Application of intraoperative CT-assisted positioning in difficult cases of cochlear implantation / 临床耳鼻咽喉头颈外科杂志

Objective:To report the experience of using CT-guided cochlear implant surgery in difficult cases such as severe inner ear deformities and anatomical abnormalities, and to discuss the application value of intraoperative CT-assisted localization in difficult cases of cochlear implant surgery. Methods:Retrospectively analyzed the clinical data of 23 cases of difficult cochlear implant surgery cases completed by our team with the assistance of intraoperative CT, and collected their medical data, including preoperative imaging manifestations, surgical conditions, and intraoperative imaging images for evaluation. Results:During the study period, 23 difficult cases（27 ears） underwent cochlear implantation under the guidance of intraoperative CT, and 4 cases were bilaterally implanted. Including 6 cases of incomplete segmentation type Ⅰ（IP-Ⅰ）, 1 case of incomplete segmentation type Ⅱ（IP-Ⅱ）, 10 cases of incomplete segmentation type Ⅲ（IP-Ⅲ）, 3 cases of common cavity deformity（CC） and 3 cases of cochlear ossification after meningitis. Facial nerve anatomy was abnormal in 9 cases, cerebrospinal fluid "blowout" was serious in 14 cases, electrode position was abnormal in 3 cases requiring intraoperative adjustment of electrode position, anatomical difficulties required intraoperative CT to assist in finding anatomical landmarks in 2 cases, and electrodes were not fully implanted in 3 cases. Conclusion:When faced with difficult cases with challenging and complex temporal bone anatomy, intraoperative CT can accurately evaluate the electrode position and provide intraoperative anatomical details, allowing immediate adjustment of the electrode position if necessary, providing safety guarantee for difficult cases of cochlear implant surgery and ensure accurate implantation of electrodes.

Expressions of annexins and epidermal growth factor receptor in pediatric middle ear cholesteatoma / 中华实用儿科临床杂志

Objective To explore the expressions of annexin and epidermal growth factor receptor(EGFR) in pediatric middle ear cholesteatoma.Methods Twenty-three children with middle ear cholesteatoma and 26 children with normal skin of external auditory canal(control group) were selected from the children enrolled in the First Affiliated Hospital of Zhengzhou University from August 2014 to March 2016.The expressions of annexin A1 (AnxA1),AnxA2 and EGFR mRNA in cholesteatoma and normal tissues were analyzed by quantitative real-time PCR (qPCR).Protein expressions of AnxA1,AnxA2 and EGFR were evaluated by using Western blot and immunohistochemistry methods.Results The expressions of AnxA1,AnxA2 and EGFR mRNA were significantly increased in cholesteatoma compared with the control group (AnxA1:4.68 ± 1.77 vs.2.65 ± 0.96,U =111.5,P ＜ 0.001;AnxA2:3.89 ± 1.00 vs.2.4 7 ± 0.81,U =84.5,P ＜ 0.001;EG FR:4.97 ± 1.85 vs.3.50 ± 0.95,U =15 3.5,P =0.004).AnxA1 and AnxA2 mRNA expressions were positively correlated with EGFR mRNA (AnxA1 and EGFR:r2 =0.283 2,P =0.009;AnxA2 and EGFR:r2 =0.213 5,P =0.027).Compared with the control group,protein expressions of AnxA1,AnxA2 and EGFR were markedly enhanced (AnxA1:0.450 ±0.031 vs.0.320 ±0.026,U =102.4,P ＜0.001;AnxA2:0.568 ±0.024 vs.0.365 ±0.028,U =94.6,P ＜0.001;EGFR:0.397 ±0.021 vs.0.228 ±0.017,U =128.4,P ＜0.001).The results of immunohistochemistry analysis showed that the ratio of AnxA1,AnxA2 and EGFR positive cells were higher than those in the control group(AnxA1:65.22％ vs.38.46％,x2 =9.296,P =0.026;AnxA2:69.57％ vs.46.15％,x2 =8.378,P =0.039;EGFR:69.57％ vs.50.00％,x2 =10.574,P =0.014).Conclusions The expressions of AnxAl,AnxA2 and EGFR are upregulated in pediatric cholesteatoma,with AnxA1 and AnxA2 expressions positively correlated with EGFR.

The Clinical Characteristics of Patients with Deafness Gene Related Hearing Loss in Children / 听力学及言语疾病杂志

Objective To study the age, the degree of hearing loss and the characteristics of inner ear imaging in children with GJB2 and SLC26A4 gene mutation-related deafness.Methods A total of 218 children with GJB2 and SLC26A4 gene mutations were enrolled in this study.Among them, with the combined test of deafness gene chip and DNA sequencing, 123 patients were diagnosed with GJB2 homozygous or complex mutations, and 95 patients were diagnosed with SLC26A4 homozygous or complex mutations.The age of the onset, the degrees of hearing loss and CT features of the temporal bone in children with GJB2 and SLC26A4 mutations were studied.Results The incidence of GJB2 and SLC26A4 gene mutations was 43.09%, 37.40%, 14.63%, 4.88% and 24.2%, 44.21%, 18.95% and 12.63% in the periods of infancy,early childhood,preschool and shoolage,respectively.The age composition of onset in the two groups showed statistical significance(P=0.014).The constituent ratio of children with moderate, severe and extremely severe degrees of hearing loss in the two groups with GJB2 and SLC26A4 gene mutations were 8.94%, 17.89%, 73.17% and 9.47%, 34.74% and 55.79%, respectively.Most of the group with GJB2 gene mutation had profound hearing loss, and the composition ratio of hearing loss degree in SLC26A4 group was statistically significant(P=0.014).99.19% of the children with GJB2 gene mutation group had normal structures of the inner ears.Only one case of CT showed bilateral internal auditory canal stenosis.For 95.79% of the children with SLC26A4 gene mutation, the CT results of the temporal bone were associated with the vestibular aqueduct expansion.Conclusion The onset age of GJB2 gene mutation children is concentrated in the infancy.Most of them are with very severe sensorineural deafness, not associated with the inner ear malformation.The onset age of SLC26A4 gene deafness children is concentrated in the early childhood.Most of them are with severe and extremely sever sensorineural deafness, closely related to vestibular aqueduct expansion and inner ear malformations.

The Clinical Characteristics and Treatment Effects on Old Patients with Sudden Sensorinerural Hearing Loss / 听力学及言语疾病杂志

Objective To study clinical characteristics and treatment effects on old patients with sudden sen-sorinerural hearing loss .Methods To compare clinical characteristics and effects of 357 cases of unilateral SSHL from Sep ,2013 to Mar ,2015 in the First Affiliated Hospital of Zhengzhou University .The patients were divided into 2 groups :the old group(66 cases)≥60 years ,and the control group(291 cases)0 .05) ,but there were less patients with the type in low frequencies (1 .51% ) and more with the type in high frequencies (22 .73% ) and the type in total deafness (50 .0% ) than those of in the control group(14 .43% ,15 .44% ,39 .52% ) .The old group had more patients with systemic diseases (60 .61% ) and the hearing impairment of the other ear (57 .58% ,P0 .05) .The old group's complete recovery rate was 10 .61% ,which was significantly lower than that in the control (P<0 .05) .Conclusion The old group has more patients with systemic diseases and the hearing impairment of the other ear .Their hearing impairment more easily occurs in the type in high frequencies and the type in total deafness . But the complete recovery rate is low ,the doctors and patients should have a reasonable expectation .

Etiological Analysis on Recurrent Otitis Media with Effusion / 听力学及言语疾病杂志

Objective To investigate the recurrent etiologic causes in otitis media with effusion(OME).Meth-ods The patients with OME had been conducted clinical evaluation and ventilation tube insertion.Among 255 cases observed,85 cases were recurrence within one year,while 170 cases were recovered.Factors including age,gender, course of disease,smoking environment,recurrent respiratory tract infection,chronic nasal sinusitis,nasal struc-tural abnormalities,adenoid hypertrophy/nasopharyneal lymphadenosis,and mastoid gasification condition,histo-ry of tube insertion,duration of ventilation tube were evaluated by univariate analysis and multivariate logistic re-gression analysis and compared among preschool children,school age children and adults.Results In univariate a-nalysis,it was strongly associated with age,higher prevalence of recurrent respiratory tract infection(χ2= 22.546,P= 0.000),chronic nasal sinusitis(χ2= 5.211,P= 0.023),adenoid hypertrophy/nasopharyneal lymphadenosis(χ2= 10.338,P= 0.002),mastoid pneumatization adverse(χ2= 15.196,P= 0.000)and duration of ventilation tubeand (χ2= 11.347,P= 0.001).In multivariate logistic regression model,five of these factors were found to be predictors of recurrent OME,which were younger age,recurrent respiratory tract infection (P= 0.001,OR= 2.992),adenoid hypertrophy/nasopharyneal lymphadenosis (P= 0.021,OR= 2.198),mastoid pneumatization adverse (P= 0.000, OR= 3.433)and duration of ventilation tube(3~6 m)(P= 0.010,OR= 2.237).When comparing the difference a-mong preschool children,school age children and adults,recurrent respiratory tract infections in preschool and school age children had the statistic significance(P<0.05),and adenoid hypertrophy in preschool had the statistic significance(P<0.05).Conclusion Younger age,recurrent respiratory tract infection,chronic nasal sinusitis,ade-noid hypertrophy/nasopharyneal lymphadenosis,mastoid pneumatization adverse and less time of ventilation tube are the risk factors causing recurrence of OME.When comparing the recurrent preschool children,school age chil-dren and adults cases,more recurrent respiratory tract infection in preschool and school age children have statistic significance,and adenoid hypertrophy in preschool has the statistic significance.

Analysis of Auditory Perception Skills in Pre - lingual Deaf Children with Inner Ear Malformation after Cochlear Implantation / 听力学及言语疾病杂志

Objective The aim of this study was to evaluate the outcomes of auditory perception skills after cochlear implantation in children with malformed inner ear and compare them with a group of congenitally deaf chil ‐dren implantees with a normal inner ear .Methods 21 children with inner ear malformation were retrospective stud‐ied .There were 9 cases with large vestibular aqueduct syndrome (LVAS) ,7 with Mondini abnormality ,5 with com‐mon cavity .The postoperative outcomes of these 21 cases were compared with 21 cases with normal inner ear struc‐ture .The outcomes of all the children after the surgery in 1 year were studied using the soundfield test in frequency ranging 0 .5 to 4 kHz and the auditory perception skills ,and the auditory perception skills consisted of natural envi‐ronmental sound recognition ,consonants recognition ,vowels recognition ,numeral recognition ,tone recognition , monosyllabe recognition ,disyllabe recognition ,trisyllabe recognition ,short sentences recognition ,selective hearing recognition .Results The results of soundfield test and auditory perception skills after cochlear implantation in 9 children with LVAS and 6 with Mondini abnormality had no significant difference (P > 0 .05) comparing with the control cases .Postoperative thresholds in soundfield test were 50 ~ 75 dB HL for 1 case with severe Mondini abnor‐mality ,the mean value of hearing ability score was 70 .5% ,and less than the results of control cases .Postoperative mean thresholds in soundfield test were 65 .26 ± 5 .13 dB HL for 5 cases with common cavity ,the hearing ability score was less than the results of control cases (P< 0 .05) .Conclusion The effect of rehabilitation had no difference between the children with LVAS and the cases with normal inner structure after cochlear implantation ,but was poo‐rer in children with severe Mondini abnormality and common cavity .It was necessary to evaluate the degree of mal‐formation of inner ear structure before cochlear implantation .

Analyses prognostic factors relevant to sudden sensorineural hearing loss / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the prognostic factors relevant to sudden sensorineural hearing loss.</p><p><b>METHODS</b>The internationally accepted standardized clinical research methods, unified design, and unified program were adopted to conduct the prospective clinical multi-center study. The sudden deafness patients between 18 to 65 years old, with the course of this disorder less than two weeks, and without any medical treatments were collected, and then, divided into four types according to the hearing curve: type A, acute sensorineural hearing loss in low tone frequencies; type B, acute sensorineural hearing loss in high tone frequencies; type C, acute sensorineural hearing loss in all frequencies; and type D, total deafness. The factors, in terms of age, gender, type of initial audiogram, time delay before the first visit, and severity of hearing loss, were included in the analyses.</p><p><b>RESULTS</b>A total of 1 024 cases with single side sudden deafness were collected in the study from 33 hospitals in China from August 2007 to October 2011, inclusive of for 492 males (48.05%) and 532 females (51.95%). The average age was (41.2 ± 12.8) years old. There were 553 cases (54.00%) in left ear, and 471 cases (46.00%) in right ear. The curative effects of different types were shown as follows: the type in low tone frequencies had the highest rate of 90.73%, the type in all frequencies was 82.59%; the type of total deafness was 70.29%; and the type in high tone frequencies had the lowest rate of 65.96%. It had significant difference of the effective rate between different types (χ(2) = 231.58, P = 0.000). Age, time delay before first visit, and severity of initial hearing loss were significantly correlated with hearing improvement.</p><p><b>CONCLUSIONS</b>Initial audiogram of SSNHL might predict hearing recovery. The young in age and a short time delay before starting treatment are positive prognostic factors for hearing recovery in SSNHL. The initial severity of hearing loss is negative prognostic factor of hearing recovery.</p>

The Effects of Tensor Tympani MuscIe on the Hearing Reconstruction Outcome / 听力学及言语疾病杂志

Objective To study the effects of the integrity of the tensor tympani muscle on the postoperative hearing recovery and the morphology of tympanic membrane,to provide the reference for the handling of the tensor tympani muscle during the operation.Methods A total of 145 cases of chronic tympanitis were grouped by the integ-rity of the tensor tympani muscle and the implanted types of biological auditory ossicles,the clinical data were ana-lyzed retrospectively.There were 80 cases in the tensor tympani muscle intact group,including 45 cases of PORP group and 35 TORP group.The tensor tympani muscle rupture group of 65 cases consisted of 34 cases of PORP group,and 31 cases of TORP group.The postoperative recovery conditions of tympanic membrane morphology, hearing threshold Ac and air-bone gap(ABG)between the tensor tympani muscle intact group and the tensor tym-pani muscle rupture group were compared 1 month or 3 months,and 6 months after the operation.ResuIts One month after the operation,there was no significant difference in tympanic membrane morphology between the two groups.Three months after the operation,the tensor tympani muscle intact group had a higher ratio about the loca-tion and shape of tympanic membrane ,closer to the normal than the tensor tympani muscle rupture group in which the ratio in the intact group was 81.25% (65/80),while in the rupture group it was 52.31% (34/65 ).After 6 months,with the operation of PORP,the tensor tympani muscle intact group of AC value was 27.48±10.02 dB HL, and ABG value was 13.57±6.36 dB,while the rupture group of AC value was 32.36±9.34 dB HL,and ABG value was 25.73±7.44 dB.With the operation of TORP,the tensor tympani muscle intact group of AC value was 28.76± 7.14 dB HL,and ABG value was 21.02±5.48 dB,while the rupture group of AC value was 39.93 ±5.12 dB HL, and ABG value was 31.41±6.25 dB.The postoperative recovery condition of the tensor tympani muscle intact group was better than those of in the rupture group.ConcIusion The tensor tympani muscle can maintain the morphology and location of the postoperative tympanic membrane.The integrity of the tensor tympani muscle may has a positive effect on the improvement of the postoperative hearing.

Clinical Analysis of 112 Cases of Vertigo Associated with Changes of Head Position / 听力学及言语疾病杂志

Objective To investigate the diagnosis and treatment of vertigo associated with changes of head position.Methods 112 patients of vertigo associated with changes of head position were analyzed from June 2006 to December 2007 through the positional tests and imaging examination.Results 45 men and 67 women from ages 12 to 75 (median 50) were included with a total of 112 patients.88 patients were diagnosed as benign paroxysmal positional vertigo(BPPV),76 patients as posterior semicircular canals BPPV,9 patients as horizontal semicircular canal BPPV,3 patients as anterior semicircular canals BPPV,9 patients as suspicious BPPV.They were treated by canalith repositioning procedure,the total improvement rate was 96.9% after 1 week.15 cases of cervical vertigo were treated by physical therapy and medication,the vertigo of 4 patients disappeared and of 11 patients was improved significantly after 2 weeks.Conclusion The positional tests and cervical plain x-ray are the simplest ways to diagnose vertigo associated with changes of head position.Physical therapy and medication are effective.It is suitable to promote in the grass-roots hospitals.

The diagnostic value of high resolution CT in assessment of temporal bone traumatic facial nerve paralysis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the diagnostic value of high resolution CT for temporal bone traumatic facial nerve paralysis and the guidance significance for surgery.@*METHOD@#Twenty-nine patients of traumatic facial nerve paralysis were investigated. The predictive diagnosis was made according to the clinical data and the image features of HRCT, then a comparative analysis of the preoperative image features and the surgical findings were carried out.@*RESULT@#The trend of temporal bone fracture displayed on the CT scan was basically consisted with the surgical findings. The direct CT signs of facial nerve injury include the bone fracture line went through the tube, bone tube rupture or continuity interruption, while the indirect CT signs include local incrassation of the facial nerve, lower bone density of the tube, geniculate fossa expansion, oppressed facial nerve, et al. The predictive diagnostic accordance rates of all the image features were above 90% as to the surgical findings.@*CONCLUSION@#High resolution CT could localize the trend of temporal bone fracture,and is helpful to estimate the extent of facial nerve injury and other complications. High resolution CT could provide reliable basis for clinical diagnosis and treatment.

The diagnostic value of high resolution CT in assessment of temporal bone traumatic facial nerve paralysis / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the diagnostic value of high resolution CT for temporal bone traumatic facial nerve paralysis and the guidance significance for surgery.Method:Twenty-nine patients of traumatic facial nerve paralysis were investigated.The predictive diagnosis was made according to the clinical data and the image features of HRCT,then a comparative analysis of the preoperative image features and the surgical findings were carried out.Result:The trend of temporal bone fracture displayed on the CT scan was basically consisted with the surgical findings.The direct CT signs of facial nerve injury include the bone fracture line went through the tube,bone tube rupture or continuity interruption,while the indirect CT signs include local incrassation of the facial nerve,lower bone density of the tube,geniculate fossa expansion,oppressed facial nerve,et al.The predictive diagnostic accordance rates of all the image features were above 90%as to the surgical findings.Conclusion:High resolution CT could localize the trend of temporal bone fracture,and is helpful to estimate the extent of facial nerve injury and other complications.High resolution CT could provide reliable basis for clinical diagnosis and trotment.

Intratympanic dexamethasone for refractory sudden deafness / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the clinical efficacy of intratympanic dexamethasone (IT-DEX) for sudden deafness (SD) which were inefficient and contraindicant for systemic steroid.@*METHOD@#Thirty-four patients who were inefficient and contraindicant for systemic steroid were treated by IT-DEX (5 g/L) for 4 times within 12 days. The improvement of audits, tinnitus and stuffy were observed. And the results between the different influencing factor such as age, sex and course of disease were compared by statistical analysis.@*RESULT@#1) For total patients, the effective power of audits, tinnitus and stuffy were 52.9%, 58.8% and 82.4% respectively. And the patients who treated within 2 weeks result in higher effective power of audits and tinnitus than those having been treated for more than 2 weeks, but there was no significant difference between these two groups (P >0.05). 2) For the patients who were inefficient and contraindicant for systemic steroid, the audible effective power of them were 44.4% and 62.5% respectively.@*CONCLUSION@#IT-DEX can treat refractory SD effectively and safely. It is an effective treatment for the patients who were contraindicant for systemic steroid, and it could be used for salvage for the patients who were inefficient for systemic steroid.

Diagnosis and treatment of congenital abnormality in external and middle ear / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical characters, methods of evaluation before surgery and effects of treatment of congenital abnormality in external and middle ear.@*METHOD@#The data of 21 cases (22 ears) with congenital abnormalities in external and middle ear who received operation in ENT Department of the First Affiliated Hospital of Zhengzhou University during 5 years from June 2000 to June 2005 were analyzed.@*RESULT@#Malformations of middle ear were presented in all cases. These mainly consisted of small tympanic cavities in 16 ears (72.7%), ossicular chain anomalies in 20 ears (90.9%) and facial nerve abnormalities in 8 ears (36.4%). The hearing improvement was observed in 15 ears (68.2%) after surgery, of which 9 ears had hearing improvement greater than 30 dB. Long term (0.5 to approximately 5 years) follow-up demonstrated that the hearing in 17 ears were kept unchanged after surgery. The postoperative complications were external auditory canal stenosis in 4 ears and lateralization of the tympanic membrane in 2 ears.@*CONCLUSION@#Careful evaluation of the hearing and CT of congenital abnormalities of external and middle ear before operation are important. Maintenance of width of the external acoustic meatus and prevention of infection are crucial in the treatment of congenital abnormalities of external and middle ear.

Imaging features and surgical approach of external auditory canal cholesteatoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To define the clinical and imaging features of external auditory canal cholesteatoma (EACC) and determine the characteristics most important to its clinical management.@*METHOD@#Seventeen cases (21 ears) of EACC were retrospectively reviewed. Clinical data were collected for the history, presentation, physical examination findings and CT scans. The surgical management approaches were reviewed.@*RESULT@#Patients presented with otalgia (n = 21), otorrhea (n = 16), ear-canal stenosis (n = 11), facial nerve dysfunction (n = 4). CT scans showed a soft tissue mass with adjacent bone erosion (n =21). Middle ear and mastoid involvement (n = 9), facial canal erosion (n = 4), sigmoid sinus erosion (n = 1) and jugular bulb dehiscence (n = 1) were observed. EACC excision and canaloplasty through transcanal approaches were performed in 12 ears, while postauricular incision and canal wall down mastoidectomy were used in 9 ears.@*CONCLUSION@#The possible causes of EACC and its possible extension may influence clinical management. Preoperative high-resolution temporal bone CT scans can be helpful in the diagnosis and management of EACC.

Clinical features and management of middle ear adhesion / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the clinical features and therapeutic efficacy of middle ear adhesion.METHODS The clinical data of 40 cases of middle ear adhesion collected during 5 years from 2002 to 2007 were studied retrospectively. RESULTS Part or all of the tympanic membrane of the patients did not move under Siegle otoscopy. The lesions of middle ear adhesion were extensive and invaded all middle ear structures including round and oval windows.The lesions were severe, especially in narrow anatomical spaces such as mesotympanum,hypotympanum and interossicular spaces.Pure tone audiometry showed that average air-bone gap (A-B gap) were (35.34?6.99) dB preoperatively.The average A-B gap were (18.47?5.76) dB 6 months after operation.Follow-up observations and postoperative CT scan showed that tympanic membranes and middle ear cavity recovered well.CONCLUSION There are various degrees of tympanic fibrous adhesion and atelectatic tympanum in middle ear adhesion,especially in mesotympanum, hypotympanum and interossicular spaces.The middle ear adhesion can be treated with operation.The key points for a successful operation include preserving normal tympanum mucosa,opening eustachian tubes, making a bigger middle ear cavity,and performing tympanoplasty with perichondrium-cartilage plates.

Expression of RANK-RANKl-OPG system in middle ear cholesteatoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the effect of nuclear factor-kappa B ligand-receptor activator of nuclear factor-kappa B-osteoprotegerin(RANKRANKL-OPG)system on bone resorption in middle ear cholesteatoma,and the reasons why middle ear cholesteatoma in children were more aggressive. METHODS The expression of RANKL and OPG in 21 adults cholesteatoma,17 children cholesteatoma and 18 normal external meatal skin was studied with immunohistochemistry. Semiquantitative analysis was used for comparison and statistical analysis. RESULTS RANKL-positive cells and the ratio of RANKL/OPG in cholesteatoma were significantly higher than that in external meatal skin(P

EXOGENOUS FGF-2 REGULATES THE METABOLISM OF RAT FACIAL MOTONEURONS AFTER INJURY / 解剖学报

Objective To study the regulatory effect of exogenous fibroblast growth factor(FGF\|2) in expressions of calcitonin gene\|related peptide(CGRP) and FGF\|2 in facial motoneurons after injury. Methods The right facial nerve was transected 6?mm distal to the stylomastoid foraman.A 3?mm\+3 piece of Gelfoam presoaked in 25??l of various test solutions(normal saline,or 16?10 6?IU/L FGF\|2,or 32?10 6?IU/L FGF\|2) was implanted adjacent to the proximal nerve stump.After three days survival,the rats were killed and brainstems were removed.Serial 20??m cryosections were cut through the whole brainstem.The CGRP and FGF\|2 immunoreactivity were studied by immunohistochemisty and image analysis. Results An increase in the CGRP and decrease in the FGF\|2 signals were presented in axotomized motoneurons with saline\|treated animals.In FGF\|2\|treated animals,the lesion\|induced up\|regulation of CGRP and down\|regulation of FGF\|2 were attenuated compairing with normal saline treated animals.Conclusion\ Exogenous FGF\|2 can increase FGF\|2 expression and decrease CGRP expression in rat facial motoneurons after injury.\;[