Objective To study the feasibility of the cochlear implantation and effects in the treatment of large vestibular aqueduct syndrome.Methods A total of 37 patients(74 ears)diagnosed with large vestibular aque-duct syndrome received cochlear implants since 2002 at the Renmin Hospital of Wuhan University.We made a retro-spectively analysis of these 37 patients(37 ears).While 37 patients(37 ears)with normal cochlear structures were considered as the control group.After activation,their speech perception at pre-operation and at 3,6,9,12 months affer the operation were evaluated.Their CAP and SIR scores were collected through questionnaires at each assess-ment interva1 .Results In LVAS group,5 patients(5 ears)had serious gusher,while no gusher was abserved in the control group.The two groups of the electrodes were all inserted in the cochlea.No serious complications occurred after implantation in the two groups.The impedance of the electrodes,the T level,C level and the hearing thresholds were similar with the normal group with cochlear implantations.The results had no significant differences when compared with the normal cochlear group (P>0.05).The speech perception ability,CAP and SIR scores were im-proved along with the increase time of implant use.At the same recovery time,the results had no significant differ-ence in the two groups(P>0.05).At the same group,the results between pre-operation and 3,6,9,12 months post-operation after device activation had significant differences (P<0.05).Conclusion Cochlear implants could be performed safely in patients with large vestibular aqueduct syndrome.The primary outcomes for patients with large vestibular aqueduct syndrome were similar to those with normal cochlear structure following the cochlear im-plantation.

Objective To detect the relationship between the expression of hypoxia inducible factor 1 alpha and VEGF in human laryngeal carcinoma.Methods The expression of HIF-1? and VEGF were confirmed in 68 cases of laryngeal carcinoma by S-P immunohistochemical methods.The relations between the expression of HIF-1? and VEGF were analysed by SPSS software.Results Of the 68 cases, 41 cases expressed HIF-1?. 46 cases expressed VEGF. 34 cases of the 41 HIF-1? positive cases expressed VEGF.Conclusion The expression of HIF-1? is related to the expression of VEGF. HIF-1? may promote the expression of VEGF in laryngeal carcinoma,thus further promoting tumor angiogenesis, invasion,and metastasis of the laryngeal carcinoma.

Thyroid cancer is more common in thyroid diseases, because of its slow growth and good prognosis, different scholars have different views on lymph node dissection. During the study of definition and positioning methods of sentinel lymph node biopsy, discuss the necessity of cervical node dissection and the application of cleaning scope in thyroid cancer surgery.
Humans ; Lymph Nodes ; pathology ; Sentinel Lymph Node Biopsy ; Thyroid Neoplasms ; diagnosis ; pathology

OBJECTIVE To d e f i n e t h e microsurgical anatomy and exposure obtained by the maxillary swing approach. METHODS Ten adult cadaver specimens fixed by formalin solution were dissected under 5 to 20 times magnification. The microsurgical anatomy and measurement were performed by mimicking the maxillary swing approach. The anatomic relationship of the muscles, arteries,veins,nerves were carefully recorded. RESULTS The maxillary swing approach provides wide exposure extending from the central base to the lateral cranial base,including turkish saddle,the ipsilateral cavernous sinus,the clivus and C1,the nasopharynx,the pterygopalatine and infratemporal fossa,and the parapharyngeal space,etc. CONCLUSION The maxillary swing approach provides a suitable route for accessing lesions involving both the central and lateral cranial base. The sphenoid pterygoid process,the Eustachian tube,and the lateral pharyngeal wall separates the central cranial base from the lateral cranial base and limits anterolateral access to the central cranial base. Removing the pterygoid process provides exposure extending from the central to the lateral cranial base and allows for wide anterolateral access to the clivus and upper cervical spine. The maxillary swing approach is difficult and limited to reach the poststyloid compartment of the parapharyngeal space,the lateral region of styloid process,the horizontal segment of the petrous carotid.

OBJECTIVE To study the clinical and radiological characteristics of jugular foramen tumors.METHODS The clinical data of 32 patients with tumors of jugular foramen region treated from May 2006 to December 2009 were retrospectively reviewed.All patients were referred to systematic imaging examination of the temporal bone,such as CT(X-ray computed tomography) and MRI(magnetic resonance).Twenty two patients were further examined by angiography and embo1ized 24 hours before operation.Thirty one patients underwent different operations via different approaches, while one patient with glomus jugular tumor didn't receive operation because of fever caused by sigmoid sinus thrombophlebitis.According to pathologic examination, 21 cases were glomus jugular tumors, 10 cranial nerve neurilemmomas.RESULTS In the 32 cases, the major initial clinical symptoms of jugular foramen tumors were tinnitus,hearing loss and facial palsy.Bone erosion and the "salt and pepper" sign were the characteristic appearance of glomus jugular tumor.Neurilemmoma showed compressive bone change, cystic area and moderate enhancement on CT.CONCLUSION The combination of CT and MRI examination is benefit for both diagnosis and the choice of surgical plan.

Objective: To explore the clinical value of the treatment of bilateral vocal cord paralysis by tenoto-my and vocal process resection with CO_2 laser. Method: Eighteen cases of bilateral vocal cord paralysis after thy-roidectomy from March 2004 to June 2006 were retrospectively analyzed. Preoperative tracheotomy and CO_2 laser tenotomy and vocal process resection were performed. Result: All patients were able to breathe through the mouth and nose immediately after the operation. Fifteen patients were extubated within 8 weeks. Three patients were op-erated again after 4-6 weeks because of granulation hyperblastosis. All patients were followed up for 1. 6 years to 2. 3 years without breathing difficulties, aspiration and with satisfactory voice. Conclusion: The approach of CO_2 la-ser tenotomy and vocal process resection can effectively relieve breathing difficulty resulted from bilateral vocal cord paralysis, achieve satisfactory voice and avoid aspiration.

This paper reported one patient who was treated through transphenoidal-upslope approach by lateral rhinotomy and the tumor was successfully removed. The patient was male of 38 years old. He suffered intermittent headache with blurred vision and left eye outreach disorder for more than a year. The visual inspection showed there was dark area of the left eye lateral. CT showed slopes density placeholder and bone window showed the slope of bone quality had been severely damaged. MRI showed T1 image slopes parts and other low signal placeholder forward to invade the sphenoid sinus. In addition, there was undermine the slope bone and brain stem boundaries clearly and T2 images showed high-signal, inhomogeneous enhancement. We found during the operation that the slope was partially destroyed and part of the tumor was prominent to the pharynx tumor. The pathologic examination confirmed that it is chordoma.
Adult ; Chordoma ; surgery ; Cranial Fossa, Posterior ; surgery ; Humans ; Male ; Microsurgery ; methods ; Skull Base Neoplasms ; surgery ; Sphenoid Bone ; surgery

OBJECTIVE To observe the changes of GABA and Glu in rat inferior colliculus following unilateral cochlear ablation and explore the function and significance of GABA and Glu in reorganization of auditory center after deafferentation. METHODS Twenty-five Sprangue Dawley (SD) rats were divided randomly into 5 groups. The content of GABA and Glu were measured by 835-50 type Amino Acid Automatism Analyzer and compared at 1 week, 2 week and 1 month after unilateral cochlear ablation respectively. RESULTS Compared with sham operated groups, the content levels of GABA decreased (from 78.00?7.50 to 51.65?10.36, about decreasing 33.6 %)1 week after unilateral cochlear ablation and there was a significant difference in GABA levels between 2 groups(P0.05). CONCLUSION The dynamic change of GABA and Glu in rat inferior colliculus reflected the neuronal activity, which implied both GABA and Glu may play an important role in reorganization of auditory center after unilateral cochlea ablation.

Objective To explore the expression of growth associated protein-43(GAP-43)in the inferior colliculus in rats following bilateral cochlear ablation.Methods 35 healthy adult SD rats were randomly divided into 7 groups:3,7,14,21,28,90 days following bilateral cochlear ablation and the sham operation group as the control group.The immunohistochemistry was used to observe the expression of GAP-43 after bilateral cochlear ablation in each group.Results GAP-43 was expressed in each group.The GAP-43 expression in bilateral cochlear ablation group were higher than that in the control group.The expression increased at 3 days,followed by a constant increase at 7 to 14 days with the peak on day 14.On day 21 the GAP-43 expression began to decrease.The mean gray level of GAP-43 in all the staining of groups had statistic significance compared to the control group except the group of day 90.However,in all the 7 groups,the mean gray level between the left and right ears had no statistic significance.Conclusion The change of GAP-43 expression in the inferior colliculus following bilateral cochlear ablation reflects synaptic plasticity in inferior colliculus the neurons.

Objective To study the clinical characteristics and treatment of neurofibromatosis type Ⅱ (neuro-fibromatosis type 2 ,NF2 ,bilateral acoustic neuroma) ,and the effects of auditory brainstem implant for treating to-tal deafness after bilateral acoustic neuroma resection .Methods One case of bilateral acoustic neuroma and all clini-cal data in terms of diagnosis ,treatment and hearing -speech rehabilitation after surgery were retrospectively stud-ied .Results The patient was a thirteen years old boy .His clinical symptoms were hearing loss on the right ear ,tin-nitus ,hoarseness and gait instability three years .MRI showed space occupying lesion in the cerebellopontine angle . The postoperative pathological diagnosis was bilateral acoustic neuroma .The initial switch -on was peformed six weeks after the surgery ,and confirmed that all electrodes generated listening responses .As the extension of recov-ery time ,the correct recognition rate of patients on the natural environment sound ,vowel ,monosyllabic were on the rise and the pure tone hearing threshold gradually decreased .The vowel correct recognition rate of postoperative 6 , 9 ,12 ,24 ,and 36 months were 14% ,18% ,20% ,24% ,and 20% ,respectively .The recognition rate of monosyl-labic and open words at each postoperative rehabilitation stage were 0 .Conclusion The clinical characteristics and treatment of bilateral acoustic neuroma were different from the unilateral acoustic neuroma .The individualized treat-ment should be followed .Auditory brainstem implant could be performed in patients with post - bilateral acoustic neuroma resection .The accurate location of the cochlear complex during the surgery was the crucial point for the success of ABI .