Advances in the treatment of infantile hemangiomas of the larynx / 临床耳鼻咽喉头颈外科杂志

Infantile hemangiomas are relatively common soft tissue tumors in infants and young children, with a prevalence of about 4.5% in full-term newborns. Subglottic Hemangioma （SGH） is a relatively rare type of hemangioma, and its special location often causes respiratory distress and potentially life-threatening conditions in infants. Therefore, it is necessary for clinicians to make an accurate diagnosis and formulate a detailed treatment plan based on the clinical manifestations, the auxiliary examinations, the medical history and the vital signs evaluation of patients.This review describes the pathophysiological mechanism of infantile hemangioma and provides a detailed discussion on commonly used treatment methods in detail.

The preliminary study of white matter integrity in patients with olfactory dysfunction / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the white matter integrity in patients with olfactory dysfunction using diffusion tensor imaging (DTI). @*Methods@#Twenty-one patients with olfactory dysfunction and sixteen age, sex and level of education matched normal subjects were recruited in this study. Sniffin′ Sticks olfactory test was performed to evaluate the olfactory function of all subjects. We acquired diffusion tensor images with a echo planar imaging (EPI) sequence from all subjects on a 3T scanner. The fractional anisotropy (FA) images were performed using DTI-studio, and bilateral piriform cortex, orbitofrontal cortex, hippocampus and insula cortex adjacent white matter as well as capsula interna were delineated from the FA images as the region of interest associated with olfactory (ROIawo) manually. Independent sample t test analysis was used to compare the FA value of all ROIawo between the controls and patients. @*Results@#In olfactory dysfunction group, the FA value of adjacent white matter of right piriform cortex and orbitofrontal cortex were significantly lower than those of control group (0.42±0.05 (±s) vs 0.45±0.05, 0.43±0.06 vs 0.49±0.07, t value was 2.32, 2.79, respectively, all P<0.05). The FA value of adjacent white matter of left piriform cortex and orbitofrontal cortex had no significant difference compared with those of control group (0.43±0.05 vs 0.45±0.04, 0.44±0.04 vs 0.47±0.06, t value was 1.65, 1.37, respectively, all P>0.05). The FA value of the adjacent white matter of bilateral hippocampus, insula cortex and capsula interna had no significant difference compared with those of control group, neither (0.45±0.08 vs 0.44±0.08, 0.45±0.09 vs 0.44±0.10, 0.41±0.08 vs 0.39±0.07, 0.41±0.07 vs 0.38±0.05, 0.64±0.08 vs 0.63±0.08, 0.64±0.07 vs 0.63±0.07, t value was 0.30, 0.15, 0.88, 1.34, 0.14, 0.35, respectively, all P>0.05). @*Conclusions@#The patients with olfactory dysfunction showed abnormal white matter connection in the major primary and secondary olfactory cortex. The reduced white matter integrity in ROIawo might contribute to the pathogenesis of olfactory dysfunction.

Assessment of the brain volume alterations in patients with hyposmia based on voxel-based morphometry / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the brain volume alterations in patients with hyposmia using voxel-based morphometry (VBM) and to correlate these alterations with the degree and duration of hyposmia.@*Methods@#Forty patients with hyposmia from Department of Otorhinolaryngology Head and Neck Surgery, Beijing Anzhen Hospital since 2013 to 2016 and forty age and sex matched normal subjects were recruited in this study. Sniffin′ Sticks olfactory test was performed to evaluate the olfactory function of all subjects. We acquired T1-weighted magnetic resonance images from all subject on a 3T scanner. VBM was performed using VBM8 toolbox and SPM8 in a Matlab environment. Independent sample t test analysis was used to compare the volume of gray and white matter between the controls and patients. In addition, the Pearson or Spearman correlation analysis was used for the correlation between the voxel value of cerebral volume alterations area and the degree and duration of hyposmia on patients (threshold discrimination identification, TDI). @*Results@#Compared with the controls, patients showed significantly decreased volume in the gray matter of right orbitofrontal cortex (number of voxel in clusters was 226, t=-4.46, P<0.001, uncorrected). There was negative correlation between decreased gray matter volume of the right orbitofrontal cortex with significantly decreased area and the TDI results (r=-0.40, P=0.01), but positive correlation with duration of hyposmia (r=0.37, P=0.02). @*Conclusions@#The patients with hyposmia show gray matter atrophy of the right orbitofrontal cortex. The duration may be an important risk factor for decreased gray matter in patients with hyposmia.

Effects of ischemia on olfactory bulb in rats / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the olfactory bulb's morphological change after ischemic injury in rats, and explore the role of vascular factor in olfactory disorders.@*METHOD@#Forty adult SD rats (weighting 250-300 g) were used, 30 of which were treated with permanent bilateral occlusion of both common carotid arteries, and the others were served as the control. The olfactory bulbs were carefully taken out on the 1st week, 4th week, 2nd month post operation, respectively, then observed the morphological changes by light microscopy. The ultra structure of cells in olfactory bulbs were also observed by transmission electron microscope.@*RESULT@#In rats with permanent bilateral occlusion of both common carotid arteries, the vascular pattern changed and the cell number decreased in olfactory bulbs by light microscopy. In the 1st week group, the mitral cells' mitochondria injury and metamorphism were found. In the 4th week group, the microvascular paramorphia, lipofuscin in mitral cells and metamorphic nerve fibers were found by transmission electron microscope.@*CONCLUSION@#Ischemia could injure the neuron and nerve fiber. This may be one of the reasons of olfactory disorders.

Correlation between olfactory disorders and morphology of nasal cavity / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the correlation between olfactory disorders and the morphology of nasal cavity in chronic rhinosinusitis (CRS).@*METHOD@#One hundred and seventy-six patients with chronic rhinosinusitis and/or polyps were included. Olfactory function, the morphology of nasal cavity and nasal sinus, especially the morphology of olfactory cleft, were surveyed by T&T Olfactometer, nasal endoscope and computed tomography (coronal and horizontal position). All patients were divided into 5 groups by different olfaction level. Data was achieved by the scoring endoscopic appearances of Kennedy, and CT staging system of Lund-Mackey and analyzed by SPSS 11.5.@*RESULT@#(1) Among all patients, 61.9% accompanied with hyposmia, 21% with anosmia , the other 17.1% with normal olfaction; (2) There was positive correlation between the scores of staging system of Lund-Mackey and the olfactory function level (P < 0.01) (3) There was positive correlation between the scores of endoscopic appearances of Kennedy and the olfactory function level (P < 0.05).@*CONCLUSION@#(1) Olfactory function were correlated with the severity of CRS; (2) As the determining methods of CRS, staging system of Lund-Mackey can be used to estimate the olfactory function generally and initially; (3) There was not significant difference between the scores of endoscopic appearances of Kennedy and the olfactory function level.