Clinical analysis of head and neck basal cell adenoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To analyze disease-related clinical features and therapeutic effects of basal cell adenoma in head and neck. METHODS Clinical data of 9 patients with pathologically diagnosed basal cell adenoma in head and neck between Mar 2007 and Jan 2016 in our department were analyzed retrospectively. The ratio of male 3 to female 6 was 1:2. The median age of the patients was 48.9 years old(22 to 65 years). 5 cases affected parotid gland, 1 occurred in left maxillary sinus and infratemporal fossa, 1 involved nasopharyngeal and pterygopalatine fossa, 1 originated from nasal vestibule and 1 derived from nasal septum. RESULTS 8 of the patients underwent surgical treatment, while one patient with tumor involving the left maxillary sinus and infratemporal fossa was given a transnasal surgery for concurrent rhinosinusitis and subsequently confirmed by pathology. The postoperative follow-up period was between 1 and 10 years. One patient with tumor affecting infratemporal fossa recurred 1.5 years after surgery, while the rest shown no signs of recurrence and complication. CONCLUSION Basal cell adenoma in head and neck is a rare kind of disease. Clinical features and imaging helped to differenced basal cell adenoma in head and neck from other diagnoses, but definite diagnosis relies on the pathological tests.Surgery may provide good effects and prognosis on patients with basal cell adenoma.

The relization of EABR test out of cochlea and the effects of different location of electrode on EABR wave / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the feasibility of the round window stimulation electrical evoked auditory brainstem response (EABR) test, and optimize the parameters of recording and stimulation electrodes positions.@*METHOD@#Ten healthy Hartley guinea pigs (20 ears) were used for the EABR test. The positive stimulation electrodes were placed into the round window niche, the animals were divided into three group according to the negative electrodes position, group A: the electric field was parallel with the projection of cochlear modiolus on the tympanic membrane, group B: the electric field was perpendicular to modiolus projection toward to the mastoid, group C: the electric field was perpendicular to modiolus projection toward to the zygomatic process. A series of optimized recording and stimulation parameters were uesed to reduce the electrical artifact.@*RESULT@#All the 20 ears were normal in the ABR testing, and EABR waves were stable and well-differentiated in the EABR tests out of cochlea. But EABR waves of group A were more stable and differentiated than those of group B and C. In group A, the threshold of EABR was (0.54 ± 0.11) mA, and latency of wave III was (1.71 ± 0.05) ms when the stimulus intensity was 0.8 mA. In group B, the threshold of EABR was (0.62 ± 0.12) mA, and latency of wave III was (1.77 ± 0.03) ms. In group C, the threshold of EABR was (0.70 ± 0.14) mA, and latency of wave III was (1.86 ± 0.04)ms. The threshold of EABR and latency of wave III were significantly different among the three groups by statistic analysis.@*CONCLUSION@#EABR waves were stable and well-differentiated in the EABR tests out of cochlea. The EABR waves were recorded more stably and differentiated when the stimulating electrode and recording electrode were paralleled with the projection of modiolus on the tympanic membrane.

Development of electrically evoked auditory brainstem response modules of REZ-I domestic cochlear implant device / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To develop electrically evoked auditory brainstem response(EABR) modules of REZ-I domestic cochlear implant device, and testify the reliability and validity of the modules.</p><p><b>METHODS</b>Postoperative EABR were recorded in guinea pigs by using the self-designed EABR module.</p><p><b>RESULTS</b>EABR waves were recorded in all 15 ears of 9 guinea pigs with normal hearing. The threshold was (159.00 ± 50.21) current level (CL) and eIII wave latency was (2.36 ± 0.46) ms of 100 µs pulse width stimulation; for 150 µs pulse width stimulation, the threshold was (131.44 ± 49.25) CL and eIII wave latency was (2.59 ± 0.46)ms; for 200 µs pulse width stimulation, the threshold was (119.63 ± 52.56) CL and e III wave latency was (2.62 ± 0.44)ms.</p><p><b>CONCLUSION</b>According the preliminary results of the study, the reliability and stability of the EABR modules of domestic cochlear implant device can meet the demands of EABR recording.</p>

Blink restoration by the functional electrical stimulation in unilateral facial nerve palsy rabbits / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Tocompare the effects of different waveforms and parameters of electrical stimulation to elicit a blink, and construct a functional electrical stimulation (FES) system to restore synchronous blink in unilateral facial nerve palsy (FNP).</p><p><b>METHODS</b>Firstly, twenty-four rabbits were surgically induced unilateral FNP and were divided into three groups, who received square, sine and triangle pulse wareforms, respectirely. Both the healthy and the paralysis eyelids of the rabbits received pulse train stimulation to produce a blink in both eyes. For each rabbit, twenty-seven combinations of frequencies (25 Hz, 50 Hz and 100 Hz) and nine pulse widths (1-9 ms) were stimulated. The threshold amplitude and electric charge to elicit a blink was compared between different waveforms and different parameters. Secondly, a FES system was constructed to treat six surgically induced unilateral FNP rabbit chosen in the twenty-four rabbits, it consisted by an electromyogram (EMG) amplifier module which record the EMG of the healthy muscle, and a stimulator which received the EMG input and output a pulse train stimulation when triggered by the EMG.</p><p><b>RESULTS</b>When the carrier frequency of the pulse train was 25 Hz, it was not able to induce a smooth blink. However, when the carrier frequencies were 50 Hz and 100 Hz, a smooth blink could be induced. The voltage required by 100 Hz was lower than 50 Hz, but it cost more electric charge. The amplitude that square waveforms required was far lower than sine and triangle, but the electric charge between the three waveforms was similar. Synchronous blink could be restored in the six unilateral FNP rabbits with the FES system.</p><p><b>CONCLUSIONS</b>To elicit a blink, square pulse train delivered in 50 Hz is a preferable option. The motion of the healthy eyelids as a source of information for stimulation of the paralyzed sides can restore the synchronous blink in unilateral FNP rabbits.</p>

Extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach for maxillary lesions / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility of the extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach.</p><p><b>METHODS</b>Eight patients underwent extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach for maxillary sinus lesions. The indications, surgical management and outcomes of the surgery were presented.</p><p><b>RESULTS</b>There were 2 cases of maxillary dentigerous cyst with oroantral fistula, 2 cases of antrochoanal polyp, 2 cases of maxillary sinus inverted papillomas, 1 case of odontogenic maxillary sinusitis with oroantral fistula, and 1 case of maxillary sinus mucocele. All patients underwent extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach without intraoperative complication, with good access to the lesions. Complete resection could be achieved through this approach, no postoperative complications occurred except one patient had a delayed wound healing of inferior turbinate, all patients were free of recurrence with the average postoperative follow-up of 7.8 months (range 4-12 months).</p><p><b>CONCLUSION</b>The extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach is recommended for some maxillary pathology owing to its good access to the lesions and complete resection.</p>

The choice of approach in chronic otitis media surgery / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the choise of operation approach for chronic otitis media surgery. METHODS Auditory and high resolution computed tomography (HRCT) assessment were carried out prior to the operation in 160 ears with otitis media. Tympanoplasty or mastoidectomy and tympanoplasty were performed. RESULTS Thirty-one patients received tympanoplasty and 129 patients received mastoidectomy and tympanoplasty. Closed and opened surgery were performed in 49 and 80 cases respectively. The ear-drying time ranged from 7 to 51days with an average of 23 days. Mean hearing increased by 15dB. CONCLUSION Assessing the HRCT scan prior to the surgery can help us choose a reasonable approach in chronic otitis media surgery.