Central Retinal Artery Occlusion Due to Subperiosteal Orbital Abscess Caused by Acute Sinusitis in a Child: A Case Report.

Central retinal artery occlusion (CRAO) is an ophthalmic emergency and has poor visual prognosis. It is commonly found in elderly people and very rare in child. We reported an 8-year-old girl who suffered from acute sinusitis, periorbital swelling, and the visual acuity of her right eye was only light perception. She was diagnosed with CRAO, SPOA (subperiosteal orbital abscess), and acute sinusitis. Emergency treatments including surgery, antibiotics, glucocorticoids, intraocular-pressure-lowering drugs, and vasodilators were taken immediately in order to save the eyesight. The visual acuity of the right eye returned to 20/400. Conclusions: Severe intraorbital complications of acute sinusitis can lead to CRAO. Timely drainage, strong antibiotics, and glucocorticoids are the most effective methods for the treatments.

Lipoid Proteinosis of the Pharynx and Larynx: A Case Report.

Lipoid proteinosis (LP) is a rare inherited multisystem disease. Classical clinical features include beaded eyelid papules, laryngeal infiltration, and neurological symptoms. Here, we report the diagnosis and treatment of a female patient with LP in order to improve physician awareness and understanding of this disease.

[In vivo distribution and pharmacokinetics of dexamethasone sodium phosphate thermosensitive in situ gel following intratympanic injection].

OBJECTIVE: To investigate the absorption and distribution of DSP (Dexamethasone sodium phosphate)-loaded thermosensitive in situ gel following IT (intratympanic injection) in guinea pig and provide rationale for clinical application. METHODS: DSP-loaded thermosensitive in situ gel was prepared by using poloxamer 407 as matrix. The HPLC assays for the determination of DSP and dexamethasone (Dex) in perilymph (PL), cerebrospinal fluid (CSF) and plasma were developed, respectively. DSP-loaded gel and solution were administered after IT or IV (intravenous injection). PL, CSF and plasma were collected periodically. The concentrations of DSP and Dex were measured by HPLC, and were used to estimate in vivo distribution and pharmacokinetic parameters of Dex in the inner ear. RESULTS: The AUC (area under curve) and t1/2 of Dex in PL following IT DSP-loaded gel were 593.7- and 28.6-fold higher than those following IV DSP solution. Moreover, DSP-loaded gel following IT extended the mean residence time (MRT) by nearly 5 times, compared with the solution. After IT, the concentration levels of Dex in CSF and plasma were much lower than that in PL. CONCLUSION: DSP thermosensitive in situ gel following IT has significant cochlea-oriented and sustained-release effect.

[Treatment result of uvulopalatopharyngoplasty and tongue base operation for the severe obstructive sleep apnea-hypopnea syndrome].

OBJECTIVE: To study the effect and operative method of UPPP and tongue base operation for the severe OSAHS at Velo- and tongue-pharyngeal obstruction. METHODS: 26 cases who were diagnosed as severe OSAHS with Velo- and tongue-pharyngeal obstruction by Muller's maneuver were treated surgically by UPPP and tongue base operation. The tongue base operation included fusiform incision or rhomboid incision in the middle of tongue base by laser or electrotome. 4 cases received tongue base lateral incision and advancement fixation. 2 cases underwent tracheotomy before the operation. 20 cases underwent tracheotomy during operation. RESULTS: The 6-month, 1-year and 3-year responders are 100%, 84.6% and 76.9% respectively. The introcession of the tongue base incision were repaired in four cases. After 1-2 years, the cases with lateral incision on the tongue base with advancement fixation had temporary aspiration after the operation and recovered through practice. CONCLUSION: The polysomnography (PSG) was essential to OSAHS and especially to severe OSAHS. Muller's maneuver is important in locating the obstructive sites of OSAHS. The stitching is essential to the cases after fusiform incision or rhomboid incision of tongue base. The combination of UPPP and tongue base operation is important for OSAHS treatment. The combined treatment of OSAHS could have a better results.