1.Application of 3D-Flair MRI and vestibular function assessment in profound sudden sensorineural hearing loss patients
Qinglei DAI ; Wenping XIONG ; Yingjun WANG ; Na HU ; Xiao SUN ; Zhaomin FAN ; Haibo WANG ; Mingming WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(1):2-9
Objective:To analyse the 3D-Flair MRI manifestations of the inner ear, vestibular function status, and their correlation with hearing treatment outcomes in patients with severe sudden sensorineural hearing loss (SSNHL), and to explore potential prognostic indicators for sudden deafness.Methods:The clinical data of adult patients with unilateral profound sudden sensorineural hearing loss were retrospectively analyzed in Otorhinolaryngology Department of Shandong Provincial ENT Hospital from March 2018 to August 2020. Patients were categorized based on the results of their inner ear 3D-Flair MRI into two groups: the normal MRI group and the abnormal MRI group. The abnormal group was further divided into three subgroups: those with non-absorbed high signal in the inner ear, those with absorbed high signal, and those with destruction of the blood-labyrinth barrier. SPSS 26.0 statistical software was applied to analyze the differences in hearing efficacy, caloric tests, vestibular evoked myogenic potentials (VEMP), video head impulse tests (vHIT), and the incidence of dizziness/vertigo among various patient groups.Results:A total of 191 patients with complete data were collected (97 males and 94 females, aged from 13 to 69 years old). There were 50 cases in the normal inner ear 3D-Flair MRI group. A total of 141 cases were found in the group with abnormal 3D-Flair MRI, including 50 cases of high signal unabsorbed, 71 cases of absorption high signal and 20 cases of blood labyrinth barrier destruction. There were no significant differences in age, sex, lateral ratio of hearing loss and course of disease among four groups (all P>0.05).The significant efficiencies of hearing recovery, in the group with normal 3D-FLAIR MRI were better than those in the abnormal group ( P<0.05) after treatment. Among the four groups, there were significant differences in the apparent efficiency and total effective rate between the normal group and the inner ear high signal absorption group ( χ2=4.007, P=0.045; χ2=6.925, P=0.009). The abnormal rates of bithermal caloric test, vHIT results and dizziness/vertigo symptoms in the abnormal group were higher than those in the normal group ( P<0.05). There were significant differences in oVEMP abnormality rate, vHIT abnormality rate and incidence of dizziness/vertigo among the three groups with 3D-FLAIR MRI abnormality ( P<0.05). There were significant differences in caloric test, oVEMP, vHIT abnormality rate and incidence of dizziness/vertigo among the four groups ( P<0.05). The positive rates of caloric test, cVEMP test and vHIT test in patients with dizziness/vertigo were higher than those in patients without dizziness/vertigo ( P<0.05). The abnormal rates of posterior semicircular canal and horizontal semicircular canal in patients with dizziness/vertigo were significantly increased ( P<0.05) than patients without dizziness/vertigo. The recovery rate, effective rate and total effective rate of patients without dizziness/vertigo were significantly better than those with dizziness/vertigo ( P<0.05). Conclusions:The 3D-Flair MRI of the inner ear and vestibular function tests have reference value for the prognosis assessment of patients with severe sudden sensorineural hearing loss. Abnormal 3D-FLAIR MRI of the inner ear, especially absorption high signal, is associated with high incidence of vestibular dysfunction and dizziness/vertigo, with poor prognosis. Patients with severe sudden sensorineural hearing loss who have symptoms of dizziness/vertigo are more likely to exhibit abnormal results in vestibular function tests, with a higher susceptibility to involvement of the posterior and horizontal semicircular canals.
2.A clinical study of electrocochleography monitoring for residual hearing retention during minimally invasive cochlear implant.
Ruijie WANG ; Jianfen LUO ; Qinglei DAI ; Xiuhua CHAO ; Yifei NI ; Fangxia HU ; Yueran CAO ; Haibo WANG ; Xiaohui ZHOU ; Lei XU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(5):425-432
Objective:To investigate the application value of intraoperative electrocochleography(ECochG) monitoring technique and insertion techniques in cochlear implant(CI) and analyze its relationship with postoperative residual hearing(RH) preservation. Methods:Thirty-one patients(35 ears) who received CI in our hospital from June 2022 to July 2024 were enrolled. The Advanced Bionics Active Insertion Monitoring(AIM) system was used for real-time ECochG monitoring during surgery. Intraoperative cochlear microphonics (CM) waveform changes were recorded and analyzed in relation to postoperative RH preservation. Results:①ECochG recordings were successfully obtained in 34 of 35 ears (97.1%). ②According to Harris classification, there were 7 ears(20.6%) of Type A(rising), 7 ears(20.6%) of Type C(declining), 8 ears(23.5%) of Type CC(fluctuating), and 12 ears(35.3%) of Type D(no response). ③The total CM amplitude decrease was significantly moderately correlated with postoperative low-mid frequency hearing loss(r=0.67, P=0.017). The total CM amplitude decrease was significantly moderately correlated with postoperative low frequency hearing loss(r=0.65, P=0.023). ④For the mean amplitude variation, the Amax was 30.70 μV, the Amin was 8.64 μV, and the Aend was 18.27 μV. ⑤Sixteen cases completed postoperative follow-up, with an average low-mid frequency(125-1 000 Hz) residual hearing loss of 15.25 dB HL and a RH preservation rate of 87.5%. Conclusion:Intraoperative ECochG monitoring can effectively predict postoperative residual hearing changes, effectively guide surgical manipulation, and improve residual hearing preservation rate.
Humans
;
Cochlear Implantation/methods*
;
Audiometry, Evoked Response
;
Cochlear Implants
;
Male
;
Female
;
Adult
;
Middle Aged
;
Monitoring, Intraoperative
;
Adolescent
;
Young Adult
;
Minimally Invasive Surgical Procedures
;
Child
;
Aged
;
Postoperative Period
3.Application of 3D-Flair MRI and vestibular function assessment in profound sudden sensorineural hearing loss patients
Qinglei DAI ; Wenping XIONG ; Yingjun WANG ; Na HU ; Xiao SUN ; Zhaomin FAN ; Haibo WANG ; Mingming WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(1):2-9
Objective:To analyse the 3D-Flair MRI manifestations of the inner ear, vestibular function status, and their correlation with hearing treatment outcomes in patients with severe sudden sensorineural hearing loss (SSNHL), and to explore potential prognostic indicators for sudden deafness.Methods:The clinical data of adult patients with unilateral profound sudden sensorineural hearing loss were retrospectively analyzed in Otorhinolaryngology Department of Shandong Provincial ENT Hospital from March 2018 to August 2020. Patients were categorized based on the results of their inner ear 3D-Flair MRI into two groups: the normal MRI group and the abnormal MRI group. The abnormal group was further divided into three subgroups: those with non-absorbed high signal in the inner ear, those with absorbed high signal, and those with destruction of the blood-labyrinth barrier. SPSS 26.0 statistical software was applied to analyze the differences in hearing efficacy, caloric tests, vestibular evoked myogenic potentials (VEMP), video head impulse tests (vHIT), and the incidence of dizziness/vertigo among various patient groups.Results:A total of 191 patients with complete data were collected (97 males and 94 females, aged from 13 to 69 years old). There were 50 cases in the normal inner ear 3D-Flair MRI group. A total of 141 cases were found in the group with abnormal 3D-Flair MRI, including 50 cases of high signal unabsorbed, 71 cases of absorption high signal and 20 cases of blood labyrinth barrier destruction. There were no significant differences in age, sex, lateral ratio of hearing loss and course of disease among four groups (all P>0.05).The significant efficiencies of hearing recovery, in the group with normal 3D-FLAIR MRI were better than those in the abnormal group ( P<0.05) after treatment. Among the four groups, there were significant differences in the apparent efficiency and total effective rate between the normal group and the inner ear high signal absorption group ( χ2=4.007, P=0.045; χ2=6.925, P=0.009). The abnormal rates of bithermal caloric test, vHIT results and dizziness/vertigo symptoms in the abnormal group were higher than those in the normal group ( P<0.05). There were significant differences in oVEMP abnormality rate, vHIT abnormality rate and incidence of dizziness/vertigo among the three groups with 3D-FLAIR MRI abnormality ( P<0.05). There were significant differences in caloric test, oVEMP, vHIT abnormality rate and incidence of dizziness/vertigo among the four groups ( P<0.05). The positive rates of caloric test, cVEMP test and vHIT test in patients with dizziness/vertigo were higher than those in patients without dizziness/vertigo ( P<0.05). The abnormal rates of posterior semicircular canal and horizontal semicircular canal in patients with dizziness/vertigo were significantly increased ( P<0.05) than patients without dizziness/vertigo. The recovery rate, effective rate and total effective rate of patients without dizziness/vertigo were significantly better than those with dizziness/vertigo ( P<0.05). Conclusions:The 3D-Flair MRI of the inner ear and vestibular function tests have reference value for the prognosis assessment of patients with severe sudden sensorineural hearing loss. Abnormal 3D-FLAIR MRI of the inner ear, especially absorption high signal, is associated with high incidence of vestibular dysfunction and dizziness/vertigo, with poor prognosis. Patients with severe sudden sensorineural hearing loss who have symptoms of dizziness/vertigo are more likely to exhibit abnormal results in vestibular function tests, with a higher susceptibility to involvement of the posterior and horizontal semicircular canals.
4.Efficacy of bismuth containing quadruple therapy in the treatment of peptic ulcer in patients with Helicobact-er pylori
Mingwan JIANG ; Shuang YU ; Qinglei WANG ; Hui LIU ; Kehang DAI
Chinese Journal of Primary Medicine and Pharmacy 2016;23(15):2297-2300
Objective To explore the efficacy of bismuth containing quadruple therapy in the treatment of peptic ulcer in patients with Helicobacter pylori.Methods We selected 307 peptic ulcer patients with Helicobacter pylori.infection,and randomly divided them into observation group (152 cases)and control group (155 cases).The observation group received quadruple therapy:colloidal bismuth pectin,pantoprazole,amoxicillin and furazolidone, 14d.The control group received the standard triple therapy:pantoprazole,clarithromycin and amoxicillin,14d.The ulcer healing rate,H.pylori eradication rate and adverse reaction were compared between the two groups.Results The ulcer healing rates,remission rates,H.pylori eradication rates in the observation group were 93.5%,92.7%, 94.8%,92.3% respectively,which in the control group were 83.4%,82.7%,84.1%,80.6% respectively,there were statistically significant differences (χ2 =4.15,4.9,6,0.94,all P <0.05).The incidence of adverse reactions did not differ significantly between the two groups (P >0.05).Conclusion Bismuth containing quadruple therapy is associated with a higher rate of H.pylori eradication compared with the standard triple therapy.

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