Analysis of 3 Surgical Approaches for the Treatment of Cerebrospinal Fluid Otorrhea: A Case Series Report.

Background: This case series report aimed to present three surgical approaches used for the treatment of cerebrospinal fluid (CSF) otorrhea, providing less invasive surgical options for managing this condition. Methods: Clinical data of 26 patients with CSF otorrhea, who underwent treatment using three surgical methods between June 2012 and June 2022, were retrospectively analyzed. The study collected information on patients' basic demographic characteristics, chief complaints, location of the defect, results of otorrhea endoscopic examination, findings from skull base thin-slice computed tomography (CT) examination, and causes of CSF otorrhea. Postoperative outcomes of CSF otorrhea were followed up. Results: Among the 26 cases of CSF otorrhea, there were 13 (50%) males and 13 (50%) females who underwent treatment using the three surgical methods. The etiology of CSF otorrhea included 10 (38%) cases of spontaneous CSF otorrhea, including 2 (8%) cases of congenital inner ear deformity and 8 (31%) cases without obvious inducement. Additionally, there were 5 (19%) cases of trauma, 6 (23%) cases of cholesteatoma complications, 3 (12%) cases of postoperative complications of brain tumor, 1 (4%) case of radiotherapy, and 1 (4%) case of a malignant tumor. A total of 12 (46%) cases of CSF otorrhea were treated by local repair of the defect. Furthermore, 3 (12%) cases underwent local repair of the defect combined with sealing of the tympanic sinus entrance, while 11 (42%) cases underwent local repair of the defect combined with sealing of the eustachian tube and the external auditory canal. No recurrence of CSF otorrhea was observed during the 6-month to 10-year follow-up period after surgery. Conclusion: The three methods for CSF otorrhea, including local defect repair, local defect repair combined with sealing of the tympanic sinus entrance, and sealing of the eustachian tube and the external auditory canal, demonstrated successful outcomes in appropriately selected patients.

Knockdown and mutation of Pou4f3 gene mutation promotes pyroptosis of cochleae in cisplatin-induced deafness mice by NLRP3/caspase-3/GSDME pathway.

OBJECTIVE: To investigate the effect and mechanism of Pou4f3 gene mutation on pyroptosis in cochleae of cisplatin-induced deafness mice. METHODS: Mice were intraperitoneally injected with cisplatin to construct an animal model of deafness, and sh-Pou4f3 and mutant vector were injected to alter gene expression. TUNEL staining was used to assess the apoptosis level of cochlear hair cells, ELISA was used to detect the secretion of inflammatory factors, and immunofluorescence and Western Blot were used to detect the expression of pyroptosis related factors. RESULTS: Cisplatin induced pyroptosis through NLRP3/Caspase-3/GSDME pathway and significantly down-regulated Pou4f3 level. Pou4f3 mutations promote cochlear hair cell pyroptosis by activating the NLRP3/Caspase-3/GSDME pathway. Knockdown of Pou4f3 can superimpose cisplatin treatment to induce pyroptosis of cochlear hair cells through NLRP3/Caspase-3/GSDME pathway. CONCLUSION: Pou4f3 gene mutation promotes pyroptosis of cochleae in cisplatin-induced deafness mice through NLRP3/Caspase-3/GSDME pathway.

Genetic and clinical phenotypic analysis of familial stapes sclerosis caused by an NOG mutation.

BACKGROUND: The noggin protein encoded by the NOG gene can interfere with the binding of bone morphogenetic protein to its receptor, thus affecting bone and joint development. The symptoms include abnormal skeletal development and conductive deafness. METHODS: In a retrospective study, clinical data of the proband and her family members, including 8 people and 50 healthy normal controls, were collected. Second-generation sequencing was performed on peripheral blood samples from them. RESULTS: The sequencing analysis indicated that in the proband, the NOG gene had a c.532T > C, p.C178R (cytosine deletion, NM_005450.6:c.532T > C), leading to an amino acid change. The proband's father, grandmother, second sister, and third sister also had this mutation, whereas family members with normal phenotypes did not have the mutation. CONCLUSION: Analysis of this family showed that the novel presentation of the c.532T > C, p.C178R mutation in the NOG gene resulted in syndrome-type autosomal dominant inheritance reflected in a mild clinical phenotype, which is of great importance for further studies of the clinical phenotype and pathogenesis of stapes sclerosis.

[A case of diagnosing and treating the remaining foreign body in nasal sinus and cranium via orbit].

This paper mainly reports a case with the foreign body staying in nasal sinus and cranium via orbit. CT manifests the foreign body staying in ethmoid sinus and entering the bottom of cranium. After completing the relevant inspection, the patient unerwent right eye exenteration, endoscopic sinus surgery with general anesthesia in emergency to take out the foreign body in nasal sinus, and Cerebrospinal fluid leak repair surgery . Then the patient recovers well, futhermore, the symptom of cerebrospinal fluid leakage doesn't appear after five months follow-up.

[Tympanosclerosis etiology and treatment].

SUMMARY: Tympanosclerosis is the middle ear tissue hyalinization and calcification caused by chronic middle ear inflammation, which mainly results in conductive deafness with unobvious clinical symptom. Etiology is unclear. The treatment is given priority to surgical treatment at present, while long-term effect reported mostly poor. This article analyzed etiology and treatment of the tympanic cavity sclerosis.

[Surgery added with fluconazole in treatment of fungal rhinosinusitis].

OBJECTIVE: To explore the effect of surgery added with antifungal agents in treatment of fungal rhinosinusitis. METHOD: One hundred and two consecutive patients with fungal rhinosinusitis were randomly divided into two groups: the control group (n=48) were treated with surgery alone, the treatment group (n=54) were treated with surgery plus antifungal therapy during operation and postoperation. The patients were followed up for 6 months and the relapse rates between two groups were compared. RESULT: No relapse was observed in the treatment group. The relapse rate of the control group was 20.8% (P < 0.01). CONCLUSION: Surgery plus antifungal therapy can prevent the relapse of fungal rhinosinusitis significantly.

[Treatment of traumatic pseudoaneurysm of head and neck (report of 4 cases)].

OBJECTIVE: To discuss the clinical features, diagnosis and treatment of traumatic pseudoaneurysm. METHOD: We report 4 unusual cases of traumatic Pseudoaneurysms of the artery of head and neck. The data of the 4 cases was analysed retrospectively. RESULT: Four patients were with history of trauma and traumatic pseudoaneurysm were diagnosed by CT and DSA. Two of them accepted interventional vascular therapy, the others accepted surgical operation. Both methods are safe and effective. CONCLUSION: Traumatic pseudoaneurysms of the artery of head and neck are rare but potentially lethal. The diagnosis is not difficult. The interventional treatment should be the first choice if possible, while the surgical approach is another choice. Doctors should try to repair the arterial wall, to keep the artery patency and to decrease the unnecessary complications.

[Expression of Endothelin-1 in laryngeal carcinoma].

OBJECTIVE: To study the expression and clinical significance of Endothelin-1 in laryngeal carcinoma. METHOD: Immunohistochemical (SP) method was used to detect the expression of Endothelin-1 in 30 cases of laryngeal carcinoma,20 cases of laryngeal benign lesions and 10 cases of. The relationship between the expression of Endothelin-1 and the clinic stage was analysed by SPSS12. 0 software. RESULT. The positive expression of Endothelin-1 in all three type tissues. There is a significant difference between the laryngeal carcinoma and the laryngeal benign lesions, the laryngeal carcinoma and the normal laryngeal mucous membrane, the laryngeal benign lesions and the normal laryngeal mucous membrane( P <0. 05). The highest expression of Endothelin-1 is in laryngeal carcinoma tissue. In laryngeal carcinoma tissue, the advanced clinical stage, the more higher expression of endothelin-1. CONCLUSION: Positive expression of Endothelin-1 in laryngeal carcinoma tissue was highest in three tissue. It may be play an important role in carcinogenesis and progress of laryngeal carcinoma.

[Secretion of platelet derived growth factor, tumour necrosis factor-alpha and hyaluronic acid into nasal fluid before and after sinus surgery].

OBJECTIVE: To detect the changing profiles of three factors in nasal fluid before and after endoscopic sinus surgery (ESS), including platelet derived growth factor (PDGF), tumour necrosis factor-alpha (TNF-alpha) and hyaluronic acid (HA), to investigate the predictive factor of healing quality after sinus surgery. METHODS: Nasal secretions were obtained from 22 patients with nasal polyp before ESS and at 1, 4, 8, 12 weeks after ESS compared to 22 controls. Nasal fluid was analyzed by enzyme-linked immunosorbent assay (ELISA) for PDGF, TNF-alpha and HA. The healing quality was evaluated at 1, 4, 8, 12 weeks postoperatively for every one. Finally, we performed a multiple logistic regression model to assess whether the healing quality was associated with age, gender, body mass, preoperative stage, and concentrations of PDGF, TNF-alpha, HA before ESS. RESULTS: 1. Each factor before surgery showed different level when compared to controls, PDGF was constant, TNF-alpha was high (P = 0.034), and HA was low (P = 0.003). Comparing patients at 1 week after surgery with control subjects, a significant increase in the concentrations of PDGF, TNF-alpha, HA in nasal secretions could be demonstrated (compared to controls, P = 0.000, 0.020, 0.038, respectively). After that, decreasing amounts of these factors were found, reaching normal conditions at 12 weeks for PDGF (compared to controls, P = 0.087), 8 weeks for TNF-alpha (compared to controls, P =0.104), 4 weeks for HA (compared to controls, P = 0.304). There was another peak for TNF-alpha at 12 weeks (compared to controls, P = 0.002). 2. The percentage of good healing at 1, 4, 8, 12 week postoperatively was 0, 4.5%, 36.4%, 81.8%, respectively. The healing quality after ESS was significantly and independently correlated to the age of patient and preoperative PDGF concentrations in nasal secretions. The younger, the better healing. The lower PDGF concentration, the better healing. CONCLUSIONS: During the wound healing of nasal mucosa, the levels of PDGF, TNF-alpha, HA were different at each postoperative stage. Age and PDGF concentrations preoperatively were suitable factors to predict the healing quality after ESS.