysis was conducted.</p><p><b>RESULTS</b>Nine studies met the criteria for meta-analysis, for idiopathic sudden hearing loss patients without diabetes received intratympanic steroid therapy, the improvement rate (RR = 1.11,95% CI = 0.96-1.28, P = 0.15) did not show any significance when compared with the patients received systemic therapy. While a significant difference of improvement rate occurred between intratympanic and systemic steroid therapy in the idiopathic sudden hearing loss patients with diabetes (RR = 1.24, 95% CI = 1.02-1.50, P = 0.03).</p><p><b>CONCLUSION</b>For the initial therapy of idiopathic sudden hearing loss patients without diabetes, systemic steroid treatment still remains the first choice, but for the idiopathic sudden hearing loss patients with diabetes, intratympanic steroid treatment should be used for the initial treatment.</p>


Subject(s)
Administration, Oral , Audiometry, Pure-Tone , Dexamethasone , Therapeutic Uses , Hearing Loss, Sensorineural , Drug Therapy , Hearing Loss, Sudden , Drug Therapy , Humans , Methylprednisolone , Steroids , Therapeutic Uses , Treatment Outcome , Tympanic Membrane
11.
Article in Chinese | WPRIM | ID: wpr-315829

ABSTRACT

<p><b>OBJECTIVE</b>To explore the health related quality of life (QOL) status of patients with peripheral facial paralysis.</p><p><b>METHODS</b>By introducing, translating and adjusting of the FaCE (Facial Clinimetric Evaluation) scale, a Chinese version came into being. The scale was further strictly tested in eighty-one patients with peripheral facial paralysis and thirty healthy volunteers.</p><p><b>RESULTS</b>The feasibility, reliability, validity and responsibility of Chinese version of FaCE scale all passed the test. The split-half reliability, Cronbach's alpha and intraclass correlation coefficient were 0.79, 0.88 and 0.87, respectively. The criteria validity calculated between FaCE and SF-36 was 0.41 (P < 0.05). Factor analysis of the construct validity showed that the 15 items were classified into six domains, which were in accordance with the original version. Every domain was sensitive and effective to discriminate between patient population and healthy population (P < 0.05). Chinese version of FaCE scale showed significant correlation with HBGS and SBGS scores (r = -0.40 and 0.42, P < 0.05).</p><p><b>CONCLUSION</b>Chinese version of the FaCE scale can effectively assess QOL status of patients with facial paralysis in China.</p>


Subject(s)
Adolescent , Adult , Aged , Facial Paralysis , Humans , Middle Aged , Quality of Life , Surveys and Questionnaires , Young Adult
12.
Article in Chinese | WPRIM | ID: wpr-315750

ABSTRACT

<p><b>OBJECTIVE</b>To summarize the clinical features of extraorbital inflammatory myofibroblastic tumor (IMT) of the head and neck.</p><p><b>METHODS</b>Fourteen cases of extraorbital IMT treated in recent 20 years were analyzed retrospectively.</p><p><b>RESULTS</b>Of the 14 patients, 9 cases with limited lesion in maxilla (n = 5), mandible (n = 2) or neck (n = 2) underwent local resection, and no recurrences were found after 1.5 to 20.0 years; 3 cases diagnosed as maxillary IMT involved in orbit, hard palate or pterygopalatine fossa received conservative therapy (prednisone, prednisone plus radiotherapy or prednisone plus chemotherapy), and no disease progression was found after 6, 9 or 2 years respectively; and 1 case diagnosed as maxillary IMT involved in orbit and pterygopalatine fossa was confirmed with cervical metastases after two operations and died of brain invasion within 17 months. One patient with localized lesion around the common carotid artery was treated with prednisone and had no disease progression with a 2-year follow-up.</p><p><b>CONCLUSIONS</b>Extraorbital IMT of the head and neck is a rare clinical entity. Pathology examination is required for final diagnosis. Corticosteroid administration may be a choice of treatments, and radical resection should be taken selectively for limited lesions.</p>


Subject(s)
Head and Neck Neoplasms , Diagnosis , Epidemiology , Humans , Neoplasms, Muscle Tissue , Diagnosis , Epidemiology , Retrospective Studies
13.
Article in Chinese | WPRIM | ID: wpr-271673

ABSTRACT

<p><b>OBJECTIVE</b>To discuss the skin complications of 16 cases received bone-anchored hearing aid (BAHA) implantations, and the clinical experience for prevention and treatment skin complications following BAHA.</p><p><b>METHODS</b>Retrospective review 16 patients who received BAHA implantation from December 2010 to March 2013, and summarize the complications and treatment.</p><p><b>RESULTS</b>Four patients (1/4) suffered from skin complications. According to Holgers classification, two patients (1/8) had a Holgers Grade 1-2 skin reaction and cured by local application of antibiotics. Two patients (1/8) experienced Holgers Grade 3 skin reaction received revision surgeries for excessive soft tissue growth. One patient replaced the BAHA abutment with a longer 9.0mm one.</p><p><b>CONCLUSIONS</b>Infection and skin overgrowth around the abutment was the common complications of BAHA implantation. Standardize the peri-operative managements, and clean the skin regularly would prevent the skin complication. Additional surgical intervention should be applied timely in the cases of severe complications.</p>


Subject(s)
Adolescent , Adult , Child , Female , Hearing Aids , Humans , Male , Postoperative Complications , Retrospective Studies , Skin Diseases , Young Adult
14.
Article in Chinese | WPRIM | ID: wpr-262462

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinical features, pathology and treatment of a rarely seen laryngeal lesion, the vocal fold bamboo nodes.</p><p><b>METHODS</b>Two patients with vocal fold bamboo nodes were retrospectively reviewed. The clinical features, pathology and treatment were presented.</p><p><b>RESULTS</b>Video laryngoscope examination showed bilaterally creamy yellow transverse band like deposits in the submucosa, which were the typical vocal fold bamboo nodes in patients with autoimmune disease. Immunofluorescence pathology showed IgA, C1q and IgM deposition in lamina propria. Both patients were initially treated with oral hormones and one patient subsequently underwent submucosal resection of the lesion. The results of pathological and immunofluorescence investigations were reported in this paper, together with a discussion of the relevant literature.</p><p><b>CONCLUSIONS</b>Vocal fold bamboo node is a special laryngeal lesion in patients with autoimmune disease. The pathological results showed immune complexes in the vocal fold lamina propria. A surgical intervention can be applied if steroid drugs are not effective or the dysraphism of the vocal folds exists due to the bamboo nodes.</p>


Subject(s)
Adult , Autoimmune Diseases , Pathology , Female , Humans , Laryngeal Diseases , Diagnosis , Pathology , Therapeutics , Laryngoscopy , Retrospective Studies , Vocal Cords , Pathology , Young Adult
15.
Chinese Medical Journal ; (24): 4449-4453, 2012.
Article in English | WPRIM | ID: wpr-331355

ABSTRACT

<p><b>BACKGROUND</b>The cochlear hydrops analysis masking procedure (CHAMP) is a new diagnostic technique for Meniere's disease (MD). But its value has not been well proven. This study aimed to evaluate the diagnostic value of CHAMP for MD.</p><p><b>METHODS</b>CHAMP test was taken in three populations using the Auditory Evoked Potential system delivered by Bio-logic Systems Corporation: (1) otologically normal subjects; (2) patients clinically diagnosed with definite MD; (3) patients clinically diagnosed with probable and possible MD.</p><p><b>RESULTS</b>According to the comparison between the normal and definite MD group, if the abnormal criterion of CHAMP was defined as latency delay less than 0.3 ms, then the corresponding sensitivity was only 52%. However, if the abnormal criterion was defined as latency delay between 0.6 and 3.8 ms, then a sensitivity of 93% and a specificity of 100% can be achieved. The complex amplitude ratio showed a significant overlap between normal and definite MD group. If the abnormal criterion was defined as a complex amplitude ratio less than 0.95, the corresponding specificity was only 50%. However, if the abnormal criterion was defined as less than 0.80, the corresponding sensitivity was 60%, and the specificity was 97%. If the abnormal criterion of CHAMP was defined as latency delay less than 0.6 ms or the complex amplitude ratio less than 0.80, CHAMP result can be obtained in all subjects with good sensitivity and specificity.</p><p><b>CONCLUSIONS</b>CHAMP can differentiate patients with Meniere's disease from otologically normal subjects with high sensitivity and specificity. The recommended criterion of abnormal CHAMP was a latency delay less than 0.6 ms or a complex amplitude ratio less than 0.80.</p>


Subject(s)
Adolescent , Adult , Aged , Audiometry, Evoked Response , Endolymphatic Hydrops , Diagnosis , Female , Humans , Male , Meniere Disease , Diagnosis , Middle Aged , Young Adult
16.
Article in Chinese | WPRIM | ID: wpr-313586

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the efficacy and satisfaction of bone-anchored hearing aids (BAHA) in patients with outer and middle ear deformities.</p><p><b>METHODS</b>Seven patients with bilateral microtia and aural atresia, and three patients with unilateral microtia and bilateral middle ear malformation were fitted with soft-band BAHA for a few months, followed by receiving unilateral BAHA implantation. Mean pure-tone thresholds and speech audiometry tests results were compared among patients without hearing aid, with soft-band BAHA, and with implanted BAHA. Scores from the BAHA users' questionnaires and Glasgow children's benefit inventory (GCBI) were used to measure patient satisfaction and subjective health benefit.</p><p><b>RESULTS</b>The mean pure-tone thresholds of the patients were (64.8 ± 5.9) dBHL for those without hearing aid, (30.2 ± 3.7) dBHL for those with soft-band BAHA, and (20.3 ± 3.9) dBHL for those with implanted BAHA. The average decline in pure-tone threshold was (36.2 ± 8.0) dBHL for those with soft-band BAHA, and an additional decline of (12.2 ± 3.4) dBHL was achieved with implanted BAHA. The average gains in speech discrimination scores (SDS) were (3.00 ± 1.07)% for those without hearing aids and (89.39 ± 5.83)% for those with implanted BAHA in sound field of 45dBHL. SDS were (57.55 ± 10.30)% for those without hearing aids and (91.19 ± 4.16)% for those with implanted BAHA in sound field of 65dBHL. The average gains in SDS were (88.21 ± 6.86)% and (38.04 ± 7.56)% tested with 45dBHL and 65dBHL respectively. Sound reception thresholds (SRT) without hearing aids were (63.1 ± 5.9) dBHL and (24.7 ± 3.5) dBHL for those with implanted BAHA. The average gains in SRT was (39.6 ± 6.2) dBHL. The BAHA application questionnaire demonstrated excellent patient satisfaction. The general benefit score was 35.59 ± 14.35.</p><p><b>CONCLUSION</b>BAHA remains one of the most reliable methods of auditory rehabilitation and improves quality of life for patients with ear deformities.</p>


Subject(s)
Adolescent , Adult , Auditory Threshold , Child , Ear Auricle , Congenital Abnormalities , Ear, Middle , Congenital Abnormalities , Female , Hearing Aids , Humans , Male , Patient Satisfaction , Treatment Outcome , Young Adult
17.
Article in Chinese | WPRIM | ID: wpr-316611

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the diagnosis and treatment of facial nerve schwannomas with facial nerve function House-Brackmann grade (HB) ≤ grade II.</p><p><b>METHODS</b>A retrospective study was conducted in Peking Union Medical College Hospital. We reviewed eight cases of facial nerve schwannomas with facial nerve function HB ≤ grade II, which were diagnosed and managed between Jan 1996 and March 2011.</p><p><b>RESULTS</b>The initial presenting symptoms of the eight patients were not facial paralysis. Eight patients were misdiagnosed and six had mistreatment histry. CT and(or) MRI results in all patients showed that the tumors originated from different part of the facial nerves. All patients received operation. Facial nerves were completely preserved in four patients because of easy separation of the tumors from the facial nerves in surgery, facial function was gradeII-III over 17 - 180 months' follow-up. The tumors were attached with the facial nerves in two patients with wide extension involving cochlea and labyrinth, therefore the tumors were removed together with the attached facial nerves, and the nerves were repaired by using the greater auricular nerves. Facial function was grade VI over 56 - 79 months' follow-up. One patient refused to sacrifice the facial nerve, wide decompression of facial nerve and tumor was undertaken, facial function was grade III over 8 months' follow-up. One chorda tympani neuroma was removed with the branch of the facial nerve, facial function was grade II over 8 months' follow-up.</p><p><b>CONCLUSIONS</b>The facial nerve schwannomas with facial nerve function HB ≤ grade II is difficult to diagnosis. The therapy strategy should depend on the patients' choice, position of the tumor and adherences of the tumor to facial nerve. Facial nerve could be preserved if the tumor is easy to be separated from the facial nerve during operation, if not, total remove the tumor and nerve repairment are indicted when invasion into the inner ear canal, cerebro pontine angle, cochlea or labyrinth. If patients refuse to sacrifice the facial nerve, facial nerve decompression and periodic follow-up are recommended.</p>


Subject(s)
Adult , Diagnostic Errors , Facial Nerve , Pathology , Facial Paralysis , Diagnosis , General Surgery , Female , Humans , Male , Middle Aged , Neurilemmoma , Diagnosis , General Surgery , Retrospective Studies , Young Adult
18.
Article in Chinese | WPRIM | ID: wpr-322480

ABSTRACT

<p><b>OBJECTIVE</b>To study the apoptosis of facial motor neurons and the expression of apoptosis-related genes, Bcl-2 and Bax, in the animal model of viral facial paralysis.</p><p><b>METHODS</b>Total of 84 Balb/c mice were divided into viral inoculation group and nerve transaction group. The animals were executed 1, 3, 7, 10, 15, 20 and 30 days after being operated respectively. The histopathological features of facial neurons in brain stem were observed by HE and Nissl stain. The changes of facial neuronal apoptosis were observed by TUNEL. The changes of expression of Bcl-2 and Bax genes in facial neurons were observed by immunohistochemistry staining.</p><p><b>RESULTS</b>After nerve transection, increased apoptotic cells were found in homolateral facial motor nucleus and the peak appeared at 10 and 15 days. The level of Bcl-2 expression in neurons declined while the expression of Bax increased gradually. Correspondingly, the ratio of Bcl-2/Bax declined. In the viral inoculation group, no visible change of apoptosis and Bax expression, but the level of Bcl-2 and the ratio of Bcl-2/Bax increased gradually.</p><p><b>CONCLUSIONS</b>Comparing to axotomy, facial motor nucleus in HSV-1 infective animal model are free of apoptosis. Both the mild form of lesion and the ability to block apoptosis of HSV-1 are likely to be involved into the phenomenon. Bcl-2 and Bax might interfere with the apoptotic response.</p>


Subject(s)
Animals , Apoptosis , Facial Paralysis , Pathology , Virology , Female , Herpesvirus 1, Human , Virulence , Mice , Mice, Inbred BALB C , Neurons , Pathology , Proto-Oncogene Proteins , Metabolism , Proto-Oncogene Proteins c-bcl-2 , bcl-2-Associated X Protein , Metabolism
19.
Article in Chinese | WPRIM | ID: wpr-250252

ABSTRACT

<p><b>OBJECTIVE</b>To study the characteristic of the cochlear hydrops analysis masking procedure (CHAMP) in normal adults, and to evaluate the diagnostic values of its parameters for membranous labyrinth hydrops.</p><p><b>METHODS</b>Twenty otologically normal adults were recruited (male:female = 10:10), and their auditory brainstem responses (ABR) were obtained to six stimulus conditions using Bio-logic auditory evoked potential system: clicks presented alone (unmasked condition) and clicks presented with ipsilateral pink noise high-pass filtered at 8, 4, 2, 1, and 0.5 kHz respectively.</p><p><b>RESULTS</b>The wave V latency of ABR to the high-pass masking pink noise clicks were longer than ABR to clicks alone. The latency delays of wave V for clicks presented with ipsilateral pink noise high-pass filtered at 8, 4, 2, 1, and 0.5 kHz compared to clicks alone were (0.30 ± 0.18), (0.97 ± 0.43), (1.65 ± 0.64), (3.21 ± 0.56), (4.66 ± 0.37) ms respectively. The complex amplitude ratio between ABR to click + 0.5 kHz high-pass noise and click alone was 0.95 ± 0.11.</p><p><b>CONCLUSIONS</b>CHAMP is a promising diagnostic method for membranous labyrinth hydrops, and the latency delay of wave V might be used as the normal criterion. The specificity of the complex amplitude ratio need further evaluation in clinical work.</p>


Subject(s)
Adolescent , Adult , Endolymphatic Hydrops , Diagnosis , Evoked Potentials, Auditory, Brain Stem , Female , Humans , Male , Noise , Perceptual Masking , Young Adult
20.
Chinese Medical Journal ; (24): 301-304, 2010.
Article in English | WPRIM | ID: wpr-314594

ABSTRACT

<p><b>BACKGROUND</b>The main risk factors for postoperative failure in tympanoplasties are large perforations that are difficult to repair, annular perforations, and a tympanic membrane (TM) with extensive granular myringitis that require middle ear exploration and mastoidectomy. The aim of this study was to investigate a novel technique of perichondrium/cartilage composite graft for repairing the large TM perforation in the patient of otitis media.</p><p><b>METHODS</b>Retrospective chart reviews were conducted for 102 patients with large tympanic membrane perforations, who had undergone tympanoplasty from August 2005 to August 2008. Tympanoplasty or tympanomastoidectomy using a perichondrium/cartilage composite graft was analyzed. The tragal or conchal perichondrium/cartilage was used to replace the tympanic membrane in patients.</p><p><b>RESULTS</b>Patients aged from 13 to 67 years were followed up in average for 24 months (10 - 36 months). Seventy-four ears (72.61%) were used the tragal perichondrium/cartilage as graft material and 27 ears (27.39%) were used the conchal perichondrium/cartilage. Graft take was successful in all patients. Postoperative complications such as wound infection, hematoma, or sensorineural hearing loss were not identified. Nine patients (8.82%) had the partial ossicular replacement prosthesis, 14 patients (13.72%) using the autologous curved incus and 79 patients (77.45%) without prosthesis. Successful closure occurred in 92% of the ears. A total of 85.8% patients achieved a postoperative hearing improvement.</p><p><b>CONCLUSIONS</b>The graft underlay tympanoplasty using perichondrium/cartilage composite is effective for the majority of patients with large perforation. The hearing was improved even if the mastoidectomy was required in the patients with otitis media with extensive granulation.</p>


Subject(s)
Adolescent , Adult , Aged , Cartilage , Transplantation , Female , Hearing Loss , General Surgery , Humans , Male , Middle Aged , Otitis Media , Retrospective Studies , Treatment Outcome , Tympanic Membrane Perforation , General Surgery , Tympanoplasty , Methods , Young Adult
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