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Relationship between vascular endothelial function and aortic compliance in patients with severe obstructive sleep apnea hypopnea syndrome and hypertension

Zhi TANG ; Cuiyi HUANG ; Lin XIAO ; Yajun HE ; Li WU ; Jiqun WANG ; Zhifeng TU

Chinese Archives of Otolaryngology-Head and Neck Surgery.2017;24(7):375-378. doi:10.16066/j.1672-7002.2017.07.014

OBJECTIVE To investigate the correlation between vascular endothelial function and aortic compliance in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) and hypertension. METHODS A total of 103 OSAHS cases were divided into simple OSAHS group(n=55) and OSAHS complicated with hypertension group(n=48, OSAHS+HT group). 20 patients with simple hypertension were included into the hypertension group, and 20 healthy people served as controls. Vascular endothelial function was evaluated by detecting flow mediated dilation of the brachial artery(FMD) with color Doppler; the changes of aortic compliance in patients were detected by echocardiography. RESULTS The FMD, aortic tension and aortic distensibility index levels of OSAHS with hypertension group were significantly lower than the normal control group, hypertension group and OSAHS group(P<0.05); The aortic stiffness index level of OSAHS hypertension group was significantly higher than the normal group, the high blood pressure group and OSAHS group(P<0.05); Analysis of Spearman correlation coefficient of patients in OSAHS with hypertension group found aortic FMD were positively correlated with aortic stiffness index, negatively correlated with aortic tension index and aortic expansion; The aortic FMD, aortic tension, swelling index and aortic stiffness index in OSAHS hypertension group had positive correlation with AHI (P<0.05), and negative correlation with LSaO2(P<0.05). CONCLUSION OSAHS is associated with vascular endothelial dysfunction and decreased aortic compliance. When combined with hypertension, vascular endothelial function and aortic compliance will be significantly affected. The severity of OSAHS was closely related to the decrease of vascular endothelial function and the changes of aortic compliance.

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Influence of nasal septum fracture on the effect of nasal bone reduction

Yunjun GAO ; Bengang PENG ; Xin WANG ; Wenjun LI ; Yiqing SUN

Chinese Archives of Otolaryngology-Head and Neck Surgery.2017;24(7):368-370. doi:10.16066/j.1672-7002.2017.07.012

OBJECTIVE To investigate the incidence rate of nasal septum fracture and it's influence on the effect of nasal bone reduction. METHODS Retrospective analysis of 212 cases of nasal fracture compared with nasal septum deviation were carried out. Among these cases 112 treated with nasal bone reduction only was called group A; the other cases were treated with nasal reduction concomitantly with septoplasty. Among them 58 cases were diagnosed with nasal septum fracture, it was called group B; 42 cases were diagnosed with nasal septum deviation, it was called group C. The postoperative nasal deformity rate was assessed, and the intraoperative findings of nasal septum contrast with preoperative CT diagnosis was analysed. RESULTS Three months after the operation, 27 cases (24.1%) of nasal deformity were found in group A; 9(9.0%) cases of nasal deformity were found in group B+C; septum fracture was found in 58 cases (100%) in group B and 30(71.8%) cases in group C introperatively. The diagnosis rate of nasal septum fracture by CT was 58.0%, while it's incidence rate was 88.0%. CONCLUSION More nasal septum fractures were observed introperatively than CT findings, and septoplasty concomitantly with nasal bone reduction can obviously reduce the rate of nasal deformity.

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Analysis of inferior turbinate in patients with deviated nasal septum by using computed tomography

Xiaowen QIU ; Jiandao HU

Chinese Archives of Otolaryngology-Head and Neck Surgery.2017;24(7):365-367. doi:10.16066/j.1672-7002.2017.07.011

OBJECTIVE To evaluate the relationship between the degree of nasal septum deviation and inferior turbinate hypertrophy with the CT. METHODS The paranasal sinus CTs of 98 cases with septum deviation were evaluated. Inferior turbinate on the deviated side of the nasal septum was considered as the control group and the inferior turbinate on the other side was taken as the study group in the same patient. The septal deviation angle, thickness of the bone, medial mucosa and lateral mucosa of the inferior turbinate were measured. RESULTS The thickness of the bone, medial mucosa and lateral mucosa of the inferior turbinate were statistically different between the study group and the control group(P<0.05). There were statistically differences between the medial and lateral mucosal thickness in study group(P<0.05). There was no positive correlation between the deviation angle and the thickness bone, medial and lateral mucosa of the inferior turbinate in the study group(P>0.05), but the value of correlation coefficents revealed the inferior turbinate bone correlated with the deviation angle most, followed by medial and lateral mucosal thickness. CONCLUSION The hypertrophy of inferior turbinate in patients with nasal septum deviation is not only caused by mucosal hypertrophy, but also by hypertrophy of the inferior turbinate bone. The preoperative CT before septoplasty can be helpful to choose the surgical methods during the operation.

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Observation of myrtol combined with cefazolin sodium pentahydrate in the treatment of pediatric acute suppurative otitis media

Xiaojun DING

Chinese Archives of Otolaryngology-Head and Neck Surgery.2017;24(7):347-350. doi:10.16066/j.1672-7002.2017.07.006

OBJECTIVE To investigate the effectof Myrtol combined with Cefazolin Sodium Pentahydrate in the treatment of acute suppurative otitis media in children. METHODS Totally 120 cases of pediatric acute suppurative otitis media were selected in our hospital from January 2014 to January 2016 and randomly divided into four groups, treated with Myrtol combined with Cefazolin Sodium Pentahydrate, Myrtol combined with Cefazolin Sodium, Cefazolin Sodium Pentahydrate, or Cefazolin Sodium, respectively. The effect and adverse reactions of the 4 groups were studied and compared. RESULTS There was no significant differences in age, sex, and average course of disease among the four groups. In Myrtol combined with Cefazolin Sodium Pentahydrate group, the clinical efficacy is better than that of the other three groups (P<0.05).There was no difference between Myrtol combined with Cefazolin Sodium group and the Cefazolin Sodium Pentahydrate group(P>0.05), and both of them are better than cefazolin sodium group(P<0.05). For the disappearance time of symptoms, including earache, hearing loss, fever and tympanic hyperaemia, Myrtol combined with Cefazolin Sodium Pentahydrate treatment was shorter than the other three groups (P<0.05). There was no significant differences among the three groups(P>0.05). CONCLUSION Myrtol combined with Cefazolin Pentahydrate Sodium treatment was superior to the other three protocols in clinical efficacy for children with acute suppurative otitis media , and does do not increase the risk of safety.

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Significance of neuromedin U expression in lymph node metastasis of laryngocarcinoma

Qichuan JIANG ; Dong CHEN ; Yanan XU ; Jian KANG ; Jianguo CHEN

Chinese Archives of Otolaryngology-Head and Neck Surgery.2017;24(7):340-342. doi:10.16066/j.1672-7002.2017.07.004

OBJECTIVE To evaluate the effect of neuromedin U(NMU) in lymph node metastasis of laryngocarcinoma and provide a new biomarker of metastasis. METHODS Samples of 120 cases of laryngocarcinoma were collected from the Otolaryngology Department of the First Affiliated Hospital of Jinzhou Medical University from 2013 to 2015. Patients were divided into two groups: metastasis group and non-metastasis group. Immunohistochemistry was performed to analyze the NMU expression in primary tumor and lymph node. An independent tissue microassay was used to analyze the relationship between NMU expression and T, N stages. RESULTS Expression of NMU in metastasis group was higher than that in non-metastasis group, NMU was positively correlated with N stages, but not with T stages. CONCLUSION The expression of NMU is higher in metastasis tissue of laryngocarcinoma, It could be used as a biomarker of lymph node metastasis of laryngocarcinoma.

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Clinical application of auricular cartilage in intact bridge tympanomastoidectomy

Shengjun WANG ; Xiaoyan HOU ; Fei YIN

Chinese Archives of Otolaryngology-Head and Neck Surgery.2017;24(7):355-357. doi:10.16066/j.1672-7002.2017.07.008

OBJECTIVE To investigate and evaluate the effects of intact-bridge tympanoplasty using auricular cartilage in treating chronic otitis media. METHODS A retrospective review of 86 cases undergoing an intact-bridge tympanomastoidectomywas performed from July,2013 to May,2016.The auricular cartilage was placed on the attic and tympanic antrum entrance to reconstruct the attic. RESULTS The outcome of dry ear and well-epithelialized mastoid cavities was achieved after 4-6 weeks. After 6-month follow-up no recurrence occurred. The pure-tone average threshold improved by (25.4±6.3) dB HL after operation,and the mean air bone gap was elevated. CONCLUSION On the basis of combination of closed and open techniques,the IBM technique is a optimal cure strategy for chronic otitis media,which can not only remove the pathological changes thoroughly to prevent disease recurrence but also maximally improve the hearing of the diseased ear.The closure of attic with auricular cartilage can ensure the space of the ossicular chain.

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Analysis of the relationship between state trait anxiety and behavioral status in patients with sudden deafness

Dandan LIU ; Chunyan FU

Chinese Archives of Otolaryngology-Head and Neck Surgery.2017;24(7):351-354. doi:10.16066/j.1672-7002.2017.07.007

OBJECTIVE To investigate the relationship between state trait anxiety and behavioral status in patients with sudden deafness. METHODS From April 2015 to June 2016, 140 cases of hospitalized patients with sudden hearing loss were selected as the observation group, and 140 healthy volunteers in our hospital for medical examination were selected as the control group. Average data, state trait anxiety, quality of life, and behavior survey were investigated in the two groups and correlation analysis was conducted. RESULTS The state trait anxiety score of the observation group was 51.20±4.19 points, and the control group was 34.40±3.49 points, and the state trait anxiety score of the observation group was significantly higher than that of the control group(t=12.949, P<0.05). The scores of physical, compulsive, interpersonal sensitivity, hostility and depression in the observation group were significantly higher than those in the control group(P<0.05). The problem solving and help scores in the observation group were significantly lower than that of the control group, while the fantasy and self accusation scores was significantly higher than that of the control group(P<0.05). In the observation group, Pearson correlation analysis shows anxiety scores were significantly correlated to the dimensions scores of quality of life, fantasy and self accusation scores(P<0.05), and were significantly negative correlated to the problem solving and help scores (P<0.05). CONCLUSION The patients with sudden deafness is accompanied by state trait anxiety and fantasy, self accusation and other bad behavior, it can seriously affect the patient's quality of life and form vicious circle, so the nursing intervention should be strengthened in clinical practice.

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Grading prevention strategy for airway burn during CO2 laser surgery of larynx

Hongbo XU ; Jugao FANG ; Pingdong LI ; Qi ZHONG ; Lizhen HOU ; Xiaohong CHEN ; Zhigang HUANG

Chinese Archives of Otolaryngology-Head and Neck Surgery.2017;24(7):333-336. doi:10.16066/j.1672-7002.2017.07.002

OBJECTIVE To explore t he significance of reducing the incidence rate of airway burn of CO2 laser laryngeal surgery by spreading the idea of grading prevention st rateg y. M ETHODS We retrospectively reviewed the data of laryngeal lesions treated by the endoscopic CO2 laser surgery from Feburary 1992 to December 2016. The period was divided into two stages, the first one is from Feburary 1992 to December 2008, and the second one is from January 2009 to December 2016. We will distinguish the difference of airway burn between the two stages. RESULTS Four cases of airway burn were found in the first stage including 3 cases of glottic cancer and 1 case of vocal cord polyp with Reink's edema. But no airway burn happened in the second stage. Two cases of endotracheal intubation cuff broken by laser were found promptly, but with FiO2 decreasing from 70% to 30%, wet gauze filling subglottic region and the endotracheal tube reserved, the laser surgery proceeded till airway burn happened. The endotracheal intubation cuffs of the remaining two cases kept intact intraoperatively, the FiO2 was 70% when airway burn happened. One case had the cervical tracheal stenosis with long-term tracheotomy, The other 3 cases had no postoperative complications. CONCLUSION The grading prevention strategy is helpful for reducing airway burn during the CO2 laser surgery of larynx.

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Analysis on risk factors of cervical lymph node metastasis in cN0 papillary thyroid carcinom

Yujuan PANG ; Xiaohong CHEN ; Jingyi ZHANG ; Jingli GAO

Chinese Archives of Otolaryngology-Head and Neck Surgery.2017;24(7):329-332. doi:10.16066/j.1672-7002.2017.07.001

OBJECTIVE To explore risk factors of cervical lymph node metastasis in cN0 papillary thyroid carcinoma. METHODS The clinical data of 537 patients with cN0 papillary thyroid carcinoma were analyzed retrospectively in Beijing Tongren hospital from Jan 2009 to Dec 2015. Patients' gender, age, multifocal lesion, carcinoma complicated with Hashimoto's thyroiditis, capsule breakthrough and tumor size were counted. RESULTS The lymph node metastasis rate of 537 patients with cN0 papillary thyroid carcinoma was 30.9%(166/537). The incidences of lymph node involvement were 24.95%(166/537) at only level VI, 5.21%(28/537) at level VI plus lateral part of neck and 0.74%(4/537) at only skip metastasis, respectively. Chi square test and multivariate logistic regression analysis showed that cervical lymph node metastasis was statistically associated with male, age<45 years, capsule breakthrough and tumor diameter>1 cm (P<0.05). After the operation, there were 17 patients with temporary hoarseness, accompanied with 1 loss to follow-up and 1 failure to return to normal after 1.5 years. There were 61 patients with temporary hypocalcemia, 2 patients failed to follow-up and 2 patients with calcium supplements after respective 1.5 and 4 years. CONCLUSION To stratify the risk of patients with cN0 papillary thyroid carcinoma, male, age<45 years, capsule breakthrough and tumor diameter>1 cm are risk factors for cervical lymph node metastasis. And we suggest that prophylactic central lymph node dissection may be appropriate.

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Treatment experience of critical children with tracheobronchial foreign body

Xin WEN ; Yingluan SONG ; Juan WANG ; Jing SHI ; Jinzhu SU ; Yanan SHI

Chinese Archives of Otolaryngology-Head and Neck Surgery.2017;24(8):422-424. doi:10.16066/j.1672-7002.2017.08.012

OBJECTIVE To investigate the rescue and treatment of critical children with tracheobronchial foreign body. METHODS From June 2011 to June 2015,there were 2489 children with tracheobronchial foreign bodies treated in Children's Hospital of HeBei Province, among which 11critical children who were rescued as soon as they came to the hospital. The clinical data of the 11critical children were analyzed. RESULTS All the 11 critical cases endured dyspnea of third degree or more severe and presented severe hypoxia, in which 2 children had been performed tracheal intubation before they came to the hospital and 1 child even showed the symptom of respiratory and cardiac arrest. Among these critical cases, the foreign body was removed directly without anesthesia in 1 child. The other 2 children with severe pneumothorax, mediastinal emphysema and subcutaneous emphysema in neck and chest area were treated by excision and drainage of emphysema firstly, and then the foreign bodies were extracted through bronchoscope after general anesthesia. The another 8 children were performed operations of extraction of bronchial foreign body and then the foreign bodies were taken out. All the 11 critical children were rescued successfully and no death cases happened. CONCLUSION Rapid diagnosis and rapid removal of foreign bodies is the key to save the lives of critical children with tracheobronchial foreign bodies.

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