Observation of nasal obstruction symptom evaluation questionnaire and Epworth sleep score in nasal cavity ventilation expansion techniques for patients with obstructive sleep apnea hypopnea / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To realize the application of nasal obstruction symptom evaluation (NOSE) and Epworth sleep score (ESS) before and after nasal cavity ventilation expansion techniques.@*METHOD@#Forty-two OSAHS patients with nasal obstructive symptoms were diagnosed by clinical symptoms and polysomnography. Nasal cavity ventilation expansion technique was performed. Before and after the surgery, the NOSE and ESS were used to compare the difference. Postoperative data were obtained at least 3 months later.@*RESULT@#Compared the data before and after operation, the NOSE and ESS were significantly decreased respectively (P0. 05).@*CONCLUSION@#The result suggest that OSAHS patients taking nasal cavity ventilation expansion operations showed improvement in severity of nasal obstructive symptoms and daily sleepy.

MRI evaluation of the olfactory pathway / 临床耳鼻咽喉头颈外科杂志

MRI scanning is an important technique to evaluate the olfactory system, special scanning parameters could reveal the fine structures of the olfactory pathway. Olfactory cleft, olfactory bulb/tract, olfactory sulcus and olfactory center are the main targets of the scanning. Chronic rhino-sinusitis, head trauma, congenital dysplasia and neural degenerative diseases are the primary causes of the olfactory dysfunction and have particular imaging presentations respectively. Besides indicating the olfactory pathway lesions, MRI could also present the etiology and the prognosis of the olfactory disorder.

Canalplasty for stenosis or atresia of the external auditory canal / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To report the experience of canalplasty in treatment of stenosis or atresia of the external auditory canal.@*METHOD@#A retrospective review was performed on 10 patients (10 ears) that underwent canalplasty. The lesions located in bony segment in 1 case, cartilaginous segment in 3 cases, both in cartilaginous and bony segments in 6 cases, in which 4 cases accompanied with the middle ear diseases. All patients received the canalplasty surgery, and tympanoplasty was applied simultaneously if the patient had otitis media.@*RESULT@#Follow-up was conducted for 8-50 months respectively, 8 of the external auditory canal was wide and tympanic membrane gained a good shape, 2 case had stenosis or atresia reoccurrence after the operation.@*CONCLUSION@#Appropriate approach and elimination of the lesions thoroughly are key points for the canalplasty.

The normative combined therapy for recurrent sinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To assess the treatment outcome after endoscopic sinus surgery (ESS) in patients with recurrent sinusitis and to research which factors could influence the clinical outcome.@*METHOD@#Endoscopic sinus surgery was performed in 55 patients. The clinical outcome and epithelization of mucosa after ESS were evaluated by Chinese ENT Association criteria.@*RESULT@#The total cure rate was 81.82%, effective rate was 92.73%. The mean period of epithelization after operation was 13.2 weeks. No serious complication occurred.@*CONCLUTION@#The treatment efficacy can be greatly improved by the normative combined therapy which include the standard and orderly perioperative treatment ,the overall shape and nasalization of nasal cavity, postoperative follow-up and clearing cav ity after ESS.

Intranasal trigeminal chemosensitivity in patients with postviral and post-traumatic olfactory dysfunction.

CONCLUSIONS: The olfactory and intranasal trigeminal systems are closely connected. With regard to intranasal trigeminal event-related potential (ERP), patients with olfactory dysfunction (OD) showed longer latency and lower amplitude, which indicated decreased trigeminal sensitivity. Different age, etiology, and olfactory status also affect trigeminal sensitivity differently. OBJECTIVE: OD is a common symptom in the rhinology clinic. ERP is considered an important method to evaluate chemosensitivity. The aim of this study was to investigate changes of intranasal trigeminal sense in patients with postviral OD (PVOD) and post-traumatic OD (PTOD). METHODS: A total of 96 participants (30 healthy adults and 66 patients with OD) aged 20-65 years were investigated. The T&T olfactometer, the Sniffin' Sticks olfactory test, and trigeminal ERPs (tERPs) were used. We evaluated trigeminal sensitivity influenced by different factors (age, etiology, and olfactory status) in healthy subjects with normal olfactory function and in patients with PVOD and PTOD. RESULTS: Patients with OD showed higher trigeminal thresholds than normal controls. Compared with controls, N1/P2 latencies of tERPs increased and amplitudes decreased in patients with OD. Older subjects showed longer latencies and lower amplitudes than young subjects in both controls and the OD group. Patients with PTOD exhibited worse psychophysical olfactory function and decreased trigeminal sensitivity.

Diagnosis and management of the acute attack of sphenoid and ethmoid fungal ball sinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To improve the diagnosis and treatment of the acute attack of sphenoid and ethmoid fungal ball sinusitis based on the analysis of clinical features.@*METHOD@#Eighteen patients with sphenoid and ethmoid fungal ball sinusitis were reviewed, and the main symptoms included headache and fever during acute attack. Endoscopy, nasal CT and MRI can provide useful information for diagnosis. Endoscopic sinus surgery was performed on thirteen patients after drug therapy, while the other 5 patients chose conservative therapy.@*RESULT@#The pathological examination confirmed the fungal lesions and the 13 patients had a good recovery. The result of CT and MRI scanning had a good accordance with the intra-operative findings. One patient receiving conservative treatment had acute attack again 2.5 months later, and antibiotics and topical nasal drugs improved the symptoms.@*CONCLUSION@#Clinical presentation and radiological imaging contribute to the differential diagnosis of the acute attack of sphenoid and ethmoid fungal ball sinusitis, then the targeted therapy can be taken.

Experience of canalplasty during the overlay tympanoplasty / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To report the experience with canalplasty during the operation of overlay tympanoplasty.@*METHOD@#A retrospective review was performed on 56 patients (59 ears) that underwent tympanoplasty and canalplasty (part with intact canal wall mastoidectomy). Transcanal and postauricular incisions were made, and the posterior canal skin flap was elevated and fixed with retractor, while the anterior flap was freed. A drill was used to remove the anterior and inferior bone bulges and the adjacent bone to expose the tympanic sulcus and annulus adequately, and the epithelium of tympanic membrane remnant was removed thoroughly. After the eradication of the middle ear disease, temporal fascia was used as an overlay graft and the canal skin was replaced, and the gel-foam soaked in antibiotic and Dexamethasone solution was used to compress the canal. The patients began to use ear drops 1 week after surgery, and the gelfoam in canal lasted for 4-6 weeks.@*RESULT@#Follow-up was conducted for 0.5-3.5 years respectively, all patients gained stage I incision cure, the external auditory canal was wide and tympanic membrane gained a good shape, the complications of skin flap necrosis, external canal stenosis and cholesteatoma pearl were not occurred.@*CONCLUSION@#Canalplasty was the necessary procedure in the operation of overlay tympanoplasty which could conduce to de-epithelization of the membrane, placement of fascia and prevention of the occurrence of cholesteatoma pearl.

Correlation between olfactory disorders and morphology of nasal cavity / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the correlation between olfactory disorders and the morphology of nasal cavity in chronic rhinosinusitis (CRS).@*METHOD@#One hundred and seventy-six patients with chronic rhinosinusitis and/or polyps were included. Olfactory function, the morphology of nasal cavity and nasal sinus, especially the morphology of olfactory cleft, were surveyed by T&T Olfactometer, nasal endoscope and computed tomography (coronal and horizontal position). All patients were divided into 5 groups by different olfaction level. Data was achieved by the scoring endoscopic appearances of Kennedy, and CT staging system of Lund-Mackey and analyzed by SPSS 11.5.@*RESULT@#(1) Among all patients, 61.9% accompanied with hyposmia, 21% with anosmia , the other 17.1% with normal olfaction; (2) There was positive correlation between the scores of staging system of Lund-Mackey and the olfactory function level (P < 0.01) (3) There was positive correlation between the scores of endoscopic appearances of Kennedy and the olfactory function level (P < 0.05).@*CONCLUSION@#(1) Olfactory function were correlated with the severity of CRS; (2) As the determining methods of CRS, staging system of Lund-Mackey can be used to estimate the olfactory function generally and initially; (3) There was not significant difference between the scores of endoscopic appearances of Kennedy and the olfactory function level.

Effects of ischemia on olfactory bulb in rats / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the olfactory bulb's morphological change after ischemic injury in rats, and explore the role of vascular factor in olfactory disorders.@*METHOD@#Forty adult SD rats (weighting 250-300 g) were used, 30 of which were treated with permanent bilateral occlusion of both common carotid arteries, and the others were served as the control. The olfactory bulbs were carefully taken out on the 1st week, 4th week, 2nd month post operation, respectively, then observed the morphological changes by light microscopy. The ultra structure of cells in olfactory bulbs were also observed by transmission electron microscope.@*RESULT@#In rats with permanent bilateral occlusion of both common carotid arteries, the vascular pattern changed and the cell number decreased in olfactory bulbs by light microscopy. In the 1st week group, the mitral cells' mitochondria injury and metamorphism were found. In the 4th week group, the microvascular paramorphia, lipofuscin in mitral cells and metamorphic nerve fibers were found by transmission electron microscope.@*CONCLUSION@#Ischemia could injure the neuron and nerve fiber. This may be one of the reasons of olfactory disorders.

Effects of steroid hormone on the expression of cyclic nucleotide-gated channels of olfactory receptor neurons / 中国耳鼻咽喉头颈外科

OBJECTIVE To observe the effects of Dexamethasone on the expression of cyclic nucleotide-gated channels (CNG channels) mRNA of olfactory receptor neurons (ORNs) by real-time quantitative reverse transcription-polymerase chain reaction(RT-PCR). METHODS Forty Wistar rats were randomly divided into four groups: 24-hours Dexamethasone treated group and its control group; 2-weeks Dexamethasone treated group and its control group. Dexamethasone was injected i.p. (1 mg/kg for 24-hours group, 0.2 mg/d for 2-weeks group). Control group rats were injected with the same volume of normal saline. Real-time quantitative RT-PCR was performed to evaluate mRNA production of CNGA2 subunits. RESULTS In Dexamethasone-injected rats, the up-regulation of CNGA2 mRNA was observed in 2-weeks group(P

The Consideration of Microsurgery Technique in the Cultivation of Rhinological Graduate Students / 中华医学教育探索杂志

This paper combines the concept,advancement and application of minimally invasive technique to investigate the methods and procedure in the cultivation of clinical graduate students.