Langerhans cell histiocytosis of the temporal bone in children: 7 cases analysis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the clinical manifestations, diagnosis, therapy and prognosis of Langerhans cell histiocytosis (LCH) of the temporal bone in children.@*METHOD@#Seven children with LCH of the temporal bone n our hospital were retrospectively summed up from April 2009 to April 2014. The patients were followed up 1-5 years, their clinical manifestations, imaging findings, diagnosis, therapy and prognosis were studied. Correlation between clinical classifications and prognosis was also analyzed.@*RESULT@#Among the 7 patients, 4 were boys and 3 were girls. 5 cases belonged to the single system group and 2 cases belonged to the multisystem group. The most common clinical characters were temporal tumor, otorrhea, otalgia, hearing loss and granulation of external auditory canal. CT of the temporal bones showed extensive osteolytic destructions with diffuse soft tissure density, without border sclerotization. The cases were. received different therapies. Followed up for 1-5 years, 4 cases were regressive, 1 case kept stable, while 2 cases showed progressive. The two boys then received standard treatment combined steroids with vinblastine. The prognosis in the multisystem group was significantly different from the single system group (P < 0.05).@*CONCLUSION@#The clinical manifestations of LCH vary a lot. The diagnosis is based on histological and immunophenotypic examination of lesion tissue. The main therapy includs surgery, chemotherapy and radiotherapy. The prognosis of the single system group is much better than the multisystem group.

Clinical multi-center study on the treatment of sudden sensorineural hearing loss accompanied with feeling of ear fullness / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effect of drug treatment for patients with sudden sensorineural hearing loss (SSNHL) accompanied with feeling of ear fullness (FEF).</p><p><b>METHODS</b>A prospective clinical multicenter research was carried out from August 2007 to October 2011. SSNHL patients aged between 18 to 65 years old and accepted no medication were recruited, with a duration less than two weeks. The patients were divided into four types according to the hearing curve: type A was acute SSNHL in low tone frequencies, type B was acute SSNHL in high tone frequencies, type C was acute SSNHL in all frequencies, and type D was total deafness. Each type was subdivided into two groups by the accompaniment of SEF or not. And each type had four different treatment programs, based on the unified designed randomized table. All patients were followed up for four weeks from the initial examination.</p><p><b>RESULTS</b>A total of 1 024 cases with single side SSNHL were recruited in the study from 33 hospitals in China, including 565 cases accompanied with FEF (55.18%), and 459 cases without FEF (44.82%). By classification of audiogram, 205 cases were type A (20.20%), of whom 122 were accompanied with FEF (59.51%); 141 cases belonged to type B (13.77%), of whom 74 were accompanied with FEF (52.48%); 402 cases were type C (39.25%), of whom 229 were accompanied with FEF (56.97%); and 276 cases were classified as type D (26.95%), of whom 140 were accompanied with FEF (50.72%). No significant difference was observed in total effective rate between the SSNHL patients accompanied with FEF or not in four acoustic types (P > 0.05). Among four acoustic types, the clinical cure rate of patients accompanied with FEF in type A was 93.44%, ranking the first; followed by 84.28% for type C; 75.71% for type D; and 70.27% for type B, respectively.</p><p><b>CONCLUSIONS</b>The therapeutic effect for patients accompanied with FEF in type A is satisfactory. The presence of FEF do not impact the therapeutic effect for SSNHL patients.</p>

Intratympanic therapy in the management of tinnitus / 临床耳鼻咽喉头颈外科杂志

Tinnitus is a common symptom which often becomes disabling, affecting the emotional and psychosocial dimensions of life. Nowadays, therapies for tinnitus vary greatly, none of which could give a satisfactory therapeutic effect however. Intratympanic therapy allows the generation of high concentration of drugs within the inner ear without systemic side effects. This review aims to introduce the commonly used medications and approaches for intratympanic management of tinnitus. Although different medications have been tested for their effects on tinnitus by intratympanic application, no breakthrough has been achieved so far. Consequently, the clinical use of specific medications for tinnitus has remained limited. A more widespread adoption of intratympanic management requires the development of specific medications for tinnitus, as well as proof of their safety and efficacy.

Branchial cleft cyst carcinoma: a case report and literature review / 临床耳鼻咽喉头颈外科杂志

The patient complained of a 20 days history of isolated mass in the right cervical region. The lesion was successfully eradicated by surgical removal. Histopathology established branchial cleft cyst carcinoma (BCCC) as the diagnosis. More attentions should be paid to the diagnosis of BCCC. Primary leisions were essential for the suspected cases. Importantly, only after excluding the metastatic squamous carcinoma in lymph nodes and other primary diseases, the diagnosis of BCCC would be established. Therapeutic strategies include complete local excision, radical neck dissection, and post-operative radiotherapy.

Serum endotoxin and TNF levels in patients with malignant obstructive jaundice / 中国普通外科杂志

0.05), but the values of ET and TNF in the CJ group were significantly lower than those in the EBD group (P