Outcomes of ossicular disruption in traumatic facial paralysis: a case series.

BACKGROUND: As tympanotomy using the transcanal approach was a routine surgical technique for traumatic ossicular disruption, the efficacy of the posterior tympanum approach was rarely explored. AIM: This study aimed to investigate whether the hearing outcomes improved after simultaneous ossiculoplasty and facial nerve decompression using the posterior tympanum approach compared with the transcanal approach. MATERIAL AND METHODS: The data of 11 patients who underwent ossiculoplasty and facial nerve decompression using the posterior tympanum approach and 21 patients who underwent ossiculoplasty via transcannal approach were analyzed. RESULTS: The average air-bone gap (ABG) of patients undergoing posterior tympanotomy showed a statistically significant improvement. Postoperative ABG within 20 dB was observed in 81.8% of patients in the posterior tympanum group and 76.2% of patients in the transcanal group. However, the ABG closure in the two groups was not statistically different. CONCLUSIONS AND SIGNIFICANCE: Simultaneous ossiculoplasty using the posterior tympanum approach was practical, and the hearing outcomes were promising for the patients with traumatic facial nerve paralysis and ossicular disruption.

The characteristic of otoacoustic emissions in full-term neonates according to ABO blood groups / Característica das emissões otoacústicas em neonatos a termo segundo grupos sanguíneos do sistema ABO

Abstract Introduction: Previous research has suggested that individuals with different blood groups show varied incidences of noise-induced hearing loss. The reduced otoacoustic emissions amplitudes indicate the higher possibilities of outer hair cell damage for noise exposure. Objective: The objective is to analyze the characteristics of otoacoustic emissions, including the occurrence of spontaneous otoacoustic emission and the amplitudes of distortion product otoacoustic emission at certain frequencies in full term neonates with different ABO blood groups. Methods: A total of 80 selected full-term female neonates who passed the initial newborn hearing screen were enrolled into the study, with equal number of participants in four ABO blood groups (Blood Group A, Blood Group B, Blood Group AB, Blood Group O). Measurements of spontaneous otoacoustic emission and distortion product otoacoustic emission were performed in both ears for all participants. Results: (1) The blood group O participants showed significantly fewer spontaneous otoacoustic emission occurrences than the other three blood groups (A = 70%, B = 80%, AB = 67%, O = 25%, p < 0.05). (2) The blood group O participants showed lower DPOAE amplitudes at 1257 Hz (M = 4.55 dB, SD = 8.36), 1587 Hz (M = 11.60 dB, SD = 6.57), 3174 Hz (M = 7.25 dB, SD = 5.99), 5042 Hz (M = 13.60, SD = 6.70) than participants with the other three blood groups in left ears (p < 0.05). In right ears, the blood group O participants showed reduced amplitudes at 1257 Hz (M = 6.55 dB, SD = 8.36), 1587 Hz (M = 13.60 dB, SD = 6.57), 3174 Hz (M = 7.65 dB, SD = 6.43), 5042 Hz (M = 13.65 dB, SD = 6.50) than participants from non-O blood groups (p < 0.05). Conclusion: Female individuals with blood group O have lower otoacoustic emissions values than individuals with the other three blood groups. We need to further investigate the possible relationships between ABO blood group and cochlear function, including the potential influences of noise damage on cochlear outer hair cells.

Resumo Introdução: Pesquisas anteriores sugeriram que indivíduos de diferentes grupos sanguíneos apresentam incidências distintas de perda auditiva induzida por ruído. As amplitudes reduzidas das emissões otoacústicas indicaram maiores ou menores possibilidades de danos às células ciliadas por exposição a ruídos. Objetivo: Analisar as características das emissões otoacústicas, inclusive a ocorrência de emissões otoacústicas espontâneas e as amplitudes de emissões otoacústicas por produto de distorção em determinadas frequências em neonatos a termo de diferentes grupos sanguíneos do sistema ABO. Método: Foram incluídos 80 neonatos a termo selecionados na triagem auditiva neonatal inicial para participar do estudo, com número igual de participantes de grupos sanguíneos do sistema ABO (grupo sanguíneo A, grupo sanguíneo B, grupo sanguíneo AB e grupo sanguíneo O). As emissões otoacústicas espontâneas e emissões otoacústicas por produto de distorção foram medidas em ambas as orelhas de todos os participantes. Resultados: (1) Os participantes do grupo sanguíneo O apresentaram ocorrências de emissões otoacústicas espontâneas significantemente menores do que os dos outros três grupos sanguíneos (A = 70%, B = 80%, AB = 67%, O = 25%, p < 0,05). (2) Os participantes do grupo sanguíneo O apresentaram amplitudes de emissões otoacústicas por produto de distorção mais baixas a 1257 Hz (M = 4,55 dB, DP = 8,36), 1587 Hz (M = 11,60 dB, DP = 6,57), 3174 Hz (M = 7,25 dB, DP = 5,99), 5042 Hz (M = 13,0, DP = 6,70) do que os participantes dos outros três grupos sanguíneos nas orelhas esquerdas (p < 0,05). Nas orelhas direitas, os participantes do grupo sanguíneo O apresentaram amplitudes reduzidas em 1257 Hz (M = 6,55 dB, DP = 8,36), 1587 Hz (M = 13,60 dB, DP = 6,57), 3174 Hz (M = 7,65 dB, DP = 6,43), 5042 Hz (M = 13,65 dB, DP = 6,50) em comparação aos participantes de grupos sanguíneos não O (p < 0,05). Conclusão: Os indivíduos do sexo feminino do grupo sanguíneo O apresentaram valores menores de emissões otoacústicas do que os indivíduos dos outros três grupos sanguíneos. É necessário continuar a investigar as possíveis relações entre o grupo sanguíneo ABO e a função coclear, inclusive as possíveis influências do dano por ruídos às células ciliadas externas da cóclea.

The characteristic of otoacoustic emissions in full-term neonates according to ABO blood groups.

INTRODUCTION: Previous research has suggested that individuals with different blood groups show varied incidences of noise-induced hearing loss. The reduced otoacoustic emissions amplitudes indicate the higher possibilities of outer hair cell damage for noise exposure. OBJECTIVE: The objective is to analyze the characteristics of otoacoustic emissions, including the occurrence of spontaneous otoacoustic emission and the amplitudes of distortion product otoacoustic emission at certain frequencies in full term neonates with different ABO blood groups. METHODS: A total of 80 selected full-term female neonates who passed the initial newborn hearing screen were enrolled into the study, with equal number of participants in four ABO blood groups (Blood Group A, Blood Group B, Blood Group AB, Blood Group O). Measurements of spontaneous otoacoustic emission and distortion product otoacoustic emission were performed in both ears for all participants. RESULTS: (1) The blood group O participants showed significantly fewer spontaneous otoacoustic emission occurrences than the other three blood groups (A=70%, B=80%, AB=67%, O=25%, p< 0.05). (2) The blood group O participants showed lower DPOAE amplitudes at 1257 Hz (M = 4.55 dB, SD = 8.36), 1587 Hz (M = 11.60 dB, SD = 6.57), 3174 Hz (M = 7.25 dB, SD = 5.99), 5042 Hz (M = 13.60, SD = 6.70) than participants with the other three blood groups in left ears (p < 0.05). In right ears, the blood group O participants showed reduced amplitudes at 1257Hz (M=6.55dB, SD=8.36), 1587Hz (M=13.60dB, SD=6.57), 3174Hz (M=7.65dB, SD=6.43), 5042Hz (M=13.65dB, SD=6.50) than participants from non-O blood groups (p<0.05). CONCLUSION: Female individuals with blood group O have lower otoacoustic emissions values than individuals with the other three blood groups. We need to further investigate the possible relationships between ABO blood group and cochlear function, including the potential influences of noise damage on cochlear outer hair cells.

[Location of tympanic segment and mastoid segment of facial nerve and prevention of prosopoplegia in operations].

OBJECTIVE: To study the location of facial nerve and prevent facial nerve injury in middle ear surgery according to dissection of temporal bone and experience of middle ear surgery. METHOD: Thirty sides of temporal bones were exposed tympanic and mastoid segment of facial nerve with facial nerve decompression. The course of facial nerve was located by the markers of middle ear. RESULT: Tympanic segment of facial nerve passed between horizontal semicircular canal and stapes,then superior and anterior to the cochleariform process. Mastoid segment of facial nerve located in posterior wall of tympanic cavity. The mastoid segment of facial nerve travelled below the level of horizontal semicircular canal and annulus membrane tympani, and the extension line of its posterior margin and posterior-one-third of horizontal semicircular canal intersected to form an included angle (117.04 +/- 2.42) degrees. External genu of facial nerve located anterior and inferior to the horizontal semicircular canal. The shortest distance was (1.97 +/- 0.53) mm between middle point of horizontal semicircular canal and facial nerve, (1.03 +/- 0.29) mm between incus short process and facial nerve, (0.93 +/- 0.25) mm between cochleariform process and facial nerve, (1.18 +/- 0.42) mm between head of stapes and facial nerve, (3.08 +/- 0.28) mm between tympani sulcus and facial nerve at the vestibule window level, and (2.13 +/- 0.34) mm between tympani sulcus and facial nerve at round window level, respectively. CONCLUSION: Horizontal semicircular canal carina, incus short process, stapes, annulus membrane tympani and cochleariform process are ideal landmarks of tympanic and mastoid segment of facial nerve, which are helpful in middle ear surgery.

An increase in intracelluar free calcium ions modulated by cholinergic receptors in rat facial nucleus.

BACKGROUND: Ca(2+) in the central nervous system plays important roles in brain physiology, including neuronal survival and regeneration in rats with injured facial motoneurons. The present research was to study the modulations of intracellular free Ca(2+) concentrations by cholinergic receptors in rat facial nucleus, and the mechanisms of the modulations. METHODS: The fluorescence intensity of facial nucleus in Fluo-3 AM loaded acute brainstem slices was detected by applying intracellular free Ca(2+) measurement technique via confocal laser scanning microscope. The changes of fluorescence intensity of facial nucleus indicate the average changes of intracellular free Ca(2+) levels of the neurons. RESULTS: Acetylcholine was effective at increasing the fluorescence intensity of facial nucleus. Muscarine chloride induced a marked increase of fluorescence intensity in a concentration dependent fashion. The enhancement of fluorescence intensity by muscarine chloride was significantly reduced by thapsigargin (depletor of intracellular Ca(2+) store; P < 0.01), rather than Ca(2+) free artifical cerebrospinal fluid or EGTA (free Ca(2+) chelator; P > 0.05). And the increase of fluorescence intensity was also significantly inhibited by pirenzepine (M(1) subtype selective antagonist; P < 0.01) and 4-DAMP (M(3) subtype selective antagonist; P < 0.01). In addition, fluorescence intensity was markedly increased by nicotine. The enhancement of fluorescence intensity by nicotine was significantly reduced by EGTA, nifedipine (L-type voltage-gated Ca(2+) channel blocker), dihydro-beta-erythroidine (alpha4beta2 subtype selective antagonist), and in Ca(2+) free artificial cerebrospinal fluid (P < 0.01), but not in the presence of mibefradil (M-type voltage-gated Ca(2+) channel blocker) or thapsigargin (P > 0.05). CONCLUSIONS: The data provide the evidence that muscarinic receptors may induce the increase of intracellular free Ca(2+) levels through the Ca(2+) release of intracellular Ca(2+) stores, in a manner related to M(1) and M(3) subtypes of muscarinic receptors in rat facial nucleus. Nicotine may increase intracellular free Ca(2+) concentrations via the influx of extracellular Ca(2+)+ mainly across L-type voltage-gated Ca(2+) channels, in a manner related to the alpha4beta2 subtype of nicotinic receptors.

[Destruction of ossicular chain and its impact on hearing of patients with chronic suppurative otitis media].

OBJECTIVE: To study the characteristic of destructive ossicular chain and to evaluate integrity of ossicular chain and its impact on bone-conduction hearing of patients with chronic suppurative otitis media. METHOD: The destruction of ossicular chain with microscopy during operation and the preoperative pure tone audiometry were observed in 148 patients (176 ears) with chronic suppurative otitis media. RESULT: Destruction of ossicular chain was often observed in patients with chronic otitis media of cholesteatoma type, granuloma type and pars flaccid perforation of tympanic membrane. It initiated destructed malleo-incudal and incudostapedial joint for pars flaccid and pars tensa perforation of tympanic membrane respectively. Normal ossicular chain structure was observed in 52 ears. Destruction of ossicular chain was observed in 124 ears. Difference were significant for speech frequency air-conduction threshold and air-bone gap between group of normal ossicular chain and group of abnormal ossicular chain (P< 0.01). There was no difference for bone-conduction threshold between the above two groups. CONCLUSION: Destruction of ossicular chain was often observed in patients with chronic otitis media of cholesteatoma type and granuloma type. The ossicular chain was normal in the patients who were both less than 40 dB in speech frequency air-conduction threshold and 30 dB of air-bone gap. The ossicular chain was destructed in the patients who were both over 55 dB in air-conduction threshold and 40 dB of air-bone gap. High frequency hearing loss was observed in patients with chronic suppurative otitis media.

[Clinical analysis of tracheobronchial foreign bodies in children in 1276 cases].

OBJECTIVE: To investigate the effective therapy methods of foreign bodies in respiratory tract to lower its complications and the mortality rate. METHOD: Review the anesthesia methods, operation methods and therapeutic efficacy of 1276 cases of foreign body in respiratory tract and report three cases of death. RESULT: Under total intravenous anesthesia we took out foreign bodies by bronchoscope in 1197 cases and did that successfully for the first time in 1196 cases. Under aspiration anesthesia by ether we took out foreign bodies by bronchoscope in 78 cases and did that successfully for the first time in 65 cases, we took foreign bodies for the second time in 12 cases. We carried out tracheotomy in three cases. Edema of larynx was found in 12 cases among which 11 cases were under aspiration anesthesia by ether and one case was under total intravenous anesthesia. Under total intravenous anesthesia, the longest time of operation was 45 minutes, we could carry out the examination by bronchoscope for five times and no edema of larynx was found in all cases. Under aspiration anesthesia by ether, the longest time of operation was limited to 5 - 10 minutes, we could carry out the examination by bronchoscope for three times at most; otherwise, edema of larynx was very severe. Three cases died over apnea. Mortality rate is about 0.24%. CONCLUSION: Total intravenous anesthesia combined with surface anesthesia of respiratory tract mucosa is the ideal anesthesia method for taking out foreign bodies in respiratory tract by bronchoscope. It is more dangerous in cases that the foreign bodies are bean or that atelectasis is found. We should notice that the less the patients are, the more dangerous the operation is. In some cases tracheotomy is needed.

[Suffocation, an important lethal factor for otorhinolaryngological disease].

OBJECTIVE: To study the importance of supervision in respiratory tract for otorhinolaryngological disease. METHOD: Nine cases died of suffocation were reported and the causes were analyzed. In the 9 cases there were 3 cases with the foreign body in bronchus, 2 cases with the trachea bleeding, 2 cases with laryngopharyngeal tumor and 2 cases with bleeding from nasopharyngeal carcinoma. RESULT: All cases were died of suffocation. CONCLUSION: Suffocation is an important lethal factor for many otorhinolaryngological disease. Tracheotomy is a prompt and effective management for the suffocation resulting from upper respiratory tract obstruction. Tracheoscopy is the first choice for patients with lower respiratory tract obstruction. And the continuous inflating pressure with intubation in cases with trachea bleeding should be avoided.

[Evaluation of healing effect for simultaneously tympanoplasty in treating chronic suppurative otitis media with cholesteatoma and/or granulation tissue].

OBJECTIVE: This study was designed to discuss possibility and factors influencing healing effect for simultaneously tympanoplasty of chronic suppurative otitis media with cholesteatoma and/or granulation tissue. METHOD: For 52 cases with chronic suppurative otitis media with cholesteatoma (30 ears) and/or granulation tissue (22 ears), cleaning lesion with simultaneously tympanoplasty was surgical procedure, among them, 12 ears treated with single tympanoplasty, 40 ears treated with mastoidectomy and tympanoplasty. RESULT: All cases had dry ears without recurring cholesteatoma. Among them, hearing of 5 patients improved more than 30 dB, 9 ears improved from 20 to 29 dB, 31 ears improved from 10 to 19 dB and 7 ears improved less than 10 dB. Hearing of no cases reduced than that in preoperation. CONCLUSION: Simultaneously tympanoplasty would be carried out possible in treating chronic suppurative otitis media with cholesteatoma and/or granulation tissue. There were two important factors influencing hearing improvement, which concluded effective area of tympanic membrane concussion, activity of stapes and/or stapes footplate. The main cause for failure in hearing improvement would be eustachian tube obstruction.

[Effects of taking the pingzhi tablets on cellular infiltration in tissues of nasal polyps].

OBJECTIVE: To assess the effects of taking the "Pingzhi Tablets" on infiltration of inflammatory in tissues of chronic sinusitis and nasal polyps. METHOD: Nasal polyps from taking the "Pingzhi Tablets" treated patients (40 cases) and untreated patients (40 cases) were investigated. The samples were stained by HE and SABC-AP immunohistochemical methods. RESULT: Compared with untreated polyps, the polyps treated by taking the "Pingzhi Tablets" contained significantly lower tissue densities of CD 11b+, CD7+ positive cells. Although the densities of CD 19+ positive cells were lower in treated polyps, the differences were not statistically significant. CONCLUSION: The findings demonstrated tissue effects of treatment with taking "Pingzhi Tablets" and the treatment was effective in suppressing the inflammatory cell infiltration.