OBJECTIVE To explore the efficacy of using tragus perichondrium under otoscope without filling to repair small perforation of tympanic membrane.METHODS A retrospective analysis was conducted on the clinical data of 32 patients who underwent surgery for small perforation of tympanic membrane in the Department of Otolaryngology,the First Hospital of Jiaxing from July 2020 to December 2022.All patients were treated with endoscopic implantation of the tragus perichondrium for tympanic membrane repair.During the operation,the tympanic cavity and external auditory canal were completely unsupported by fillers,and the patient was followed up for 6 months postoperatively.Analyze the gas conduction hearing threshold and gas bone conduction difference before and after surgery,postoperative perforation healing rate,perforation healing time,VAS score,and incidence of complications.RESULTS Thirty-two cases of small perforation of tympanic membrane were successfully treated with surgery,and the postoperative perforation healing rate was 96.88%.The average healing time was(20.1±7.61)days,and the healing morphology was good.The postoperative average hearing threshold of air conduction[(19.84±5.55)dB HL]was significantly lower than the preoperative average hearing threshold of air conduction(31.56±6.69)dB HL,and the difference was statistically significant(t=14.77,P<0.05);The postoperative average air bone conduction difference[(8.87±3.64)dB]was significantly lower than the preoperative average air bone conduction difference[(20.50±3.27)dB],and the difference was statistically significant(t=14.41,P<0.05).The postoperative VAS score of 0-3 points accounts for 93.75%.There were 2 cases of postoperative tympanitis,1 case of unhealed tympanic membrane,and no secondary cholesteatoma or facial paralysis.CONCLUSION The minimally invasive treatment of small perforation of tympanic membrane using endoscopic implantation of the tragus perichondrium without filling is a minimally invasive and effective surgical method with high postoperative healing rate,good hearing rehabilitation effect,mild pain,and few complications.

Humans ; Laryngeal Diseases ; surgery ; Larynx ; surgery ; Microsurgery ; instrumentation ; Otorhinolaryngologic Surgical Procedures ; instrumentation ; Surgical Instruments

Hoarseness ; diagnosis ; etiology ; Humans ; Vocal Cord Paralysis ; complications ; diagnosis

AlM:To provide a proper assessment of the clinical use of orthokeratology by observing and analyzing the ocular biometric changes of the eyes and the stereopsis of the myopia.
METHODS:Sixty eyes from 30 myopia ( from 8 to 17 years old) were fitted with orthokeratology. Stereopsis, visual acuity, near visual acuity, central corneal thickness, anterior chamber depth, average anterior corneal refractive power ( K value ) , and intraocular pressure were measured before the orthokeratology treatment and 3mo after it. Refraction was expressed as spherical equivalent ( SE) , and the subjects were divided into 3 groups according to refraction: low myopia group (SE<-3.00D), moderate myopia group (-3. 00D≤SE<-6. 00D), and high myopia group (SE≥-6. 00D).
RESULTS:All subjects had significant improvements in visual acuity and near visual acuity 3mo after the orthokeratology treatment (P<0. 01). ln the comparisons of any pair of the groups, there was no significant difference in the near visual acuity ( P>0. 05 ). Three months after the orthokeratology treatment, Naked eye near stereoacuity values of all subjects were decreased (P<0. 01). There was no significant difference in the comparisons of the differences of stereopsis between any pair of the groups ( P> 0. 05 ). There was significant correlation in stereopsis and anisometropia ( Pearson coefficient r = 0. 778, P < 0. 01 ). And with greater anisometropia, the stereopsis was higher. All subjects had significantly lower K values than before 3mo after the orthokeratology treatment ( P< 0. 01 ). There was no significant difference in central corneal thickness, anterior chamber depth, and intraocular pressure (P>0. 05).
CONCLUSlON:Orthokeratology could lower K value in a short time and change the corneal curvature to correct myopia, to improve visual acuity and near visual acuity. lt also has an influence on improving stereopsis. There are no obviously changes in patients' central corneal thickness, anterior chamber depth or intraocular pressure after the orthokeratology treatment, making it a safe and effective treatment for adolescent.

AIM:To evaluate the availability and our experience of intraoperative image-guidance in endoscopic nasocular operation.METHODS:Seven cases of endoscopic nasal surgery with intraoperative image-guidance were retropectively reviewed,including 3 cases of optic nerve injury;3 cases of foreign object of optic behind the eyeball;1 case of retrobulbar tumor(angeioma).RESULTS:The preoperative preparatory time would take 15 minutes,including coordination,head holder localization,conventional instrument registration.In our cases,the localization accuracy between 3-D image landmarks of navigation system and actual anatomical landmarks was less than 1.3mm.The optic nerve and other anatomical points could be orientated accurately in intraoperative procedures.No complication occurred.CONCLUSION:Nasal endoscope combined with imageguidance systems provides accurate anatomical localization of anterior skull base with enlarged operation field.It is possible for surgeons to observe important anatomical structures during endoscopic surgery.It could increase the effectiveness and decrease surgical complications,especially in complicated cases.

·AIM: To study the effect of an intravitreal injection of angiostatin on vascular leakage in the retina and iris of oxygen-induced retinopathy of prematurity (ROP).·METHODS: Brown Norway rats at postnatal day 7 (P7) were exposed to hyperoxia (750mL/L O2 )for 5 days (P7-12) and then returned to normoxia to induce retinopathy. Angiostatin was reconstituted in sterile Phosphate Buffered Saline(PBS) and diluted to desired different concentrations. Angiostatin solution was injected into the vitreous of the right eye of the ROP rats at P14 and the age-matched normal rats through pars plana using a glass capillary, and the left eye received the same volume of sterile PBS as the control. Vascular permeability was quantified at 1, 2 and 3 days after the injection by measuring albumin leakage from blood vessels into the retina and iris using the Evans blue method and normalized by total protein concentrations. The expression of vascular endothelial growth factor (VEGF) in retina was evaluated using the Western Blot analysis and immuno-histochemistry 24 hours following the injection.·RESULTS: ROP rats showed significant increases of vascular permeability in the retina and iris (P<0.01). Angio-statin reduces vascular permeability in a dose-dependent manner in the retina of ROP rats. The reduction showed a time course trend. [Angiostatin injection reduced retinal vascular permeability by approximately 1.5 and 2-fold at P15 (P<0.05) and P16 (P<0.01), respectively.] Angiostatin injection significantly reduced VEGF levels in the retina of ROP rats but did not affect retinal VEGF levels in normal rats.·CONCLUSION: Angiostatin significantly decreases pa-thological vascular permeability in the retina and iris of ROP rats but not in normal rats. Angiostatin down-regulates VEGF expression in retina of ROP rats. These results suggest that angiostatin may have a therapeutic potential in the treatment of ROP and other diseases with vascular leakage.