Objective:To report the experience of the application of internal carotid artery stent in skull base surgery, and to clarify the important role of internal carotid artery stent in skull base surgery.Methods:A retrospective study of 22 cases with skull base neoplasms implanted with internal carotid artery stents in the Department of ENT Head and Neck Surgery at the Sixth People′s Hospital affiliated with Shanghai Jiao Tong University between July 2019 and January 2021 was conducted. Among them, 17 were male and 5 were female, aged between 33 and 75 years. There were 5 cases on the left, 16 cases on the right, and 1 case on both sides. Of these, there were 4 cases of jugular paraganglioma, 1 case of chondrosarcoma in the jugular foramen, 1 case of carotid body paraganglioma, and 16 cases of nasopharyngeal carcinoma after radiotherapy.Results:The degree of internal carotid artery erosion was assessed by computed tomography angiography (CTA), magnetic resonance imaging and digital subtraction angiography (DSA) images in 22 patients before surgery. It was found that the internal carotid artery was involved to varying degrees in all patients, so internal carotid artery stents were implanted before surgery. Tumor tissue was found to surround the internal carotid artery to varying degrees. Total or subtotal tumor resection was performed in all patients, and no intraoperative and postoperative complications occurred. The postoperative follow-up was 5 months to 2 years, and all patients had no complications such as spontaneous bleeding and pseudo aneurysm. There were no signs of stenosis or occlusion of the internal carotid artery stent segment in all cases.Conclusions:For patients with skull base tumors, preoperative imaging indicates the limited involvement of the internal carotid artery, and internal carotid artery stent implantation before surgery is a safe and effective treatment.

Persistent geotropic direction-changing positional nystagmus (DCPN) has been described in recent years as no latency or fatigability but a null plane when head is turned toward the affected side. Different from the canalolithiasis of horizontal semicircular canal, it is similar with cupulolithiasis, but the direction of nystagmus are opposite. Light cupula theory has been used to explain the characteristics of this unique nystagmus. In this paper, the characteristics, possible etiologies, pathogenesis, related diseases, diagnosis, treatment and prognosis of DCPN are reviewed.

Objective To establish an auditory evoked potential (AEP) detection system in zerbafish.Methods The AEP detection tank was designed and made, and then verified for its quality and reliability via four experiments: anesthesia experiment, swim bladder deflation, noise exposure and goldfish AEP test.Finally, zebrafish (total length form 10 mm to 46 mm) were determined using this system for AEP.Zebrafish randomly were divided into five groups according to total length (TL=12~15 mm, n=6;TL=17~20 mm,n=4;TL=22~26 mm, n=4;TL=32~37 mm, n=9;and TL=42~46 mm,n=12).Goldfish, as control group, were purchased for local petshop (TL=38~54 mm,n=8).Results The results of these four verifying experiments confirmed the biological, rather than artefactual, nature of the responses represented by the recorded waveforms.The AEPs were detected up to a much higher frequency limit (12 kHz) than previously reported.In this study, all fish demonstrated a range of hearing frequency from 100 Hz to 12 kHz without frequency expansion during development.The best hearing was observed at 600 Hz~1 kHz.The mean values of the frequency-averaged thresholds (mean SEM) were 141.7±1.32, 124.8±1.31, 121.8±1.49, 117.8 ±1.09 and 124.4±1.87 dB w, respectively, for the 5 TL groups.The AEP thresholds demonstrated both developmental improvement and age-related loss of hearing sensitivity.Conclusion An auditory evoked potential detection system of zerbafish has been established with stable performance and can be used for AEP detection of zebrafish.

OBJECTIVE: To examine the value of self-treatment for Posterior canal benign paroxysmal positional vertigo (PC-BPPV). The treatment effect was compared between patients treated with modified Epley in outpatient clinic combined with self treatment at home and patients treated by modified Epley alone. METHOD: A randomized controlled trial were carried out in the Department of Otolaryngology Head and Neck Surgery, the Affiliated Sixth People's Hospital of Shanghai Jiao Tong University from December 2012 to May 2013. 147 out of 150 patients with unilateral idiopathic BPPV-PSC were enrolled in follow-up. Among which, 73 patients were allocated in modified Epley-alone group and 74 were allocated in slef-treatment group. RESULT: The success rate was 53.4% in modified Epley-alone group vs 83.8% in self-treatment group (P < 0.01) after 1 week treatment. In the modified Epley-alone group,the success rate of hand repositioning group and chair-assisted repositioning group was 45.9% vs 61.1% (P > 0.05), the risk rate was 0.752, 95% CI (0.486 - 1.163). In the self-treatment group, the success rate of hand repositioning group and chair-assisted repositioning group was 87.5% vs 81.0% (P > 0.05), the risk rate was 1.081, 95% CI (0.888-1.316). Incidence rate of serious complications was 0% in the modified Epley-alone group and 1.3% in the self-treatment group (P > 0.05). CONCLUSION Complementary self-treatment with modified Epley maneuver treated PC-BPPV sooner and more effectively, Compared with modified Epley maneuver alone. And its incidence rate of serious complications didn't increase. Chair-assisted repositioning showed better result than hand repositioning alone, and self-treatment at home can reduce the effect of the gap. We found that complementary self-treatment with modified Epley maneuver had more benefits for patients with PC-BPPV.
Aged ; Benign Paroxysmal Positional Vertigo ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Patient Positioning ; methods ; Self Care ; Treatment Outcome

Objective:To investigate lesion size caused by channel radiofrequency volumetric reduction of por-cine tongue base in vitro using the technique of three-dimensional reconstruction. And to evaluate safety about channel radiofrequency volumetric reduction of tongue base. Method: Eighteen fresh porcine tongues were randomly separated into six groups,and each group had three ones. The tongue bases were designed six points according to description of Powell. Tongues base were acted on 10 s and 6 level by Coblation radiofrequency system and were cut into serial freezing histological sections. These segments were sectioned at 20 μm on the injury lesion and stained with H & E. Collected 2D digital imagine of order histological sections, drawn and cut apart part of the le-sion of these sections. Images were procesed IPS and were taken three-dimensional reconstruction and statistics an-alyzes with SPSS10. 0. Result: The mean value of tongue base lesion volumes among points was (359. 5± 5. 6)mm~3 ,(364. 3±7. 0)mm~3 ,(363. 7±7. 2)mm~3, (354. 1±11. 8)mm~3, (349. 4±17. 2)mm~3 ,(353. 5±7. 9)mm~3 separately. Statistic analysis by one-way ANOVA showed that there was a insignificant difference between the groups(P>0. 05). Conclusion:These results demonstrated no significant effect lesion size in channel radiofrequency volumetric reduction in the different points of the tongue base. These data also indicated that coblation radiofre-quency system is a safe method for obstructive sleep apnea hypopnea syndrome.

OBJECTIVE: To investigate the methodology and efficacy of endoscopic sphenopalatine artery diathermy in management of refractory epistaxis. METHOD: Twenty patients with severe intractable posterior epistaxis, who had underwent various procedures like nasal packing, electro- or chemical cautery or others and still exacerbated, were subjected to this study. Under general anesthesia, according to the endoscopic anatomy of the sphenopalatine foramen, the sphenopalatine artery was identified under the posterior tip of the middle turbinate. After the pedicle of the artery was delineated, a bipolar cauterized the artery and transected it. RESULT: Twenty patients have been followed up for 5 to 20 months with an average of 10 months. No patients suffered recurrent epistaxis during the period. Only 1 patients in this series reported minor nasal adhesion. CONCLUSION Diathermy of sphenopalatine artery, as a purely endonasal procedure, is an effective and microinvasive means of achieving long-term control of refractory epistaxis. It has few complications associated with other forms of arterial ligation.
Adult ; Aged ; Diathermy ; methods ; Endoscopy ; Epistaxis ; surgery ; Female ; Humans ; Male ; Maxillary Artery ; surgery ; Middle Aged ; Treatment Outcome

OBJECTIVE: To investigate lesion size caused by channel radiofrequency volumetric reduction of porcine tongue base in vitro using the technique of three-dimensional reconstruction. And to evaluate safety about channel radiofrequency volumetric reduction of tongue base. METHOD: Eighteen fresh porcine tongues were randomly separated into six groups,and each group had three ones. The tongue bases were designed six points according to description of Powell. Tongues base were acted on 10 s and 6 level by Coblation radiofrequency system and were cut into serial freezing histological sections. These segments were sectioned at 20 microm on the injury lesion and stained with H & E. Collected 2D digital imagine of order histological sections, drawn and cut apart part of the lesion of these sections. Images were processed IPS and were taken three-dimensional reconstruction and statistics analyzes with SPSS10.0. RESULT: The mean value of tongue base lesion volumes among points was (359.5 +/- 5.6) mm3, (364.3 +/- 7.0) mm, (363.7 +/- 7.2) mm3, (354.1 +/- 11.8) mm3, (349.4 +/- 17.2) mm3, (353.5 +/- 7.9) mm3 separately. Statistic analysis by one-way ANOVA showed that there was a insignificant difference between the groups (P>0.05). CONCLUSION These results demonstrated no significant effect lesion size in channel radiofrequency volumetric reduction in the different points of the tongue base. These data also indicated that coblation radiofrequency system is a safe method for obstructive sleep apnea hypopnea syndrome.
Animals ; Catheter Ablation ; adverse effects ; methods ; In Vitro Techniques ; Sleep Apnea, Obstructive ; surgery ; Surgery, Computer-Assisted ; Swine ; Tongue ; injuries ; surgery ; Treatment Outcome

OBJECTIVETo explore the feature of nasal mucosa remodeling in experimental allergic rhinitis.

METHODSTwenty-four male Hartley guinea pigs (4 weeks, 250 -300 g) were randomly divided into four groups (control group and allergen exposure groups 1 - 3), each group had 6 guinea pigs. Allergen exposure animals were sensitized by intraperitoneal (ip) injection of ovalbumin (OVA). Sensitized guinea pigs were subjected to either brief or prolonged exposure to allergen. Both brief exposure group (allergen exposure groups) and prolonged exposure group (allergen exposure group 2 and 3) received a daily intranasal challenge with 5% OVA in 0.9% saline from Day 22 to Day 28, the prolonged exposure group (allergen exposure group 2 and 3) followed by twice weekly exposure to 5% OVA intranasal for an additional 8 and 12 weeks respectively. Control animals were given saline only. At 24 h after the last intranasal challenge, the guinea pigs were killed and the heads of the animals were removed and fixed in 10% neutral buffered formalin for 24 hours, then decalcified in 5% trichloroacetic acid for 10 days. The tissue blocks were embedded in paraffin. The paraffin sections 3 microm thick were stained with hematoxylin and eosin (HE), alcian blue (pH, 2. 6)-periodic acid-Schiff (AB-PAS), and Masson's Trichrome (MT). The infiltrating eosinophils in nasal mucosa were examined, AB-PAS-positive cells in the surface epithelium in nasal septal mucosa were counted. The percentage area of MT stained extracellular matrix in septal mucosa and conchae and damage of epithelium were determined by an image analyzer.

RESULTSThe control group only presented a few eosinophils. Significant eosinophil infiltration was observed in the sensitized groups. Compared with control group (intact epithelium 87.7% +/- 11.1%), there was no significant epithelial damage in 1 week exposure group. Significant epithelial damage were observed in 8 and 12 weeks groups (intact epithelium 36.7% +/- 16.9%, 37.9% +/- 12.9%, respectively). An increase in AB-PAS-positive cells was observed in the mucosa of nasal septum in the prolonged allergen exposure groups, but not in the brief allergic inflammation group in comparison with the control. The brief OVA exposure group did not show increased collagen fibrils within the mucosa of nasal septum and conchae. In contrast, after prolonged OVA exposure an increase in matrix was observed. Furthermore, in both the nasal septum and conchae, significant increasing of ECM deposition was found in a further prolonged exposure for 12 weeks compared to 8 weeks.

CONCLUSIONSEpithelial damage, goblet cells hyperplasia and extracellular matrix deposition were observed as the features of remodeling in this guinea pig model of allergic rhinitis.

Animals ; Disease Models, Animal ; Eosinophils ; immunology ; Epithelial Cells ; pathology ; Extracellular Matrix ; pathology ; Goblet Cells ; pathology ; Guinea Pigs ; Male ; Mice ; Nasal Mucosa ; cytology ; pathology ; Rhinitis, Allergic, Perennial ; immunology ; pathology

Aim To investigate the effects of progesterone on morphine rewarding effect and levels of endogenous opioid peptides in hypothalamus of rat brain. Methods Conditioned place preference(CPP)test was used to investigate the morphine rewarding effect, and radioimmunoassay (RIA) was established to deter-mine levels of ?-endorphin(?-EP), leu-enkephalin(L-EK) and dynorphin A(DynA) in hypothalamus of rat brain.Results Compared with NS control group, 5 mg?kg-1 morphine successfully induced the formation of CPP(P

Objective To explore the characteristics of field potentials within vestibular nuclei evoked by electrical stimulus.Methods Double silver electrodes were placed on the surface of the round window.The vestibular nuclei field potential was recorded under the condition of electrical stimulus.Results The field potential consists of a negative wave(N1),the threshold was 0.59?0.07 mA or 0.90?0.50 V,the latency of N1 peak was 1.20?0.13 ms.When double stimuli were applied,no response was noted.The second stimulus or the response was small if the time interval was less than 4 ms.Conclusion Evoked vestibular nuclei potential can be obtained by peripheral labyrinth electrical stimulus,which is quite stable.