OBJECTIVE: To investigate the efficacy outcomes of laser assisted outpatient septal spur surgery for contact point pain in a carefully selected group of patients. METHOD: This investigation included 32 patients who were selected for laser-assisted septal spur surgery in an outpatient surgical suite. All had endoscopically visible spur contact as well as nansal CT scans. Patients of sinusitis were excluded. The area of the contact point was treated with decongestant and lidocaine. If the headache completely disappeared or diminished by more than 50% in intensity, subjects were considered candidates for surgery. Headache characteristics were assessed preoperatively and at follow-up (30 months after surgery) using a standardized questionare. RESULT: Nine cases (28.1%) were free from pain at the last follow-up; 19 cases (59.4%) had their headache scores improved after surgery; four cases (12.5%) had a less than 25% reduction in their headache score. No septal perforation, hematoma, was reported. CONCLUSION For selected patients with contact point headaches, septoplasty may be useful. The positive dicaine test may indicate better effect of operation. Laser-assisted outpatient septal spur surgery for contact point pain shows good results in short-term effect, and has less complications, but long-term follow-up is required to assess its real effect.
Adult ; Anesthesia, Local ; Female ; Headache ; etiology ; surgery ; Humans ; Laser Therapy ; Male ; Middle Aged ; Nasal Cavity ; Nasal Mucosa ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVE: The objective was to investigate the effectiveness of holmium-YAG laser-assisted septoplasty for septal deviations under local anesthesia. METHOD: All holmium-YAG laser-assisted septoplasty procedures performed at Beijing hospital (Beijing, China) between August 2009 and May 2012. These patients were operated upon in an outpatient surgical suite. RESULT: The success rate after surgery with regard to nasal obstruction (50 patients) is 92.0% (46 patients) of patients reporting remarkable improvement. Of the 32 patients with rhinologic headaches, A total of 28 subjects (87.5%) had their headache scores improved by 50% or more after surgery; nine (28.1%) were pain free at the last follow-up; four (12.5%) had a less than 25% reduction in their headache score. There were no patients with severe postoperative bleeding. There were no patients with septal perforation. CONCLUSION The holmium-YAG laser-assisted septoplasty is a useful approach to correct septal deviations. There is improved safety due to the enhanced viewing conditions and ample operating space during septal surgery, particularly in posterior septal spurs. The holmium-YAG laser-assisted septoplasty can limit the dissection to the area of deviation, thereby reducing postoperative swelling and the development of complications. It also has other advantages including lower medical costs, and faster return to full activity.
Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Laser Therapy ; methods ; Male ; Middle Aged ; Nasal Septum ; surgery ; Treatment Outcome ; Young Adult

Objective To study the changes of the rat's hearing threshold by long-term treatment with Vitamin-C and the reason of the changes. Methods Forty-two Wistar rats were randomly divided into two groups: the treatment group was treated with water added Vit-C and the placebo group was treated with drinking water.(1)Concentrations of malondialolehyde(MDA)of the cochlea with fluorescence chromatometry.(2) Auditory sensibilities with auditory brainstem response testing.(3) The frequency of the mtDNA~(4834)bp deletion in the cochlea with polymerase chain reaction technique. Results Hearing threshold of both groups become worse with aging,and the treatment group showed the better auditory sensitivities,the less concentrations of MDA and the less frequency of mtDNA~(4834)bp deletion compare with the placebo group. Conclusions Long-term treatment with Vitamin-C could reduce the degree of hearing loss of the rats and the concentrations of MDA of the cochlea and the frequency of mtDNA~(4834)bp deletion in the cochlea.The oxygen radicals theory should be the etiology of presbyacusis.

Objective To investigate the acoustic characteristics of snoring sound in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and with simple snoring. Methods 22 patients with OSAHS and 15 with simple snoring were included in this study. Natural overnight snoring was digitally recorded and portable sleep mo-nitoring was performed simultaneously. 10 snores, which were the 1st snores after 10 cycles of obstructive apnea, from each patient in OSAHS group, and 10 snores from each patient in simple snoring group were analyzed in the time and frequency domains. Results The sound waves of snoring in the two groups exhibited different patterns both in the time and frequency domains. The snoring spectrum of patients with simple snoring showed distinct fun-damental- harmonic structures which were not clear in patients with OSAHS. The central frequency of the patients with OSAHS was higher, and 800 Hz power ratio was lower than those of the patients with simple snoring. In the OSAHS group, the central frequency of the patients with moderate-to-severe OSAHS was higher, and 800 Hz power ratio was lower than those of the patients with mild OSAHS. The differences of the two parameters were of statistical significance. Conclusion The snoring sounds in patients with OSAHS and with simple snoring have dif-ferent characteristics in time and frequency domains, indicating that it is feasible to research the OSAHS by way of snore monitoring and analyzing technique.

Objective To study the effectiveness of intravenous Lidocaine on subjective tinnitus in the elderly, and analyze its correlation with the effectiveness of subsequently oral Carbamazepine.Methods A prospective case-control study was conducted in 120 elderly patients with subjective tinnitus, who were divided into two groups.The control group (n=60) was treated with oral Carbamazepine 0.1 g Bid for one month, and the treatment group (n=60) was treated with 2％ lidocaine by intravenous injection.Patients in the treatment group were observed on responses in tinnitus during the period with Lidocaine injections.The treatment group was further divided into the improvement subgroup and the no-improvement subgroup, according to responses to intravenous lidocaine.All the patients in the treatment group received oral carbamazepine 0.1 g Bid for one month following the intravenous lidocaine injection phase.Results In the control group, 5 patients showed marked improvement, 20 patients showed partial improvement, 33 patients showed no improvement, and 2 patients showed symptom deterioration, with an effectiveness rate of 41.7％ (25/60).In the treatment group, 6 patients showed marked improvement, 26 patients showed partial improvement, 24 patients showed no improvement, and 4 patients showed symptom deterioration, with an effectiveness rate of 53.3％ (32/60).Of the 32 patients in the improvement subgroup, 6 cases showed marked improvement, 16 cases showed partial improvement, 8 cases showed no improvement, and 2 cases showed symptom deterioration after subsequent oral Carbamazepine treatment, and the effectiveness rate was 68.8％ (22/32).Of the 28 patients in the no-improvement subgroup, 1 case showed marked improvement, 9 cases showed partial improvement, 16 cases showed no improvement, and 2 cases showed symptom deterioration, and the effectiveness rate was 35.7％ (10/28).The effectiveness rate in the improvement subgroup was higher than in the no-improvement subgroup (68.8％ vs.35.7％, x2 =6.55, P＜0.05).The effectiveness of lidocaine followed by carbamazepine was better than that of carbamazepine alone (68.8％ vs.53.3％, x2 =6.13, P＜0.05).Conclusions Oral Carbamazepine treatment following intravenous Lidocaine injection in elderly patients with subjective tinnitus has better therapeutic outcomes than treatment with oral Carbamazepine alone, but is not as effective in patients with negative responses to Lidocaine as in patients with positive responses.

[ABSTRACT]OBJECTIVETo evaluate the diagnostic value and curative effect of keyhole neurovascular decompression with local anesthesia for vestibular paroxysmia.METHODSOf 40 patients with trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia, 8 of them combined with vestibular paroxysmia underwent keyhole neurovascular decompression under local anesthesia to explore the vascular compression of acoustic nerve root and have the neurovascular decompression. The evaluation of the vertigo after operation was performed with symptom report card. The patients were followed-up for 36 to 61 months. RESULTSThe vessels compressing the root zone of the vestibular nerve were found in 8 patients with vestibular paroxysmia, of whom 7 patients had the vascular compression vertigo induced during operation and the vertigo was disappeared after operation, moreover, one patient had no vascular compression vertigo induced during operation and the vertigo was not changed after operation. With the average follow-up of 57 months, of 8 patients with vestibular paroxysmia, 7 patients had no recurrence of the vertigo, and the effective control rate was 87.5%.CONCLUSION Local anesthesia keyhole neurovascular decompression was not only an effective way for treating vestibular paroxysmia and controlling the vertigo, but also had certain clinical significance in the diagnosis of vestibular paroxysmia.

Objective To investigate the localization,zone and activation intensity of olfactory center in young versus elderly healthy volunteers by functional magnetic resonance imaging (BOLD-fMRI),so as to elucidate the effect of age on olfactory center in healthy population.Methods Thirteen right-handed healthy adult volunteers were recruited and divided into two groups:young group (5 males and 3 females,mean aged 23 years) and elderly group (2 males and 3 females,mean aged 69.2 years).The olfactory stimulus was r-undecalactone,and it was given according to a block design.The fMRI detection was performed on Philips Achieva 3.0 T MR scanner,and data of BOLE-fMRI was processed and analyzed to get cerebration image by using SPM2.Results In groupaveraged maps,both young and elderly group showed significant olfactory activation in right parahippocampal gyrus,left hippocampal sulcus,right and left superior temporal gyrus,etc,subcortical activation in right thalamus,dorsal pons,and cerebellum activation in cerebellar vermis.Activations in right inferior frontal gyrus,right middle frontal gyrus,right medial occipito-temporal gyrus and right fimbria of hippocampus were observed only in young group,while activation in bilateral middle temporal gyrus was observed only in elderly group.Activation area was apparently smaller and activation degree was lower in elderly group than in young group.Activation intensity in right superior parietal lobule and bilateral superior temporal gyri was higher in male group than in female group (t=13.7,6.08,5.36,respectively,all P＜0.001).Conclusions The intensity of activation in olfactory center is lower in the elderly than in the young,and absence of part of the active regions is found in the elderly,which demonstrates the regression of olfactory center in the elderly.The olfactory center shows right-predominant activation,and olfactory activation intensity in some cortical regions is higher in males than in females.

Objective To study the clinical characteristics of tracheotomy in patients with critical diseases and obesity aged 80 years and over. Methods A total of 120 patients with critical diseases and obesity undergoing tracheotomy from July 2006 to August 2011 were retrospectively reviewed,and divided into advanced age group(aged 80-99 years,n=60) and control group(aged 60-79 years,n=60).Surgery time,operation preparation,surgery skill and complication after surgery were compared between the two groups. Results A total of 60 patients undergoing tracheotomy were successfully performed by relative surgery skills according to characteristics of critical obesity in advanced age group.There was 1 case (1.7％) and 0 case with trachea cannula exodus,3 cases (5.0％) and 4 cases(6.7％) with cuff leak,4 cases (6.6％) and 3 cases(5.0％) with stoma bleeding,5 cases (8.3％) and 7 cases (11.4％) with subcutaneous emphysema in advanced age and control groups,respectively.Total complication rate was similar between the two groups of patients [13 cases (21.7％) vs.14 cases (23.3％),x2 =1.00,P＞0.05]. Conclusions Individualized procedure of tracheotomy may reduce complication of patients with critical diseases and obesity aged 80 years and over.

Objective:To measure the voice samples of the normal aged in order to systemically study the fea-tures of the voice changes. Method :To collect and analyze 146 voice samples of the normal aged with sonogram.Result:The fundamental frequency of the voice of the aged decreases and rises in the male more than 80 yearsolder. The low frequency harmonics are regulation and the intensity is strong in the formant of the aged. Thedifference reduces in voice between male and female. The harmonics to noise ratio tends downwards and the am-plitude perturbation quotient tends upwards along with the growth of age in the aged male. The changes of the above-mentioned parameters are not significant in the aged female. Conclusion:The voice changes are normalphysiological ones in the normal aged. The changes of the parameters are used to evaluate normal aged voice andabnormal one. The changes show that the function in the aged phonation tends to decline to a certain extent andit must be protected and be trained.

OBJECTIVE The head of malleus (HOM) was regarded as the landmark for the middle cranial fossa approach,and its relationship with internal auditory meatus(IAM) was measured. The purpose of this study was to find a safe method to locate IAM. METHODS Twelve heads of adult cadaver fixed with 10 % formaldehyde (23 sides) were microsurgically dissected from the middle cranial fossa approach. The foramen spinosum,Ferrein's foramen,greater petrosal nerve,lesser petrosal nerve,facial nerve,HOM,arcuate eminence,superior petrosal sinus,semicircular canal,and IAM were exposed. First,blue lines method was used to locate IAM. Second,HOM as the landmark was used to locate IAM. RESULTS The angles between the SSC and the longitude axis of IAM are 58.52??4.84?。 A perpendicular line (AB) was drew from the center of HOM to the longitude axis of the temporal bone (the longitude axis of the superior petrosal sinus),line BC was drew from the anterior 30?(28.93?? 6.07?) to the line AB. On the line BC,fundus of IAM can be located (6.69?1.10) mm medial to HOM,the center of the internal acoustic pore can be located (20.1?1.48)mm medial to HOM. CONCLUSION In the middle cranial fossa surgery,HOM can be used to locate IAM and its surroundings structures when traditional landmarks are unrecognized.