Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology最新文献

Objective: To study the role of superantigens produced by Staphylococcus aureus in the pathogenesis of nasal polyps.

Method: sinonasal mucus and polyp/mucosa tissue were obtained from sixty-nine patients with chronic rhinosinusitis (42 patients with bilateral nasal polyps, 27 without nasal polyps). Samples from twelve normal subjects were also obtained for comparative negative controls. Mucus specimens were cultured for bacteria. Tissue specimens were assayed by ELISA for staphylococcal exotoxins. In addition, the histopathology of nasal polyps was studied. The paraffin sections were stained with hematoxylin and eosin, and these were examined for eosinophil counts.

Result: The percentages of Staphylococcus aureus in sinonasal mucus were 7.1 for chronic rhinosinusitis with nasal polyp (CRSwNP) subjects, 3.7% for chronic rhinosinusitis without nasal polyps (CRSsNP). and 0 for controls respectively. There were no significant differences between these groups. In CRSwNP subjects 23 of 42 samples (54.76%) demonstrated reactivity for at least one staphylococcal exotoxin. There were no positive results in the CRSsNP or control groups. The mean eosinophil counts were 23. 94+/-13. 88 in CRSwNP group, 0.29+/-0.51 in CRSsNP group, and 0. 08+/-0.28 in controls. The differences in these three groups were all significant ( P <0.05). There was a trend toward higher eosinophil levels in polyps of ELISA-positive patients compared with that of ELISA-negative patients, although this was not statistically different ( P >0.05).

Conclusion: There were correlation between Staphylococcal superantigens and nasal CRSwNP, and superantigens were possible etiological agents in the pathogenesis of CRSwNP.

Objective: To assess the clinical and pathological features of the patients with ENT adenoid cystic carcinoma (ENTACC) who presented with hard lump, and to detect its prognosis.

Method: A retrospective analysis was performed on 9 patients with ENTACC by their clinical data.

Result: The period from the occurrence of primary symptoms to definite diagnosis was 4 years and 3 months on average. All patients were followed up from 6 months to 15 years. All of the cases relapsed after operation and radiotherapy. Five patients died, among which 3 died with lung metastases, 2 with local lymphatic metastases, 1 with bone metastases and 1 with encephalic diffusion. The other 4 cases still survive. The longest survival period with tumor was 6 years and 3 months.

Conclusion: The pathological result of these 9 cases were all salivary gland derived adenoid cystic carcinoma of solid type. It was mainly characterized by the development of ENT hard lump. All of the patients should be diagnosed in time. Extensive excision and postoperative radiotherapy are needed at the first time. The tumor of solid histological pattern appears with much poorer prognosis compared with that of other histological pattern.

Objective: The aim of our study was to clarify the diagnosis value of total IgE and the relationship between total and specific IgE.

Method: Eight-seven Artemisia pollen-sensitive allergic rhinitis patients with obvious autumn onset and 80 nonatopic healthy controls were recruited for this study. Serum levels of total IgE were determined by using the Elecsys IgE reagent kit (Roche). Serum-specific IgE antibodies against Artemisia pollen were measured by using a fluorescent enzyme immunoassay (UniCAP system, Pharmacia and Upjohn Diagnostics).

Result: The serum total IgE levels in patients with allergic rhinitis were compared with the controls. The total IgE levels of the patients were much higher than those of the controls(Geometric mean of the patients and the controls were 0. 185 U/L and 0. 050 U/L respectively, P <0.01). The correlation of the serum Artemisia pollen specific IgE and total IgE levels in patients with allergic rhinitis was made. No correlation was found between the total and specific IgE levels ( P >0. 05).

Conclusion: There are some reference values for the serum total IgE levels to the diagnosis of the Artemisia pollen-induced allergic rhinitis patients. There are no correlation between the serum Artemisia pollen specific IgE and total IgE levels in patients with allergic rhinitis. Its value is limited to predict the specific value according the total IgE.

Objective: To explore the orbital management in advanced squamous cell carcinoma of maxillary sinus with orbital invasion.

Method: Forty-six postoperative cases of advanced squamous cell carcinoma of maxillary sinus with orbital invasion were followed up. Two,three,five-year survival rates and 2-year recurrence rates were analysed in,orbital bone invaded group, periorbit invaded group and orbital content invaded group.

Result: Two, three,five-year survival rates and 2-year recurrence rates were 65.2%, 55.6%, 46.7% and 38.1% in orbital bone invaded group; 57.1%, 50.0%, 45.5% and 53.8% in periorbit invaded group; 44. 4%, 37. 5%, 37. 5% and 62. 5% in orbital content invaded group, respectively. Survival rates of three groups descended and recurrence rates of three groups ascended but without statistical significance( P >0. 05).

Conclusion: During the surgery for advanced squamous cell carcinoma of maxillary sinus with orbital invasion without the evidence of optical nerve and eye ball involvement, preservation of orbital contents is considerable even though the orbital bone and periorbit are involved by the tumor.

Objective: To study the clinical value of thyroid imaging in differentiate the origin cervical mass.

Method: Sixty-nine patients with cervical mass were subjected to 99mTc-pertechnetate imaging. 99Tc-MIBI hot spot imaging and perfusion imaging were performed in some of patients with cold or cool nodules. The findings of thyroid imaging were compared with follow up and histopathologic results.

Result: Thirty-three of 69 patients were found with thyroid nodules, 36 patients mass were outside thyroid. Twelve of 33 thyroid nodules were found to be subacute thyroiditis. Two cases regarded as thyroglossal duct cyst were found to be ectopic thyroid glands. Twenty-seven of 36 masses out side thyroid were thyroglossal duct cysts.

Conclusion: 99m Tc-pertechnetate imaging, 99mTc-MIBI hot spot imaging and perfusion imaging are useful to differentiate the origin of cervical mass, and differentiate ectopic thyroid from thyroglossal duct cyst.

Objective: To observe the effects of ephedrine on histomorphology and ultrastructure of nasal cavity mucosa from the healthy SD rats and explore the intervenient role of adenosine triphosphate(ATP).

Method: Twenty-three SD rats were divided randomly into three groups: Group A as control group; Group B for ephedrine; Group C for ephedrine and ATP (injection of ATP into peritoneal while ephedrine was given). Nasal cavity mucosa were taken for light microscopy (LM), transmission electron microscopy (TEM) at the 1st, 2nd, 3rd and 8th week of the experiment.

Result: The damages in Group B of nasal cavity mucosa of the 1st, 2nd, 3rd week was aggravated gradually, histomorphology and ultrastructure of nasal cavity mucosa had no recovered after withdrawing drug until 8th week. Few damages in Group C of nasal cavity mucosa had been found in 1st week and a few damages were found in 2nd and 3rd week. The injured cells recovered definitely after stopping ephedrine and continuous application of ATP for another 5 weeks.

Conclusion: The nasal cavity mucosa of SD rats can be damaged by ephedrine and the degree of damages of which becomes more serious with the increase of time. Furthermore the damages do not recover. ATP can alleviate the damages of nasal cavity mucosa from SD rats caused by ephedrine and prevent nasal cavity mucosa from the damages induced by ephedrine.

Objective: To realize the epidemic features of rhinosinal inflammatory diseases in children and their correlation with asthma in Nanjing,China.

Method: A questionnaire survey on children chronic rhinosinusitis (CRS) and airway diseases was conducted among 1087 elementary school children, aged from 9 to 10, of seven schools in Nanjing city by random cluster sampling, from March to September, 2004. The questionnaires include such questions as age, gender, family history, basis diseases, inducements, environment, therapy, correlative lower airway diseases and so on. The survey included screening suspects of CRS and allergic rhinitis (AR) by filling up the questionnaires by their parents and then special examination withtion of asthma of children was obtained by inquiring whether children were diagnosed by physician in last 12 months. The results were dealt with statistics.

Result: Nine hundred and eighty nine questionnaires were returned. The response rate was 91% and 942 questionnaires were available. The prevalence rate of CRS of children aged from 9 to 10 was 8.8% in Nanjing city. The prevalence rate of AR was 5.1%. The prevalence rate of asthma of children was 5.3%. The incidences of asthma of children with CRS and AR were 19.3% and 39.6% respectively, while that of children without rhinosinal inflammatory diseases was 1. 8%. The results showed that the differences of the incidences of asthma between children with CRS, AR and without rhinosinal inflammatory diseases were statistically significant( P <0.01).

Conclusion: Chronic rhinosinusitis is a common disease in children. The prevalence rates of CRS and AR in children aged from 9 to 10 in Nanjing city were 8.8% and 5. 1%. The incidence of asthma in children with rhinosinal inflammatory diseases is markedly higher than that in children without these diseases.

Objective: To explore the establishment of the mimetic aging effect in the inner ear of the rat.

Method: Twenty-four Wistar rats were randomly divided into two groups: group A (D-galactose group, n = 14), which were treated with hypodermic 5% D-galactose (150 mg x kg(-1) x d(-1)) for 8 weeks and then with intraperitoneal saline for 10 days, and group B (control group, n = 10), which were given saline only. Auditory brainstem response(ABR) was used to detect the hearing threshold of rats, and colorimetry was used to analyze the activity of the glutathione peroxidase (GSH-PX). The inner ear tissue was harvested and mitochondrial DNA was amplified to identify the 4 834 bp deletion mutation by nested primer polymerase chain reaction (nested PCR) technique.

Result: The incidence of mitochondrial DNA 4 834 bp deletion of group A was 100% (28/28), while the deletion of group B was 0. The activity of the GSH-PX in group A (59.07 +/- 8.70 U) was lower than that in group B (142.10 +/- 7.02 U). The difference between group A and group B was significant (t-test, P < 0.01). Variation in ABR threshold of (5.36 +/- 3.08) dB peSPL was observed in group A, and (6.50 +/- 3.37) dB peSPL in group B. The difference in shift of ABR threshold between group A and group B was not significant (P > 0.05).

Conclusion: The mimetic aging effect in the inner ear of the rat can be induced by D-galactose, and this rat model presents high incidence of mtDNA4834 deletion. But no hearing loss was found in this model.

Objective: To explore the correlation between sensorineural hearing loss (SHL) and otitis media with effusion (OME).

Method: The data of 38 cases with OME who had no recovery of bone conduction hearing threshold were reviewed. The bone conduction hearing thresholds at different frequencies in both healthy and suffering ears were measured and their relationship with age, duration, character and amount of effusion were also discussed.

Result: At different frequencies, the bone conduction hearing thresholds of the suffering ear were higher than those of the healthy ear (P < 0.05). The older of the age and the longer of the duration, the more possibility of SHL occurrence. Its occurrence was more likely to appear in patients with mucous effusion than in patients with serous effusion, however, it had no relationship with the amount of the effusion.

Conclusion: OME may lead to SHL, and the etiology and mechanism is complicated and unclear. The patients with older age, longer duration and mucous effusion are more susceptible to SHL, and should be early diagnosed and managed.

Objective: To investigate the clinical significance of the micrometastasis of prelaryngeal lymph nodes in the patients with glottic carcinoma.

Method: In prelaryngeal lymph nodes from 26 patients with glottic carcinoma, cytokeratin 19 (CK19) mRNA was detected with reverse transcription polymerase chain reaction (RT-PCR), comparing with the routine histopathologic methods (HE staining).

Result: The positive expression of CK19 mRNA in prelaryngeal lymph nodes was detected in 8 patients (30.77%). While there was no positive finding by routine methods. The difference was significant (P < 0.05). In 8 cases with stage I glottic carcinoma, no micrometastasis in the prelaryngeal lymph node was found, and in 18 cases with stage II - VA glottic carcinoma, micrometastasis was found in 8 cases (44.44%) (P < 0.05).

Conclusion: The detection of prelaryngeal lymph nodes micrometastasis with RT-PCR is more sensitive than with the routine histopathologic methods. The study of micrometastasis of prelaryngeal lymph nodes may provide information for the clinical management of the patients with glottic carcinoma.