Research progress on correlation between childhood obesity and obstructive sleep apnea / 临床耳鼻咽喉头颈外科杂志

Prevalence of childhood obesity is progressively increasing, reaching worldwide levels of 5.6% in girls and of 7.8% in boys. This also leads to a corresponding increase in the prevalence of obesity-associated morbidities particularly those involving obstructive sleep apnea（OSA）. Obesity is an independent risk factor and regulator of OSA in children. There is a bidirectional causal relationship between OSA and obesity in children. The factors involved in the association between OSA and obesity are systemic inflammation, oxidative stress, and gut microbiota etc. However, a causal link between obesity-related inflammatory state and OSA pathogenesis still needs to be properly confirmed. The present review aimed to investigate the links between childhood obesity and OSA.

The Correlation between the Response Thresholds of ASSR and Pure Tone Thresholds in Young Deaf Children / 听力学及言语疾病杂志

Objective To investigate the correlation between auditory steady-state response (ASSR)and behavioral audiometry threshold in deaf children.Methods A total of 63 cases (126 ears)of severely and profoundly hearing impaired children from 0.5 years to 6 years were divided to Group A of 0.5~1.0 years,Group B of 1.1~3.0 years and Group C of 3.1~6.0 years old.ASSR and behavioral hearing tests were conducted in the sound field. 0.5~1.0 years old children were tested with the behavior observation Audiometry (BOA),1~2 years old children with visual reinforcement audiometry (VRA),while those of 3 ~6 with play audiometry (PA).Results For the ASSR response thresholds and pure tone hearing thresholds at 0.5,1,2 and 4 kHz,the correlation coefficients were 0.75,0.76,0.76,and 0.83,respectively.There was a significant correlation (P <0.01 ).The hearing thresholds were generally lower than the ASSR response thresholds,and with increasing frequency,the gaps were narrowed between the two.For Group A at each frequency the response thresholds and behavioral audiometry correlations were lower than those of Group B and C with the lowest at 0.5 kHz.Conclusion For the children of 0.5~6 years, ASSR and behavioral audiometric thresholds have good correlations.ASSR can provide information about the behav-ior thresholds for young children and those high risk children and for fitting hearing aids.

A clinical review of 3 cases of children with bronchial tumor / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics of bronchial tumors in 3 children to improve the diagnosis of pediatric bronchial tumor.</p><p><b>METHODS</b>Three cases of children bronchial malignant tumors diagnosed by rigid bronchoscopy were analyzed retrospectively.</p><p><b>RESULTS</b>The 3 children were males, aged from 6 to 10 years old, and presented with cough, sputum, and fever symptoms for 1 day to 3 months. Chest CT scan and airway remodeling examinations indicated the children's main bronchi were blocked and then the diagnoses of bronchial foreign bodies were made. However bronchial tumors were found in the 3 children by rigid bronchoscopy and were determined as mucoepidermoid carcinoma, large cell lung carcinoma with rhabdoid phenotype, and inflammatory myofibroblastic tumor, respectively.</p><p><b>CONCLUSIONS</b>Children with bronchial tumor often present with cough, wheezing and other respiratory symptoms that are not specific to bronchial tumor. When a child complaint of repeated cough and wheezing symptoms with unknown cause, not only bronchial foreign body and also bronchial tumor should be considered.</p>

Perioperative management of bilateral bronchial foreign bodies in infants / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the perioperative management of bilateral bronchial foreign bodies in infants to improve the cure rate in the children.</p><p><b>METHODS</b>The medical charts of 45 infants with bilateral bronchial foreign bodies were reviewed. Clinical features and key points to surgery as well as post-operative care were analyzed.</p><p><b>RESULTS</b>All foreign bodies were removed with rigid bronchoscopy under general anesthesia, and 44 of 45 infants were cured with assistance of anti-infective treatments within 3-5 days and one with acute laryngitis and bronchitis was cured through 10-day anti-infective treatment with vancomycin.</p><p><b>CONCLUSION</b>Removal of foreign body by rigid bronchoscopy under general anesthesia is a preferred method to treat bilateral bronchial foreign bodies in infants, to whom early diagnosis, early treatment and postoperative careful care are keys to get a good outcome.</p>

Analysis of deafness-related gene mutations in 100 non-syndromic hearing loss patients in Henan province / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To preliminarily determine the gene mutation frequency and the hotspots in Henan province, we analysed the deafness-related gene mutation in patients with non-syndromic hearing loss (NSHL).@*METHOD@#Genomic DNA samples of 100 patients with NSHL in Henan province were extracted from peripheral blood after clinical history inquiry and clinical examination, Four common deafness genes GJB2, SLC26A4, mitochondrial 12SrRNA, and GJB3 were detected by Sanger sequencing method,and then data analysis were conducted.@*RESULT@#Among 100 patients with NSHL. the gene mutation frequency was 44%. In these patients, 29 cases had GJB2 mutations, 13 cases had SLC26A4 gene mutations, and 3 cases had mitochondrial 12SrRNA mutations.@*CONCLUSION@#Among the patients with NSHL in Henan province, the most frequent mutation causing hereditary deafness was mutation in GJB2, followed by SLC26A4,and it will provide a theoretical basis to determine the etiology of deafness in Henan Province.

Risk factors of acute respiratory dysfunction in children with airway foreign body / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>This study aims to analyze the independent risk factors of acute respiratory dysfunction (ARD) in children with airway foreign body and to assess possible prevention and treatment option in the future.</p><p><b>METHODS</b>Clinical data of 456 cases of children with airway foreign body were retrospectively collected and analyzed by cluster sampling, including 246 males and 210 females, who received operation in our hospital between July, 2009 and December, 2012, aged 0.5-11 years old, onset to treatment time was 0.15-14 days. Clinical characteristics including age, gender, past medical history, time of onset, temperature, location of the foreign body, category of foreign bodies, complicated by pneumonia, complicated by subcutaneous and mediastinal emphysema were gathered. Temperature, respiratory rate, heart rate, cyanosis, transcutaneous oxygen saturation or arterial blood analysis were assayed before operation. Risk factors with statistical significance were screened with univariate logistic regression analysis, independent risk factors of ARD were determined with multivariate logistic regression analysis.</p><p><b>RESULTS</b>Acute respiratory dysfunction occurred in 78 (17.1%) patients. The foreign bodies in 455 cases were successfully removed brochoscopically in the first time. One case received chest surgery for foreign body removal. Total of 452 cases were successfully extubated and ventilator weaned 4-6 h after brochoscopy. In 2 cases, the ventilator was weaned 2-4 d after brochoscopy in ARD group, and 2 cases with severe pneumonia died. Age, location of the foreign body, temperature, complicated by pneumonia, complicated by subcutaneous and mediastinal emphysema did not show significant difference between acute respiratory dysfunction group and non- acute respiratory dysfunction group (P < 0.05). Multivariate logistic regression analysis showed location of the foreign body and complicated by pneumonia, complicated by subcutaneous and mediastinal emphysema were independent risk factors for ARD.</p><p><b>CONCLUSION</b>Early judgement of the risk factors of acute respiratory dysfunction in children with airway foreign body can provide a reference for the operation and perioperation period treatment.</p>