1.The analysis of smooth pursuit test in unilateral vestibular peripheral vertigo
Jing BI ; Peng LIN ; Taisheng CHEN ; Hong DONG ; Wei SONG ; Xuejie FAN ; Yue MI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(1):8-10,15
Objective:To analyze the result of smooth pursuit test(SPT) in unilateral vestibular peripheral vertigo and investigate its influencing factors.Method:Smooth pursuit test (SPT) and spontaneous nystagmus (SN)were examined in one hundred and eighty-five patients with unilateral peripheral vertigo(case group) and 51 normal persons(control group) by Video-Nystagmography (Synapsys, France), and the gain of SPT and SN were selected as the observation parameters in order to analyze the waveform and gain of SPT and the relativity between SN and the gain of SPT.Result:Of the 185 patients, 105(56.8%),72(38.9%) and 8(4.3%) cases producedⅠ,Ⅱ and Ⅲ waveforms respectively. Of these patients, 58(31.4%) demonstrated SN and none had Ⅳ waveform. While of 51 normal persons, 38(74.5%), 13(25.5%) persons producedⅠand Ⅱwaveforms repectively and there were no Ⅲ, Ⅳ waveforms or SN. There was statistical significance between the stong and weak gain of SPT in these two groups. Weak gain was significantly different between two groups. The stong and weak gain of SPT in case group were 0.86±0.06,0.80±0.06; 0.78±0.09, 0.65±0.1; 0.68±0.13, 0.45±0.12. The relativity between SN and the gain of SPT was positive when they had same direction(r_s=-0.63,P<0.05)and negative when opposite (r_s=0.34,P<0.05).Conclusion:Ⅰ,Ⅱ,Ⅲ three waveforms of SPT could appear in unilateral vestibular peripheral vertigo and the corresponding gains are gradually decreasing.SN is the influencing factor of SPT.
2.The application of improved CHQS for mass epidemiology study on hearing impairment
Cheng LIU ; Guangqian XING ; Xia XU ; Zhibin CHEN ; Han ZHOU ; Dengyuan WANG ; Huiqin TIAN ; Xingkuan BU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(1):19-20,24
Objective:To develop and evaluate the improved Chinese hearing questionnaire for school children(CHQS)for mass epidemiology study on hearing impairment in China.Method:Using the probability proportion to size(PPS) method, 8 412 residents were investigated in 40 clusters in Jiangsu province with the WHO ear diseases and hearing disorders survey protocol.87.9% of the residents aged 7 years and over answered the questionnaire and accepted the pure tone audiometry.Result:The prevalence of hearing impairment was 12.9% by the questionnaire. Compared with golden standard(pure tone audiometry), Sen=58.5%, Spe=96.7%, PV+=78.9%, PV-=91.7%, overall accuracy=90.0% . The sensitivity for women was higher than men.Conclusion:The questionnaire produced high efficiency and specificity values.It could be used in mass hearing screening, particularly in remote and rural area, although the sensitivity was as low as most questionnaires.
3.A comparison between anatomical landmark registration and surface registration for computer-assisted endoscopic sinus surgery
Huan JIA ; Qi CHEN ; Rongping CAO ; Jun YANG ; Qi HUANG ; Zhentao WANG ; Hao WU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(2):49-52,56
Objective:To evaluate the clinical advantage and disadvantage of anatomical landmark registration(ALR) and surface registration(SR) in computer-assisted endoscopic sinus surgery(CAESS).Method:Twenty-six patients were selected for the CAESS, the preparatory times and mean target registration errors (TRE) were recorded in order to compare the difference between them two, their convenience and their value were also analyzed.Result:CAESSs were successfully used in 26 cases without complications. The average preparation time of SR was(8.5±1.9)minutes, that of ALR was(6.5±1.7)minutes. In the SR group, the TRE of naso-labial angle was(1.43±0.26)mm, that of front end of middle turbinate was(1.92±0.47)mm, that of front end of inferior turbinate was (1.82±0.49)mm, and that of back end of inferior turbinate was (2.03±0.42)mm. Them in ALR group were (1.58±0.35)mm,(2.05±0.37)mm,(1.92±0.31)mm and (2.48±0.64)mm ,respectively.24 cases (92.2%) were not affected or were slightly affected by the navigation system. The value of navigation was affirmative in 22 cases (84.6%), and its value was mainly related to TRE.Conclusion:The accuracy of surface registration was superior to that of anatomical landmark registration, but the anatomical landmark registration was more convenient and need less preparation time. The value of navigation system is its accuracy, convenience and no disturbance to surgery. The navigation system is more valuable in the complex cases than that in the general case.
4.Clinical observation of 116 cases of laryngofissure avoiding tracheotomy
Jiandong ZHAO ; Wenming WU ; Jialing WANG ; Liangfa LIU ; Dongyi HAN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(3):114-115,118
Objective:To evaluate the clinical effect of laryngofissure without tracheotomy.Method:One hundred and sixteen cases of laryngofissure without tracheotomy in our department were analyzed retrospectively.Result:Of 116 cases, 101 cases had the laryngeal carcinoma; 9 cases had laryngeal stenosis; 6 cases had benign tumor of larynx. All the incisions were healed by first intention; and postoperative duration of hospital stay were 7 to 20 days. Three cases recurred in 101 cases of laryngeal carcinoma (2.97%), and underwent reoperation,the 5 year survival rate was 100%. One case recurred in 9 cases of laryngeal stenosis, and underwent reoperarion of laryngoplasty with T-tube implanted. No recurrence in 6 cases of benign tumor of larynx.Conclusion:Laryngofissure without tracheotomy have the advantage of less trauma , fast rehabilitation and no destroying the normal respiratory functions. It is completely feasible so long as surgeons grasp the adaption of operation strictly and select suitable cases.
5.Analysis of the reason for the adhesion of vocal cord after CO_2 Laser laryngeal surgery
Hongwu CAI ; Anzhou TANG ; Zhiwen XU ; Jiping SU ; Yong ZHOU ; Dongxiao NONG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(4):147-148,151
Objective:To investigate the reason for the adhesion of vocal cord after CO_2 Laser laryngeal surgery.Method:One hundred and nineteen patients who were untaken CO_2 Laser laryngeal microsurgery.Result: Among 119 cases,9 cases of bilateral vocal cord paralysis, 42 cases of vocal cord polyps and 3 cases of precancerous laryngeal lesions did not show vocal cord adhesion after CO_2 Laser laryngeal microsurgery.Contrarily, one of 5 cases with laryngeal stenosis, 5 of 41 cases with laryngeal papilloma and 6 of 19 cases with laryngeal carcinoma shew the adhesion of vocal cord after CO_2 Laser laryngeal microsurgery.Conclusion:Through selecting the appropriate patient and surgery spot, processing correctly during and after surgery, using the suitable dosage of laser and reducing the heat radiation, the adhesion of vocal cord can be avoided after CO_2 Laser laryngeal surgery.
6.Clinical significance of SKP2 and MRP-1/CD9 expression in glottic carcinoma and adjacent tissues
Yan WANG ; Yan SUN ; Wenhai SUN ; Zhijun CHEN ; Fengmiao AN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;(4):158-160,165
Objective:To study the expression of SKP2 and MRP-1/CD9 protein in glottic cancer and adjacent tissues,and to analyze its significance for a safe surgical margin.Method:Thirty-eight cases of glottic squamous cell carcinoma were studied for its cancer tissue, tissue 2 mm, 5 mm , and 10 mm away from cancer ,and 10 cases of vocal cord polyp were served as control. SKP2 and MRP-1/CD9 protein were examined by immunoh istochemical method.Result:The positive expression of SKP2 proteins decreased in sequence of polyp mucosa, those adjacent to carcinoma (10 mm, 5 mm, 2 mm ) and cancer tissue, and there was significant difference between them(P<0.05);On the contrary, the positive expression of the MRP-1/CD9 proteins increased in sequence of polypusmucosa, those adjacent to carcinoma (10 mm,5 mm, 2 mm) and cancer tissue,and there was significant difference between them (P<0.05).Conclusion:SKP2 and MRP-1/CD may act as the reference index for judging the biological speciality of LSCC. It is appropriate to regard 5 mm or above 5 mm away from tumors as a safe margin for surgical treatment of glottic carcinoma.
7.Study of blood dynamics of ophthalmic artery in patients with sudden sensorineural hearing loss using color doppler flow imaging
Jihao REN ; Yongde LU ; Tuanfang YIN ; Shuhui WANG ; Qichang ZHOU ; Ping FAN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2001;(4):159-160,162
Objective: To investigate the relationship between the pathogenesis of sudden sensorineural hearing loss (SSHL) and the disorder of blood circulation in inner ear. Method :Blood dynamics of the ophthalmic artery were studied quantitatively using color doppler imaging in 34 patients with SSHL. Result:Compared with 34 self-controls and 15 normal controls, 28 patients (82.4%) with SSHL had significantly lower blood flow velocities and higher resistance indices (P<0.05),and there was no significant difference between the selfcontrol group and the normal control group (P>0.05). Conclusion: The study suggested that the blood situations-the decreased blood flow velocities and perfusion and increased resistance of ophthalmic artery in patients with SSHL maybe play a role in the pathogenesis of SSHL.
8.Study of the reconstruction methods after vertical partial laryngectomy for glottic carcinoma of the larynx
Fengbing ZHANG ; Zhichun HUANG ; Yincheng CAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2001;(6):249-250,252
To study the reconstruction methods after vertical partial laryngectomy for glottic carcinoma of the larynx. Method:58 cases with glottic carcinoma of the larynx were treated with vertical partial laryngectomy or extended vertical partial laryngetomy .The clinical materials of these cases were retrospectively studied.Result:The total decannulation rate was 93.1% and the 3-and 5-year survival rates were 87.2% and 80.5% respectively .The voice was socially acceptable in 93.1%(54/58) of the patients. Aspiration was only 3. All resumed mouth-food-taking.Conclusion:The reconstruction methods after vertical partial laryngectomy were mainly decided by the extent of the laryngeal defect. If the laryngeal defect of the framework was small, the pedicle muscular flap was the best reconstruction method in comparison with other reconstruction methods .If the laryngeal defect of the framework was too big ,allograft nasal septal cartilage or epiglottic laryngoplasty should be performed .
9.Etiological analysis and individualized treatment of pharyngeal paraesthesia
Zhengcai LOU ; Xuhong GONG ; Fangyi LOU ; Lanjuan HE ; Qiaoying ZHU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2009;(14):639-641,645
Objective:To analyze the nosazontology of pharyngeal paraesthesia and investigate the treatment. Method: Two hundred and twelve misdiagnosed pharyngeal paraesthesia patients were investigated by history inquiry,routine examination, 24-hour esophageal pH monitoring, barium X-ray of the oesophagus, anxietas-athy-mia private measuring scale, coefficient of variation of the R-R(CVR-R), bioavailable testosterone detection(Bio-T), erection experiment and questionnaire about man climacteric syndrome. The concomitant symptoms and positions of pharyngeal paresthesia were also studied. We adopted individuallied sequential multi-therapy for every patient according to the cause of disease. Result:The cause of disease within 212 cases of pharyngeal paraesthesia included 62 psychictrauma,32 endocrine system disease,106 upper gastrointestinol disease, circulatory disease,9 circulatory disease,3 idiopathic. With individualized treatment, 110 cases had fully recovered, 63 cases excellence and 31 cases utility,and the efficiency rate was 96.23%. Conclusion:Pharyngeal paraesthesia can be caused by several factors. Thorough examination and comprehensive analysis should be applied to those incurable patient who has been treated for a long time. Short course of treatment and irrational drug use are the main causes of short term recurrence and unsatisfactory curative effect.
10.Channel radiofrequency volumetric reduction of tongue base a vitro porcine three-dimensional reconstruction experiment for the treatment of obstructive sleep apnea hypopnea syndrome
Jian GUAN ; Hongliang YI ; Dongzhen YU ; Yanyan HUANG ; Shankai YIN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2009;(15):700-702,705
Objective:To investigate lesion size caused by channel radiofrequency volumetric reduction of por-cine tongue base in vitro using the technique of three-dimensional reconstruction. And to evaluate safety about channel radiofrequency volumetric reduction of tongue base. Method: Eighteen fresh porcine tongues were randomly separated into six groups,and each group had three ones. The tongue bases were designed six points according to description of Powell. Tongues base were acted on 10 s and 6 level by Coblation radiofrequency system and were cut into serial freezing histological sections. These segments were sectioned at 20 μm on the injury lesion and stained with H & E. Collected 2D digital imagine of order histological sections, drawn and cut apart part of the le-sion of these sections. Images were procesed IPS and were taken three-dimensional reconstruction and statistics an-alyzes with SPSS10. 0. Result: The mean value of tongue base lesion volumes among points was (359. 5± 5. 6)mm~3 ,(364. 3±7. 0)mm~3 ,(363. 7±7. 2)mm~3, (354. 1±11. 8)mm~3, (349. 4±17. 2)mm~3 ,(353. 5±7. 9)mm~3 separately. Statistic analysis by one-way ANOVA showed that there was a insignificant difference between the groups(P>0. 05). Conclusion:These results demonstrated no significant effect lesion size in channel radiofrequency volumetric reduction in the different points of the tongue base. These data also indicated that coblation radiofre-quency system is a safe method for obstructive sleep apnea hypopnea syndrome.