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

Objective: To discuss the diagnosis and treatment of cavernous hemangioma in internal auditory canal (IAC).

Method: One case of cavernous hemangioma in IAC was diagnosed and treated. The clinical data including clinical manifestation, hearing tests, imaging findings and pathology diagnosis were reviewed.

Result: The tumor was totally removed by translabyrinthine approach without any complication, such as facial paralysis or cerebrospinal fluid otorrhea.

Conclusion: Cavernous hemangioma of the IAC have arisen from vascular plexuses surrounding Scarpa's ganglion. It is a rare occupying lesion in IAC of benign nature. Early diagnosis depends on clinical manifestation and imaging findings. Subtle radiographic findings may help in differentiating these lesions from schwannomas. The ultimate diagnosis is made on pathologic examination of the tissues after surgical extirpation.

Objective: To explore if the ear barotrauma could be prevented or not if the provided nasopharyngeal pressure is higher than the Eustachian tube resistance during the pressure increases in the hyperbaric chamber.

Method: Eight volunteers of healthy men were divided into 4 groups, with 2 persons in each group who were the tested and the control for each other. The positive pressure of 6kPa was given via mask to the nasopharynx of the tested, while the control took normal breath. The pressure in the hyperbaric chamber was increased by 5kPa with the velocity of 0.5kPa/s. No positive or negative measurement to open Eustachian tube was allowed for both tested and controls. The pressure within the tympanic cavity was measured. Similarly, the pressure in the hyperbaric chamber was increased by 20kPa with the same velocity. The tested were not allowed to adjust the Eustachian tube, while the controls could do so. The pressure within the tympanic cavity was measured once again.

Result: When 5 kPa in the hyperbaric chamber was reached, the pressure within the tympanic cavity of the tested and the control was -11.2 daPa and -168.6 daPa (P < 0.01), respectively. When 20 kPa was reached, the pressure within the tympanic cavity of the tested and the control was -8.3 daPa and -7.6 daPa (P > 0.05), respectively. Ear barotrauma could be prevented by providing positive pressure which is higher than the Eustachian tube resistance through mask to the nasopharynx.

Objective: To investigate the diagnostic value of CT and MRI in tumors of parapharyngeal space (PPS).

Method: The data of one hundred and thirty-eight patients with PPS tumor treated in our department during the period from January, 1988 to January, 2005 were collected and reviewed. Eighty-three men and 55 women were enrolled, not including patients with metastasis tumors in PPS or nasopharyngeal carcinomas invading PPS. The age varies from 7 to 73 yrs(average 44.7 yrs). Among the patients, 12 were operated for the second time because of recurrence. All the patients were examined by CT or/and MRI.

Result: CT and MRI could provide the position, size, confine of the tumor and its relationship with cervical blood vessels well, which were important to operation schemes.

Conclusion: CT and MRI before operation are valuable to the treatment of PPS tumors.

Objective: The purpose of this study was to describe the changes of resonance characteristics of the nasal cavity (including nasal sinuses) and nasal airway resistance (NAR) after endoscopic sinus surgery (ESS), through objective measurement of nasality and NAR before and after ESS.

Method: Sixty- eight patients received the examinations of nasality and NAR using Nanometer and Atmos Rhinomanometry before and after ESS separately.

Result: The nasality of patients with type III and type II stage 2, stage 3 chronic sinusitis was obviously improved ( P <0. 05), but still below the normal range 1 month after ESS. The nasality didn't recover to the normal level 3 months postoperatively. However the total NAR apparently decreased 1 months after ESS ( P <0. 01) and returned to normal 3 months postoperatively. Nasality and the total NAR of patients in type II stage 1 turned to normal 1 month after ESS. There are no distinctive changes in nasality and total NAR of type I stage 1 patients.

Conclusion: The total NAR significantly decreased close to normal among the patients with severe sinus or/and nasal lesions after ESS, however nasality continued aberrant for a relatively long period. It is suggested that nasality can't be ameliorated immediately after ESS. On the contrary, it is possible to bring some undesirable effects to the professional voice users, such as announces, for the changed resonance characteristics of the nasal cavity due to the excessive destruction of its normal structure.

Objective: To investigate the indications, complications and their prevention of tracheotomy in patients with liver transplantation.

Method: Data of 45 patients with liver transplantation who underwent tracheotomy were summarized.

Result: Twenty-five patients(54.35%) succeeded in removing trachea cannula in one month after tracheotomy. Hemorrhage after tracheotomy occurred in 11 patients and haemostasis succeeded in all of them. Subcutaneous emphysema occurred in 2 patients. Infection of tracheal fistula occurred in 4 patients. Common bacterial culture of sputum was positive in 9 patients. No other operative complication occurred.

Conclusion: Indications of tracheotomy in patient with liver transplantation include respiratory complication and lower respiratory tract infection. Postoperative hemorrhage and infection are the main complications and available measures should be adopted.

Objective: To study the expression and its significance of STAT3, STAT5, Survivin and Ki67 in the Epstein-Barr virus associated nasal NK/T cell lymphoma.

Method: The expression of STAT3, STAT5, Survivin and Ki67 were detected with immunohistochemistry in 25 cases of nasal NK/T cell lymphoma, and their relationship was analyzed. Nasal cavity tissues from 20 cases of chronic sinusitis were as the control group.

Result: The positive rates of STAT3 in the lymphoma and in control group were 56% and 10%, respectively (P <0.01). The positive rates of STAT5 in the lymphoma and in control group were 68% and 15%, respectively (P <0.01). The positive rates of Survivin and Ki67 of nasal NK/T cell-lymphoma were 68% and 72%, respectively; but it in the control group was 0% and 20%, respectively, P <0.01. The expression of STAT3 was positively related to that of Survivin and Ki67(r =0. 428, P <0. 05 and r =0. 704, P <0. 01); The expression of STAT5 was not related to that of Survivin and Ki67.

Conclusion: The pathway of STAT may play a role in the development of nasal NK/T cell lymphoma. STAT maybe take part in the formation of nasal NK/T cell lymphoma through induction of Survivin and Ki67.

Objective: To observe the effect of remifentanil on hemodynamic and angiotentratin- II in children undergoing endoscopic-assisted adenoidectomy.

Method: Thirty patients, ASA I -II , were randomly divided into two groups , remifentanil group and fentanyl group. Remifentanil group received remifentanil combined with propofol anesthesia, fentanyl group received fentanyl combined with propofol anesthesia . Vecuronium was given as muscle relaxant in both groups. ECG, HR, BP, Sa02 were monitored in both groups during operation,and peripheral venous blood samples were taken on 1d before operation(T1),at the time of endotracheal intubation (T2 ), 10 minutes after operation beginning (T3 ),5 minutes after extubation (T4 ) for check angiotentratin- II , then recorded the time of anesthesia, the time of recovery from anesthesia and the time of extubation.

Result: Comparing with T1, T2, and T3 were significant lower in both group about the HR, BP and angiotentratin-II. There was no significant difference in two groups about SaO2. HR and BP is little lower in remifentanil group than in fentanyl group . The anesthesia time was significantly longer in Remifentanil group than that in fentanyl group. The recovery time was significantly shorter in Remifentanil group than that in fentanyl group. The extubation time was significantly shorter in remifentanil group than that in fentanyl group.

Conclusion: Remifentanil is better than fentanyl for stabilizing hemodynamic,decreasing the stress responses,reducing the time of recovery and extubation in children undergoing endoscopic-assisted adenoidectomy.

Objective: To study correlation between HPV infection and the etiology of human papilloma and uncover the effects of HPV57 infection on IP, in order to provide a new way for IP precaution and treatment.

Method: Sixty formalin-fixed, paraffin-embedded specimens of IP were definitely diagnosed by pathologists. They were examined by the polymerase chain reaction (PCR) technique to amplify HPV DNA with HPV L1 consensus primer and HPV57 type-specific primer. Ten specimens of chronic sinusitis were taken as control group.

Result: All of the sixty IP specimens showed negative after amplification by HPV 1.1 consensus primer MY09/11. There were forty-seven specimens(47/60, 78.3%) showed positive for HPV type 57 after amplification by HPV57 type-specific primer.

Conclusion: Our findings suggest a possible role for HPV type 57 in the pathogenesis of nasal inverted papilloma.

Objective: To describe the clinical presentation of ossifying fibroma of the temporal bone, and to discuss its diagnosis and treatment.

Method: A rare case of ossifying fibroma of the temporal bone was presented. The patient was a 8-year-old boy with a one year history of left ear discomfort, suppurative otorrhea and progressive hearing loss. Physical examination of the ear revealed a stenosis of left external auditory canal (EAC), and an obvious expansion at mastoid region. Audiometry showed no hearing of the left ear. A postauricular approach was used to expose the mass. Frozen section evaluation during operation was not definitive but suggested benign nature in histology. The tumor was fully resected. The EAC was sealed by sutured skin, and the extended mastoid cavity was obliterated with abdominal fat.

Result: The final pathological report indicated the stromal cells were negative for S-100 protein and epithelia membrane antigen (EMA), supporting the diagnosis of ossifying fibroma. One-year follow-up showed the sealed EAC was satisfactory with complete interior and no tumor recurred.

Conclusion: Ossifying fibroma of the temporal bone is a rare entity, which is a benign neoplasm but may show an aggressive behavior by compression and encroachment upon adjacent structures. Early and complete removal was advocated.

Objective: To explore the correlation between the expression of brain derived neurotrophic factor (BDNF) and presbycusis in the cochleae of the aged rats.

Method: The mRNA expression of BDNF and presbycusis in the cochleas of the aged rats was quantitated by real time PCR.

Result: The expression of BDNF in the cochleas of the aged rats with presbycusis was obviously less than that in the control group. And the difference was statistically significant.

Conclusion: The expression of BDNF is closely correlated to presbycusis in the aged rats.