Comparison of two conchal formers for nonsurgical correction on Conchal Crus.

Objectives: Conchal Crus is a kind of congenital auricular deformation which is often overlooked. Few studies reported a large number of cases. We compared the efficacy of EarWell and self-made conchal formers on Conchal Crus to summarize our experience of correction and to find out the influencing factors. Methods: Two groups of Conchal Crus babies underwent conchal correction with the EarWell and self-made conchal formers respectively. The combined auricular deformities in these babies were corrected with EarWell Infant Ear Correction System. Conchal Crus deformity was classified as severe and mild. Auricular and conchal morphologic outcomes were graded as excellent, good, and poor. Results: The auricular morphologic results were comparable between the two groups. There was no significant difference in the effective (excellent plus good) rate between the two groups, but the excellent rate for conchal results in the Self-made group was significantly higher than that in the EarWell group. The former incidence of pressure ulcers was significantly lower than the latter. Multinomial regression analysis showed that the more severe conchal deformity was, the less likely the conchal shape tended to be improved. Conclusion: Both conchal formers could correct Conchal Crus effectively. The self-made conchal former could make more excellent conchal fossae and lead to less pressure ulcers at the Conchal Crus. The degree of Conchal Crus deformity was an important influencing factor in the conchal correction outcome. Level of evidence: 4.

[An observation of long term effect of one-stage hearing reconstruction on tympanosclerosis].

Objective:To observe the long-term hearing stability of patients with tympanosclerosis after one-stage hearing reconstruction. Method:Forty-one patients with tympanosclerosis were included in the study. Their puretone thresholds before operation and those at 3 months, 6 months, 1 year, 2 to 5 years after operation were retrospectively analyzed. Differences between pre-and postoperative air-bone gaps（ABG） for speech frequencies（0.5, 1, 2, 4 kHz） as well as those of averaged ABG were calculated. Result:Preoperative averaged ABG of 44 ears was （36.0±10.4） dB. Averaged ABG at 3 months, 6 months, 1 year, 2 to 5 years after operation were （24.1±8.8） dB, （24.5±9.8） dB, （22.4±11.3） dB and （22.5±4.1） dB respectively. Averaged ABG at different time after operation were all significantly less than preoperative results but didn't differ between each other. Postoperative ABG for different frequencies varied between 9.3 and 33.7 dB. They were significantly less than preoperative results, but didn't differ between the four frequencies. At different time after operation, averaged ABG of type Ⅰ were always significantly less than those of type Ⅱ, while the latter were always significantly less than those of type Ⅳ. Differences between preoperative ABG and ABG at different postoperative time were not significantly different. Neither were differences between pre-and postoperative ABG for different frequencies. Conclusion:Hearing reconstruction has the same effect on hearing improvement of patients with tympanosclerosis at different frequencies. Type Ⅰ patients has the best hearing results while type Ⅳ patients has the worst. There is no significant difference between the long-term（1 year and more than 2 years after operation） and the short-term（3 months and 6 months after operation） hearing level. Hearing level of patients with tympanosclerosis remain stable in a long time after operation.

Genome-wide DNA methylation analysis of human peripheral blood reveals susceptibility loci of diabetes-related hearing loss.

Diabetes-related hearing loss (DRHL) is a complication of diabetes mellitus that is drawing more attention currently. DNA methylation has a critical role in the pathogenesis of type 2 diabetes mellitus (T2DM) and its complications. Therefore, we investigated the genome-wide DNA methylation of peripheral blood of T2DM patients with/without hearing loss in order to explore the susceptibility loci of DRHL. Between DRHL group and control group, 113 gene sites were identified to be differentially methylated regions (DMRs). Among 38 DMRs with whole samples, the classification accuracy is up to 90%. With alignment to T2DM susceptibility genes and deafness genes published, KCNJ11 was found to be the only overlapped gene. The DNA methylation level of KCNJ11 was associated with stroke (t = 2.595, p < 0.05), but not with diabetic nephropathy and diabetic retinopathy. The detective rate of distortion product otoacoustic emissions (DPOAE) from low to high frequencies (0.7-6 kHz) on the right ear was significantly correlated with the methylation level of KCNJ11. The auditory brainstem response (ABR) threshold on the right ear was also correlated (r = 0.678, p < 0.05). This DNA methylation profile indicates the susceptibility loci of DRHL. The potassium metabolism may have a critical role in the hearing loss caused by hyperglycemia.

Vincamine exerts protective effect on spiral ganglion neurons in endolymphatic hydrops guinea pig models.

The aim of this study was to investigate the protective effects of vincamine in endolymphatic hydrops (ELH). After ELH guinea pigs treated by vincamine, the concentration of VAP in plasma, and the levels of cAMP, MDA, SOD, GSH-Px in right cochlea were measured using spectrophotometric method. The V2R, NMDAR1, p-NMDAR1, AQP2, p-AQP2, caspase3/9 and c-caspase3/9 expressions in right cochlea were detected using western blot analysis. The cochlear hydrops degree and SGNs density were evaluated by hemotoxylin and eosin staining (HE) test. Normal hearing and vestibular function were warranted by the tests of auditory brainstem response (ABR) and electronystagmography (ENG). After glutamate-injured SGNs treated with vincamine, the MDA, SOD GSH-Px, NGF, BDNF, NT3, NT4 and Trks levels were measured. Meanwhile, the Bcl2, Bax, NMDAR1, p-NMDAR1, PI3K, p-PI3K, Akt, p-Akt, caspase3/9 and cleaved-caspase3/9 expression levels were detected. Furthermore, the viability, apoptosis and necrosis of SGNs were tested by MTT and Hoechst/PI staining methods. The results indicated that vincamine could significantly inhibit the expression levels of cAMP, MDA, V2R, p-NMDAR1, p-AQP2 and c-caspase-3/-9 in cochlea, alleviate the cochlear hydrops degree, regulate the audiological and vestibular dysfunctions. The SGNs density, SOD and GSH-Px levels were also increased by vincamine. In vincamine-treating groups, the MDA, Bax, p-NMDAR1, and c-caspase3/9 levels were observably decreased, while SGNs survival, SOD, GSH, NGF, BDNF, NT3, NT4, Trks, Bcl2, p-PI3K, p-Akt expressions were improved. The present study indicated a novel use of vincamine in suppressing ELH formation by down-regulating the VAP/AQP2 signaling pathway. It also manifested that vincamine exerted protective effects on hearing via improving neurotrophin-dependent PI3K/Akt signaling pathway in SGNs.

[Clinical analysis of 28 patients with chronic rhino-sinusitis only characterized olfactory disorders].

OBJECTIVE: To analyses the clinical characteristics of 28 chronic rhino-sinusitis patients only characterized olfactory disorders. METHOD: Twenty-eight patients who have only olfactory disorder were diagnosed chronic rhino-sinusitis, among which 16 patients accepted intranasal budesonide for 15 days. All patients accepted CT scan, T&T test and olfactory event-related potentials test before and after treatment. RESULT: (1) No difference was found between 21 patients ( < or = 12 months) and 7 patients (>12 months) (P > 0.05), significant difference was found between maxillary sinus,ethmoid sinus and frontal sinus, sphenoid sinus in CT scan (P < 0.01). (2) Olfactory function improves after treatment (P < 0.01). Significant difference is found between 12 patients ( < or =12 months) and 4 patients (P < 0.01). CONCLUSION: (1) Chronic rhino-sinusitis patients who have only olfactory disorder were found; (2) Intranasal budesonide treatment could improve olfactory functions of chronic rhino-sinusitis' patients.

[MRI features of olfactory bulb volume in healthy middle and old-aged persons.].

OBJECTIVE: To investigate the differences of olfactory bulb (OB) volumes between younger and older, male and female, left-side and right-side in healthy middle and old-aged persons by MRI. METHODS: Ninety five healthy middle and old-aged volunteers (male:female = 45:50) were divided into 2 groups, group one included persons aged from 50 to 69, group two included persons elder than 70. The left-side, right-side and both-side volumes of OB, the volumes of brain and the ratio of OB/brain were measured by MRI. RESULTS: (1) The left-side and both-side volumes of OB (x(-) +/- s), the volumes of brain [(39.89 +/- 8.7) mm(3), (81.70 +/- 16.8) mm(3) and (1281.86 +/- 140.2) cm(3)] in 50 - 69 years old group were respectively larger than those in >/= 70 years old group [(34.45 +/- 10.4) mm(3), (72.10 +/- 19.3) mm(3) and (1165.77 +/- 165.3) cm(3)], and the differences reached statistical significance (t were respectively 2.649, 2.449, 3.516, all P < 0.05). There were no significant differences of right-side OB volumes and the ratio of OB/brain between 50 - 69 years old group and >/= 70 years old group (t were respectively 1.904, 0.616, each P > 0.05). (2) The male's OB volumes of left-side, right-side and both-side, the brain volumes and the ratio of OB/brain were respectively larger than females', and the differences reached statistical significance (t were respectively 4.461, 3.630, 4.399, 3.800, 2.400, all P < 0.05). (3) The right-side OB volumes were larger than left-side's and significant differences were found in female group, 50 - 60 years old group and >/= 70 years old group (t were respectively 2.732, 2.117, 3.516, all P < 0.05). There were no significant differences of OB volumes between left-side and right-side in female (t = 2.649, P = 0.110). The ratio of right-side OB/brain were larger than the ratio of left-side's and the differences reached statistical significance (t = 3.183, P = 0.002). CONCLUSIONS: MRI could be used to measure the volume of OB. The older the people, the smaller the OB volumes. There was no influence of age on the ratio OB/brain. The OB volumes of right-side were larger than those of left-side. The OB volumes of male were larger than those of female.