Analyses of chronic otitis media with intact tympanic membrane concurrent with intracranial complication / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical and imaging characteristics of chronic otitis media with intact tympanic membrane.</p><p><b>METHOD</b>Ten patients were retrospective studied in the department of otorhinolaryngology of Guangdong general hospital from December 2006 to January 2015. The clinical characteristics of their manifestations, audiology and imaging examinations were analyzed.</p><p><b>RESULTS</b>All the cases could be divided into two groups: the intracranial complication group who was primarily diagnosed as intracranial complications, and the hearing loss group who primarily complained of hearing loss. Five cases belonged to the first group, which include 1 cerebellar abscess, 3 meningitis and 1 meningoencephalitis, 2 of them were profound hearing loss, 2 were mixed hearing loss, and 1 was normal hearing. The other 5 cases belonged to the hearing loss group, 3 were mixed deafness, 2 were conductive deafness. All the case showed positive high-resolution computed tomography (HRCT) features. In the first group, four cases showed the soft tissue shadow in tympanic antrum/superior tympanic pouch and 1 case showed a wide damage of skull base, in addition to intracranial complications. In the second group, five cases showed soft tissue imaging in tympanic antrum/superior tympanic pouch. Pathology showed that 2 cases were cholesterol granuloma(one was in the first group and the other was in the second group), 4 were intracranial inflammatory(the first group) and 4 were cholesteatoma(the seond group).</p><p><b>CONCLUSIONS</b>In chronic otitis media with intact tympanic membrane, intracranial complications may be the primarily diagnosis, which should be paid much attention by multidisciplinary team. HRCT and audiology were valuable for early diagnosis.</p>

Retrospective analysis of cytogenetic abnormalities detected by fluorescence in situ hybridization in pa-tients with multiple myeloma / 实用医学杂志

Objective To investigate the relationship of the cytogenetic abnormalities detected by FISH in patients with MM and their clinical features. Methods FISH on bone marrow (BM) cells was performed in 57 enrolled MM patients. Relationships between cytogenetic abnormalities and clinical features were analyzed. Results By statistical analysis , both D13S319 deletion and RB1 deletion were associated with high level of serum LDH (P = 0.024; P = 0.018) and BM plasma cells index (P = 0.027; P = 0.013). 1q21 amplification was significantly associated with high level of LDH (P = 0.030 ) and the occurence of light chain type myeloma (P = 0.023). IgH rearrangement was associated with renal function damage (P = 0.009). There were correlations among D13S319 deletion, RB1 deletion, 1q21 amplification and IgH rearrangement (P<0.01). Conclusion The genetic abnormalities detected by FISH in patients with MM were correlated with various clinical poor prognostic indicators, which can evaluate the condition and prognosis of patients more efficiently.

The correlations between varying tinnitus severity and anxiety and depression in non-acute tinnitus patients / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the correlation betwen varying degrees of non-acute tinnitus and anxiety and depression.@*METHOD@#Seventy-seven outpatients with non-acute tinnitus as their in chief complaint were submitted to Tinnitus Handicap Inventory(THI), Self-Rating Anxiety Scale(SAS), and Self-Rating Depression Scale (SDS).@*RESULT@#THI and its three subscales were found to have significant correlations with SAS and SDS. The group (THI ≥ 38) had more anxiety and depression than the mild (THI < 38). Significant correlations were also observed between THI, SAS and SDS in the group with THI ≥ 38, in contrast with the group of THI < 38.@*CONCLUSION@#Patients with THI ≥ 38 suffered from severe anxiety and depression than the mild. Doctors should pay more attention to these patients, especially their psychological disorders.

Application of HRCT multi-planar reconstruction for measuring cochlear morphology in cochlear implantation / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the value of high-resolution temporal bone CT (HRCT) multi-planar reconstruction (MPR) technique for measuring cochlear morpholog in the preoperative evaluation of cochlear implant.@*METHOD@#We retrospectively analyzed the clinical data of 80 cochlear implant recipients. The groups were investigated in our research according to the patient's sex, age and whether the inner ear is malformed or not. Temporal bone HRCT MPR was applied to analyze the measurement parameter in the standard orientation of the cochlea image: the largest distance from the round window to the lateral wall (distance A), the perpendicular distance (B) and angle of the basal turn of the cochlea relative to the midsagittal plane (γ). Reproducibility of the measured data was evaluated and the results between the different groups were compared.@*RESULT@#Measurement of parameter values between the intraobserver and interobserver showed good reproducibility. In normal group, distance A [(8.79±0.34) mm] and perpendicular distance B [(6.58±0.28) mm] of males' cochleae were significantly larger than A [(8.53±0.47) mm] and B [(6.22±0.43) mm] of females' (P0.05). The A and B values didn't change with age (P>0.05), but the angle γ tended to decrease with increasing age (r=-0.25, P0.05).@*CONCLUSION@#HRCT MPR technique is simple and reliable in measurement of cochlear morphology. It can be used to guide the surgery and provide an objective basis for designing the personalized electrode. More clinical application of this technology is recommended.

Efifcacy of thalidomide combined with VAD in treatment of Elderly multiple myeloma and its adverse reactions / 中国生化药物杂志

Objective To investigate the efifcacy of thalidomide combined with VAD in treatment of elderly multiple myeloma(MM). Methods 76 cases of elderly MM were randomly divided into two groups, control group (n=38) were treated with VAD alone while the observation group (n=38) were treated with thalidomide and VAD. Clinical efifcacy and adverse reactions in two groups were compared. Results The total effective rate in observation group was 84.21%, which was signiifcantly higher than 55.26%in control group (P<0.05). After treatment, the M protein, myeloma cells andβ2-microglobulin in observation group were (20.77±4.15)×10-2μg/mL, (12.84±2.85)×10-2μg/mL and (2.48±0.53)μg/mL, which were signiifcantly lower than before treatment and control group(P<0.05). Hemoglobin in observation group was (108.83±5.81) g/L, which was signiifcantly higher than before treatment and control group(P<0.05). The adverse reactions were nausea, vomiting, drowsiness, constipation, infection and rash and so on in two groups after treatment, and there was no signiifcant difference between two groups. Conclusion Thalidomide combined with VAD regimen has a better effect in treatment of elderly multiple myeloma than single VAD, has less adverse reactions and well tolerated.

Serum levels of β2-microglobulin and lactic dehydrogenase in patients with multiple myeloma and their clinical significance / 中国医师进修杂志

Objective To evaluate the clinical significance of the serum β2-microglobulin (β 2-MG) and lactic dehydrogenase (LDH) in multiple myeloma (MM) patients.Methods The serum levels of β2-MG and LDH in 63 MM patients (MM group) and 20 healthy person (control group) were measured by biochemical assay.Results The serum levels of β 2-MG and LDH in MM group were higher than those in control group[(3.81 ± 0.62) mg/L vs.(2.43 ± 0.91) mg/L and (296.4 ± 34.7) U/L vs.(145.5 ±17.8) U/L,P ＜ 0.05].Furthermore,the serum levels of β 2-MG and LDH increased gradually with MM clinical staging (P ＜0.05).After VAD chemotherapy,the serum levels of β 2-MG and LDH in clinical response MM patients(54 cases) were significantly decreased [(2.51 ± 1.36) mg/L vs.(3.57 ± 0.82) mg/L and (159.1 ± 35.2) U/L vs.(285.3 ± 87.6) U/L,P ＜ 0.05],while those in no response patients (9 cases)were unchanged (P＞ 0.05).Conclusion The serum levels of β 2-MG and LDH can be taken as a clinical index to classify the clinical phase,prognosis and effectiveness of chemotherapy in MM patients.

The surgical treatment effect on upper airway in treating refractory hypertension accompanied with OSAHS / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical treatment effect of refractory hypertension accompanied with OSAHS by surgery on upper airway.@*METHOD@#Thirty-two patients were enrolled in our research. PSG and blood pressure were examined on preoperation and 6th month, 1 year, 2 year of postoperation.@*RESULT@#The AHI and the time of SaO2 < 90% were lower significantly, and LSaO2 was improved (P < 0.01). The blood pressures of 32 patients were decreased.@*CONCLUSION@#The operation on upper airway could improve the hypertension of patient with OSAHS effectively.

Clinical approach of trans-horizontal semicircular canal and vestibule for treatment of Mondini dysplasia with cerebrospinal fluid leakage / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the clinical manifestation of Mondini dysplasia with cerebrospinal fluid leakage and investigate the effect of the surgical repair through trans-horizontal semicircular canal and vestibule approach.@*METHOD@#Four cases which were operated by the approach of trans-horizontal semicircular canal and vestibule in our hospital were analyzed retrospectively.@*RESULT@#The leakages were all stopped by the primary surgical closure after six-month follow up.@*CONCLUSION@#Mondini dysplasia should be considered in children or teenagers with recurrent bacterial meningitis whether or not with otorhinorrhea. Pure tone audiometry and a temporal bone CT or MRI will confirm the diagnosis. A trans-horizontal semicircular canal and vestibule approach is an effective and simple way for the treatment.

The effect of reversal steps stapedotomy on the treatment of otosclerosis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To determine the efficacy of reversal steps stapedotomy in the treatment of otosclerosis.@*METHOD@#From January 2006 to December 2009, a total of 70 patients (81 ears) with otosclerosis who underwent stapedotomy were retrospectively evaluated. Among these 81 ears, 41 ears underwent classical stapedotomy and 40 ears underwent reversal steps stapedotomy. We compared the postoperative results of pure tone tes , the intraoperative complications of stapes and incus and the incidence rate of postoperative vertigo after surgery between the two groups.@*RESULT@#The rate of postoperative air bone gap < or = 20 dB was 70.7% in the classical stapedotomy group and was 80.0% in reversal steps stapedotomy group. There were no significant differences between the two groups (P =0.181). The reversal steps stapedotomy group seem to had less complications of stapes and incus. The incidence rate of postoperative vertigo in reversal steps stapedotomy group significantly lower than in classical stapedotomy group (P = 0.037).@*CONCLUSION@#Reversal steps stapedotomy can effectively improve the hearing of patients with otosclerosis and can reduce the complications of stapedotomy.