Objective The aim of this study is to evaluate word recognition abilities in 4-talker babble noise (BN) in children with normal hearing (NH), and to explore the lexical effects, age on speech recognition ability in children.Methods Children of 3~6 years old with normal hearing (N=212)were participated in this study.One hundred and twenty-four children were performed under the quiet conditions,while 88 were performed in 4-talker babble noise.The standard-Chinese version of the lexical neighborhood test was used to assess spoken word recognition performance.The speech level was 70 dB SPL, and signal to noise ratio (SNR) was chosen 4 dB in BN.Results The correct scores of the NH children in quiet for the DE, DH, ME, and MH words were 96.45%±5.17%, 88.87%±7.73%, 91.90%±7.31% and 82.38%±7.95%, while the scores in BN were 85.34%±11.23%, 66.42%±11.08%, 68.81%±15.99% and 48.58%±12.81%, respectively.The word-recognition performance in BN was significantly poorer than that in quiet.The word recognition scores showed that the lexical effects were significant in the BN (P<0.05).Children scored higher with dissyllabic words than with monosyllabic words;easy words scored higher than hard words in both quiet and noisy environments.The word-recognition performance also increased with age in each lexical category in the 3-to 6-year-old NH children.Conclusion Age and lexical characteristics of words had significant influences on the performance of Mandarin-Chinese word recognition in BN.The lexical effects were more noticeable under noise listening conditions than in quiet.The word-recognition performance in noise increased with age in NH children of 3-to 6-years old in noise and had not reached adult-like performance at 6 years of age.

Chronic subjective dizziness(CSD) was defined as persistent nonvertiginous dizziness or subjective unsteadiness.Patients are hypersensitivity to motion stimuli,such as head movement and motion of objects in the visual surrounding,and have difficulty with precise visual tasks.The concept of CSD was first proposed by Staab and Ruckenstein,which indicates relationships between chronic dizziness and acute vestibular or psychiatric disorders,including neuro-otologic type,psychiatric type or interactive type.Treatment includes vestibular rehabilitation therapy,pharmacologic interventions and psycho-behavioral interventions(cognitive behavioral therapy).

PURPOSE: Previous reports have shown that hyperglycemia-induced inhibition of transient receptor potential vanilloid sub type 4 (TRPV4), a transient receptor potential ion channel, affects the severity of hearing impairment (HI). In this study, we explored the role of TRPV4 in HI using HEI-OC1 cells exposed to high glucose (HG). MATERIALS AND METHODS: HEI-OC1 cells were cultured in a HG environment (25 mM D-glucose) for 48 hours, and qRT-PCR and Western blotting were used to analyze the expression of TRPV4 at the mRNA and protein level. TRPV4 agonist (GSK1016790A) or antagonist (HC-067047) in cultured HEI-OC1 cells was used to obtain abnormal TRPV4 expression. Functional TRPV4 activity was assessed in cultured HEI-OC1 cells using the MTT assay and a cell death detection ELISA. RESULTS: TRPV4 agonists exerted protective effects against HG-induced HI, as evidenced by increased MTT levels and inhibition of apoptosis in HEI-OC1 cells. TRPV4 overexpression significantly increased protein levels of phosphorylated p38 mitogen-activated protein kinase (p-p38 MAPK), while TRPV4 antagonists had the opposite effect. Our results indicated that TRPV4 is a hyperglycemia-related factor that can inhibit cell proliferation and promote cell apoptosis by activating the MAPK signaling pathway in HEI-OC1 cells. CONCLUSION: Our results show that the overexpression of TRPV4 can attenuate cell death in HEI-OC1 cells exposed to HG.
Apoptosis ; Blotting, Western ; Cell Death ; Cell Proliferation ; Enzyme-Linked Immunosorbent Assay ; Glucose* ; Hearing Loss* ; Hearing* ; Ion Channels ; Protein Kinases ; RNA, Messenger

OBJECTIVE: To describe consultation practice patterns of an otolaryngology chief resident in China. METHOD: The pattern and frequency of patient encounters during the Xijing Hospital of the Fourth Military Medical University otolaryngology residency program for one chief resident were retrospectively analyzed. RESULT: A total of 1062 new inpatients were consulted during a 10-month period of otolaryngology residency, including emergency consultation for 467 cases (43.97%) and routine consultation for 595 cases (56.03%). The chief resident consulted an average of 28 new patients perweek. The most common diagnosis for an emergency consultation was epistaxis (279 cases, 59.72% of emergency consultation), characterized by disturbances of blood coagulation, hypertension, renal failure or liver failure, iatrogenic factors. The second cause was laryngeal obstruction and tracheotomy (113 cases, 24.19% of emergency consultation). There were 43 cases with foreign body in bronchus . For routine consultation on general internal medicine, chronic rhinitis and sinusitis (169 cases) was the most common disorder, followed by chronic pharyngitis, acute or chronic tonsillitis. For consultation on surgery, most cases were concerned about preoperative evaluations (67 cases) of the chronic otolaryngological disorders. CONCLUSION Consultation is an inimitable clinical practice and a challenge to otolaryngology residents. The chief residents should be prepared for the consultation practice. Accumulation of related data from consultation is necessary and helpful for chief residents.
Humans ; Otolaryngology ; Otorhinolaryngologic Diseases ; diagnosis ; therapy ; Physicians ; Referral and Consultation ; statistics & numerical data ; Retrospective Studies ; Workforce

OBJECTIVE: To investigate the effective method in treatment of pediatric chronic sinusitis. METHOD: Two hundred and ten children were clinically diagnosed as chronic sinusitis and randomly divided into three groups as pulmicort, rhinocort and routine treatment group, respectively. All the patients in different group were systemic treated by corresponding method for two weeks. RESULT: The effective rates were 84% for pulmicort treatment group, 61% for rhinocort treatment group and 48% for routine treatment group, so the effective rate for the patients treated with pulmicort were significantly higher than that with either rhinocort or routine treatment. CONCLUSION Pulmicort can be used to treat pediatric chronic sinusitis with higher effective rate.
Anti-Inflammatory Agents ; therapeutic use ; Budesonide ; therapeutic use ; Child ; Child, Preschool ; Chronic Disease ; Female ; Humans ; Male ; Sinusitis ; drug therapy

OBJECTIVE: To investigate the character of upper airway and to offer the reference for clinical treatment through observing the upper airway caliber and its corresponding pharyngeal wall of OSAHS patients by magnetic resonance imaging (MRI). METHOD: The upper airway of 33 obstructive sleep apnea hypopnea syndrome (OSAHS) patients diagnosed by PSG were analyzed and compared by MRI. The cross-sectional area of the upper airway and thickness of lateral parapharyngeal wall were calculated. The cross-sectional area of the upper airway and thickness of lateral and posterior pharyngeal wall were also measured in 20 nonsnoring age-matched normal subjects selected as the control group. RESULT: The cross-sectional areas of upper airway of OSAHS patients were smaller than that of the control. The Thickness of posterior pharyngeal wall and lateral pharyngeal wall of the retropalatal region, retroglossal region and epiglottal region were thicker in patients group than that of the control. The thickness and length of the palate in patients group were larger than that of the control. The cross-sectional areas of retropalatal region of OSAHS patients had negative correlation with apnea hypopnea index (AHI). There was also negative correlation between the retroglossal region cross-sectional area and the neck circumference. CONCLUSION Measurement of upper airway with MRI could observe the change of pharynx cross-sectional area and had reference value in guiding the clinical diagnosis and treatment.
Adult ; Case-Control Studies ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Palate ; pathology ; Palate, Soft ; pathology ; Pharynx ; pathology ; Respiratory System ; pathology ; Sleep Apnea, Obstructive ; pathology

Objectives The function of the semicircular canal receptors and the pathway of the vestibulo-ocular reflex (VOR) can be diagnosed with the clinical head impulse test.The aim of the study was to investigate the horizontal VOR by means of video head impulse test in peripheral vestibular disorders.Methods Using the vHIT,we examined horizontal semicircular canal VOR in a group of 55 patients and a control group of 20 healthy subjects.The group of patients included 10 cases of vestibular neuritis (VN),6 cases of vestibular schwannoma (VS),12 cases of Meniere's disease (MD),and 15 cases of bilateral vestibulopathy (BV),as well as 13 cases of idiopathic sudden hearing loss with vertigo(ISHL).Results Instantaneous gains of 40 ms,60 ms and 80 ms of horizontal VOR were 0.88 ± 0.17,0.94 ± 0.13 and 0.96 ±0.13,respectively.Regression gain at 60 ms was 0.99 ± 0.11,and asymmetry was 5.6 ± 3.5.Normal range of 60 ms instantaneous gain was ＞ 0.73,normal range of regression gain was ＞ 0.80.AbnormalvHIT was found in VS (100％),VN (90.9％),BV (86.7％),MD (40.0％) and ISHL (38.5％).Three conditions of refixation saccades occurred in cases with abnormal VOR:isolated covert saccades (12.5％),isolated overt saccades (45.0％) and the combination of overt and covert saccades (42.5％).Conclusions The vHIT detects abnormal VOR changes in the combination of gain assessment and refixation saccades.Since isolated covert saccades in VOR changes can only be seen with vHIT,peripheral vestibular disorders are likely to be misdiagnosed with the HIT.

Objective:The present study was to compare the frequency characteristics of bone- conducted vibration (BCV) and air-conducted sound-induced ocular vestibular evoked myogenic potential(oVEMP) with different stimulation settings, so as to select an optimal setting.Methods:Bruel and Kjaer artificial mastoid was used to calibrate bone vibrator, the mini-shaker. The outputspectrum and transient waveform were recorded when the input frequency was set at different frequencies and data were further analyzed to get the peake quivalent force level value of the output vibration. oVEMP was recorded as we previously reported with normal young adults. Response prevalence, latency, wave interval, amplitude, amplitude ratio, and bilateral amplitude asymmetry ratio were recorded and analyzed. SPSS 24.0 software was used for statistical analysis.Results:Output peak equivalent force level increased as the intensity of primary input stimulation increased at certain frequency,while it decreased as the frequency of primary input stimulation increased at certain intensity. Peak equivalent force level of 500 Hz tone burst (1-2-1) input stimulation was greatest as 139.8 dB when using mini-shaker for vibration stimulation,even greater when using bone conductor B-71.Twenty subjects were elicited with normal oVEMP with N1 and P1 waves in both ears using air-conducted stimulation or bone-conducted vibration.The response rate in these subjects was 95% and 100% respectively. The latency of N1 was (11.33±1.35) ms and (10.14±0.38) ms, latency of P1 was (16.24±1.56) ms and (15.65±1.19) ms, interval N1-P1 was (4.59±1.26) ms and (5.55±0.81) ms, symmetry coefficient was 12.22%[5.50%,21.85%] and 8.74%[3.37%,14.08%], amplitude was 3.07[2.05,4.43] μV and 3.07[2.05,4.43] μV in sound and bone conducted vibration group, respectively. The latency of N1, latency of P1, interval N1-P1, symmetry coefficient and n1-P1 amplitude of BC-oVEMP were different statistically (all P<0.05). Conclusions:500 Hz 45 dB input stimulation setting is the optimal parameter for BC-oVEMP. BC-oVEMP can be recorded simply, safely and quickly in normal young people, thus it is a clinically practical way of measuring utricular function.

Objective:To analyze the clinical features and surgical outcomes of petrous bone cholesteatomas (PBCs).Methods:Data from 39 PBCs patients treated in the Department of Otorhinolaryngology, Xijing Hospital from September 2011 to December 2017 were reviewed retrospectively, including 23 males, 16 femals, aged 12-71 years old, with the median age of 37. Clinical classifications, surgical methods, facial and hearing function, and intraoperative and postoperative complications were made summary analysis.Results:In this study, five patients were congenital PBCs and 34 patients were acquired PBCs. The common clinical symptoms were hearing loss (100%, 39/39), ear discharge/pus (89.7%, 35/39) and facial paralysis (46.2%, 18/39). According to Sanna′s classification, 14 cases were supralabyrinthine, including three cases underwent transcochlear (TC) approach, six cases underwent transotic (TO) approach and five underwent translabyrinthine (TL) approach. 10 cases were infralabyrinthine, including eight cases underwent subtotal petrosectomy, one case underwent TO approach and one underwent TL approach.10 cases were massive, including seven cases underwent TC approach, three cases underwent TO approach. Five cases were infralabyrinthine-apical, including two cases underwent TC approach, two cases underwent TO approach, and one case underwent endoscope assisted infratemporal fossa type B. The degree of facial nerve (FN) dysfunction from high to low was massive (6/10), supralabyrinthine (8/14), infralabyrinthine-apical (2/5) and infralabyrinthine (2/10). 19 cases involved in facial nerve operation, three cases underwent FN decompression, four cases underwent FN rerouting, four cases underwent nerve grafting, and one case underwent facial-hypoglossal anastomosis. Preoperative FN involvement in 18 cases, and the FN function was improved in 14 cases after surgery. The improved rate of postoperative FN function was 77.8%. The bone conducted hearing retained 50.0% (14/28) postoperatively. Five cases with cerebrospinal fluid leak were managed by inserting free muscle plugs and cavity obliteration. Two cases with the cholesteatomas matrix involved the sigmoid sinus and the jugular bulb, and occlusion of the sigmoid sinus was performed. Postoperatively, two patients presented with synkinesis. The patients were followed up for 40 to 115 months, and there was no recurrence.Conclusions:There are no specific clinical manifestations for PBCs, thus, it is difficult in early diagnosis and treatment. According to Sanna′s classification, preoperative FN and hearing function, the best surgical approach should be selected with minimal recurrences and perioperative morbidity.

Objective:To investigate the auditory and speech abilities of children with congenital auditory neuropathy (AN) after cochlear implant (CI), and to analyze the role of genetic testing in predicting the postoperative outcomes of CI in AN patients.Methods:Fourteen children diagnosed with AN by audiological battery test and underwent CI surgery in Xijing Hospital of the Air Force Medical University from 2002 to 2021 were included in this study (9 males and 5 females), with an implantation age of (3.1±1.7) years (mean±standard deviation, the same as follows). The preoperative audiological results and deafness gene results were analyzed. Another 52 children with ordinary sensorineural hearing loss (SNHL) were selected as the control group (30 males and 22 females), with an implantation age of (2.2±0.9) years. The demographic factors such as age and gender were matched with those of the AN group. The modified Category Auditory Performance (CAP-Ⅱ) and Speech Intelligence Rate (SIR) were used to evaluate the development of postoperative auditory and speech abilities in two groups. The Mandarin Speech Test System was used to test the speech recognition rate of monosyllabic and disyllabic words and sentences. Matlab 2022 software was used to analyze the data.Results:The results of gene in 14 children with AN showed that 6 cases had OTOF gene mutations, 2 cases (siblings) were confirmed to have TNN gene mutations through whole exome sequencing, and the remaining 6 cases were not find any clear pathogenic gene mutations. All subjects underwent CI surgery with electrodes implanted into the cochlea smoothly, and there were no postoperative complications. After surgery, all AN children had improved auditory and speech abilities, but only 64% (9/14) of AN children with CI had auditory ability scores comparable to the control group of SNHL children (including 2 children with TNN gene mutations), and 36% (5/14) of AN children had lower scores than the control group of SNHL children.The average speech recognition rate of two children with TNN gene mutations was 86.5%, and of two children with OTOF gene mutations was 83.2%. Conclusions:AN children achieved varying degrees of auditory and speech abilities after CI, but the postoperative effects varied greatly. Some children achieved similar results as ordinary SNHL children, but there were still some children whose effects were worse than those of ordinary SNHL children. The postoperative efficacy of CI in two children with AN caused by TNN pathogenic genes were comparable to that of ordinary SNHL in children. Genetic testing had certain reference value for predicting the postoperative effect of CI in AN children.