Objective:To evaluate the feature of juvenile onset recurrent respiratory papillomatosis (JORRP).Methods:Thirty-eight cases with JORRP were analyzed retrospectively from June,1986 to June,2000.Results:The average age was 3.5 years before diagnosis.Average 3.45 operations had been performed per patient .Of 38 cases ,eight had comlications of laryngeal dysfunction after operations.Peristomal and tracheal papilloma were spread in six of the nineteen cases with tracheotomies.Conclusion:JORRP is the most common laryngeal tumor in children. Most patients have frequent recurrences and multiple operations. Care should be taken to avoid damaging the normal laryngeal structure during surgical excision.

Tinnitus is a common symptom which often becomes disabling, affecting the emotional and psychosocial dimensions of life. Nowadays, therapies for tinnitus vary greatly, none of which could give a satisfactory therapeutic effect however. Intratympanic therapy allows the generation of high concentration of drugs within the inner ear without systemic side effects. This review aims to introduce the commonly used medications and approaches for intratympanic management of tinnitus. Although different medications have been tested for their effects on tinnitus by intratympanic application, no breakthrough has been achieved so far. Consequently, the clinical use of specific medications for tinnitus has remained limited. A more widespread adoption of intratympanic management requires the development of specific medications for tinnitus, as well as proof of their safety and efficacy.
Ear, Inner ; Humans ; Tinnitus ; drug therapy ; Tympanic Membrane

Objective To investigate the roles of endothelins and nitric oxide in the pathogenesis of sudden sensorineural hearing loss(SSHL). Methods 26 patients with SSHL in Changsha area from October 2000 to April 2001, and 18 healthy subjects in the same period were enrolled in this study. Plasma endothelins level was detected by radioimmunoassay, and serum nitric oxide(NO) level was detected by cadmium-reduced spectrophotometry. Results The plasma endothelins level in the SSHL patients was significantly higher than that in the healthy subjects, and the serum NO level in the SSHL patients was significantly lower than that in the healthy subjects(P0.05). Conclusion The increase of ET level and the decrease of NO level may play an important role in the pathogenesis of SSHL, which may serve as an index to predict the hearing improving or not, but were not related to the degree of hearing loss.

Objective:To investigate the clinical effect of streptomycin perfusion of the labyrinth (SPL) inthe treatment of Meniere's disease. Method: 13 patients with Meniere′s disease and 3 patients with delayedendolymphatic hydrops (DEH) underwent SPL. The follow－up time was between 5 and 7 years (average 6.3years). Result:Vertigo was completely controlled in 9 patients, substantialy controlled in 4, limitedly controlledin 2 and not controlled in 1. Hearing was improved in 1 patients, stabilized in 5 and worse in 10. Tinnitus wasimproved in 3 patients, stabilized in 5 and worse in 8. Conclusion:SPL is a safe and effective method in thetreatment of Meniere′s disease and DEH, but the hearing may be insulted and tinnitus may be worse in somepatients.

Objective:To study the clinical manifestations and treatment of the primary cervical tracheal malig-nant tumor of children. Method:Five cases diagnosed as primary tracheal malignant tumor with fibrolaryngoscopy, CT scan and pathology were retrospectively analyzed and reviewed. Extraction of malignant tumor was performed with tracheoscope and nasal endoscope after emergent tracheotomy below the tumor in 4 cases, and tracheotomy after intubation in 1 case. After operation, 4 children received radiotherapy, and 1 case received laser therapy add radiotherapy. Result:Five cases were followed up for three to eight years, and no recurrence was found. Conclu-sion: There was no specific manifestation in early tracheal malignant tumor, but it was critical and emergent during symptoms appear. Imaging examination was a very invaluable dignosis method. Optimal and effective therapeutic protocol is tracheostomy under local anesthesia to keep upper airway patency followed by surgical extraction and radiotherapy. It was not appropriate to have tracheal wall resection for children.

OBJECTIVE: To analyze the clinical manifestations, diagnosis, therapy and prognosis of Langerhans cell histiocytosis (LCH) of the temporal bone in children. METHOD: Seven children with LCH of the temporal bone n our hospital were retrospectively summed up from April 2009 to April 2014. The patients were followed up 1-5 years, their clinical manifestations, imaging findings, diagnosis, therapy and prognosis were studied. Correlation between clinical classifications and prognosis was also analyzed. RESULT: Among the 7 patients, 4 were boys and 3 were girls. 5 cases belonged to the single system group and 2 cases belonged to the multisystem group. The most common clinical characters were temporal tumor, otorrhea, otalgia, hearing loss and granulation of external auditory canal. CT of the temporal bones showed extensive osteolytic destructions with diffuse soft tissure density, without border sclerotization. The cases were. received different therapies. Followed up for 1-5 years, 4 cases were regressive, 1 case kept stable, while 2 cases showed progressive. The two boys then received standard treatment combined steroids with vinblastine. The prognosis in the multisystem group was significantly different from the single system group (P < 0.05). CONCLUSION The clinical manifestations of LCH vary a lot. The diagnosis is based on histological and immunophenotypic examination of lesion tissue. The main therapy includs surgery, chemotherapy and radiotherapy. The prognosis of the single system group is much better than the multisystem group.
Child ; Combined Modality Therapy ; Deafness ; etiology ; Ear Canal ; pathology ; Ear Diseases ; etiology ; Female ; Histiocytosis, Langerhans-Cell ; diagnosis ; pathology ; therapy ; Humans ; Male ; Prognosis ; Retrospective Studies ; Steroids ; therapeutic use ; Temporal Bone ; pathology

Objective To study the expression of copper transport protein 1 in the inner ear of rat and the changes of CTR1 expression after those round window niche copper sulfate and cisplatin infusion .Methods 24 male wistar rats were randomly divided into 4 groups :Group I as the normal control group (nontreatment group);Group II as the round window niche cisplatin infusion group(0 .5 mg/ml);Group III as the round window niche cisplatin infusion group (1 mg/ml);group IV as the round window niche copper sulfate infusion (0 .02 mg/kg) .The CTR1 protein was detected by the immunohistochemical (IHC) otaining and Western-blot ,and the CTR1mRNA expres‐sion levels were detected by RT -PCR .Results The expression of CTR1 protein was observed in the cytoplasm and cell membrane of Corti organ cells ,spiral ganglion cells and stria vascularis in all groups .The average optical densi‐ties of CTR1 protein was a downward trend .The expression of CTR1 protein was observed in four different groups . The optical density analysis of CTR1 showed that the optical densities were 0 .532 ± 0 .031 ,0 .394 ± 0 .024 ,0 .234 ± 0 .030 and 0 .191 ± 0 .015 ,respectively .There was a downward trend ,and there were statistically differences among the groups (P<0 .05) .The CTR1 mRNA was observed in all groups .The optical density analysis of CTR1 mRNAshowed that the optical densities were 0 .508 ± 0 .035 ,0 .391 ± 0 .022 ,0 .240 ± 0 .02 and 0 .186 ± 0 .021 ,respective‐ly .It had a downward trend and were statistically differences among the groups (P<0 .05) .Conclusion The CTR1 protein was abundantly expressed in Corti organ ,spiral ganglion cells and stria vascularis of the cochlea .The round window cisplatin and copper sulfate infusion can change the expression of CTR1 proteins in inner ear .

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.

OBJECTIVE: To study the clinical manifestations and treatment of the primary cervical tracheal malignant tumor of children. METHOD: Five cases diagnosed as primary tracheal malignant tumor with fibrolaryngoscopy, CT scan and pathology were retrospectively analyzed and reviewed. Extraction of malignant tumor was performed with tracheoscopy and nasal endoscope after emergent tracheotomy below the tumor in 4 cases, and tracheotomy after intubation in 1 case. After operation, 4 children received radiotherapy, and 1 case received laser therapy add radiotherapy. RESULT: Five cases were followed up for three to eight years, and no recurrence was found. CONCLUSION There was no specific manifestation in early tracheal malignant tumor, but it was critical and emergent during symptoms appear. Imaging examination was a very invaluable diagnosis method. Optimal and effective therapeutic protocol is tracheostomy under local anesthesia to keep upper airway patency followed by surgical extraction and radiotherapy. It was not appropriate to have tracheal wall resection for children.
Adolescent ; Child ; Endoscopy ; Female ; Humans ; Male ; Nose ; surgery ; Retrospective Studies ; Trachea ; surgery ; Tracheal Neoplasms ; diagnosis ; surgery ; Tracheotomy ; methods

OBJECTIVE: To investigate the efficacy of round window catheter placement with dexamethasone perfusion for 13 patients with intractable sudden sensorineural hearing loss (SSNHL). METHOD: Dexamethasone (2.5 mg) was perfused transtympanically through round window catheter by Micro-infusion pump. The perfusion was taken twice a day and continued for an hour each time, for a total of 7 days. RESULT: Thirteen patients have been followed up for 1 month. Five of them (38.5%) were demonstrated a 17-54 dB improvement in pure-tone threshold average (PTA). The other 8 patients (61.5%) had no effect. CONCLUSION Round window catheter placement with dexamethasone perfusion is a cost-effective and useful treatment for SSNHL patients who had no effect through conventional therapy, although hearing thresholds of these patients had hardly improved to normal levels.
Adult ; Aged ; Catheterization ; Dexamethasone ; administration & dosage ; therapeutic use ; Female ; Hearing Loss, Sensorineural ; drug therapy ; Hearing Loss, Sudden ; drug therapy ; Humans ; Male ; Middle Aged ; Round Window, Ear