A phased swallowing training program after partial laryngectomy / 中华物理医学与康复杂志

Objective:To construct an evidence-based phased swallowing training program for patients after partial laryngectomy applying the Delphi method.Methods:Evidence was screened systematically applying evidence-basing principles to construct a first draft of a phased swallowing training program for patients after partial laryngectomy. After two rounds of Delphi expert consultation a final draft was formed.Results:The protocol was composed of 27 items covering 5 aspects of the gastrointestinal decompression period, the first- and second-stage continuous tube feeding periods, trial feeding of the intermittent tube feeding period and the oral feeding stage.Conclusion:The phased swallowing training program is scientifically sound and feasible in clinical practice. It can provide references for clinic staff to improve swallowing management.

Surgical management of elderly patients with medial wall pyriform sinus cancer / 中华肿瘤杂志

Objective@#To investigate the clinical efficacy of preoperative-, postoperative-radiotherapy and surgery for preserving laryngeal function in patient over 70 years of age with medial wall pyriform sinus cancer.@*Methods@#Clinical data of 48 patients over 70 years of age with medial wall pyriform sinus cancer who received surgical treatment from January 2001 to December 2010 were retrospectively analyzed. Among them, 21 cases were given preoperative radiotherapy and surgery (R+ S). The radiation therapy dose was 45 Gy. And 14 cases′ larynx is preserved. In addition, 27 cases were given postoperative radiotherapy and surgery (S+ R). The radiation therapy dose was 65 Gy. And 10 cases had preserved laryngeal function. Survival rates were analyzed by the Kaplan-Meier method. Chi-square test was used to compare complications between two groups.@*Results@#The larynx preservation rate in R+ S group [66.7% (14/21)] was significantly higher than that in S+ R group [37.0% (10/27), P<0.05]. The complication rate and decannulation rate in R+ S group were 42.9% (9/21) and 64.3% (9/14), respectively, showing no difference compared with those in S+ R group [37.0% (10/27) and 50.0% (5/10), respectively] (all P>0.05). The complication rates of patients with and without larynx preservation were 41.7% (10/24) and 37.5% (9/24), respectively, showing no difference between two groups (P>0.05). The overall 3-years and 5-years survival rates for all patients were 54.2% (26/48) and 35.4% (17/48), respectively. There was no significant difference in survival rates between R+ S [38.1% (8/21)] group and S+ R group [33.3% (9/27), P>0.05)]. In the R+ S group, the survival rates in patients with and without larynx preservation were 40.0% (4/10) and 29.4% (5/17), respectively, showing no significant difference between two groups (P>0.05).@*Conclusions@#It is secure and effective to choose the operation with laryngeal preservation for patient over 70 years of age with medial wall pyriform sinus cancer based on their physical conditions and the tumor extension. The preoperative- and postoperative-radiotherapy have the similar effect. Preoperative radiotherapy and surgery increases the laryngeal preservation rate.

Treatment of intractable aspiration after partial laryngectomy by cuffed tracheostomy tube with inner cannula / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate the efficacy of cuffed tracheostomy tube with inner cannula for the treatment of intractable aspiration after partial laryngectomy.@*Methods@#From May 2010 to June 2015, 15 patients with intractable aspiration after partial laryngectomy of laryngeal and hypopharyngeal carcinoma were enrolled. Cuffed tracheostomy tube with inner cannula was used in the 15 patients for treatment of intractable aspiration. The patients and their family were trained to manage the cuffed tracheostomy tube with inner cannula and to eat since the 14th day after surgery. Cuff was initially inflated with 10 ml air and then deflated of 0.5 ml air every 2-3 days. Until the inflation of cuff was no longer required, the cuffed tracheostomy tube was replaced by metal tracheostomy tube. The patients′ swallowing function and aspiration were evaluated 6 months after treatment.@*Results@#The 15 cases with intractable aspiration were treated with cuffed tracheostomy tube with inner cannula and after 2-3 months, 14 of them replaced the cuffed tracheostomy tubes with inner cannula by metal tracheostomy tubes and recovered oral eating, and tracheostomy tubes were no longer required for 12 of 14 patients in following 3-6 months, showing a total decannulation rate of 80% in the patients with refractory aspiration.@*Conclusion@#It was safe and effective to treat aspiration after laryngeal and hypopharyngeal surgery with cuffed tracheostomy tube with inner cannula.

Lymphadenectomy using dissection and protection of carotid sheath and main nerves in surgery for benign diseases in the neck / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the significance of lymphadenectomy using dissection and protection of carotid sheath and main nerves in treating complex benign disease of neck.@*Methods@#A total of 54 cases with benign diseases in neck who received the protective surgical treatments were reviewed. There were 25 cases of recurrent branchial fistula, 15 cases of lymphoid tuberculosis, 5 cases of cystic hygroma, 5 cases of racemose angioma, and 4 cases of Madelung's disease. According to the location and extent of disease, all cases received operation with dissection and protection of carotid sheath and main nerves to removal lesions with lymphoid tissue and fat-connective tissue.@*Results@#All cases recovered well, and no recurrence occurred with follow-up of 3 to 65 months. There was no other complication except for occurring of Horner syndrome in 1 patient.@*Conclusion@#The protective surgical method has certain application value in the treatment of benign neck diseases that have no indefinite boundary and widely distribute.

A clinical reaserch of endoscopic endonasal transsphenoidal surgery for pituitary macroadenoma / 临床耳鼻咽喉头颈外科杂志

Objective:To share our exprience with the surgical management of pituitary macroadenoma and giant adenoma excision technique through the endoscopic transsphenoidal approach. Method:A retrospective analysis data of 27 patients with pituitary macroadenoma and giant adenoma surgery methods, postoperative complications and follow-up results. Result:All patients have no postoperative complications happened such as: nasal bleeding, intracranial hemorrhage, cerebrospinal fluid leak, blood sugar increased. Tumors invaded cavernous sinus in 5 cases, surrounded internal carotid artery in 2 cases, compressed optic chiasma in 7 cases and encroached optic nerve in 1 case. Postoperative vision decline occurred in 2 cases: 1 case recovered to the preoperative level after being taken out nasal stuffing and with conservative treatment, 1 case (preoperative visual acuity 0.1) restored light perception after conservative treatment. Postoperative diabetes insipidus occurred in 4 cases, and recovered in next week with corresponding therapy. Conclusion:Endoscopic endonasal transsphenoidal surgery is a safe and effective surgical technique.

Use of Self-retaining Laryngoscope in Difficult Laryngealy Exposure in Laryngeal Microsurgery / 听力学及言语疾病杂志

Objective To investigate the safe and effective method for laryngeal microsurgery in difficult la‐ryngeal exposure cases .Methods We selected 62 patients’ clinical data who had received laryngeal microsurgery with difficult laryngeal exposure and could not exposure by normal self -retaining laryngoscope between July 2012 and June 2015 .There were 42 cases of vocal cord polyp ,9 cases of the vocal cyst ,5 cases of the vocal amyloidosis , 4 cases of severe atypical hyperplasia of vocal cords and 2 cases of vocal cord high differentiated squamous carcino‐ma .We completed all kinds of laryngeal microsurgery to expose the glottis by adjusting the postures of patients ,in‐creasing the anesthesia depth ,using self -retaining laryngoscope with endoscopy which can be adjusted and pressing the throat .Results In 62 patients ,58 patients were successfully operated with adjustable self -retaining laryngo‐scope with endoscopy ,the success rate was 93 .55% .And 25 cases was exposed the glottis completely by increasing the anesthesia depth ,however ,when we increased the anesthesia depth ,there were 10 cases needed to combined with pressing the throat to expose .Five patients had retropharyngeal injure with different levels .One case with small jaw deformity of the vocal cord polyp surgery was not successful ,the success of electronic endoscopic under surface anesthesia surgery .The other one case with teeth unkempt and porcelain teeth and two cases of intraoperative frozen tip vocal cord cancer completed the operation of the open throat under the non trachea incision .Conclusion Most of difficult exposed laryngeal can be safely and effectively exposed through using the adjustable self -retaining laryngo‐scope with endoscopy while normal self -retaining laryngoscope can not .When necessary ,we can put 30°endoscope into the side channel of self -retaining laryngoscope to complete all kinds of laryngeal microsurgery .

Diagnosis and surgical treatment of Madelung's disease / 中国耳鼻咽喉头颈外科

OBJECTIVE To discuss t he diagnosis and surgical methods of the Madelung's disease. METHODS Detailed clinical data of 6 patients with Madelung's disease who was received surgical treatment in our department from January 2011 to November 2015 were reviewed. RESULTS All patients were male, aged from 35 to 65 years. The 6 patients had excessive subcutaneous fat deposit predominantly around the neck. One of the 6 patients had excessive fat deposit in larynx. All patients had history of heavy drinking. Two patients had the complication of cardiac disease, pulmonary disease and cerebral disease. One patient had the complication of glucose intolerance. Five patients were associated with sleep apnea syndrome. One patient came to hospital with dyspnea in emergency. All patients had received surgical treatment and abstinence from alcohol, 4 patients had the total neck lipectomy and tracheotomy. One patient had the total neck lipectomy with no tracheotomy. One patient had received emergency surgery-partial neck lipectomy and tracheotomy because the patient came to hospital with dyspnea in emergency. This case was referred to respiratory department without a second surgery for his severe complications and high surgical risk. This case discharged with tracheal tube. No obvious recurrence was seen during a follow-up of 15 days to 48 months. The pathological results were nonencapsulated fat. CONCLUSION Madelung's disease is a kind of benign disease arised from lipodystrophy which characterized by massive accumulation of nonencapsulated subcutaneous fat mainly located symmetrically in the fascial space of neck and shoulder. Most patients had heavy drinking history, chronic alcoholism may be a major risk factor. It may be associated with some complications. Total neck lipectomy has good effect. The aim of the operation is to improve outline appearance and function of the neck, which is good for patient's quality of life.

Study on prelaryngeal node metastases in different glottic carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the rules of prelaryngeal node metastases in different glottic carcinoma in order to provide basic information for standard operation the laryngeal cancer. METHODS Prelaryngeal lymph node dissection was performed in 92 cases with glottic carcinoma.The differences of tumor staging, pathological typing, postoperative cervical or local recurrence, survival time were compared and analyzed between the groups of positive and negative prelaryngeal node. RESULTS There were 5 cases (5.4%) with positive prelaryngeal node among 92 cases. The prelaryngeal nodes in advanced laryngeal cancer (III, IV stage) was more easily to be metastasized than those in early stages (I, II), the difference was statistically significant. There was no significant difference in prelaryngeal node metastasis among different pathological types.The local and regional recurrence rates in positive prelaryngeal lymph node metastasis group were higher than those in the negative group, the difference was statistically significant. Compared with positive group, the negative group had a longer survival time,and the difference was statistically significant. CONCLUSION The rate of prelaryngeal node metastases is high in patients with advanced glottic carcinoma. Once the prelaryngeal node metastases occur, the recurrence rate will be increased and the prognosis is poor, that suggest the importance of standardized treatment.

Efficacy and safety of harmonic scalpel in neck dissection: a Meta-analysis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To systematically evaluate the efficacy and safety of harmonic scalpel in neck dissection.@*METHOD@#Available literatures of PubMed, EMBASE, Cochrane Library, Google Scholar, CBM, CNKI, WangFang and VIP published before June 2014 were searched. Inclusion criteria and quality assessment were performed. All data were analyzed by using RevMan 5.2 software.@*RESULT@#Fourteen studies including 632 cases were enrolled. Among them, 319 cases were in harmonic scalpel group and 313 cases in conventional resection group. Compared with conventional resection group, the harmonic scalpel group showed shorter surgery time(weighted mean difference [95% confidence intetval]: -28.01 [-36.83, -19.19], Z = 6.22, P < 0.01)and less intra-operative blood loss (weighted mean difference [95% confidence intetval]: -46.68 [-57.25, -36.12], Z = 8.66, P < 0.01). The number of cervical lymph nodes dissected and the incidence of postoperative chylous leakage were similar in both groups.@*CONCLUSION@#Using the harmonic scalpel in neck dissection was as efficient and safe as that of the conventional technique with the advantage of shorter time of surgery and less intraoperative blood loss.

The options of surgery and laryngeal preservation for hypopharyngeal cancer patients more than 65 years old / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the effectiveness of preserving laryngeal function for senile hypopharyngeal cancer patientsolder than 65.@*METHOD@#The clinical data of 58 surgery cases of senile hypopharyngeal cancer patients more than 65 years old were colleted and analyzed. Thirty-one cases preserved the laryngeal function, while the rest did not. Perfect preoperative preparation was done before surgery. Surgical resection specimens were sent to frozen-section examination. When the negative incisal margin was confirmed, the defect was repaired by the appilication of local stitching, ribbon muscle flap, major myocutaneous flaps, split thickness skin and replacement of esophagus by stomach. Radical radiotherapy was used after surgery. Survival rate was calculated by the Kaplan-Meier method. Chi-square test was used to compare complications of the two groups.@*RESULT@#The 3 years and 5 years survival rate for all cases were 48.3% (28/58) and 27.6% (16/58), respectively. For patients with laryngeal function preservation, the 3 years and 5 years survival rate were 51.6% (16/31), 29.0% (9/31), respectively. For cases without laryngeal function preservation, the 3 years survival rate and 5 years survival rate were 44.4% (12/ 27), 25.9% (7/27), respectively. The result showed no obvious difference in survival rate between two groups (P > 0.05). Surgery complication rate were 45.2% (14/31) and 40.7% (11/27), without obvious differences between the two groups (P > 0.05).@*CONCLUSION@#It is feasible for senile hypopharyngeal cancer patients to choose suitable operation based on their physical conditions and the tumor extension. The key issues include well perioperative treatment management, correct indications grasp, and intraoperative repair skills improvement.

Evaluation on the hearing, speech and quality of life for cases received cochlear implant / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Through the use of the categories of auditory performance (CAP-II), the speech, spatial and qualities of hearing scale-parents' version (SSQ-P), children using hearing implants quality of life (CuHI-QoL) in patients with prelingual hearing impairment to compare the rehabilitation effect between preoperative and postoperative auditory performance, speech behavior and quality of life and at the same time to figure out dose rehabilitation effect connected to age.@*METHOD@#Mainly used classification method to compare the audotory performance, speech behavior and quality of life of 50 patients before and after 2.5 years after the implantation. At the same time these 50 patients are divided on the basis of the age received the surgery, A group received the surgery before 6(1.0-5.9) years old and group B received the therapy after this age (6.0-10.9). Their auditory performance, speech behavior and quality of life were all evaluated.@*RESULT@#There were statistical difference between two kinds of classification method of CAP-II. In the study of SSQ-P and CuHI-QoL, there was no statistical difference in well-being and happiness before and 3 years after the implant, also there was no statistical difference in parental stress between two age groups. In addition to the above two, the rest all have statistical significance.@*CONCLUSION@#After the implant, postoperative auditory performance, speech behavior and quality of life all had improved and the smaller the age, the better the performance.

Clinical and diagnosis analysis of malignant lymphoma in nasal cavity and paranasal sinus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical features, imaging characteristics, pathological types, the misdiagnosis causes and the early diagnosis method of malignant lymphoma in nasal cavity and paranasal sinuses.@*METHOD@#Clinicopathological data of 34 patients with malignant lymphoma in nasal cavity and paranasal sinuses were retrospectively analyzed.@*RESULT@#Most of patients were middle aged man, the incidence of malignant lymphoma of nasal cavity and paranasal sinuses accounted for 21.7% of nasal malignant tumor over the same period, nasal malignant lymphoma incidence rate was higher than the sinus malignant lymphoma (76.5% VS. 17.6%). The main symptoms were presented as snuffle, epistaxis, purulent nasal discharge, fever and so on. Nasal neoplasm, nasal mucosa hyperemia, erosion, necrosis are the main signs of the disease. CT features were summarized as the lesions located in the anterior-middle area in nasal cavity, homogeneous in density, soft tissue swelling in some cases and less bone destruction. The majority pathological type of nasal malignant lymphoma was NK/T cell lymphoma, but the common pathological type of paranasal sinus malignant lymphoma was B-cell lymphoma. The misdiagnosis rate of malignant lymphoma in nasal cavity and paranasal sinus was 21.2%.@*CONCLUSION@#Malignant lymphoma in nasal cavity and paranasal sinuses without specific clinical characteristics, but has some certain CT characteristics. Combined with the clinical, imaging and pathological features, can improve the cognition and diagnosis of the disease.

Middle ear cancer recurrence after operation+radiotherapy with adjacent tissue necrosis: two cases report / 临床耳鼻咽喉头颈外科杂志

Retrospective analysis of two cases of advanced carcinoma of the middle ear. Two patients underwent operation and radiotherapy. A case developed extensive necrosis in ear and neck, which finally led to lethal hemorrhage. Multiple relapse with cranial fossa invasion and extensive necrosis was found in the other case.

Laryngeal function preserving surgery in elderly hypopharygeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the indications and the effective treatment methods of laryngeal function preserva tion in aged patients with hypopharyngeal carcinoma.@*METHOD@#Clinical data about 41 patients with hypopharygeal carcinoma were analysed. These patients were more than or equal to 60 and were treated from January 2006 to December 2011. Among them, 25 cases were treated with laryngeal functions preserved and the hypopharynx defect was immediately re paired by the adjacent tissue flap or (and) the pactoralis major myocutaneous flap according to the size of defect after tumor resecting. The survival rate was calculated by Kaplan-Meier method.@*RESULT@#In 25 patients with laryngeal function preservation, 16 cases were 60-69 years old, 6 cases were 70-79 years old and 3 cases were 80-88 years old. The tumour located at lateral wall of pyriform sinus in 14 cases, at anterior wall of pyriform sinus in 3 cases, at inside wall of pyriform sinus in 3 cases, at upper side wall of hypopharynx invading tonsil or tongue base in 3 cases, at posterior hypopharyngeal wall in 2 cases. The average length of post-operation stay was 22.2 days. Eight cases suffered from post-operative complications (32%), including of pharyngeal fistula in six cases and pulmonary infection in two cases. The respiratory function and pronunciation were all restored, in 25 cases, among which 20 cases removed tracheostomy tube about 3 months after surgery. 2 cases were missed after 1-year followed up. 2 cases died of local tumor recurrence. 4 cases died of neck recurrence. 8 cases died of pulmonary matastasis. The 1-year and 3-year survival rate of the disease in the group was 67.5% and 43.9% respectively.@*CONCLUSION@#As the aged cases of hypopharygeal carcinoma are choosed appropriately and repaired feasibly, surgery for the disease with laryngeal function retention may be safe and effective.

Experience of the laryngeal recurrent nerve dissection in difficult thyroid surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the methods of the larygeal recurrent nerve dissection in different and difficult thyroid surgery, so as to minimize damage and improve the safety of the operation.@*METHOD@#The process and methods in different laryngeal recurrent nerve dissection about 52 hospitalized patients from 2010 to 2012 were retrospectively analyzed. These cases include large nodular goiter, nodular goiter behind the sternum or located in the lower pole of the thyroid gland, thyroid cancer, tumors of parathyroid gland, etc. We studied the conditions of lesions involving the laryngeal recurrent nerve and the defensive measures to protect the nerve.@*RESULT@#The laryngeal recurrent nerve was dissected successfully in 50 cases, except 2 cases whose laryngeal recurrent nerve were violated by thyroid cancer.@*CONCLUSION@#When we dissect the laryngeal recurrent nerves in different and difficult thyroid, the glands and tumors were mostly needed to be freed and turned inward and forward. After that, the laryngeal recurrent nerves can be dissected successfully with the markers of tracheoesophageal groove, inferior thyroid artery and/or angle under the thyroid cartilage.

Investigation of outcomes by controllable appliance in patients with obstructive sleep apnea and hypopnea syndrome treatment / 安徽医科大学学报

44 obstructive sleepapnea-hypopnea syndrome ( OSAHS) patients were Supplemented by an controlla-ble appliance in their intervene treatments. The data of polysomnography ( PSG) , Epworth sleepiness scale( ESS) and quality of life-Quebec sleep questionnaire( QSQ) before and 3 treatment period months after oral appliance were recorded. Correlations between subjective and objective measure before treated with OA and subsequently investi-gate treatment mechanism of oral appliance( OA) . Correlations indexes between before and after 3 treatment with an controllable appliance, and evaluation had statistically significance ( P <0. 05 ) . Absolute correlations between PSG indexes and subjective measures before oral appliance ranged from 0. 321 ~0. 433 , and 3 treatment period months after oral appliance ranged from 0. 306~0. 437 . Both PSG indexes and quality of life improved significantly after oral appliance(P<0. 05).

Imaging characteristics of CT, MRI of tumors involving skull base in the parapharyngeal space / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss imaging characteristics of CT, MRI of tumors involving skull base in the parapharyngeal space,maximatily limit and improve the diagnosis rate of tumors involving skull base in the parapharyngeal space.@*METHOD@#Thirty-one patients with tumors involving skull base in the parapharyngeal space treated in our department were collected and reviewed. All the patients have pathological diagnosis and were examined by CT and/or MRI. To explore shape of tumor, its relation with surrounding structures, CT shows density size and the MRI signal directly through retrospective analysis of imaging characteristics of CT, MRI.@*RESULT@#In all the 31 cases, 19 tumors were schwannoma, 8 tumors were mixed tumor of salivary gland, 2 tumors were carotid body tumor. 2 tumors were nasopharyngeal carcinoma involving skull base. Schwannomas and salivary gland mixed tumor can be expressed as round or oval with periphery smooth, and had intact capsule. The tumors had necrosis, sac variable area. Pleomorphic adenoma are all derived from deep parotid. Schwannoma had clear boundary with deep parotid. The effect of cavum nasopharyngeal and cavum oropharyngeal is relevant to tumor sizes and locations. Imaging characteristics of CT, MRI for carotid body tumor show soft tissue mass with attenuation similar to that of muscle. CT enhancement scan show intense enhancement. MRI show imaging of flowing empty vein. Imaging characteristics of MRI for nasopharyngeal carcinoma involving skull base in the parapharyngeal space show oval mass with low density signal, T1WI enhancement scan show necrosis, sac variable area.@*CONCLUSION@#CT and MRI could provide the position, size, boundary of the tumor and its relationship with cervical blood vessels well, which were important to operation schemes. CT and MRI before operation are valuable to the treatment of PPS tumors.

Clinical analysis on 15 cases with cystic lymphangiomas located in head and neck in children / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the diagnosis and effective treatment of cystic lymphangiomas located in head and neck in children.@*METHOD@#Fifteen cystic lymphangiomas,diagnosed with pathological evidence, located in head and neck in children were retrospectively analyzed including clinical characteristics, diagnosis, treatment and follow-up data.@*RESULT@#CT and ultrasonography were used to evaluate the size, shape and extent of lymphangiomas in all patients. All patients were treated with surgery. Complete resection was performed in 14 cases, and subtotal resection in one case. Two post-operative complications were found,one was paralyses of mandibular branch of facial nerve, another was Horners syndrome. Tracheotomy operation was done in one case,and the tracheal cannula was taken away before discharged from hospital. Fourteen patients were followed up. There was no recurrence during the follow-up from 6 months to 8 years, while one case who suffered from Horner's syndrome after operation was not cured.@*CONCLUSION@#CT and ultrasonography are effective to diagnose cystic lymphangiomas and evaluate the security of clinical treatment. Total or subtotal resection is effective to treat cystic lymphangiomas.

Analysis of clinical characteristics and treatment outcome of bilateral and unilateral sudden sensorineural hearing loss / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the clinical characteristics and treatment of bilateral and unilateral sudden sensorineural hearing loss (SSHL) and figure out the differences between bi-and unilateral sudden sensorineural hearing loss, and further improve the diagnosis and treatment of SSHL.@*METHOD@#The retrospective study was based on 334 patients with SSHL (315 with uni-SSHL versus 18 with bi-SSHL) and all of the patients were in-patients.@*RESULT@#The incidence of bi-SSHL was 5.4% of patients with SSHL. There was no significant difference on the clinical features such as age, gender, interval from onset of symptoms to seeing doctors and associated symptoms between bi-and unilateral SSHL. 27.8% of the patients with bi-SSHL had preexisting diabetes mellitus, which was significantly higher than the rate of the uni-SSHL (9.8%, P<0.05). Hearing loss was more profound in the uni-SSHL ones, however, the hearing improvements were better than their counterparts. The overall effective rate of the two groups was 58.4% and 13.9% respectively. Earlier diagnosis and treatment with steroids would have a good prognosis.@*CONCLUSION@#Unilateral SSHL is more common than bilateral SSHL. Bilateral SSHL occurs more common with preexisting diabetes mellitus and has worse prognosis compared to unilateral SSHL. The earlier steroid treatment the better prognosis.

Applied anatomy of operation through posterior tympanum approach / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To provide the anatomic data for operation on the middle ear through the observation and measurement of related anatomic structure.@*METHOD@#Forty human temporal bones of 20 voluntary bone donors were dissected, relative anatomical data of operation were observed and measured under operating microscope through posterior tympanum approach entering posterior tympanum.@*RESULT@#The average distances from suprameatal spine to short crus of incus, pyramid segment of facial canal were 19.14 mm, 16.30 mm, respectively. The average distances from pyramid segment of facial canal to the surface of mastoid, crotch of chorda tympani nerve, posterior wall of auditory meatus were 20.84 mm, 11.28 mm, 4.40 mm, respectively. The average length of facial nerve in the horizontal segment, the perpendicular paragraph was about 11.60 mm, 15.30 mm, respectively. The average distance from pyramidal eminence to the anterior lip of round window niche, from oval window to round window niche, from incudostapedial joint to round window niche was 4.46 mm, 3.74 mm, 3.80 mm, respectively. The included angle of facial nerve in the horizontal segment and chorda tympani nerve with facial nerve in the perpendicular paragraph was 110.4 degrees, 24.8 degrees, respectively. Horizontal semicircular canal and facial nerve in the level paragraph was 17.5 degrees, long process of incus and incus buttress was 46.0 degrees.@*CONCLUSION@#The position of anatomic structure in middle ear was constant and the relationship including distance and angle between anatomic structures changed in limited region. The anatomical parameters provide a reference value for avoiding the injury during the operation.