OBJECTIVE: To explore the factors related to the occurrence of otitis media with effusion (OME) in patients with long-term tracheal intubation. METHOD: This retrospective study included 47 cases with endotracheal intubation more than 7 days (endotracheal intubation group) and 20 cases without mechanically ventilated in the same period(control group). The relationships between secretory otitis media with age, gender, intubation method,duration of intubation, breathing patterns, consciousness, gastric tube position were analysed. RESULT: The study showed 27 out of 47 patients in endotracheal intubation group had OME, 9 cases had negative pressure in the middle ear and 11 patients were normal. No OME was found in control group, and 2 cases with negative pressure in bilateral middle ear were detected. The incidence of OME was significantly increased in patients with the application of ventilator in PEEP mode or nasotracheal tube, and with conscious disturbance or tracheal intubation using for more than 10 days. The presence of OME had a significantly higher rate in patients with nasal intake subjects than the oral intake subjects. The incidence of OME decreased significantly in patients using glucocorticoid. CONCLUSION The incidence of OME increased in patients applied with tracheal intubation for more than 7 days. Ventilator in PEEP mode, nasotracheal tube, and conscious disturbance were closely related with OME. Application of glucocorticoids reduced the incidence of OME.
Ear, Middle ; Glucocorticoids ; Humans ; Incidence ; Intubation ; Intubation, Intratracheal ; Otitis Media with Effusion ; Pressure ; Retrospective Studies

China ; Humans ; Otolaryngology

OBJECTIVE: To explore the difference of mitochondrial DNA 4,834 bp deletion mutation in tissues of inner ear, kidney and skeletal muscle and to discuss the possible mechanism of this kind of mutation in doxorubicin induced mtDNA 4,834 bp deletion mutation rat model. METHOD: Twenty-eight Wistar rats were randomly divided into two groups, one was experimental group (18 rats), the other was the blank control group (10 rats). The rats of experimental group were treated with intraperitoneal injection doxorubicin (1 mg/kg) twice a week for 3 months. The blank controls received an equivalent volume of saline instead. The tissues of inner ear, kidney and skeletal muscle were harvested and the mitochondrial DNA 4,834 bp deletion mutation was detected by nested-PCR (nested polymers chain reaction) technique. The product of PCR was sequenced directly. RESULT: Two rats of the experimental group and the blank group died during the experiment. The frequency of the mitochondrial DNA 4,834 bp deletion mutation of inner ear, kidney and skeletal muscle were 68.75% (11/16), 75.00% (12/16) and 100.00% (16/16) respectively. The difference of this kind of mutation between tissues of the inner ear and the skeletal muscle was statistic significance (P < 0.05). There were no significant difference between the inner ear tissue and the kidney tissue (P > 0.05). None of the rats of the blank control group carry this kind of mitochondrial DNA mutation. CONCLUSION The mitochondrial DNA 4,834 bp deletion mutation could be induce by doxorubicin in rats, and a notable difference were found of the frequencies of this kind of mutation between tissues of the inner ear and the skeletal muscle. So it suggested that this kind of mitochondrial DNA common deletion mutation was tissue specific.
Animals ; DNA, Mitochondrial ; genetics ; Doxorubicin ; toxicity ; Ear, Inner ; Gene Deletion ; Kidney ; metabolism ; Muscle, Skeletal ; metabolism ; Rats ; Rats, Wistar ; Sequence Deletion ; drug effects

OBJECTIVE: To study the changes in facial nerve function, morphology and neurotrophic factor III (NT-3) expression following three types of facial nerve injury. METHOD: Changes in facial nerve function (in terms of blink reflex (BF), vibrissae movement (VM) and position of nasal tip) were assessed in 45 rats in response to three types of facial nerve injury: partial section of the extratemporal segment (group one), partial section of the facial canal segment (group two) and complete transection of the facial canal segment lesion (group three). All facial nerves specimen were then cut into two parts at the site of the lesion after being taken from the lesion site on 1st, 7th, 21st post-surgery-days (PSD). Changes of morphology and NT-3 expression were evaluated using the improved trichrome stain and immunohistochemistry techniques ,respectively. RESULT: Changes in facial nerve function: In group 1, all animals had no blink reflex (BF) and weak vibrissae movement (VM) at the 1st PSD; The blink reflex in 80% of the rats recovered partly and the vibrissae movement in 40% of the rats returned to normal at the 7th PSD; The facial nerve function in 600 of the rats was almost normal at the 21st PSD. In group 2, all left facial nerve paralyzed at the 1st PSD; The blink reflex partly recovered in 40% of the rats and the vibrissae movement was weak in 80% of the rats at the 7th PSD; 8000 of the rats'BF were almost normal and 40% of the rats' VM completely recovered at the 21st PSD. In group 3, The recovery couldn't happen at anytime. Changes in morphology: In group 1, the size of nerve fiber differed in facial canal segment and some of myelin sheath and axons degenerated at the 7th PSD; The fibres' degeneration turned into regeneration at the 21st PSD; In group 2, the morphologic changes in this group were familiar with the group 1 while the degenerated fibers were more and dispersed in transection at the 7th PSD; Regeneration of nerve fibers happened at the 21st PSD. In group 3, most of the fibers crumbled at the 7th PSD and no regeneration was seen at the 21st PSD. Changes in NT-3: Positive staining of NT-3 was largely observed in axons at the 7th PSD, although little NT-3 was seen in the normal fibers. CONCLUSION Facial palsy of the rats in group 2 was more extensive than that in group 1 and their function partly recovers at the 21st PSD. The fibres' degeneration occurs not only dispersed throughout the injury site but also occurred throught the length of the nerve. NT-3 immunoreactivity increased in activated fibers after partial transection.
Animals ; Facial Nerve ; metabolism ; pathology ; physiopathology ; Facial Nerve Injuries ; classification ; metabolism ; pathology ; physiopathology ; Neurotrophin 3 ; metabolism ; Rats ; Rats, Wistar

OBJECTIVE: To detect the influence of heat coagulation of middle meningeal artery (MMA) on plasma CGRP and SP levels in migraine rat triggered by nitroglycerin (NTG). METHOD: Twenty-four female Wistar rats were randomly divided into four groups, with six rats in each group. In group A, rats were treated with isotonic saline; in group B, rats were injected subcutaneously with 10 mg/kg nitroglycerin to set up the animal model of migraine; in group C, rats were subjected to sham surgery by merely exposing MMA and then injected with nitroglycerin (10 mg/kg); and in group D, rats were firstly subjected to heat coagulation of MMA and, subsequently, injected with nitroglycerin (10 mg/kg). Following the injection, the animal's behavior was continuously recorded by an observer. Radioimmunoassay was employed to measure the amounts of CGRP and SP in venous plasma. RESULT: Injection of 10 mg/kg nitroglycerin was able to trigger the animal model of migraine as evidenced by the appearances of a series of symptoms, such as, scratching head frequently, climbing cage and red ear. Rats in group A occasionally showed off scratching head, whereas, rats from group B and group C presented with much severe symptoms. Of note, rats in group D appeared slightly scratching head and climbing cage, without red ear compared with group B and C. At the same time, the amounts of plasma CGRP and SP in group B, group C, or group D were increased significantly compared with that of group A (P < 0.05). Furthermore, the plasma CGRP and SP levels in group D were much lower than that in group B and group C (P < 0.05), but there was no statistical difference between group B and group C (P > 0.05). CONCLUSION Heat coagulation of MMA may relieve symptoms of rats following nitroglycerin infusion, possibly by inhibiting the release of CGRP and SP.
Animals ; Calcitonin Gene-Related Peptide ; blood ; metabolism ; Electrocoagulation ; Female ; Meningeal Arteries ; Migraine Disorders ; chemically induced ; metabolism ; therapy ; Nitroglycerin ; adverse effects ; Rats ; Rats, Wistar ; Substance P ; blood ; metabolism

Objective To investigate the effect of G protein?coupled estrogen receptor (GPER) on the diastolic function of renal interlobular artery and reduce renal ischemia?reperfusion injury in rats. Methods Female ovariectomized rats were divided into control group; ischemia?reperfusion injury (IRI) group;GPER?specific agonist (G1) intervention group;GPER?specific blocker+GPER?specific agonist (G15+G1) intervention group. Histopathological examination (HE staining), renal function test and Paller score were used to identify the success of the model and the degree of kidney damage. In vitro microvascular pressure diameter measuring instrument was used to detect the relaxation and contraction activity of renal interlobular artery in each group. Immunofluorescence technique was used to observe the expression of GPER on the renal interlobular artery. Westernblotting was used to detect the expression of GPER protein in renal interlobular artery of rats in each group. The NO content was determined by a nitrate reductase method. Results Compared with IRI group, serum BUN, Scr level and Paller score in G1 intervention group were significantly decreased (all P<0.05). The systolic rate of renal interlobar artery was significantly increased [(40.76 ± 1.57)％ vs (29.78 ± 1.87)％, P<0.05]. The results of immunofluorescence showed that GPER was expressed in renal interlobular artery smooth muscle cells and endothelial cells, and the expression of IRI group was higher than that of the control group. The expression of G15+G1 intervention group was lower than that of G1 intervention group (all P<0.05). Compared with the IRI group, the NO content in the G1 intervention group increased significantly (all P<0.05). Conclusions During renal ischemia ?reperfusion injury, GPER may regulate the systolic and diastolic activity of the renal interlobar artery by increasing the content of NO, so as to alleviate the renal ischemia?reperfusion injury.

Objective:To investigate the clinical features, pathological types, imaging features, and surgical strategies of lateral skull base benign tumors with intracranial invasion.Methods:From January 2011 to March 2021, 36 patients of lateral skull base benign tumors with intracranial invasion were included in this retrospective study. Among the 36 patients, 14 cases were male, 22 cases were female, the aged range from 20-67, with the median age of 48. The clinical manifestations, characteristic imaging findings, pathological types, surgical approach selection, and prognosis were analyzed.Results:36 cases of lateral skull base tumors with intracranial invasion were all accepted surgeries. 23 cases were neurogenic tumors, facial nerve tumors ( n=8), neurogenic tumors in jugular foramen with unknown origin( n=6), hypoglossal schwannoma ( n=3), transotic intralabyrinthine schwannoma ( n=3), vestibular schwannoma involving the middle ear( n=2), vagal nerve schwannoma( n=1). Other types of tumors included meningioma ( n=10) and paraganglioma (Di 1 or 2, n=3). Different pathological types of tumors had different clinical manifestations and imaging manifestations. Sixteen cases were subjected to primary resection, while, other 20 cases underwent staged operation. Among the patients with staged operation, 10 patients had completed the second stage operation, five patients were waiting for the second stage operation, the other five patient′s residual intracranial tumor were significantly reduced and the space between tumor and brain tissues widened after the first stage operation, so, the following up with "wait and scan”policy was suggested. The total resection rate of tumors was related to the pathological nature, in which neurogenic tumors were 15/17, and meningiomas were 5/8. The main postoperative complications were cerebrospinal fluid leakage and infection in the operation area. There were two cases of postoperative intracranial infection, and three cases of cerebrospinal fluid leakage occurred in non staged operation cases. Conclusions:Lateral skull base tumors with intracranial invasion are rare. The most common pathological type is schwannoma, followed by meningioma and paraganglioma. For this type of tumor, if there is infection in the operation area and neck invasion is large, it is suggested to choose staged surgery, which can reduce the risk of intracranial infection and the incidence of cerebrospinal fluid leakage. Staged surgery strategy can also reduce the difficulty of second stage surgery, so the operation is much safer than non staged surgery.

Objective:To analyze the disease characteristics, diagnosis and treatment methods of venous pulsatile tinnitus treated by intervention of sigmoid sinus.Methods:Fifty patients (from Shandong Provincial ENT Hospital, Shandong University between February 2014 and July 2020) with venous pulsatile tinnitus treated by sigmoid sinus surgery were analyzed retrospectively. The tinnitus characteristics, imaging findings, surgical methods, intraoperative findings and postoperative tinnitus changes were recorded. The patients were followed up for 6-12 months. The sign rank sum test was used to analyze the difference in tinnitus grading before and after surgery. There were 50 patients with unilateral venous pulsatile tinnitus, including 49 females and 1 male. The age ranged from 17 to 67 years, with a median age of 44 years. There were 45 cases of right tinnitus and 5 cases of left tinnitus. The degree of tinnitus before operation was grade Ⅱ or above, including 4 cases of gradeⅡ, 11 cases of grade Ⅲ, 22 cases of grade Ⅳ and 13 cases of grade Ⅴ.Results:Thirty-seven cases were cured, 8 cases were ineffective (no change in tinnitus), 3 cases were markedly effective (tinnitus grade decreased by 3 in 2 cases, 4 in 1 case), and 2 cases were effective (tinnitus grade decreased by 1). The difference of tinnitus grade before and after operation was statistically significant ( Z=-5.70, P<0.05). Temporal bone CT showed 36 cases of sigmoid diverticulum (including 17 cases with sigmoid sinus dehiscence), 12 cases of sigmoid sinus dehiscence and 2 cases of absence of the temporal bone cortex abutting to sigmoid sinus. Thirty-five cases were performed with closure of sigmoid sinus diverticulum, 4 cases were performed with resurfacing of the sigmoid plate, 5 cases were performed with narrowing of sigmoid sinus, 4 cases were performed with simple opening of pre sigmoid mastoid air chamber, 1 case of opening was performed with pre sigmoid mastoid air chamber combined with narrowing of sigmoid sinus, and 1 case was performed with opening of pre sigmoid mastoid air chamber combined with closure of sigmoid sinus diverticulum. Conclusions:Venous pulsatile tinnitus is common in women. The common causes may be sigmoid sinus wall abnormalities such as sigmoid sinus diverticulum and perisigmoid bone defect. Imaging examinations are helpful for diagnosis. Venous pulsatile tinnitus can be treated with surgery.

Objective To explore the long-term efficacy and safety of triple semicircular canal occlusion (TSCO) in the treatment of intractable Meniere's disease (MD) so as to provide an alternative surgical procedure for treating this disorder.Methods Data from Forty-nine patients,who were referred to our hospital and diagnosed with unilateral MD strictly meeting the criteria issued by Chinese Academy of Otolaryngology-Head and Neck Surgery Committee (2006) from Dec.2010 to Jul.2012,were retrospectively analyzed in this work.Forty-nine patients,in whom the standardized conservative treatment was given at least one year and frequent vertigo still occurred,received TSCO.Vertigo control and auditory function were measured.Pure tone audiometry,caloric test,and cervical vestibular evoked myogenic potential (cVEMP) were performed for evaluation of audiological and vestibular function.Magnetic resonance hydrograph of inner ear was performed in patients received TSCO after 2 years for the observation of morphology of membranous labyrinth.Postoperative follow-up period was more than 2 years.Results According to the preoperative staging of hearing,among these 49 patients,there were 2 cases in stage Ⅱ (with an average hearing threshold of 25-40 dBHL),40 in stage Ⅲ (41-70 dBHL) and 7 in stage Ⅳ (over 70 dBHL).Vertigo was controlled effectively in all 49 cases in two-year follow-up,of which 40 cases (81.6％) were completely controlled and 9 cases (18.4％) were substantially controlled after surgery.The rate of hearing preservation was 69.4％ and the rate of hearing loss was 30.6％.Post-operatively,all patients suffered from temporary vertigo and balance disorders.Vertigo was disappeared in all patients within 3-5 days,while averagely recovered after 13.5 days.Two years afer treatment,loss of semicircular canal function by caloric test was found in the operation side of all patients and no change in cVEMP test was noted.All patients had no facial paralysis,cerebrospinal fluid leakage,and other complications.Magnetic resonance hydrograph of inner ear showed that endolymph fluid in the position of plugging had no water after 2-years of TSCO.Conclusions TSCO,which can reduce vertiginous symptoms effectively in patients with intractable MD in long-term follow-up,represents an effective and safe therapy for this disorder.TSCO is expected to be used as an alternative procedure for the treatment of MD in selected patients suffering from severe hearing loss or recurrence after endolymphatic sac surgery.