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

Objective: To study the general incidence of tympanosclerosis among patients with chronic suppurative otitis media(CSOM), and to explore the type of hearing loss and the relationship between the hearing loss and the degree and site of tympanosclerosis in CSOM patients.

Method: One hundred and one patients with CSOM were studied retrospectively. A full history was taken and thorough ENT examinations were carried out. Pure tone audiograms(PTA) of all patients were measured and analysed. The operative findings of tympanosclerosis were also inspected and analysed.

Result: The incidence of tympanosclerosis was found to be 35. 64 percent. Most tympanosclerosis cases had dry ear (77. 78 per cent). The majority of hearing loss associated with tympanosclerosis was of the conductive type. Of the 92. 56 percent who had myringosclerosis, the PTA showed an AB gap <40 dB. When sclerosis affected both tympanic membrane and middle ear, 45. 45 per cent of patients had an AB gap >40 dB.

Conclusion: The exact aetiology and pathogenesis of tympanosclerosis is as yet not well known. There is a direct relationship between the degree of hearing loss and the degree and site of tympanosclerosis.

Objective: To study the clinical presentation, imaging characteristics, intraoperative findings, and histopathologic features of inflammatory myofibroblastic tumor of the temporal bone.

Method: The clinical information of 1 case was reported and the literatures were also reviewed. The specimens were prepared for immunohistochemical staining and light microscopy.

Result: The lesions were locally aggressive with extensive bony erosion. Histologically, the tumor was composed of spindle cells and large number of chronic inflammatory cells. Immunohistochemical stains demonstrated Vimentin, SMA and CD68 were positive meanwhile S-100 and CK were negative.

Conclusion: Inflammatory myofibroblastic tumor of the temporal bone are rare lesions with a potential of local recurrence. Therapy should consists of surgical excision with steroids reserved for residual or intracranial disease or in patients in whom surgery is not an option.

Objective: To explore the possibility of local application of RNAi technique in inner ear of the living mammalian.

Method: The left ear was set as the experimental ear and the right ear in the same animal model was for the control. The vector mixed with cationic polymer was infused through the round window, its expression was measured by immunofluorescence. Distortion product otoacoustic emissions (DPOAE) and auditory brainstem response (ABR) were recorded 1 d, 3 d and 7 d after the infusion respectively.

Result: The expression of the vector was detected 1 d after the infusion and still remained 7 d post-infusion. The hearing loss existed temporarily 1 day post-infusion and eliminated afterward.

Conclusion: The RNAi non-viral vector can express in the inner ear harmlessly and is probably a promising tool for the down regulation gene therapy in the future.

Objective: To investigate the preservation of parathyroid glands and its function during total or near-total thyroidectomy.

Method: One hundred and thirty one patients underwent total thyroidectomy, near total thyroidectomy, hemithyroidectomy and isthmectomy. In operation, the parathyroid glands were exposed, or were identified under microscope when necessary. The third rank of inferior thyroid arteries was ligated to preserve parathyroid glands in situ, and the parathyroid function was observed after thyroidectomy.

Result: Four patients (3%) had a transient hypoparathyroidism after thyroidectomy, 26 patients (20%) had a obviously biochemical hypocalcemia with no symptoms, 73 patients (56%) had a lower calcium level in the first 3 days after surgery compared with preoperative level, 28 (21%) patients who underwent ipsilateral total and contralateral subtotal isthmectomy were all normocalcemic after surgery. There were no permanent hypoparathyroidism and death in our study population.

Conclusion: In total or near-total thyroidectomy, parathyroid glands and its artery blood-supply should be exposed and preserved. Vasodilator and calcium supplementation should be given to patients with obviously lower serum calcium level after surgery to prevent permanent hypoparathyroidism.

Objective: To explore the effect of inhibiting aquaporin-1 (AQP-1) on proliferation and apoptosis of the Hep-2 cell.

Method: The expression of AQP-1 in Hep-2 cell was identified through immunohistochemistry. After using acetazolamide, an antagonist of AQP-1, the assay of cell proliferation, apoptosis and the expression of AQP-1 were performed by microculture tetrazolium salt(MTT) and flow cytometry, TUNEL respectively.

Result: The expression of AQP-1 is mainly found on membrane of Hep-2 cell and the expression is significantly reduced when the concentration of acetazolamide is 5 x 10(-5) mol/L. Noteworthily, inhibiting AQP-1 by acetazolamide, the rate of cell growth and cell apoptosis significantly increases with the time prolong. It showed time-dependent phenomena. There is positive relationship obviously between cell apoptosis rate and inhibition rate of the AQP-1 protein expression.

Conclusion: The inhibiting AQP-1 with acetazolamide may significantly induce apoptosis of Hep-2 cell. It suggest that AQP-1 may be as new target of therapy of laryngeal cancer.

Objective: To establish the animal model of aero-otitis media.

Method: Thirty healthy guinea-pigs were selected and PVC tube was placed from left nasal cavity to nasopharynx for 7 days. Hypobaric chamber experiment was performed before and after tube placement, and also after the treatment. Eardrum examination and tympanogram were carried out each time before and after the hypobaric chamber experiment.

Result: (1)The inflammation of nasal cavity, nasal sinuses and nasopharynx could be seen on CT after PVC tube placement. After treatment, the inflammation subsidised. (2) There was significant difference in left eardrum and tympanogram before and after tube placement, as well as after tube placement and after treatment. Significant difference could also be seen between left ear and right ear after the tube placement.

Conclusion: The animal model in this study may provide reference in diagnosis, classification, treatment and health evaluation of earo-otitis media in pilots.

Objective: To identify the expression of Survivin and its relationship with tumor angiogenesis in differentiated thyroid carcinomas.

Method: The expression of Survivin, VEGF and MVD were detected by immuno-histochemical staining (SP methods) in 47 differentiated thyroid carcinomas, 10 thyroid adenoma and 10 normal thyroid tissues and their content were measured by pathological image analysis system.

Result: The expression of Survivin and VEGF in differentiated thyroid carcinomas was 46.8% and 61.7%, respectively. No expression of Survivin was detected in thyroid adenoma and normal thyroid tissues. The expression of Survivin was significantly correlated with the expression of VEGF and MVD in differentiated thyroid carcinomas. The expression of Survivin was significantly associated with clinical stages, tumor complete capsule and lymph node metastasis.

Conclusion: The up-regulation of Survivin expression and its close relationship with angiogenesis may play an important role in carcinogenesis and development of differentiated thyroid carcinomas.

Objective: To explore the feasibility,surgical techniques and the clinical curative effect of preservation of laryngeal function in surgical treatment of T3 supraglottic laryngeal carcinoma (SLC).

Method: A retrospective review of 70 cases with T3 SLC that we treated from 1994 to 2003 were accomplished. All of the cases were treated with partial laryngectomy. Among them, 42 cases underwent supraglottic horizontal partial laryngectomy, 19 supraglottic horizontovertical laryngectomy, 8 supracricoid partial laryngectomy and 1 near total laryngectomy. All patients were received postoperation radiotherapy with the dosage for 50-60 Gy.

Result: The 3 year and 5 year-survival rates were 79.2% and 68.4%, respectively. Out of the 70 cases, 60 cases were decannulated with a decannulation rate of 85.7%. The normal diet was resumed in all patients, no buckling and dysphagia obviously. All patients had their successful phonation, no one failure for laryngotracheal atresia.

Conclusion: It is feasibility to preservative laryngeal function in surgical treatment of T3 SLC, if surgeons master indications correctly, use many kinds restorative procedure expertly and improve surgical skill.

Objective: With the evaluation of auditory brainstem response(ABR) and auditory steady-state response(ASSR), to explore the hearing disorder and the functional change of auditory pathway in brainstem in children with cerebral palsy(CP).

Method: Fifty-eight cases of CP children were tested with ABR and ASSR, ninety-nine healthy children served as control.

Result: The prolongation of the peak latency and the interpeak latency were observed in CP children comparing with the control. ASSR results showed mild hearing loss especial at low frequencies in children with CP.

Conclusion: With ABR and ASSR, we could provide the qualitative and quantitive diagnosis for hearing disorder and functional change of auditory pathway in brainstem in children with CP objectively.

Objective: To investigate the resemblances and differences of congenital unilateral malformations of lung and bronchial foreign bodies in clinical manifestation, physical sign and radiological examination, and to summarize the characteristics and to introduce diagnostic methods of the congenital unilateral malformations of lung.

Method: Ten patients with the congenital unilateral malformation of lung, who were diagnosed the pulmonary atelectasis or the bronchial foreign body initially, were analyzed. Three typical cases were analyzed in details.

Result: Four patients were confirmed by rigid bronchoscope. Four patients were confirmed by X-ray and high resolution CT of lung, one patient by high- resolution CT and 3D stereographs of lung, one patient by autopsy. Six cases were the congenital malformations of the right lung and 4 cases were the left lung. Three cases of them combined with congenital cardiovascular diseases and other malformations.

Conclusion: There are many resemblances between the congenital unilateral malformation of lung and the bronchial foreign body in clinical manifestation and physical sign. The congenital unilateral malformation of lung was referred as the bronchial foreign body easily. Although it can be confirmed by rigid bronchoscope, the risk of the operation for these children was very high. So if the disease was considered, high resolution CT and 3D -stereographs of lung can make a definite diagnosis.