Objective To investigate the clinical value of otoendoscopic surgery for cholesteatoma of middle ear mastoid process through external auditory canal.Methods A C-shaped incision was made in the external auditory canal and then the external auditory canal flap was separated to expose the tympanic anulus.If the flaccid part of the eardrum was perforated,the tympanic anulus was lifted.If the pars tensa membranae tympani was perforated,the anterior inferior tympanic anulus was preserved to expose the tympanic cavity,and the granulation tissue was removed within the tympanic cavity.Under the continuous perfusion,the bone of the lateral wall of the upper tympanic cavity was grinded,the cholesteatoma around the attic and auditory ossicles was removed,the bone of the mastoid was grinded,and the mastoid cavity cholesteatoma was removed.Gelatin sponge support was placed in mastoid cavity and tympanic cavity.According to the degree of destruction of the auditory ossicles,different types of artificial ossicles were placed.Tragus cartilage covered with perichondrium or biofilm was placed on the surface of mastoid cavity and attic.The tympanic membrane was repaired by tragus perichondrium built-in method or tragus cartilage-perichondrium dissection method.Finally,the external auditory canal flap was paved and the surgical cavity was filled.Results The median threshold of airway hearing was 52.0 dB HL (range,33.8-67.5 dB HL) before surgery,which was significantly higher than that at 6 months after surgery[25.0 dB HL (range,15.0-50.0 dB HL),Z=-6.454,P=0.000].The median threshold of airway bone conduction hearing before the operation was 35.0 dB HL (range,21.2-52.5 dB HL),which was significantly higher than that at 6 months after surgery[15.0 dB HL (range,3.8-27.5 dB HL),Z=-6.453,P=0.000].All the patients were followed up at 2 weeks,and 1,3,and 6 months after surgery.Afterwards,follow-ups were performed every 3 months until 24 months after surgery.All the patients had good tympanum healing,and 2 patients had recurrence at 1 year after surgery.All the patients had no complications such as facial paralysis or sensorineural deafness.Conclusions Combining continuous and non-continuous perfusion,otoendoscopic surgery for cholesteatoma of middle ear mastoid process through external auditory canal has a high healing rate of eardrum,few complications,and significant postoperative hearing improvement.It is a minimally invasive,safe,and effective surgical method.

Objective To investigate the clinical value of otoendoscopic surgery for cholesteatoma of middle ear mastoid process through external auditory canal.Methods A C-shaped incision was made in the external auditory canal and then the external auditory canal flap was separated to expose the tympanic anulus.If the flaccid part of the eardrum was perforated,the tympanic anulus was lifted.If the pars tensa membranae tympani was perforated,the anterior inferior tympanic anulus was preserved to expose the tympanic cavity,and the granulation tissue was removed within the tympanic cavity.Under the continuous perfusion,the bone of the lateral wall of the upper tympanic cavity was grinded,the cholesteatoma around the attic and auditory ossicles was removed,the bone of the mastoid was grinded,and the mastoid cavity cholesteatoma was removed.Gelatin sponge support was placed in mastoid cavity and tympanic cavity.According to the degree of destruction of the auditory ossicles,different types of artificial ossicles were placed.Tragus cartilage covered with perichondrium or biofilm was placed on the surface of mastoid cavity and attic.The tympanic membrane was repaired by tragus perichondrium built-in method or tragus cartilage-perichondrium dissection method.Finally,the external auditory canal flap was paved and the surgical cavity was filled.Results The median threshold of airway hearing was 52.0 dB HL (range,33.8-67.5 dB HL) before surgery,which was significantly higher than that at 6 months after surgery[25.0 dB HL (range,15.0-50.0 dB HL),Z=-6.454,P=0.000].The median threshold of airway bone conduction hearing before the operation was 35.0 dB HL (range,21.2-52.5 dB HL),which was significantly higher than that at 6 months after surgery[15.0 dB HL (range,3.8-27.5 dB HL),Z=-6.453,P=0.000].All the patients were followed up at 2 weeks,and 1,3,and 6 months after surgery.Afterwards,follow-ups were performed every 3 months until 24 months after surgery.All the patients had good tympanum healing,and 2 patients had recurrence at 1 year after surgery.All the patients had no complications such as facial paralysis or sensorineural deafness.Conclusions Combining continuous and non-continuous perfusion,otoendoscopic surgery for cholesteatoma of middle ear mastoid process through external auditory canal has a high healing rate of eardrum,few complications,and significant postoperative hearing improvement.It is a minimally invasive,safe,and effective surgical method.

Objective To investigate the effect of exogenous interleukin-10 (IL-10) on STAT3 protein activation in rats with allergic rhinitis (AR).Methods60 SD rats were randomLy divided into AR model group, IL-10 group and control group, with 20 in each group.AR group and IL-10 group were treated with conventional ovalbumin (OVA) combined with aluminum hydroxide sensitization method.The negative control group was treated with saline instead of 48 h after the last challenge.The levels of IL-6, TGF-β and P-STAT3 in nasal mucosa and serum IgE were measured by ELISA kit.The expression of IL-6, TGF-β and P-STAT3 in nasal mucosa was detected by Western-blot Detection.ResultsAR group exhibited severe clinical manifestations of AR, such as friction around, tears flowing, the signs of which in IL-10 group were significantly lower than that in the control group (P<0.05).Compared with the control group, the levels of serum IgE and IL-6, TGF-β and P-STAT3 in the nasal mucosa were significantly higher than those in the control group (P<0.05).After treatment with IL-10, the levels of TGF-β and P-STAT3 were significantly increased (P<0.05).Western-blot showed that compared with the control group IL-6, TGF-β and P-STAT3 in nasal tissues of AR group and IL-10 group were significantly increased, while the expression level of IL-10 group was lower than that of AR group.ConclusionTreatment of AR with exogenous IL-10 can significantly relieve the clinical manifestation of AR, inhibit STAT3 activation immune response, and achieve the purpose of treatment of AR in some extent.

Objective To investigate the expression of IFN-γ, IL-5, IL-17 and TGF-βby Th cells and Th17 cells in rats with allergic rhinitis upon the intervention of IL-10.Methods SD rats were ran-domly divided into three groups including allergic rhinitis ( AR ) group, IL-10 treated group and control group (n=10).Rats in AR group and IL-10 treated group were sensitized by injection of ovalbumin (OVA) and aluminum hydroxide on the 1st, the 7th and the 14th days.The rats treated with equal volume of saline were set up as the control.The corresponding interventions ( OVA, OVA and IL-10, saline) were respec-tively given to rats in each group on the 21th day for 7 consecutive days.The clinical manifestations in rats were observed within 30 minutes after each administration.Serum samples were collected at 48 hours after the last challenge for the detection of IgE and OVA-sIgE.ELISA and Western blot assay were performed to detect IFN-γ, IL-5, IL-17 and TGF-βin nasal mucosa samples.Results Some characteristic symptoms of AR were observed in rats from AR group and IL-10 treated group.Compared with IL-10 treated rats, rats in AR group showed severe clinical symptoms such as constant rubbing and tearing of the eyes (P<0.05).The levels of IgE and OVA-sIgE in serum samples and the levels of IFN-γ, IL-5, IL-17 and TGF-βin nasal tis-sues were significantly increased in rats with RA (P<0.05), but were reduced with IL-10 intervention (P<0.05).Conclusion Exogenous IL-10 could be used to treat AR by reducing the expression of IFN-γ, IL-5, IL-17 and TGF-βin nasal tissues.

OBJECTIVE: The objective of this study was to evaluate the effect of nasal packing, septal suture technique and vacuum sealing drainage (VSD) after septoplasty. METHOD: Ninety patients of nasal septal deviation in Combination with outfracture of the inferior turbinates who had received septoplasty were selected in this study. The patients were allocated into three groups, with thirty in each: for packing group, marcel materials were used for nasal packing after septoplasty; for suturing group, septal suture technique was performed after septoplasty; for VSD group, one drainage tube was used for negative pressure sucking after septoplasty without nasal packing. Postoperative signs and symptoms were compared between three groups. The comfort degree assessment included headache and nasal obstruction were evaluated by using visual analogue scale (VAS) at the 12th hour and 24 hour after operation. The edema in nasal cavity, hemorrhage. abscess,adhesive and healing rates after operation were compared among three groups. RESULT: The VAS score of headache and nasal obstruction and the severity of patient's conditions were significantly less in septal suture group and VSD group than that in packing group at the 12th and 24th hour after operation. The mucosa edema of nasal cavity was significantly slighter in septal suture group and VSD group than that in packing group at the third day after operation. The healing rates and number of complications are better in septal suture group and VSD group than those in packing group at the 7th day after operation. There were no hemorrhage or abscess in VSD group. CONCLUSION Septal suture technique and VSD after septoplasty can significantly relieve the distress of patients and reduce the healing time of mucosa in nasal cavity without increasing the risk of complications.
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nasal Obstruction ; surgery ; Nasal Septum ; surgery ; Nasal Surgical Procedures ; Negative-Pressure Wound Therapy ; methods ; Postoperative Period ; Rhinoplasty ; methods ; Suture Techniques ; Young Adult