Differentiation of Human Umbilical Cord Mesenchymal Stem Cells into Hair-cell Like Cells in Vitro / 听力学及言语疾病杂志

Objective To induce human umbilical cord mesenchymal stem cells (hUC-MSCs) to hair-cell like cells in the inner ear, using a two-step neural differentiation method.Methods The hUC-MSCs were obtained from human umbilical cords by tissue adherence culture,whose surface antigen CD29, CD34, CD44, CD45, CD90, HLA-ABC, and HLA-DR could be identified by flow cytometry.In the neural stem cells induced phase, the NSE positive cells were analyzed by microscope and immunohistochemistry.In the second stage, the expression of hair-cell like cells markers (Math1, MyosinⅦa, Brn3c) were tested by qRT-PCR and immunofluorescence method.Results The control group and the protocol group had little NSE after differentiation while the protocol B group presented a neurobiological structure and demonstrated a higher NSE positive ratio after 5 days' neural stem cells induction (P<0.05).Compared to the control group, the mRNA and protein level of Math1, MyosinⅦa, and Brn3c exhibited a significant increase in the differential group,which induced for 4 weeks in the hair-cell like cells in the inner ear's induced phase(P<0.05).Conclusion The two-stage induction (hUC-MSCs-neural stem cells-hair-cell like cells) could produce more MyosinⅦa,Brn3c and Math1,which may provide an appropriate way to treat sensorineural deafness.

The Expression of STAT3 and SOCS3 Protein in the Middle Ear Cholesteatoma / 听力学及言语疾病杂志

Objective To study the expression of signal transducer and activator of transcription 3 (STAT3) and Suppressor of cytokine signaling 3(SOCS3) in the middle ear cholesteatoma epithelium ,and the possible roles of STAT3 and SOCS3 in middle ear cholesteatoma .Methods The immunohistochemical assay was used to detect ex-pression of STAT3 and SOCS3 protein in 30 cases of middle ear cholesteatoma epithelial tissue and 20 cases of nor-mal external auditory canal skin tissues as the control group .Results STAT3 immunoreactivity was detected in the nuclei and cytoplasm of epithelial cells .The expression rates of STAT3 in middle ear cholesteatoma epithelial tissue were 76 .7% and higher than in the normal epithelium (25 .0% ) .The differences between the two groups were sta-tistically significant (P<0 .05) .SOCS3 immunoreactivity was detected in the cytoplasm of epithelial cells .The ex-pression rates of SOCS3 in middle ear cholesteatoma epithelial tissue were 33 .3% and lower than in the normal epi-thelium (65 .0% ) .The differences were statistically significant (P<0 .05) .The expression of STAT3 and SOCS3 in the middle ear cholesteatoma had negative correlation (r= - 0 .476 ,P<0 .05) .Conclusion The abnormal ex-pression of STAT3 and SOCS3 in the middle ear cholesteatoma may be involved in hyper proliferation and anti -ap-optosis of cholesteatoma cell ,and play an important role in the formation and development of middle ear cholesteatoma .

Speech Perception in Patients with Cochlear Implants and Hearing Aids in Opposite Ears / 听力学及言语疾病杂志

Objective The aim of the present study was to investigate the ability to perceive syllables phrases ,mono-syllabic words ,disyllabic words ,when using a CI and an HA in non -implanted ears (bimodal fitting) ,and the relationship be-tween aided thresholds in the HA ear and bimodal effectiveness .Methods Eighteen children who consistently used a bimodal fitting participated in the study .The loudness of speech in the HA ear matched that with implanted ear ,and the aided thresh-olds in the HA ear were obtained .The recognition rate of syllables phrases ,monosyllabic words ,and disyllabic words was tested under the aforementioned two modes in both the quiet and noisy backgrounds .Results The speech performance of children for monosyllabic words were 82 .67% ± 12 .23% ,83 .61% ± 12 .22% ,for disyllabic words 76 .00% ± 16 .13% ,78 .11% ± 14 .84% , for syllables phrases 60 .11% ± 17 .18% ,65 .43% ± 16 .76% ,with a CI alone or with bimodal fitting in a quiet environment ,re-spectively .In a noisy environment ,monosyllabic words were 75 .50% ± 14 .12% ,76 .83% ± 14 .15% ,and disyllabic words were 68 .22% ± 17 .15% ,77 .18% ± 16 .83% ,and syllables phrases were 49 .39% ± 19 .26% ,56 .33% ± 19 .55% .The results sug-gested that speech performance in a quiet or a noisy environment was significantly better with bimodal hearing than with a CI a-lone .All were statistically significant except the recognition rate of monosyllabic words in quiet background (P<0 .05) .Signifi-cant negative correlations were found between aided thresholds at 250 and 500 Hz ,and the bimodal advantages were noticeable for the some speeching perception .Conclusion Bimodal hearing enhances speech performance for deaf patients .The low -fre-quency residual hearing in the HA ear may play a major role in enhancing auditory and speech performance .

The application of Tb-ABR and ASSR in pediatric hearing assessment / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the correlation between the threshold of tone burst auditory brain stem response (Tb-ABR) and ASSR (auditory steady-state response) and the threshold of BA (behavioral audiometry). To investigate the accuracy and clinical value of Tb-ABR and ASSR in pediatric hearing assessment.@*METHOD@#From January, 2014 to December, 2014, 76 children (123 ears) recieved hearing examination in the First Affiliated Hospital of Zhengzhou University. They were classified into three groups according to the hearing level: 23 children (46 ears) with normal hearing ability in group A, 27 children (32 ears) with slightly-moderate sensorineural deafness in group B and 26 children (45 ears) with severe-profound sensorineural deafness in group C. Tb-ABR, ASSR, BA in 4 frequencies (0.5, 1.0, 2.0, 4.0 kHz) were tested and the results were statistically analyzed.@*RESULT@#(1) At the 4 frequencies (0.5-4.0 kHz), we obtained 132 thresholds of Tb-ABR, 144 of ASSR, 152of BA. And 166 thresholds were obtained in Tb-ABR+ASSR+BA in total . (2) The thresholds of Tb-ABR, ASSR and those of BA in all 3 groups had linear relations at 0.5-4.0 kHz. The correlation coefficients of group A were 0.76, 0.82, 0.87 and 0.91; 0.52, 0.57, 0.67 and 0.64. Those of Group B were 0.89, 0.95, 0.98 and 0.95; 0.74, 0.82, 0.87 and 0.90. Those of Group C were 0.91, 0.90, 0.92 and 0.89; 0.93, 0.95, 0.95 and 0.91.@*CONCLUSION@#(1) Both ASSR and Tb-ABR can allow reasonably accurate predictions for the pediatric hearing assessment. The correlation between Tb-ABR threshold and BA threshold is higher in normal hearing children and slightly-moderate sensorineural deafness children. The correlation between ASSR threshold and BA threshold is higher in severe-profound sensorineural deafness children. (2) The hearing test combination can evaluate the residual hearing ability for children with severe hearing loss.

The Expression of GAP-43 in Cochlear Nucleus and Inferior Colliculus after Unilateral Cochlear Damage in Rats / 听力学及言语疾病杂志

Objective To study the changes of the expression of growth associated protein -43(GAP 43) in cochlear nucleus and the inferior colliculus (IC) in rats after unilateral cochlear damage at different time points after surgery ,and explore the remodeling and repair process of synapse in brainstem auditory center of rats after auditory deprivation .Methods Thirty rats were randomly divided into six groups :the 3 ,7 ,15 ,30 ,60 days group (with u-nilateral cochlea damage) and the control group (without cochlea damage) with 5 rats in each group .The immuno-histochemical SP method was used to detect the expression of GAP -43 in cochlear nucleus and inferior colliculus at different time points after cochlea damaged in the control group .Results After the unilateral cochlear ear was dam-aged at 3 ,7 ,15 days ,GAP -43 in operation side cochlear nucleus were expressed and the expression level signifi-cantly increased compared with normal control group .After 30 days postoperatively ,GAP - 43 expression level decreased ,but it was still higher than normal control group .After 60 days postoperatively ,GAP - 43 expression level was slightly higher than that of normal control group .After 3 days postoperatively ,GAP - 43 expression level was higher than normal control group .After 7 ,15 days postoperatively ,expression levels were increased .After 30 , 60 days postoperatively ,the expressions gradually decreased ,but still higher than the normal control group .Conclusion After unilateral cochlea damaged ,GAP - 43 was expressed an obvious dynamic change process in cochlear nucleus and infe-rior colliculus .It may reflect the axonal regeneration and synaptic plasticity after hearing loss in brainstem auditory neurons .

Cause Analysis of emporal bone Anatomy Factor Underwent Radical Mastoidectomy in 36 Cases / 听力学及言语疾病杂志

Objective To explore the main anatomical factors for relapse in patients underwent radical mas-toidectomy and discuss the preventive measures .Methods A retrospective study was carried out 36 patients who had underwent radical mastoidectomy and 100 patients (100 ears) who had been cured underwent radical mastoidectomy during July 2011 toSeptember 2013 .The patients underwent axial and coronal temporal Computed Tomography (CT) .The incidence of low -lying middle cranial fossa ,high jugular bulb ,anterior locati(36 ears)on of sigmoid si-nus ,dehiscent tympani tegmen ,dehiscent of the facial nerve canal ,large sinus tympani ,low -lying horizontal facial nerve were recorded .Results The incidence of low -lying middle cranial fossa(36 .1% ) ,anterior location of sig-moid sinus(41 .7% ) ,dehiscent tegmen tympani (30 .6% ) ,dehiscent of the facial nerve canal (41 .7% ) ,large sinus tympani(25 .0% ) ,low -lying horizontal facial nerve(22 .2% ) were higher than those of in the normal group .There was no significant difference in high jugular bulb .Conclusion The main anatomical factors for relapse in patients un-derwent radical mastoidectomy were low -lying middle cranial fossa ,anterior location of sigmoid sinus ,dehiscent tegmen tympani ,dehiscent of the facial nerve canal ,large sinus tympani ,low -lying horizontal facial nerve .

Incidence of facial nerve dehiscence in mastoidectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To describe the incidence and location of the facial nerve dehiscence (FND) in chronic suppurative otitis media patients with and without cholesteatoma.</p><p><b>METHODS</b>360 patients (370 ears) who received canal wall down tympanomastoidectomy due to otitis media(145 ears without cholesteatoma and 225 ears with cholesteatoma) were analyzed retrospectively, in which the incidence and locations of FND was studied, and the relevance for FND, clinical features (age, disease duration, preoperative facial paralysis) and intraoperative findings (state of FND and lateral semicircular canal fistula), were analyzed.</p><p><b>RESULTS</b>The presence of FND was 31.6% of total surgical procedures and the locations of FND were the tympanic segment. The dehiscence was detected 28.4% (94/334) in adults, but 61.1% (22/36) in the patients 18 years and younger, the differences were statistical significance (P < 0.05). The dehiscence rate was 37.1% (104/280) and 14.4% (13/90) respectively, in the cases of disease duration more than and less than 5 years, with significant difference (P < 0.05). Facial nerve dehiscence was detected in 29 patients (20.0%) and 89(39.1%) in cases without and with cholesteatoma respectively (P < 0.05). Facial nerve prolapse over the oval window was 11.4% (42/370), with FND of 83.3% (35/42). The incidence of lateral semicircular canal fistula was 7.8% (29/370), with FND of 65.5% (19/29). The presence of preoperative facial paralysis with FND was 75.0% (18/24), and that without FND was 28.6% (99/346), the differences were statistical significance (P < 0.05).</p><p><b>CONCLUSIONS</b>The incidence of FND most commonly located at the tympanic segment. The facial nerves should be taken much care in mastoidectomy for patients with cholesteatoma, preoperative facial paralysis and lateral semicircular canal fistula, as well as long disease duration.</p>

The relationship between ossicular status and conductive hearing loss in cholesteatoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate and analyze the characteristic of destructive ossicular chain and it's impact on air-bone gap (ABG) among patients with cholesteatoma.@*METHOD@#Data from 204 cases (213 ears) undergoing an initial surgery for cholesteatoma were retrospectively reviewed to evaluate the relationships between preoperative pure tone audiometry data and intraoperative assessment of individual ossicular destruction.@*RESULT@#Incus was the most significantly affected ossicle. Furthermore, the destruction of malleus and stapes was often accompanied by the destruction of incus. A partially eroded incus caused significantly increase in ABG from that of an intact incus with cholesteatoma abutting (P < 0.05). A partially eroded incus and a partially eroded stapes caused significantly increase in ABG compared to a partially eroded incus (P < 0.05). A completely eroded incus caused significantly increase in ABG compared to a partially eroded incus (P < 0.05). False fibre-connected would significantly influence on ABG in some ossicular chain erosion patterns (P < 0.05). Cholesteatoma abutting an intact ossicle significantly altered average ABG compared to a normal ossicle (P < 0 01).@*CONCLUSION@#Different ossicular chain erosion pattern caused different degrees of ABG.

Clinical study of 300 patients with subjective tinnitus from collegian / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the clinical and psychoacoustic characteristics of tinnitus patients from university students.@*METHOD@#The study included 300 tinnitus patients. All patients were interviewed by the same investigator and using the same questionnaire. Data were collected and analyzed.@*RESULT@#Hearing loss was seen in 54.3% of the patients. There was no correlation between tinnitus severity and tinnitus loudness (P > 0.05). There was a significant relationship between high-pitched tinnitus and high-frequency SNHL (P < 0.01). In 86.0% of these patients, tinnitus had produced an adverse effect on their psychology and daily life.@*CONCLUSION@#There is a significant relationship between high-pitched tinnitus and high-frequency SNHL. Tinnitus has an impact on the life of patients from the university students.

The clinical characteristics and the treatment of external auditory canal cholesteatoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluated the characteristics, stage classification and treatment of external auditory canal cholesteatoma (EACC).@*METHOD@#Fifty-nine cases (60 ears) with EACC undergoing surgery were retrospectively analyzed in our study.@*RESULT@#Hearing impairment, otalgia and otorrhea were common symptoms of EACC patients. A total of 60 ears were classified into 4 stages: Stage I (26 ears) underwent canaloplasty, stage II (14 cars) underwent both canaloplasty and tympanoplasty, stage III (19 ears) underwent mastoidectomy, and stage IV (1 ear) required both canaloplasty and neoplasty of capsula articularis articulations temporomandibular.@*CONCLUSION@#Besides the lesion in external auditory canal, EACC also invaded into the middle ear and the temporal bone. Stage classification by the signs of the temporal bone computed tomography and the patients' clinical findings was helpful for surgery.

Posttraumatic benign paroxysmal positional vertigo: analysis of 23 cases / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the clinical presentation and outcome between patients with traumatic-BPPV (t-BPPV) and idiopathic-BBPV(i-BPPV).@*METHOD@#The clinical records of 186 patients with posterior canal BPPV were reviewed retrospectively. All patients were diagnosed using the Dix-Hallpike test and treated with the canalith repositioning procedure. The outcome of patients with t-BPPV was compared with patients with i-BPPV.@*RESULT@#Twenty-three of 186 patients with BPPV fulfilled the diagnostic criteria for t-BPPV. Women were affected i-BBPV more often than men (2.3:1), and women and men were equally affected t-BBPV (1:1). After one physical treatment, 34.8% of patients with t-BPPV had complete resolution of signs and symptoms in comparison to 85.3% of patients with i-BPPV (P < 0.05). During the 2-year follow-up, 56.5% of t-BPPV patients and 19.0% of i-BPPV patients had recurrent attacks (P < 0.05).@*CONCLUSION@#The nature and severity of the traumas causing t-BPPV are diverse. It appears that t-BPPV is more difficult to treat than i-BPPV, and also has a greater tendency to recur.

The first branchial fistula :An analysis of 16 cases / 临床耳鼻咽喉头颈外科杂志

Objective: To discuss how to improve the level of diagnosis and treatment about the firstbranchial fistula. Method:16 cases with the first branchial fistula were analyzed retrospectively. Result :Of all thepatients underwent surgery, 14 cases were free from disease postoperatively within 0.5 years follow-up, 2patients underwent re-operation because of recurrence. Conclusion:Knowing about the disease fully, selectingproper surgical incision and possessing skilled surgical technique is important to improve the level of diagnosisand treatment about the first branchial fistula.