OBJECTIVE: To assess the clinical effeetiveness of prelingually deaf children after cochlear implantation at different ages so as to provide reasonable expectations for the patients and guidance for the clinical treatment. METHOD: Electronic databases PubMed, YZ365. COM, WANFANG DATA, CMJD, CHKD, CNKI were searched using relevant keywords. Extracted data included author, year of publication, diagnosis, et al. Reported treatment outcomes were clustered into speech discrimination and hearing abilities. Meta-analyses were performed on studies with numerical results using random or fixed effects model. RESULT: There were eight randomized control studies including 442 patients. Comparing speech perception of prelingually deaf children after cochlear implantation younger than three years old (experimental group) and 3-6 years old (control group), three and six months after operation showed that experimental group performed significantly worse than control group; 12 months after operation showed that experimental group performed significantly better than control group. Comparing hearing abilities, three and six months after operation showed that experimental group performed significantly worse than control group; 12 months after operation showed showed that experimental group performed significantly better than control group. Comparing speech perception of younger or older than 4. 5 years old children showed that after 1.5-2 years of operation children implanted younger than 4.5 years of age performed significantly better than children implanted older than 4.5 years old. Comparing speech perception of 7-12 years old children showed that after 3, 6, 12 months of operation patients of 7-12 years old performed significantly better than those children older than 12 years old. Comparing speech perception of implantation younger or older than 18 years old (7-14 yeas old was group A, > 14-18 yeas old was group B, older than 18 yeas old was group C) showed that after one and four years of operation A > B > C, and there were significant differences among them. Comparing warble tone threshold average (WTA) showed that after one year of operation A < B < C, and there were significant differences among them. However, after four years of operation, there was no significant difference among them. CONCLUSION Prelinguistically deafened patients younger than three years old with cochlear implantation, insisting on scienctific rehabilitation training for a long period of time can receive the optimal recovery effect. The older patients are suggested as early as possible receiving cochlear implantation. The longer they are implanted, the better results they will receive. Moreover, the younger age they are implanted, the faster postoperative language progress they will receive. Further controlled studies with longer follow-up periods and more person included may make the effectiveness of cochlear implantaion more reliable.
Adolescent ; Child ; Cochlea ; Cochlear Implantation ; Deafness ; Hearing Tests ; Humans ; Language ; Language Development ; Speech Perception ; Treatment Outcome

OBJECTIVE: Assess and compare the clinical efficacy and safety of cochlear implantation in deaf patients with inner ear malformation and in the ones with normal inner ear structure, so that to clarify whether it is effective to restore hearing for the deaf patients with inner ear malformation. METHOD: The literature with relevant key words were retrieved in the databases including PubMed, YZ365. com, WANFANG data, CMJD, CHKD and CNKI with language limited to Chinese and English. Extracted data included author, year of publication, diagnosis, treatment, et al. The clinical efficacy of cochlear implantation was assessed by the complications, electrode impedance, behavior T-level, hearing abilities and speech discrimination. Meta-analysis was performed using random or fixed effects model according to the heterogeneity of data. RESULT: There were 11 randomized control studies involving 655 patients included in this study. There was no statistically significant difference among the deaf patients in mixed inner ear-malformation group, Mondini group and large vestibular aqueduct syndrome group in the aspects of postoperative complications, electrode impedance, behavior T-level, hearing abilities and speech discrimination. CONCLUSION Cochlear implantation could be the way of treatment and rehabilitation for deaf patients with inner ear malformation. Further controlled studies with longer follow-up periods and more multiracial cases included may help to evaluate the efficacy of cochlear implantation for deaf patients with inner ear malformation more reliably.
Cochlear Implantation ; Ear, Inner ; abnormalities ; Electric Impedance ; Electrodes ; Hearing ; Hearing Loss ; therapy ; Humans ; Postoperative Complications ; Randomized Controlled Trials as Topic ; Speech Perception

Objective:To investigate the relationship between herpesviridae and malignant or benign laryngeal diseases.Method:128 paraffin-embedded laryngeal squamous cell carcinoma and laryngeal epithelium hyperplastic lesions were detected by polymerase chain reaction (PCR) and PCR-ISH for herpesviridae. Result:HSV-1 was detected in 10 cases by PCR,among them 3 were laryngeal squamous cell carcinoma (LSCC),1 was carcinoma in situ(CIS),4 were laryngeal polyps and 2 were laryngeal keratosis. Except 1 LSCC and 1 CIS, 8 of 10 cases were positive while detected by PCR-ISH. In benign diseases, signals were shown from basal layer to superficial cell; in malignant lesions, the signals were scattered in the diseases.Conclusion:Most of laryngeal diseases were not related to herpesviridae, but HSV-1 may acts as initiator in the development of a few cases.

Cerebellopontine Angle ; anatomy & histology ; Ear, Inner ; anatomy & histology ; Humans ; Microsurgery ; Neuroma, Acoustic ; surgery

Cerebellopontine Angle ; anatomy & histology ; Ear, Inner ; anatomy & histology ; Humans ; Microsurgery ; Neuroma, Acoustic ; surgery

Objective:To explore whether the phospholipidoproteinaceous material deposit within the alveoli by a high-ifeld 3T MRI has signal characters and its application for diagnosing pulmonary alveolar proteinosis.Methods:A total of 11 patients with pulmonary alveolar proteinosis previously diagnosed by ifberoptic bronchoscope lung biopsy underwent 64-slice helical CT scans and 3T MRI scans, and the CT scans and the MRI scans were compared.
Results:hTe phospholipidoproteinaceous material deposit within the alveoli presented longer or equal T1 relaxation time and longer T2 relaxation time, without characters of fatty or deposits of protein-like substance signals and enhancement. The distribution, form, number and size of the lesions at T2WI were almost the same as those at CT, the lesions were irregular in morphology, and there was a clear boundary between the lesions and the adjacent normal lung tissues. Dynamic contrast-enhanced MRI showed thickened pulmonary arteriolae and venulae in the lesions with more obviously thickened pulmonary venulae, which were in conformity with the pulmonary artery and venule enhancement. CT scan in 1 out of the 11 cases showed lesions in both lungs mainly consisted of stripe-shaped and reticular structures, and no obvious sign of pulmonary alveolar proteinosis residue was found. MRI scan detected alveolar proteinosis that failed to be shown by CT scan.
Conclusion:3T MRI T2WI can easily detect the lesions of long T2 signals formed by the lipoproteinaceous material deposit within the alveoli. In the lesions, geographic appearance was presented, and the crazy paving pattern was dimly visualized. MRI can relfect the morphological characters of PAP like CT and it is slightly better compared with CT in such aspects as evaluating the theraputic effect of lung lavage. As supplement to CT, high-field 3T MRI can serve as an important examination for lung diseases.

Objective To summarize and analyze the pathogenesis ,methods of hearing reconstruction and curative effect of mixed hearing loss .Methods Patients with mixed hearing loss who underwent hearing reconstruc-tion from Jan 2009 to Dec 2011 in the ENT department of PLA General hospital were reviewed retrospectively .Af-ter the operation ,air conduction (AC) ,bone conduction (BC) ,air-bone gap (ABG) at main frequencies and audi-ometry changes were analyzed .Results Among 32 cases ,15 cases were chronic otitis media ,13 cases otosclerosis , 2 cases Van der Hoeve ,and 2 cases congenital middle ear malformations .There were 26 cases with significantly im-proved hearing after surgery ,and the effective rate was 81 .25% .AC showed great improvement at 0 .25~4 kHz (P<0 .05) while there was no change at 8 kHz (P>0 .05) .BC showed improvements at 1 and 2 kHz and improved significantly only at 2 kHz .After operation ,pure tone audiometry at AC and BC separately improved 24 .94 ± 8 .15 dB and 5 .90 ± 7 .96 dB;ABG narrowed down to 19 .04 ± 11 .06 dB .Conclusion Mixed hearing losses are mostly seen in chronic otitis media and tympanosclerosis .After auditory rehabilitation ,patients can experience improved hearing .

Objective To compare the bronchial blocker and double-lumen tube for one-lung ventilation in patients undergoing esophageal cancer resection.Methods Forty ASA physical status Ⅰ-Ⅲ patients of both sexes,aged 42-63 yr,scheduled for elective esophageal cancer resection,were randomly divided into 2 groups (n =20 each):double-lumen endotracheal tube group (group DLT) and bronchial blocker group (group BB).After induction of anesthesia,the patients were intubated with a left-sided double-lumen endotracheal tube and correct positioning was verified by fiberoptic bronchoscopy in group DLT.After induction of anesthesia,the patients were intubated with a conventional single-lumen endotracheal tube,and then the bronchial blocker was inserted under the guidance of fiberoptic bronchoscope in group BB.The intubation time,one-lung ventilation time,time to achieve lung collapse,operation time,extubation time,tube malposition and hypoxemia were recorded.The lung collapse was scored at the end of operation.Hoarseness and throat sore within 2 days after extubation and pulmonary infections within 7 days after operation were recorded.Results Compared with group DLT,intubation time and time to achieve lung collapse were significantly prolonged,and the incidence of hoarseness and throat sore within 2 days after extubation was decreased in group BB (P ＜ 0.05).There was no significant difference in the one-lung ventilation time,operation time,extubation time,lung collapse score,incidence of tube malposition,hypoxemia and pulmonary infections within 7 days after operation between the two groups (P ＞ 0.05).Conclusion The efficacy of bronchial blocker is similar to that of double-lumen tube when used for one-lung ventilation in patients undergoing esophageal cancer resection.

OBJECTIVE To evaluate the clinical feature and surgical treatment of large nasopharyngeal angiofibromas with intracranial orcavernous sinus extension.METHODS A total of 16 male patients were collected with a age ranged from 11 to 35 years(mean,17.21 years).All patients underwent resection of nasopharyngeal angiofibromas with intracranial or cavernous sinus extension.The procedure included lateral rhinotomy,craniofacial combined approach,median labiomandibulotomy combined with a trans-palatal,transmaxillary approach and middle face degloving approach.RESULTS Sixteen cases received 28 procedures.Seven patients had no recurrence but 9 patients had recurrence at least once.Twenty eight procedures include 11 times lateral rhinotomy,6 times craniofacial combined approach,2 times frontotemporal approach,4 times transpalatal approach,2 transmaxillary approach,1 median labiomandibulotomy combined with a trans-palatal and 2 times middle face degloving approaches.CONCLUSION Radical operative resection is the main treatment method for nasopharyngeal angiofibroma with intracranial or cavernous sinus extension.The first operation recurrence rate is 8/15(53.0%) and sphenoid tumor residual may often be ignored in the operation and it is the main site of tumor recurrence.Craniofacial,median labiomandibulotomy combined with a trans-palatal and middle face degloving approaches were the best choices for large nasopharyngeal angio fi broma with intracranial or cavernous sinus extension.

Objective To assess the feasibility of adenoviral vectors mediate cochlear gene transfer by postau-ricular microinjection through the round window membrane in mouse. Methods Twelve 5-week old C57BL/6J mice were selected for the study: 8 were implanted with Ad-EGFP by postauricular microinjection through the round window membrane, and 4 with artificial perilymphatic fluid. On postoperative days 5 and 14, the animals were sac-rificed and the surface preparation of cochleae was observed. Results Two animals died after operation. Bright green fluorescence in the cochleae was observed in Ad- EGFP groups. Gene expression on day 14 after operation was higher than that on day 5. However, the control group was free of fluorescence. Oonclusion The postauricular route of the cochlear gene transfer in mice is simple to operate with little side-effect. The technique of transgenic delivery into the inner ear through RWM by mieroinjection is feasible and effective.