Expression of NKCC1 and Na-K-ATPase in C57BL/6J mice with age-related hearing loss / 中国耳鼻咽喉头颈外科

OBJECTIVE Disturbance of K+ ion balance in inner ear is associated in age-related hearing loss. Our study is to investigate the role of NKCC1 and Na-K-ATPase in cochlea and auditory function regulated by with different expression of NKCC1 and Na-K-ATPase. METHODS Auditory threshold of young or old C57BL/6J mice was measured by auditory brainstem response(ABR). The expression of NKCC1 and Na-K-ATPase in mice cochlea were evaluated by reverse transcription polymerase chain reaction(RT-PCR) and western blotting. Furosemide and Ouabain were applied in vivo to inhibit NKCC1 and Na-K-ATPase in C57BL/6J mice. RESULTS C57BL/6J mice developed hearing loss at 12M by ABR threshold shifting to (75±10), (78±26) and (81±14)dB SPL at frequencies of 8, 16 and 32 kHz; PCR showed that the relative expression of NKCC1 and Na-K-ATPase mRNA in the aged group decreased, which were 0.52±0.06 and 0.35±0.04 times higher than those in the young control group, the difference was statistically significant(t =7.466 and 16.11, all P＜0.05). WB showed that relative expression of NKCC1 and Na-K-ATPase protein level in the aged group decreased by 0.79±0.02 and 0.68±0.05 times as much as that of the young control group, the difference was statistically significant(t =8.857 and 6.771, P all＜0.05). After applied with Furosemide and Ouabain to suppress the two ion transporters, the ABR threshold increased to (50±17), (53±21), (55±17)dB SPL and (56±6), (70±17), (73±6)dB SPL at frequencies of 8, 16 and 32 kHz. CONCLUSION In vivo experiment of C57BL/6J suggested that NKCC1 and Na-K-ATPase might be related to age related hearing loss.

Effectiveness of music combined cognitive behavior therapy on subjective tinnitus and observation of changes of resting-state EEG / 中国耳鼻咽喉头颈外科

OBJECTIVE To invest igate the therapeutic effects of music combined cognitive behavioral therapy on subjective tinnitus and the changes in spectral characteristics of resting electroencephalogram(EEG) before and after treatment under eyes closed condition. METHODS 8 patients with subjective tinnitus were enrolled as experimental group including 4 males and 4 females, with a mean age of 33.57±8.52 years from 18 to 40 years, 6.00±3.63 months of illness and right-handedness. Music combined cognitive behavioral therapy included a total of 6 sessions of treatment. The initial session of the treatment aimed to establish basic trust with the patient and understand the patient's personality, tinnitus symptoms, medical history, and other basic conditions. The light music which was specially processed by mactching the frequency and intensity to the patient's tinnitus were selected as combined audio of cognitive behavioral therapy. 7 minutes of closed-eye resting state EEG, THI scale, VAS scale, and SAS scale of the patients with subjective tinnitus were collected. The last 5 sessions was a tailored relaxation therapy including training and counseling patients to understand the treatment feedback after each meeting. After 3 months of the therapy, 7 minutes of EEG, THI, VAS and SAS scales of the 8 patients were asessed. The results of 7min-EEG, THI, VAS, and SAS scales were compared in patients with tinnitus before and after treatment. In addition, 8 patients with normal hearing and without tinnitus were enrolled as control group including 4 males and 4 females, with a mean age of 21.26±7.56 years from 20 to 45 years and right-handedness. The control group underwent 7 minutes of EEG examination. RESULTS The difference between the two groups before treatment was statistically significant(t =4.404, P <0.05). The full-band(0.5-44 Hz) energy of EEG before and after treatment in 8 patients with subjective tinnitus was statistically significant(t =3.705, P <0.05), and the average power of EEG after treatment in the experimental group and the control group was similar. The THI scale(t =3.664, P <0.05) and VAS scale(t =3.265, P <0.05) were compared before and after treatment and the difference was statistically significant. The difference of SAS scales between the two groups was not statistically significant(P >0.05). CONCLUSION Music combined with cognitive behavioral therapy has a significant effect on subjective tinnitusand the closed-eye resting state of brain power can show the recovery of subjective tinnitus of patients objectively which has significance for rehabilitation.

A multi-center clinical retrospective study on the therapeutic effect of endoscopic myringoplasty / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze the therapeutic effect of endoscopic myringoplasty.@*Methods@#A retrospective analysis of 523 patients with chronic otitis media who underwent endoscopic myringoplasty between June 2016 and June 2017 in eight tertiary hospitals in China. Among all the patients, 256 were male and 267 were female, aged from 18 to 68 years old. The grafts used to repair the tympanic membrane were all tragus cartilage-perichondrium complex. All patients were followed up at 1 month, 3 months, 6 months, 9 months, and 12 months after surgery, at least 3 months. The closure rate of tympanic membrane perforation by different factors, the hearing results, and the incidence of postoperative complications were analyzed. SPSS 21.0 software was used to analyze the data.@*Results@#Three months after operation, the closure rates of anterior, inferior, posterior and subtotal perforation were 92.4% (109/118), 94.9% (93/98), 95.6% (129/135), and 89.0% (153/172) respectively, the difference was not statistically significant (χ2=5.779, P=0.123). The closure rates of small, medium and large perforations were 100.0% (82/82), 93.7% (178/190) and 89.2% (224/251) respectively. The difference was statistically significant (χ2=10.927, P=0.004). The closure rates of dry ear and wet ear tympanic membrane perforation were 93.1% (392/421), 90.2% (92/102), the difference was not statistically significant (χ2=1.011, P=0.915). The preoperative pure tone audiometry(PTA) was (38.4±5.3) dBHL, while, the 3-month postoperative PTA was (25.1±5.7) dBHL. The difference was statistically significant (t=39.079, P<0.001). The preoperative air bone gap (ABG) was (22.4±4.3) dB, while 3 months postoperative ABG was (9.1±3.8) dB. The difference was statistically significant (t=53.004, P<0.001). Of all 523 patients, 14 (2.7%) had middle ear infection, 8 (1.5%) had dislocated tympanic membrane, 12 (2.3%) had parageusia, 35 (6.7%) had tinnitus, 28 (5.4%) had hearing loss, 26 (5.0%) had vertigo,33 (6.3%) had reperforation, 2 (0.4%) had secondary cholesteatoma, and none had facioplegia.@*Conclusions@#Endoscopic myringoplasty is a safe and effective surgical method with good postoperative outcome.

Efficacy of autologous fat injection to treat patulous Eustachian tube / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the efficacy of autologous fat injection of eustachian tube pharyngeal orifice in the treatment of Patulous eustachian tube (PET). METHODS We selected 18 patients who had no obvious improvement after medical treatment of PET over 1 months. They were treated with autologous fat injections to narrow the pharyngeal ostium of the eustachian tube. The treatment results were documented, including the patient's supervisory feeling and visual analogue scale (VAS). RESULTS The total effective rate was 83.3％ after 12 months of follow-up (symptoms significantly reduced in 27.8％ of patients and partial improvement is 55.6％), 16.7％ the symptoms remain unchanged, no one worsened. No patients had any complications. CONCLUSION Autologous fat injection of the eustachian tube is a effective and safe treatment for PET with the percentage of significant or partial relief of 83.3％, It is easy to conduct in clinical practice which could potentially serve as an alternative treatment for PET.

The Pure Tone Audiometry and Auditory Brainstem Response in Patients with Small Acoustic Neuroma's / 听力学及言语疾病杂志

Objective To understand the characteristics of the hearing loss in patients with small acoustic neuroma .Methods A retrospective analysis was used to analyze the results of pure tone audiometry (PTA) and au-ditory brainstem response (ABR) in 35 patients (35 ears) diagnosed with small acoustic neuroma .The types of au-diometric curves ,degrees and frequencies of hearing loss and latent periods of ABR were analyzed .Results Moder-ate deafness was the most common type in this study ,with a total of 13 ears (37 .14％ ,13/35) .In addition ,8 ears were profound deafness (22 .86％ ,8/35) ,7 ears of binaural severe deafness (20 .00％ ,7/35) ,6 ears of mild deafness (17 .14％ ,6/35) ,and 1 normal ear (2 .86％ .1/35) ,respectively .The types of audiometric curves were mainly U -shaped and sloping .15 audiometric curves were U -shaped (42 .86％ ,15/35) ,15 sloping (42 .86％ ,15/35) ,3 flat (8 .57％ ,3/35) ,and 1 tent-shaped (2 .86％ .1/35％ ) .The main frequencies of hearing loss were 1 kHz ,2 kHz ,4 kHz ,and 8 kHz .The mean thresholds had statistically significant differences (P<0 .05) compared with the other frequencies by S -N -K test .ABR was abnormal in 32 ears(91 .43％ ,32/35) .20 of the ears'I - V waves were prolonged or the inter-aural latency difference of V wave was>0 .4 ms .Five ears failed to show any ABR wave , but their 4 kHz pure tone threshold was < 80 dB HL .25 (71 .43％ ,25/35)ears'ABR results indicated a retroco-chlear nature of ear disease .Conclusion Moderate deafness is the most common type of hearing loss in small acous-tic neuroma patients ,but only 71 .43％ of the patients'ABR indicate a retrocochlear disease ,so an analysis of PTA together with ABR will help to diagnose .

Estimation of spectral oscillatory power of resting-state EEG in subjective tinnitus / 中国耳鼻咽喉头颈外科

OBJECTIVE To explor e the characteristics of spectral oscillatory power of resting-state electroencephalography(EEG) in subjective tinnitus patients and to lay the foundation for study of central mechanism of tinnitus.METHODS 31 subjects(15 subjects with subjective tinnitus and 16 age matching healthy subjects) underwent a 128-channel resting-state EEG analyses. After a series of preprocessing, data were segmented into 8 frequency bands, including δ(0.5～3.5 Hz), θ(4～7.5 Hz), α1(8～10 Hz), α2(10～12 Hz), β1(13～18 Hz), β2(18.5～21 Hz), β3(21.5～30 Hz) and γ(30.5～44 Hz). The group differences of spectral power were analyzed by independent t test. Correlation between spectral power of each frequency band and tinnitus subjective symptoms were also analyzed. RESULTS Significant higher spectral power of the α1, β and γ bandwere found in the left and right temporal areas of tinnitus group compared with that of normal group.Tinnitus subjects also had higher spectral powerof the δ and θ band in temporo-parietal areas than that of the normal group. There was no significant difference of spectral power in other frequency bands. Moreover, signif icant positive cor relation were found between tinnitus loudness and spectralpower of right anterior lateral(R=0.66, P =0.007) and right anterior medial(R=0.58, P =0.031) areas. CONCLUSION Tinnitus subjects have higher spectral oscillatory power on right and left temporal lobe and temporo-parietal area. A positive correlation exsit between tinnitus loudness andspectral power of right anterior lateral and medial areas in tinnitus subjects, whichindicate that central reorganizationexsit in tinnitus reorganization andγ band maybe considered as a possible biomarkerforthe tinnitus subjective symptom.

Clinical Characteristics of Tinnitus:An Analysis of 2 171 Patients / 听力学及言语疾病杂志

Objective To evaluate and characterize tinnitus patients, and provide profiles for further studying tinnitus.Methods This study included 2 171 tinnitus patients seeking treatment between Janurary 2014 and December 2015 from department of head and neck surgery,Sun Yixian Memorial Hospital,Zhongshan University.Tinnitus measurements consisted of pure tone audiometry and tinnitus matching procedures.The characteristics of tinnitus were analyzed by the essential information and auditory checks of the patients.Results Average age was 44.08±15.37 years old.Tinnitus frequently occurred between 41 to 50 years old(491 cases,22.60%).Unilateral tinnitus was more than bilateral tinnitus, while the cranial tinnitus was rare.The patients with mild or moderate tinnitus had the largest population,with higher average hearing threshold at 8 000 Hz in tinnitus ear than non tinnitus ear.The highest frequency of tinnitus matching frequency was high frequency(4~8 kHz).The first three causes for tinnitus were unknown reasons,sudden deafness and middle ear disease.Conclusion Larger population was subjective tinnitus.Tinnitus was closely related with hearing loss.The causes for tinnitus were complex.Tinnitus retraining therapy is a treatment that is worth to be popularized.

Effectiveness of ear molding in the treatment of congenital auricular deformation / 中国耳鼻咽喉头颈外科

OBJECTIVE To evaluate the short-term efficacy of ear molding in the treatment of congenital auricular deformation. METHODS Twenty-four infants(twenty-eight ears) were treated with ear molding devices(EarWell Infant Ear Correction System). Doctors and parents were surveyed 1 months after treatment. RESULTS All cases were treated successfully without severe complications. 25 ears(89％) and 26(92％) were rated as very satisfied or satisfied by doctors and parents, respectively. CONCLUSION Ear molding is a noninvasive treatment, and effectively corrects congenital auricular deformation.

Clinical analysis of 54 cases of jugular foramen tumors with surgical treatment / 中华显微外科杂志

Objective To summarize the condition of surgical treatment and prognosis of 54 cases of jugular foramen tumors in the past 5 years.Methods All 54 cases were treated with operation by Fisch approach.Thirty-eight cases underwent total or near total resection of the tumor.Most resection of the tumor was underwent in 16 cases,in which,7 cases underwent postoperative radiotherapy or gamma knife therapy.The facial nerve monitoring was used in all cases.The facial nerve was anatomized and shifted in 35 cases,was just anatomized like a bridge in 10 cases,and was excised partly in 9 cases,in which,4 cases underwent facial-hypoglossal nerve anastomosis and 3 cases underwent transplantation of facial nerve and great auricular nerve.Results The external auditory canal was closed in 41 cases.The near pedicled temporalis muscle flap was obliterated in the operating cavity in 35 cases.Six cases underwent fat filling in the operating cavity.Eighteen patients showed facial palsy in varying degrees after operation.Among them,14 cases improved to different extents in 2 weeks to 9 months and 4 cases did not improve.One case showed recurrent laryngeal nerve paralysis in the same side before operation and improved in half a year after operation.Postoperative subcutaneous hematoma occurred in 2 cases,wound infection in 1 case.All the cases improved by debridement suture and anti-infective therapy.The cavity filling necrosis occurred in 2 cases,which recovered after debridement and dressing.For half a year after operation,except 9 cases of residual or recurrent,and the rest showed no recurrence.Conclusion The Fisch approach of surgical treatment of jugular foramen tumors can provid good exposure,clear vision,facilitate hemostasis.The skills of intraoperative facial nerve monitoring,facial nerve anatomy like a bridge or anatomy and shift when necessary are beneficial to the total or nearly total resection of tumor and reduce the injury of facial nerve.The operating cavity filling and selective external auditory canal closure can effectively reduce the surgical cavity effusion and the incidence of postoperative infection.

Role of MiR-34a/Bcl-2 apoptotic pathway in age-related hearing loss of mouse model / 中华老年医学杂志

Objective To explore the possible mechanism of miR 34a/Bcl-2 apoptotic pathway in the mouse model of age-related hearing loss.Methods A C57BL/6 mouse model of age-related hearing loss was conducted,and 4-week-old and 12-month-old mice were considered as the objects.The auditory brainstem response (ABR) was used to test the hearing function.The TdT-mediated dUTP nick end labeling (TUNEL) was used to observe the apoptosis of neuron in auditory cortex.The mRNA and protein levels of miR-34a,Bcl-2 and caspase 3 were detected by real-time PCR and Western bloting,respectively.Results The ABR showed that the hearing threshold level at 4,8,16,32 kHz were higher in 12-month-old mice than in 4-week-old mice [(80.0±2.5) dBHL vs.(32.0 ±4.5) dBHL,(74.0±3.5) dBHL vs.(51.0±1.2) dBHL,(86.0±4.6) dBHL vs.(51.0±3.5) dBHL,(87.0±6.6) dBHL vs.(56.0±1.5) dBHL,all P＜0.05].Compared with 4 week-old mice,the total number of neurons in auditory cortex was decreased,the number of apoptosis neurons was increased,the expressions of miR-34a (t=6.02,P=0.001),Bax (t=6.51,P=0.012) and Caspase 3 (P=0.023) rised,and the expression of Bcl-2 (t=7.12,P=0.032) declined in 12 month-old mice.Conclusions The activation of miR-34a/Bcl-2 apoptotic pathway may be one of the mechanisms of age-related hearing loss.

Evaluation on short-term efficacy of balloon dilation in the treatment of symptomatical eustachian tube dysfunction / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo evaluate the short-term efficacy of Eustachian tube balloon dilation (ETBD) in the treatment of symptomatic Eustachian tube dysfunction (SETD) by subjective and objective analysis.METHODS Forty patients who underwent ETBD were included. Subjects’ inclusion criteria were as followed: symptoms of ETD (aural fullness predominantly, with or without otalgia, muffle hearing and tinnitus), normal tympanic membrane, type A or C tympanograms, and without a history of any middle ear diseases. Main outcomes including subjective improvement, otoscopy, pure-tone audiometry, impedance audiometry, R-value in tubomanometry (TMM) and Eustachian Tube Score (ETS) were assessed 1 week and 6 months postoperatively.RESULTSAll cases were dilated successfully. A significant effect of treatment was documented when measuring subjective improvement, impedance audiometry, R-value in TMM and ETS 1 week and 6 month postoperatively. Subjective symptoms were not relieved only in one patient. The overall success rate for all patients was 98%.CONCLUSIONETBD can provide short-term benefits to those who are diagnosed with SETD and refractory to medical management. SETD might be an optimal indication for ETBD in the treatment of ETD.

Fungus culture of the ear discharge and therapeutic effects in 60 outpatients with otitis externa / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To assess the diagnosis and therapeutic effects for fungal otitis externa by clinical symptoms, endoscopic findings, and fungus culture of the ear discharge.@*METHOD@#Sixty outpatients diagnosed with otitis externa were enrolled in the study. All patients were treated with a thorough debridement of the ear and one antifungal medication regimens (compound resorcinol solution) in case of a positive fungus culture. One subgroup of patients treated with daub glycerol during 2 weeks of follow-up.@*RESULT@#Positive cultures were found in 42 cases. The efficacy was observed in all patients even in those who received only ear endoscopy.@*CONCLUSION@#Fungal otitis externa could be easily diagnosed by ear endoscopy. A thorough debridement of the ear and utility of compound resorcinol solution is an easy and effective approach for treatment of fungal otitis externa.

Eustachian tube balloon dilation in eustachian tube dysfunction related diseases / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the effect of Eustachian tube balloon dilation (ETBD) in treatment of eustachian tube related diseases.@*METHOD@#Fifteen cases (20 ears) of otitis media with effusion and 22 cases (30 ears) of symptomatic Eustachian tube dysfunction were recruited. Technique of tubomanometry (TMM) showed obstructive Eustachian tube dysfunction in all patients. All the patients were received ETBD and followed up with VAS evaluation of ear fullness, muffled hearing, poping sound in the ear and tinnitus. And also the TMM change and middle ear effusion.@*RESULT@#Ear fullness, muffled hearing released with 1 week (ear fullness: 8.2 ± 1.4 vs. 2.0 ± 1.2, P < 0.05, muffled hearing: 6.2 ± 1.2 vs. 3.1 ± 0.8, P < 0.05). No recurrence was seemed within 6 months. The eustachian function test turned better. Symptomatic Eustachian tube dysfunction had an effective rate of 96.6% while otitis media with effusion was 95.0%.@*CONCLUSION@#ETBD have good short-term effect in obstructive eustachian tube dysfunction related middle ear dysfunction, which might provide a good way to solve the eustachian tube related diseases.

Analysis Of Vestibular Function in Patients with Sudden Deafness / 听力学及言语疾病杂志

Objective To study the vestibular function in patients with sudden deafness .Methods Retrospec-tive analysis of 436 cases of patients with sudden deafness ,being divided into two groups according to whether the merger of vertigo .147 cases with vertigo group ,75 cases of which were mild to moderately severe hearing loss .In-clud the rise type of 28 cases ,26 cases of flat type ,21cases of decline type .72 cases of which were severe hearing loss .In 289 cases without vertigo ,157 cases had mild moderate and severe hearing loss .Includ the rise type of 36 cases ,57 cases of flat type ,64 cases of decline type .One hundred and thirty two cases of which were severe hearing loss .Use video electronystagmogram (VNG) to test the vestibular function .Process the data with SPSS 13 .0 soft-ware .Results One hundred and twenty three(83 .7% )cases of the vertigo group suffered from vestibular function decline ,with 51 cases of mild to moderately severe hearing loss ,72 cases of severe and above .165 (57 .1% )cases of the without vertigo group suffered from vestibular function decline .There were 45 cases of mild to moderately se-vere hearing loss ,120 cases of severe and above .35 patients with vertigo patients with BPPV ,28 cases of which happened within 1 week in sudden deafness occured and 80% of which were vestibular function decline .Conclusion Patients with sudden deafness with vertigo suffered from vestibular function damage .Patients with sudden deafness without vertigo also suffered from vestibular function damage .And the more serious the hearing loss ,the higher the vestibular function decline opportunities .

Hidden hearing loss in tinnitus patients with normal audiograms: implications for the origin of tinnitus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate hidden hearing loss in tinnitus patients with normal audiograms by means of auditory brainstem response (ABR) and explore the origin of tinnitus.@*METHOD@#Pure tone thresholds, ABR thresholds, amplitude of wave I and wave V of ABR were analyzed in 40 tinnitus patients and 15 controls.@*RESULT@#There was no significantly difference in pure tone thresholds and ABR thresholds between those tinnitus patients and controls while a reduced amplitude of wave I and normal amplitude of wave V of ABR in the tinnitus patients became evident.@*CONCLUSION@#Tinnitus patients with normal audiograms have hidden hearing loss at the level of primary auditory nerve and the generation of tinnitus is likely attributed to a homeostatic response of neurons in brainstem.

Intralesional bleomycin-A5 with dexamethasone injection under pedestal laryngoscope for huge laryngopharyngeal and laryngeal hemangiomas / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the therapeutic effect of intralesional bleomycin-A5 with dexamethasone injection under pedestal laryngoscope for huge laryngopharyngeal and laryngeal hemangiomas.@*METHOD@#Intralesional bleomycin-A5 with dexamethasone injection under pedestal laryngoscope was performed in huge laryngopharyngeal and laryngeal hemangiomas.@*RESULT@#The injection frequencies were 3 times in 4 cases, 4 times in 3 cases, and 5 times in 9 cases. Twelve cases (75%) were cured, and 4 cases (25%) were improved.@*CONCLUSION@#Intralesional bleomycin-A5 with dexamethasone injection under pedestal laryngoscope is a safe, effective and minimally invasive therapeutic method for huge laryngopharyngeal and laryngeal hemangiomas.

Utility of Sp/Ap curve area ratio electrocochleography in diagnosis of Meniere's disease / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Comparison of the sensitivity of Sp/Ap amplitude and area ratio in the aid of diagnosis of Meniere's disease. Meniere's disease was defined by the 1995 American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium.@*METHOD@#The study sample consisted of 35 patients in our hospital, who were undergone tympanic electrocochleography (EcochG). A control group of 10 patients (20 ears) with normal Sp/Ap ratio and EcochG data were identified. Sp/Ap amplitude and area curve ratios for both group were measured.@*RESULT@#The traditional upper limit and the upper limit of normal for Sp/Ap amplitude and area curve were respectively 0.4, 46 and 1.94. Of 35 patients with Meniere's disease, had an abnormal Sp/Ap amplitude ratio,and had an abnormal Sp/Ap area curve ratio; the difference between groups was statistically significant.@*CONCLUSION@#Sp/Ap curve area curve ratio is more sensitive than conventional Sp/Ap amplitude ratios in diagnosis of Meniere's disease.

Analysis and comparison of the masking and TRT for patients with subjective tinnitus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the effect of tinnitus masking and tinnitus retraining therapy (TRT) in patients with subjective tinnitus, and to analyze the effect of TRT within the positive or negative group of tinnitus masking test.@*METHOD@#The 217 patients from January, 2006 to April, 2008 in our hospital, were performed with the determination of tinnitus including pitch matching, intensity matching, Feldmann masking curve and residual inhibition test with Tinni Test. Of which 143 cases were positive and 74 were negative in tinnitus masking. The follow-up was 6 months and 10 cases were lost. 207 patients were divided into two groups for prospective study: 69 cases in tinnitus masking group and 138 cases in TRT group, The curative effect was evaluated according to tinnitus handicap inventory (THI) and Subjective Visual Tinnitus Scale (SVTS).@*RESULT@#Both masking treatment and TRT were effective for cases with tinnitus, there was significant difference of the score of THI and SVTS of tinnitus between pretherapy and posttherapy (P < 0.01). TRT therapy was more effective than masking therapy, there was significant difference of the THI score between TRT and masking group,but there was no significant difference of of the SVTS between them. TRT therapy was suitable for the patients with both positive effect and negative effect of masking test, and there was no significant difference between them.@*CONCLUSION@#Both TRT and masking therapy are the most important therapy for tinnitus patients, but TRT is much more effective than masking therapy in some aspects.

Cochlear otosclerosis: 3 cases report and literature review / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical features in cochlear otosclerosis.@*METHOD@#Three cases with cochlear otosclerosis in our hospital from March 2007 to October 2008 were reported and the relevant literatures were reviewed. All the cases were confirmed the diagnose by temporal bone high-resolution CT scan (HRCT).@*RESULT@#The chief complaint when visited was recurrent episodic vertigo or equilibrium disturbance with progressing hearing loss in all cases. Two ears in 2 cases were simple sensorineural deafness and considered the pure cochlear otosclerosis. Others were mixed deafness with the descent of bone conduction in different extent. The characters in HRCT: the low density area could be seen in different areas of the otic capsule, the pericochlear lucency or double-ring effect were the typical signs.@*CONCLUSION@#The diagnosis of cochlear otosclerosis is considered in the insoluble sensorineural deafness and the mixed deafness with vestibular symptoms and chronic hearing loss history. Temporal bone HRCT plays an important role in the clinical diagnosis of cochlear otosclerosis.

Characteristic of nystagmus and treatment of horizontal semicircular canal benign paroxysmal positional vertigo / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the characteristic of nystagmus and treatment of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV).@*METHOD@#The positioning nystagmic features in 43 patients with HSC-BPPV treated between April 2004 and October 2006 were recorded and analyzed with video nystagmography. After the subtype and the effect side were determined, the appropriate repositioning maneuvers were chosen.@*RESULT@#(1) Geotropic nystagmus was recorded in 27 cases, of whom 19 cases were treated with barbecue maneuver and/or combined forced prolonged position maneuver, while the others were treated with Asprella's maneuver. (2) Apogeotropic nystagmus was recorded in 16 cases with two types, one of which could turn into geotropic nystagmus with Gufoni's maneuver or spontaneously (in 12 cases), the other type could not (in 4 cases) transform accepted barbecue maneuver and/or combined forced prolonged position maneuver. The total improvement rate was 72.1% after 1 week and 81.4% 3 months later respectively.@*CONCLUSION@#The otolith position and the pathogenesis could be distinguished according to the nystagmic characteristics and type of HSC-BPPV. It was necessary to apply the appropriate repositioning maneuvers to treat HSC-BPPV.