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The relation between the morphological change of supratubal recess and otitis media

Journal of Clinical Otorhinolaryngology Head and Neck Surgery.2010;(1):21-24. doi:10.3969/j.issn.1001-1781.2010.01.007

Objective:To observe the anatomic characteristics of supratubal recess and the morphological change of it in the sick ear. To investigate the relation between the morphological changes of supratubal recess and otitis media.Method:Using high resolution CT to observe and measure the supratubal recess of the normal ears and the ailing ones.Result:For the normal adults, the anteroposterior diameter of the supratubal recess is(3.83±1.28)mm,the vertical diameter(3.67±1.14)mm,the height(3.76±0.36)mm;and the length of the cog is(2.84±0.38)mm.The size of the supratubal recess showed no significant difference between left and right(P＞0.05).There was no relationship between the size of the supratubal recess and pneumatization of mastoid cells (P＞0.05).There was significant differences in size of the supratubal recess between normal ears and the ears with cholesteatoma(P＜0.05),but there was no relationship between the size of the supratubal recess and pneumatization of mastoid cells(P＞0.05)in the ears with cholesteatoma.There was no significant differences in size of the supratubal recess between normal ears and the ears with chronic otitis media(P＞0.05).In the ears with cholesteatoma,40% had osseous destruction in supratubal recess.Conclusion:For the normal adults, the size of the supratubal recess showed no significant difference between left and right, and there was no relationship between the size of the supratubal recess and pneumatization of mastoid cells. Anterior tympanic isthmus , posterior tympanic isthmus and supratubal recess which is the supplement of the formers constitute the air way between attic and mesotympanum. The supratubal recess of the cholesteatoma is smaller than the normal, when the eustachian tube dysfunction occurs, the air way in the middle ear would herein be affected, and cholesteatoma forms eventually. There was no significant differences in size of the supratubal recess between normal ears and ears with chronic oti-tis media, as in the clinic.The effect of the supratubal recess should be taken into account when we consider the pathogeny and treatment of the middle ear cholesteatoma.

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Endoplasmic reticulum molecular chaperone involved in the impairment of inner ear consistented with the mimetic aging rats

Jing XIE ; Linhui LUO ; Qiuhong XUE ; Xin LI ; Shusheng GONG

Journal of Clinical Otorhinolaryngology Head and Neck Surgery.2010;(1):28-32. doi:10.3969/j.issn.1001-1781.2010.01.009

Objective:To explore the involvement of endoplasmic reticulum molecular chaperone GRP78 in the impairment of inner ear consistented with the mimetic aging model.Method:Twenty-four Wistar rats were randomly divided into two groups. model group was in duced by daily hypodermic injection of 10% D-galactose (800 mg·kg~(-1)·d~(-1)) for 8 weeks and the control group was given saline accordingly. Spatial learning and memory was measured by Morris-Water-Maze. Colorimetry was used to analyze superoxide dismutase (SOD) and malondialdehyde (MDA) extracted from inner ear tissue. Hearing threshold of rats were detected with Auditory brainstem response (ABR).In addition, expression of GRP78 in the inner ear was detected by immunohistochemistry,RT-PCR and Western blot. The control group was studied parallel.Result:The escape latency in the model group injected with D-galactose was markedly longer than that in the control group.accordingly ,the changes of SOD and MDA were more significant in the model group, the difference between two groups was significant(t-test,P<0.01). the variation of ABR in two groups was observed, There was no statistically difference of the hearing in the model group compared with the control group(P>0.05). The expression of GRP78 was significantly different between two groups ,which is increased in the inner ear tissue of model group(P<0.01).Conclusion:The impairment of inner ear tissue partly dued to the oxidative stress in the model, which was induced by D-galactose.and endoplasmic reticulum molecular chaperone was thought to contribute to the impairment mechanism of inner ear in mimetic aging model.

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Clinical characterization of audiometrics and vestibular evoked myogenic potentials in patients with large vestibular aqueduct syndrome

Jun WU ; Jinling WANG ; Juan XIE ; Liping HAN ; Lei GAO

Journal of Clinical Otorhinolaryngology Head and Neck Surgery.2010;(1):25-27. doi:10.3969/j.issn.1001-1781.2010.01.008

Objective:To investigate the clinical and diagnostic characteristics of audiometric findings and vestibular-evoked myogenic potentials in patients with large vestibular aqueduct syndrome (LVAS).Method:Thirty LVAS subjects(60 ears) recruited received pure tone audiometry, acoustic immittance, auditory brain stem responses (ABRs), distortion-product otoacoustic emission(DPOAE), Vestibular evoked myogenic potentials(VEMP) and caloric test, and the diagnostic significance of the results was analyzed.Result:All 30 cases(60 ears) showed progressive and fluctuating hearing loss, while 16 cases experienced dizziness when hearing fluctuated. Most of our cases showed sensorineural hearing loss, and 47 ears(94.0%) showed air-bone gap in the low frequencies, with mean gaps of (43±17)dB HL at 250 Hz, (33±18 )dB HL at 500 Hz, in which the middle ear function showed normal. The acoustically evoked short latency negative response(ASNR) with medium latency(3.06±0.52)ms was elicited from 18 ears(64.3%). The mean amplitude of vestibular evoked myogenic potentials(VEMP) of 42 ears was (147.10± 107.55)μv,and the threshold of VEMP of 19 ears was 75 dB nHL,of 7 ears was 65 dB nHL.Conclusion:Characteristics of hearing performance, such as progressive and fluctuating hearing loss, air-bone gap at the low frequencies with normal middle ears, the ASNR, and increased amplitude and decreased threshold of the VEMPs, will help clinicians make initial diagnosis of LVAS ,and provide a reference for further imaging examination.

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Preliminary study on diplopore puncture of tympanum and intratympanic administration for management of acute secretory otitis media

Zulin TAN ; Yang ZHANG ; Xianrong XU ; Jidong ZHANG ; Zhanguo JIN

Journal of Clinical Otorhinolaryngology Head and Neck Surgery.2010;(1):16-18. doi:10.3969/j.issn.1001-1781.2010.01.005

Objective:To evaluate the therapeutical effects of diplopore puncture of tympanum and intratympanic administration(DPTIA) on patients with acute secretory otitis media(ASOM).Method:One hundred and forty -one cases with ASOM were divided into two groups randomly,with 69 cases(80 ears) in group A(experimental group) and 72 cases(84 ears) in group B(control group).Group A was treated with DPTIA combined with medication, group B was treated with haplopore puncture of tympanum combined with medication. All patients accepted 1 to 3 courses of treament,and were observed during the period of treatment and 3 months after treatment.Result:The factors (including gender, age, side of ailing ear, course of disease, air-bone gap in the pure tone average,and acoustic immitance type in ailing ear) which may impact the prognosis were matched in two groups prior treatment(P＞0.05). While there was a significant difference in the cure rate and the total effective rate respectively between two groups after treatment(P＜0.05).No adverse reaction or complication was seen.Conclusion:DPTIA is a safe, reliable and effective way to manage patients with ASOM.

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Comparative analysis of the recurrent mutations between Uigur and Han ethnic deaf group in Xinjiang region of China

Qi LI ; Ruping FANG ; Deliang HUANG ; Guojian WANG ; Xin LIU ; Pu DAI

Journal of Clinical Otorhinolaryngology Head and Neck Surgery.2010;(1):11-15. doi:10.3969/j.issn.1001-1781.2010.01.004

Objective:To investigate the recurrent mutations between Uigur and Han ethnic deaf group in Xinjiang region and determine the relationship between ethnicity and mutations.Method:DNA were extracted from peripheral blood of 125 deaf patients from Urumqi and Korla special educational schools in Xinjiang.Audiologic examinations showed that all patients had severe to profound bilateral sensorineural hearing hoss. The coding region of GJB2 gene, SLC26A4 and mitochondrial DNA target fragments were amplified by polymerase chain reaction(PCR).Mutations in GJB2 gene, SLC26A4IVS7-2 A>G, mtDNA 1494C>T and mtDNA1555 A>G were identified by sequencing analysis.Result:Allelic Frequency of the GJB2 35delG and SLC26A4IVS7-2 A>G mutations in Han deaf students were 7.4%and 10.1%,respectively, whereas not found in Uigur deaf groups.The difference was statistically significant. We did not find significant differences in GJB2 235 delC, 299-300delAT, mtDNA A1555G and C1494T allelic frequency between Uigur and Han students.Conclusion:Prevalence of the recurrent mutations between Uigur and Han ethnic deaf group in Xinjiang has a great diversity.

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Clinical experience in facial nerve tumors:A review of 27 cases

Fan ZHANG ; Yucheng WANG ; Chunfu DAI ; Fanglu CHI ; Liang ZHOU ; Bing CHEN ; Huawei LI

Journal of Clinical Otorhinolaryngology Head and Neck Surgery.2010;(1):4-7. doi:10.3969/j.issn.1001-1781.2010.01.002

Objective:To analyze the clinical manifestations and the diagnosis of the facial nerve tumor according to the clinical information, and evaluate the different surgical approaches depending on tumor location.Method:Twenty-seven cases of facial nerve tumors with general clinical informations available from 1999.9 to 2006.12 in the Shanghai EENT Hospital were reviewed retrospectively.Result:Twenty(74.1%) schwannomas,4 (14.8%)neuofibromas ,and 3(11.1%)hemangiomas were identified with histopathology postoperatively.During the course of the disease,23 patients(85.2%)suffered facial paralysis,both hearing loss and tinnitus affected 11 (40.7%)cases,5(18.5%)manifested infra-auricular mass and the others showed some of otalgia or vertigo or ear fullness or facial numbness/twitched. CT or/and MRI results in 24 cases indicated that the tumors originated from the facial nerve.Intra-operative findings showed that 24(88.9%)cases involved no less than 2 segments of the facial nerve,of these 24 cases 87.5%(21/24)involved the mastoid protion,70.8%(17/24)involved the tympanic protion, 62.5%(15/24)involved the geniculate ganglion, only 4.2%(1/24)involved the internal acoustic canal(IAC),and 3 cases (11.1%)had only one segments involved. In all of these 27 cases ,the tumors were completely excised,of which 13 were resected followed by an immediate facial nerve reconstruction,including 11 sural nerve cable graft,1 facial nerve end-to-end anastomosis and 1 hypoglossal-facial nerve end-to-end anastomosis.Tumors were removed with preservation of facial nerve continuity in 2 cases.Conclusion:Facial nerve tumor is a rare and benign lesion,and has numerous clinical manifestations.CT and MRI can help surgeons to make a right diagnosis preoperatively.When and how to give the patients an operation depends on the patients individually.

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Bilateral versus unilateral sudden sensorineural hearing loss

Maomei NI ; Dehong LI ; Weihui PENG ; Yikun PENG ; Juanjuan REN

Journal of Clinical Otorhinolaryngology Head and Neck Surgery.2010;(2):74-76. doi:10.3969/j.issn.1001-1781.2010.02.009

Objective:To analyze the clinical characteristics and treatment effect between bilateral(bi-)and unilateral(uni-) sudden sensorineural hearing loss(SSNHL).Method:Four hundred and eighty cases of SSNHL were retrospective study,which were divided into two groups of bi-SSNHL(n=40) and uni-SSNHL(n=440).Clinical characteristics and treatment effects were compared of the two groups.Result:The incidence rate of bi-SSNHL was 8.3 percent and uni-SSNHL was 91.7 percent of all patients with SSNHL. Bi-SSNHL occurs more commonly in patients of old age, diabetes mellitus, and lipid panes abnormalities compared to uni-SSNHL. Twenty-eight ears in the bi-SSNHL group showed hearing recovery (35%),compared with 56.4 percent of patients with uni-SSNHL.Conclusion:Bi-SSNHL and uni-SSNHL may have a completely different clinical characteristics and treatment effect,that implies a different pathophysiology and prognosis. Recognition their different clinical characteristics and treatment effect between bilateral and unilateral SSNHL can help in counseling and managing the patients and correctly evaluate the prognosis.

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Clinic analysis of cerebrospinal rhinorrhea in 24 cases

Hui LIAO ; Yonggang KONG ; Xiaolin HUANG ; Renzhong LIU ; Zezhang TAO ; Yuzhen WU

Journal of Clinical Otorhinolaryngology Head and Neck Surgery.2010;(2):71-74. doi:10.3969/j.issn.1001-1781.2010.02.008

Objective:To discuss the clinical experience of diagnosing and managing of cerebrospinal fluid(CSF)rhinorrhea.Method:Twenty-four cases of cerebrospinal rhinorrhea were analysed retrospectively from Janu 2003 to Sept 2008, among which 18 cases from department of Otolaryngology Head and Neck Surgery and 6 cases from Neurosurgery.Result:Postoperative follow-up lasted from 4 months to 72 months. All the cases were successfully cured, among which 6 cases with conservative treatment and 18 cases under surgery,and no relapse case was found. The 18 cases under surgery included endoscopic approach(12 cases), extra-nasal approach(4 cases), transnasal approach under microscope(2 cases).Conclusion:It is not only minimally invasive, safety and efficiency of transnasal endoscopic technique for CSF leaks, but also without facial scarring after operation. Transnasal endoscopic approach can be preferred for the closure of uncomplicated CSF leak, located at the cribriform plate or the sphenoid sinus. The extra-nasal or intracranial approach may be an attractive option for more complicated and large CSF leak, or the leak site is not easily found with endoscopic.

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Studying on patient's nasal cycle of OSAHS with acoustic rhinometry

Weihua XU ; Guangbin SUN ; Qin FANG ; Qun CHEN ; Na SUN ; Jingfei ZHANG ; Yi ZHANG ; Mingzhong REN

Journal of Clinical Otorhinolaryngology Head and Neck Surgery.2010;(2):69-70. doi:10.3969/j.issn.1001-1781.2010.02.007

Objective:To study the effect of OSAHS on adult nasal-cycle.Method:The nasal cycle of 20 healthy adults,18 patients of snoring and 22 patients of OSAHS were examined with acoustic rhinometry,which was performed every 30 minutes in 7 hours.Result:The ratio of nasal cycle in healthy adults was(19/20,95.0%), in snoring patients was(15/18,83.0%),in patients of OSAHS was(15/22,68.2%). The mean alteration amplitude of nasal cycle in healthy adults was significantly larger than that in patients with OSAHS (P<0.05).The distribution of the healthy adults and patients with OSAHS between the typical cycle categories was significantly different(P<0.05).Conclusion:The characteristics of nasal-cycle in of OSAHS patients were different with healthy adults,which maybe owing to change of physical function of nasal cavity.

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Clinical analysis of orbital apex syndrome caused by sinus diseases

Zhibin ZHAO ; Zheng FU ; Zhonglin MU ; Yenong TAN

Journal of Clinical Otorhinolaryngology Head and Neck Surgery.2010;(2):66-68. doi:10.3969/j.issn.1001-1781.2010.02.006

Objective:To investigate the clinical characters and therapeutic methods of orbital apex syndrome caused by sinus diseases.Method:Six cases of orbital apex syndrome originated from sinus diseases were retrospective analyzed in our hospital from August 2003 to February 2009. Different therapeutic methods were taken according to different causes of disease.Result:Four cases of sinus infection,one cases of sphenoethmoid mucocele , one cases of sinus squamous cell carcinoma. The results of patients with orbital apex syndrome included cure and effectiveness in 2 cases respectively, death from myocardial infarction in one case, and one case is still following up.Conclusion:Orbital apex syndrome originated from sinus diseases was rare, which was mainly caused by sinus infection . The key point is the correct etiology diagnosis in early phase . Treatment with endoscopic sinus surgery early is a good effective method for orbital apex syndrome caused by sinus diseases, in the same time with enough dosage of antibiotic and glucocorticoid therapy intravenously.

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