Clinical analysis of bilateral same-day myringoplasty for 22 cases with bilateral tympanic membrane perforation / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of bilateral same-day myringoplasty and the indications for myringoplasty for patients with bilateral tympanic membrane perforation, and to summarize relevant experience.</p><p><b>METHODS</b>Twenty-two patients underwent bilateral same-day underlay myringoplasty, and all cases were consistent with the indications for myringoplasty. The preoperative hearing and postoperative hearing at three months were compared, and the postoperative symptoms and complications were observed. Forty patients underwent monaural myringoplasty as the control group over the same period. All cases were followed up for 1 - 3 years.</p><p><b>RESULTS</b>The postoperative hearing was increased by an average of 18 dB, and the rate of closure of tympanic membrane perforation was 93.2% (41/44). There were seven patients with ear fullness after operation in the bilateral myringoplasty group and two patients in the control group (χ(2) = 4.5374, P = 0.0332). There were no differences in the postoperative hearing improvement, the rate of closure and the rates of other discomfort symptoms except for ear fullness between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>It was feasible and safe to perform bilateral same-day myringoplasty for bilateral tympanic membrane perforation, but the postoperative temporary discomfort of bilateral ear fullness should be informed the patients in advance.</p>

Functional analysis of the vertical semicircular canal using vertical plane swing test and study of its normal values / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The purpose of this study was to set up a method to analyze the vertical semicircular canal function and study the normal values of the vertical semicircular canal function using the vertical plane swing test.</p><p><b>METHODS</b>A prospective analysis of 100 normal persons (aged from 18 to 59 years), who were treated by using the vertical plane swing test with the newly developed automatic vestibular function diagnosis and therapy system (SRM-IV). These persons were rotated 180° at a sinusoidal speed (acceleration 45°/s, maximum speed 90°/s) in the vertical semicircular canal plane. Using a PC, evoked vertical nystagmus was analyzed in order to evaluate the excitability of vertical semicircular canals, including the number and the duration of nystagmus, the slow phase velocity and other parameters. Meanwhile, the all persons were divided into two groups, order and younger than 45 years respectively. In the test procedure, with the two pairs of the right anterior vertical semicircular canal and left posterior vertical semicircular canal (RALP) as well as the left anterior vertical semicircular canal and the rear right vertical semicircular canals (LARP), the average slow phase velocity of the vertical nystagmus and the canal paresis (CP) of the two pairs of vertical semicircular canals were calculated using PC and SPSS13.0 software for statistical analysis.</p><p><b>RESULTS</b>There was no significant difference between the two groups (P > 0.05). The general CP of RALP was 10.2% ± 7.1%, and LARP was 10.4% ± 6.2%. The normal CP range of the vertical semicircular canal in the health group was identified (idea: ≤ 20%; normal high: 20% - 25%).</p><p><b>CONCLUSION</b>The 180° vertical plane sinusoidal swing method is effective in functional analysis of the vertical semicircular canal, it is expected to be reliably used in clinical treatment.</p>

Operation of hypopharyngeal carcinoma with restrained vocal cord motility / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility of laryngeal function preservation in surgical treatment of hypopharyngeal carcinoma with restrained vocal cord motility.</p><p><b>METHODS</b>Twenty-six cases of hypopharyngeal carcinoma treated with conservative hypopharyngectomy were retrospectively analyzed. Partial resection of pyriform sinus and partial laryngectomy were performed. Suturing the remaining hypopharyngeal mucosa was used to cove the wound of hypopharynx in 5 cases, epiglottis complex flap in 21 cases. All patients received postoperative radiotherapy.</p><p><b>RESULTS</b>The overall 3- and 5-year survival rates were 61.4% and 50.8% respectively. 76.9% (20/26) patients have laryngeal functions (voice, respiration and deglutition) completely restored and 23.1% (6/26) partially restored (voice and deglutition).</p><p><b>CONCLUSIONS</b>To improve the quality of life of the cases, the preservative surgery is feasible for the selected hypopharyngeal carcinoma cases with restrained vocal cord motility.</p>

Study of the key points and safety measures during perioperative period in patients with obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the safety measures during perioperative period in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), to minimize uvulopalatopharyngoplasty (UPPP) major complications.</p><p><b>METHODS</b>The complications and other relative information of 1446 OSAHS patients treated with UPPP were analyzed. Complications of 1004 OSAHS patients adopted standardized management measures after 2004 and 442 OSAHS patients who performed UPPP before 2003 were compared.</p><p><b>RESULTS</b>Among the 1446 cases of OSAHS surgery, there were 49 cases (3.39%) of difficult intubation; 8 cases (0.55%) intraoperative mild arrhythmia; 13 cases (0.90%) of surgery dangerous situations after extubation; 19 cases (1.31%) of intraoperative primary hemorrhage; 11 cases (0.76%) of mild arrhythmia during the postoperative observation period; 21 cases (1.45%) of uncontrolled hypertension immediately after surgery; 32 cases of secondary hemorrhage a week after surgery. All complications were cured and no death occurred. Compared with those operations before 2003, complications were significantly reduced with enforcement of standardized management of perioperative measures since 2004. The data had significant difference by chi(2) test (P < 0.05).</p><p><b>CONCLUSIONS</b>There are five key points during the perioperative period of OSAHS surgery: preoperative examination, intubation, surgery, postoperative extubation, and postoperative care. Risk factors and complications could be prevented effectively in the above five important processes.</p>

Analysis and application of the images from the segmenting CT in the space of nasal endoscope / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the images from the segmenting CT in the space of nasal endoscope and to observe the benefits in applying the method in endoscopic sinus surgery.</p><p><b>METHODS</b>Five patients with inverted papilloma and ten patients with chronic rhinosinusitis were enrolled. The images from the coronal CT were put in the ideal model of the nasal cavity, which had been designed by SketchUp software package, and the space of the model in the 0 degree rod-lens telescope was simulated and observed according to definite elevation angle between the endoscope and bottom of nasal cavity and the distance of the endoscope entering the nasal cavity. The surgical plan was designed and compared with the models of the intraoperative corresponding vision.</p><p><b>RESULTS</b>The anatomical form of the images from the coronal CT and the directions of the space in the visual field of the endoscope were correlative with the elevation angle between the endoscope and bottom of nasal cavity and the distance of the endoscope entering the nasal cavity. Based on the elevation angle and the entering distance of the endoscope, the images from the CT scan in the space of nasal endoscope were analysed according to the order, which were consistent with the findings in the intraoperative corresponding vision, providing the accurate directions of the space for the endoscopic sinus surgery.</p><p><b>CONCLUSIONS</b>The changes of the images of the CT scan in the space of the endoscope were consistent with the perspective law. To know the perspective law could grasp the directions of the space in the visual field of the endoscope and ensure the safety of the endoscopic surgery. The method was simple and feasible. The benefits of this technique were confirmed by clinician.</p>

Applied study of voice function rehabilitation by mucosa tube performed in operation of late laryngocarcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the voice function rehabilitation by mucosa tube performed in operation of late laryngocarcinoma and to improve the survival quality of patients with late laryngocarcinoma.</p><p><b>METHODS</b>Forty-six patients were treated between Oct. 1991 and May 2006, including 41 males and 5 females. The average age of the patients was 54. Seventeen cases were glottic carcinomas (T3N0M0 12, T3N1M0 5), 27 cases were supraglottic carcinomas (T3N1M0 16, T4N1M0 5, T3N0M0 6), 2 cases were pyriform sinus cancer (T4N1M0 2). For those patients with late laryngocarcinoma, who had lost the chance of partial laryngectomy, mucosa tube shaping during the operation could realize voice functional rehabilitation. Only the survive arytenoids of healthy side was preserved, in order to rehabilitate voice, a mucosa tube was sutured using healthy survive arytenoids and a mucosa strip was connected to the trachea and the mucosa of hypopharynx. Survival analysis was performed by using Kaplan-Meier method.</p><p><b>RESULTS</b>Forty-one out of 46 patients obtained almost normal voice and swallow function. The 5-years survival was 76%.</p><p><b>CONCLUSIONS</b>The operation of voice function rehabilitation by mucosa tube performed can get good voice and swallow function to patients with late laryngo carcinoma.</p>

Three-axis otoconia maneuver treatment in benign paroxysmal positional vertigo / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate three-axis otoconia maneuver (TOM) for benign paroxysmal positional vertigo (BPPV).</p><p><b>METHODS</b>The data from twenty BPPV patients who received three-axis otoconia maneuver treatment and 20 BPPV patients who received canalith repositioning (CRP) maneuver treatment were analyzed retrospectively.</p><p><b>RESULTS</b>There were 17 patients received 1 TOM session and 3 patients received 2 TOM sessions while 16 patients received 1 CRP session and 4 patients received 2 CRP sessions. The chi-square (X2) test was used in evaluating the association between two independent samples in a contingency table. Both methods had no statistically significant. The significance level for statistical tests was 5% (alpha = 0.05).</p><p><b>CONCLUSIONS</b>Three-axis otoconia maneuver could be effective used in benign paroxysmal positional vertigo with the advantage of repeatedly practicable and instrumental.</p>

Effect of glutamate on distortion product otoacoustic emission and auditory brainstem response in guinea pigs / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the changes of the potentials and structure of the guinea pig cochlear during whole cochlear perfusion with glutamate.</p><p><b>METHODS</b>Cochlear microphonics (CM), compound action potential (CAP), distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) were measured to indicate the cochlear functional properties during whole cochlear perfusion. The morphology of the cochlear was monitored by transmission electron microscopy.</p><p><b>RESULTS</b>There were no significant DPOAE changes before and after glutamate perfusion. CM I/O function maintained a nonlinear characteristic during infusion. After glutamate perfusion, ABR latencies were delayed. There was significant difference in CAP threshold before and after glutamate perfusion. The average CAP threshold was elevated 35 dB. The OHCs appeared normal, but IHCs and afferent dendrites showed cytoplasmic blebs after glutamate infusion.</p><p><b>CONCLUSIONS</b>Glutamate is thought to be a primary amino acid neurotransmitter at the synapses formed by cochlear hair cells and spiral ganglion neurons. However, the excessive glutamate is neurotoxic for cells, and it can destroy the IHCs and spiral ganglion neurons. The present method can also be built up as an animal model of auditory neuropathy.</p>