OBJECTIVE To explore the outcomes of CO2 laser assisted stapedotomy with artificial stapes prostheses in the treatment of advanced otosclerosis. METHODS Between January 2010 and January 2014, 15 patients (16 ears) diagnosed as advanced otosclerosis accepted CO2 laser assisted stapedotomy with artificial stapes implantation in our department. The averaged preoperative air conduction threshold of the speech frequency was 70.21 dB HL, the averaged bone conduction threshold was 38.49 dB HL, the averaged air-bone gap (ABG) was 31.72 dB HL. All cases were followed up for more than 6 months after operation. RESULTS All cases accepted auditory follow up after 6 months postoperatively. The speech frequency average air conduction threshold was 43.7 dB HL, the average bone conduction threshold was 28.95 dB HL, the average ABG was 14.75 dB HL. The ABG≤20 dB was achieved in 9 ears (56.3%) and ABG closure (≤10 dB) was achieved in 6 ears (37.5%). No cases appeared intractable vertigo, sensorineural hearing loss, secondary facial paralysis and other serious complications. CONCLUSION CO2 laser assisted technique reduced the probability of serious complications of stapedotomy, most patients with hearing level improved significantly. It's a safe, practical, relatively economical choice for advanced otosclerosis.

OBJECTIVE To assess the ultrasonographic features and clinical significance of the complications of the thyroglossal cysts. METHODS We retrospectively reviewed the ultrasonographic findings in 41 cases with complications of the thyroglossal cyst, which was confirmed surgically and pathologically. 43 cases with simple thyroglossal cyst consisted of the control group. The location, size, internal echo, internal septa, wall thickness, posterior acoustic feature, boundary, vascularity, and fistulas of the lesion were analyzed and compared with the control group. RESULTS Most of the inflammatory thyroglossal cyst showed thickening walls, indistinct boundaries, posterior echo enhancement, and peripheral vascularity on ultrasound images. There were significant differences of the thickness of the cyst wall, indistinct boundary, and peripheral vascularity between the two groups. CONCLUSION The characteristic findings of thyroglossal cyst with inflammation are thickened wall, indistinct boundary, and peripheral vascularities. Ultrasonography can be useful tool in determination of the appropriate time of the operation to reduce the recurrence rate.

OBJECTIVE To assess the treatment reliability of covered stent for carotid artery blowout after head and neck tumors resection. METHODS Five cases with postoperative rupture of carotid artery invaded by the head and neck tumor were reviewed. They presented with life threatening massive neck or oral bleedings. All of them were treated with self expanding covered stents through intervention therapy approach. RESULTS The covered stent were successfully deployed in the target arteries in all cases,the instant isolation effect was quite satisfactory. After treatment, angiography showed successful occlusion of the pseudoaneurysm, patency of carotid artery lumen, and significant improvement of clinical symptoms without neurologic dysfunction. Following up 2 to 36 months, 3 patients were alive with no disease, two patients died of recurrence. CONCLUSION For the treatment of carotid blowout, endovascular occlusion with covered stent is a minimally-invasive, safe and reliable methods.

OBJECTIVE To investigate the clinical pathological characteristics of differentiated thyroid carcinoma (DTC) in children and adolescents. METHODS The clinical data of 30 children and adolescents with DTC were retrospectively reviewed. Meanwhile the clinical pathological characteristics of DTC were analyzed according to patients' age and gender. RESULTS Papillary thyroid carcinoma (PTC) was found in 27 cases and follicular thyroid carcinoma (FTC) in 3 cases. The average diameter of tumors was (2.56±1.1) cm. In the group of children, the incidence of lymph node metastasis was 92.3% (12/13), pulmonary metastasis was 46.2% (6/13), and those in the group of adolescents was 88.2% (15/17) and 35.3% (6/17) respectively. Children group tended to present with more vascular invasion, thyroid capsule invasion, and invasion out of thyroid, and a higher rate of cervical lymph node metastasis (P=0.025, 0.007, 0.025, 0.033). CONCLUSION Thyroid carcinoma in childhood and adolescent has a stronger invasive feature. It is easy to local invasion, lymph node and distance metastasis.

OBJECTIVE To observe the effect of administration intranasal corticosteroids on small airway disfunction for allergic rhinitis (AR) patients. METHODS AR patients with small airway disfunction were administrated intranasal corticosteroids for twelve weeks. Before treatment, nasal VAS, RQLQ were recorded, pulmonary function test were given. After therapy, VAS, RQLQ were obtained again at the 4th, 8th and 12th week. Pulmonary function test were performed at the 4th and 12th week. RESULTS VAS, RQLQ were all improved after therapy (P <0.01). The indices of FEV1/FVC%, MMEF pred%, MEF75pred%, MEF50pred%, MEF25pred%were also improved significantly (P<0.05), especially for MMEFpred%, MEF75pred%, MEF50pred% (P<0.01). CONCLUSION Small airway lesions can be obviously improved by the intranasal corticosteroids applied for AR. It has positive significance for preventing AR from developing into asthma.

OBJECTIVE To analyze the clinical features of 8 patients with sigmoid sinus diverticulum and to improve the level of diagnosis and treatment. METHODS The tinnitus patients were asked in detail about the history, and performed a series of routine hearing tests (pure tone audiometry, acoustic impedance audiometry, otoacoustic emission inspection and brainstem auditory evoked potential (BAEP) etc.) and temporal bone HRCT scan. Eight cases were diagnosed with sigmoid sinus diverticulum, in which six cases undertook a surgery to reconstruct the sinus wall while the other 2 cases chose conservative treatment. RESULTS The diagnosis of 6 cases was proved to be correct by surgery, and the pulsatile tinnitus disappeared after reconstructing the sinus wall. No one recurred after following up from 2 to 12 months. Two cases of conservative treatment had no obvious improvement in symptoms. CONCLUSION Clinical manifestation, hearing examination, temporal bone CT/HRCT and Cranial CTA/CTV contributed to the diagnosis of sigmoid sinus diverticulum. Sinus wall reconstruction is a better approach.

OBJECTIVE To discuss the diagnosis and treatment of cholesterol granuloma of the middle ear and the choice and effect of surgical methods. METHODS A retrospective analysis was conducted on 18 cases of cholesterol granuloma of the middle ear confirmed by surgery and pathology. Different choices of surgical methods were made according to the lesion extension of this disease. RESULTS All patients were followed up for at least 6 months. Two cases with eustachian tube obstruction had ventilation tube inserted for a long time. One case who had recurrence and metastasis of nasopharyngeal carcinoma in the middle ear was transferred to oncology department for further treatment. Post-operative dry ears were obtained in the other cases whose pure tone thresholds were improved to different degrees. CONCLUSION Etiology of cholesterol granuloma of middle ear remains controversial. It's supposed to result from the bleeding, occlusion of ventilation and disturbance of drainage of the air cavity because of the middle ear inflammation, and bone marrow exposure. The middle ear and mastoid surgery can completely remove the disease tissues, and establish ventilation system of mastoid-tympani-eustachian, which is the key point of the middle ear surgery.

OBJECTIVE To investigate the time of aerosol inhalation using Budesonide Suspension and Mucosolvan drived by oxygen on prevention of pharyngeal and oral mucosa damage induced by radiotherapy in nasopharyngeal carcinoma (NPC). METHODS All 108 cases with NPC were divided into 4 groups, each group 27 cases. In 3 treatment groups,aerosol inhalation using Budesonide Suspension and Mucosolvan drived by oxygen were began at the initial , after 5 times, after 10 times radiotherapy respectively. In control group, aerosol inhalation was not used. The rates of third degree of pharyngeal and oral mucosa injury during different dose of radiotherapy were compared among the 4 groups. RESULTS At the dose below 30 Gy, there were no case of third degree of pharyngeal and oral mucosa injury occurred in 3 treatment groups, one case in control group. At the dose of 30 to 40 Gy, third degree injury occurred in all groups, there was no statistical difference among the 4 groups. At the dose over 40 Gy, the patients of third degree injury in group 1 and 2 were less than that in control group. There was no difference between group 3 and control group. CONCLUSION The right time of aerosol inhalation using Budesonide Suspension and Mucosolvan drived by oxygen for prevention of pharyngeal and oral mucosa complication induced by radiotherapy in NPC is at 5 to 10 times after radiotherapy.

[ABSTRACT]OBJECTIVE To obser ve t he pathological changes of nasal mucosa in rats after instillation of 37℃ normal saline. METHODS Forty-eight qualified rats were given instillation of 37℃ nomal saline 30 times, once per minute. Another 2 qualified rats served as control. After instillation, in the 15, 30 minutes and 1st, 3rd, 7th, 14th, 42th, 28th day respectively, the nasal septum mucosa of 6 rats was observed by light and electron microscopy. The corresponding area of the mucosa of control group was also observed by light and electron microscope. RESULTS Under light microscope, the arrangement of cell was disordered in the 1st, 3rd, 7th days. But there is no damage of vascular gland structure. After 14 days, the disorder recovered. With electron microscope, edema of cells, expansion of perinuclear gap, disorder of cilia and microwilli was found in the 30 minutes, 1st, 3rd day. All these began recover in the 7th days, and completely restored in the 28th day. CONCLUSION 37℃ nomal saline drip can damage nasal mucosa, but the damage is light, which is characterized by disorder and shortage of cilia and microvilli, edema of the epithelial cells. And the damage can recover quickly. It began in the 30 minutes after instillation, reached its peak in the 3rd day. And the recovery began in the 7th day, and completed in the 28 day.

OBJECTIVE To investigate the effects of simulated noise-weightlessness combined factors on auditory brainstem response thresholds and the cochlear structure after a medium-long term (2-8 weeks). METHODS Healthy adult rats were randomly divided into male/female experimental and control groups. The male and female experimental groups were exposed to simulated noise-weightlessness environment and exerted impulse noise exposure at the end. Auditory brainstem response (ABR) threshold was recorded at the beginning, the 2nd, 4th and 8th weeks and after impulse noise exposure exerting. The cochlea was also examined by scanning electron microscopy each time after ABR threshold record. RESULTS ABR thresholds in experimental groups after impulse noise exposure were significantly increased (P<0.05). Female experimental group were lower than those of the male experimental group at 2 and 4 weeks (P<0.05). Scanning electron microscope observation showed that the inner and outer hair cell were losing and lodging, and the longer exposed to the compound factors, the heavier pathological changes observed on the cochlear hair cell. CONCLUSION Noise-weightlessness combined factors can cause the morphology and function damage of rat cochlear in medium-long term. The damage of impulse noise was more than steady noise on rat auditory function. Sex differences was also observed. Rat cochlear hair cell pathological changes increased with the exposed time.