The role of TLR4/NF-κB signaling pathway in sleep deprivation induced Meniere's disease / 临床耳鼻咽喉头颈外科杂志

Objective:By detecting the levels of proteins in the Toll-like receptor-4/nuclear factor-κB （TLR4/NF-κB） signaling pathway and downstream proinflammatory cytokines in peripheral blood of patients with Meniere's disease （MD）, Pittsburgh Sleep Quality Index （PSQI） scores were collected to investigate the correlation between sleep disorders and MD and the role of TLR4/NF-κB signaling pathway in mediating sleep disorders inducing MD. Methods:Thirty-two MD patients and 20 family members of patients without middle ear and inner ear related diseases were selected. Basic data, PSQI and fasting peripheral blood of all subjects were collected. Enzyme linked immunosorbent assay.The levels of interleukin-1β（IL-1β）, tumor necrosis factor-α（TNF-α）, monocyte chemokine-1（MCP-1）, Toll-like receptor 4（TLR4） and nuclear factor-κB（NF-κB） in peripheral blood were detected by ELISA, and the data were statistically analyzed. Results:①PSQI score of MD group was higher than that of normal control group, and the difference was statistically significant（P<0.01）; The scores of every factors of PSQI in MD group were higher than those in normal control group, and the scores of factors 2, 4 and 6 were significantly different from those in normal control group. ②In the MD group, there were 18 patients with sleep disorders, with a prevalence rate of 56.25%, including 6 males with a prevalence rate of 50.00% and 12 females with a prevalence rate of 60.00%. ③The levels of five test indexes in MD group, sleep disorder group and non-sleep disorder group were higher than those in control group, and the levels of TLR4 and NF-κB in MD group were significantly different from those in control group（P<0.05）. The levels of IL-1β, TNF-α, TLR4 and NF-κB in sleep disorder group were significantly different from those in control group（P<0.05）. The levels of five test indexes in non-sleep disorder group were not statistically significant compared with those in control group. The levels of five test indexes in the MD sleep disorder group were higher than those in the MD group and the non-sleep disorder group, with no statistical significance. The levels of five test indexes in MD group were higher than those in non-sleep disorder group, with no statistical significance（P>0.05）. Conclusion:①Sleep disorders may be one of the important predisposing factors of some MD, and the effects of sleep disorders on MD are different between the sexes. ②Sleep disorders may activate TLR4/NF-κB signaling pathway to induce MD. The selection of TLR4/NF-κB signaling pathway related proteins and downstream pro-inflammatory factor inhibitors to intervene MD may provide a new idea for protecting the hearing balance function of MD.

Character of early tinnitus about sudden deafness / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the clinical characteristics of early tinnitus in patients with sudden deafness.@*METHOD@#Forty-seven patients with sudden deafness and early tinnitus recieved subjective review and filled out classified questionnaire of tinnitus. By pure tone audiometry and tinnitus matching test, we obtain the distribution, quantity and matching loudness of tinnitus patients.@*RESULT@#(1) Objective examination: the most common frequencies of tinnitus were 8000 Hz and 4000 Hz. The most common numbers were two frequencies. The matching loudness was (16.63 ± 8.37) dB. (2) Subjective examination: the tinnitus was monotone (74.0%), sustained (89.0%), third level loudness (45.0%), third level annoying (60.0%), high frequency (83.0%), sound of cicadas (66.7%). The most influencing factors were hearing (28.2%) and mood (29.5%). (3) Relationship between tinnitus and pure tone hearing threshold curve: there was a significant correlation between the frequency of pure tone audiometry and the matching loudness of tinnitus (r = -0. 370, P 0.05).@*CONCLUSION@#(1) The results of subjective examination were consistent with those of objective examination. (2) The tinnitus should be considered in the early treatment of sudden deafness.

Analysis the treatment of sudden sensorineural hearing loss with steroid from different administration routes / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the treatment of sudden sensorineural hearing loss with steroid from different administration routes.@*METHOD@#One hundred and eighty-eight patients with diagnosis of sudden sensorineural hearing loss were selected, in accordance with the random number table, and all patients were divided into three groups. With different administration routes, they were devided into systemic steroid therapy group, intratympanic steroid therapy group and postauricular steroid therapy group,and the curative effects were collected and analyzed.@*RESULT@#The total effective rate was 78.26% in systemic steroid therapy group, 80.70% in intratympanic steroid therapy group and 80.65% in postauricularsteroid therapy group,and no statistical difference was detected among these three groups (P > 0.05).@*CONCLUSION@#The treatment of sudden sensorineural hearing loss with steroid from different adminsthation routes all can achieve a relatively favorable prognosis, and there were no obvious different among those different treatments.

Analysis of personality characteristics of sudden deafness patients / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To Study the personality characteristics in patients with sudden deafness.@*METHOD@#Thirty-eight sudden deafness patients and 45 healthy volunteers were assessed by Eysenck personality questionnaire (EPQ).@*RESULT@#The standard scores of P, E, N dimensions of patients with sudden deafness were greater than healthy volunteers. The standard score in L dimensions of patients with sudden deafness was less than healthy volunteers. The difference of the standard score of P dimension revealed statistical significance (P 0.05).@*CONCLUSION@#Sudden deafness patients have emotional instability and psychoticism personality characteristics.

One case of laryngeal pleomorphic adenoma / 临床耳鼻咽喉头颈外科杂志

A male patient, 55 years old, suffered from intermittent sound,voice depression and shortness of breath for one year,and from dysphagia for 3-4 months. Through fiber laryngoscopy,we could see tumor in the left posterior aryepiglottic fold. The tumor's surface was smooth. A portion of the tumor protruded to the laryngeal cavity and the aryepiglottic fold external,it also covered most of the glottis. Bilateral vocal cord were smooth and had good mobility. Throat CT demonstrated an irregular soft tissue mass on the left side of the aryepiglottic fold in supraglottic area with obscure normal boundary from adjacent structure. The left side of pyriform sinus became shallow without obvious bone destruction. The pathological report showed pleomorphic adenoma. The diagnosis was laryngeal pleomorphic adenoma.

The characteristic of enlarged vestibular aqueducts syndrome in pure tone audiometry: low frequency air-bone gap / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The purposes of this study was to analyse the significant of low frequency air-bone gap in enlarged vestibular aqueduct (EVA) patients according to the pure tone audiogram and the benefit for clinic diagnosis of the EVA.@*METHOD@#The audiology testing include (1) play audiometry or pure tone audiometry, tympanometry, middle ear muscle reflex thresholds and stapedius muscle reflex; (2) High-resolution computed tomography (CT) scan of the temporal bone and magnetic resonance imaging was used for diagnoses the EVA.@*RESULT@#All the 78 patients (154 ears) were diagnosed as the typical EVA by CT or MRI. Inner ear malformations were found in 3 ears otherwise the structures of middle ear in all the patients were absolutely normal. The audiology analysis showed 154 ears were type A tympanogram including 126 ears with typical A, 25 ears with As, 3 ears with Ad type. In the 250 Hz pure-tone test:A-B gap were observed in 126 ears(126/154,81. 8%) with the different hearing loss degree: 1 ear mild, 11 ears moderate, 19 ears moderate severe, 40 ears severe and 53 ears profound. In the 500 Hz pure-tone test: A-B gap were found in 102 ears(102/154, 66. 2%) with the different hearing loss degree: 9. ears moderate, 17 ears moderate severe, 35 ears severe and 41 ears profound.@*CONCLUSION@#Our study suggested a 66. 2% -81. 8% possibilities to find the EVA through the pure-tone audiometry firstly in the basis of the normal tympanograms with the significant A-B gap.

Effect of frequency difference and intensity difference on mismatch negativity change in normal persons / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the effect of frequency difference and intensity difference on mismatch negativity (MMN) change in normal persons. Emphatically to observe the effect on the latency and amplitude of normal people's MMN, as well as the threshold of the acoustic difference which may induce the MMN. METHODS Twenty-four adults were included in this study. Their thresholds of pure tone audiometry were within 20dBHL. The MMN were measured by using the Smart EP ( ear potentiometer provided by the company of Intelligent Hearing) and the rule of the change by the difference of frequency and intensity to the latency and amplitude of normal people’s MMN were studied. RESULTS Along with the decreasing of the difference of the frequency, the MMN latency prolonged gradually. The amplitude of the MMN decreased gradually as the decreasing of the intensity difference. CONCLUSION A stable MMN graph is an important indicator of objective physiological test with hearing distinguish.