[Study on the measurement of glottic proportion in subjects with normal larynx].

Objective:The aim of this study is to explore the glottic proportion（GP） and gender difference in Chinese subjects with normal larynx. Methods:Two hundred patients with normal larynx in Sixth Medical Center of PLA General Hospital from January 2017 to December 2019 were selected as the experimental group. Group 1 included 100 females and group 2 included 100 males. Sixty patients with normal larynx in the Pontes article were selected as the control group, including 30 females as group 3 and 30 males as group 4. Results:The GP range in group 1 was 0.78-1.76, with a mean of 1.24; 0.82-2.20 in group 2, with a mean of 1.37; 0.91-1.20 in group 3, with a mean of 1.04; 1.07-1.44 in group 4, with a mean of 1.21. Statistical analysis showed that the data of the four groups were normal distribution, the standard deviation was 0.16 in group 1, 0.26 in group 2, 0.08 in group 3, 0.10 in group 4, and the test of homogeneity of variance was P<0.05. Games-Howell test was used for multi-group analysis, including group 1 and group 2, group 3 and group 4, group 1 and group 3, group 2 and group 4. The statistical results of the four groups all showed P<0.05, indicating that there were statistical differences. Conclusion:On the whole, the average GP of male group was higher than that of female, but not all males have a greater GP value than females. In the range of high GP value, males accounted for a large proportion, while in the range of low GP value, females accounted for a large proportion. In the past, most articles regard men and women as two groups to study the glottic proportion, and it was suggested that more attention should be paid to individual differences when discussing glottic proportion and related laryngeal diseases.

Short-term outcome of transcutaneous glucocorticoid injection for laryngeal contact granuloma in females.

OBJECTIVE: To evaluate the short-term efficacy of transcutaneous glucocorticoid injection for laryngeal contact granuloma in females. METHODS: A total of 14 female patients with laryngeal contact granuloma treated in our outpatient department from November 2017 to January 2020 were included in the study. Inspiratory-phase laryngoscopy images were collected before treatment and 1 month after each injection, and the lesion size was measured and evaluated with ImageJ software. RESULTS: Two patients achieved complete remission after one injection, with a percent reduction of 100%. After two injections, 4 patients achieved complete remission, with a percent reduction ranging from 96% to 100%. After 3 injections, 4 patients achieved complete remission (including one patient with bilateral lesions), and the percent reduction ranged from 95% to 100%. Three patients achieved incomplete remission, with a percent reduction of 46%, 55%, and 81%, respectively. In one case, there was no remission, and the granuloma increased in size after treatment. CONCLUSION: In women with laryngeal contact granuloma, transcutaneous glucocorticoid injection therapy can quickly resolve the granuloma in a short period.

[Clinical analysis of 46 cases of female laryngeal contact granuloma].

Objective:To investigate the clinical characteristics, diagnosis and treatment of female laryngeal contact granuloma. Method:The clinical data of 46 female patients with laryngeal contact granuloma diagnosed and treated by our clinical team from March 2011 to October 2018 were retrospectively analyzed. Result:The age of the 46 patients ranged from 5 to 58 years old, with an average age of 36.76 years old. The causes of the contact granulomas historically may be the result of intubation in 33 cases, laryngopharyngeal reflux in 8 cases, chronic cough in 2 cases, laryngopharyngeal reflux combined with chronic cough in 2 cases, and voice abuse and excessive clearing of the throat in one case. All patients were followed up for at least half a year, and all of them were cured. Among the 6 patients with large lesions who underwent surgical treatment, 3 relapsed within 3 months, PPI treatment was performed for 2 to 6 months after recurrence, and no recurrence was observed during follow-up, with an average course of treatment of （1.67±2.34） months. All the 11 patients who received corticosteroid injections recovered after 1 to 7 injections, with a median of 3 injections, and an average course of treatment of （2.64±1.69） months. All the 13 patients with oral PPI were cured, with an average course of treatment of （4.15±2.76 ）months; No recurrence was found in the follow-up of 16 patients with conservative treatment under regular observation, with an average course of treatment of （5.88±3.76） months. The difference in cure time between the intervention group （30 cases） and the observation group （16 cases） was statistically significant, and the cure time of the intervention group was shorter than that of the observation group （H=11.902, P=0.008）. Conclusion:Female patients with laryngeal contact granuloma are common after intubation, and various treatments or conservative observation can achieve good results, and treatment intervention may shorten the cure time.

The role of nonacid reflux in laryngopharyngeal reflux diseases.

OBJECTIVE: To analyze the role of nonacid reflux in laryngopharyngeal reflux diseases (LPRD). METHODS: From January 2014 to April 2019, 344 patients associated with LPRD underwent 24-h multichannel intraluminal impedance-pH monitoring, and their reflux symptom index (RSI) and reflux finding score (RFS) were recorded. The numbers of acid, weakly acidic and alkaline reflux events in the laryngopharynx were counted, and the consistency analysis of the results with the results of the RSI and RFS was conducted. RESULTS: Among the 344 patients, nonacid reflux events accounted for 74.1% (1367/1845) of the all reflux events. There were 111 patients with ≥ 3 acid reflux events, 218 patients with ≥ 3 any kinds of reflux events, and 257 patients with positive results of RSI or RFS. Taking the results of the RSI and or RFS as a reference, the sensitivity, specificity and consistency test Kappa value for the diagnosis of LPRD according to the existence of ≥ 3 acid reflux events were 41.2%, 94.2% and 0.228, respectively. With the existence of three or more all kinds of reflux events as the standard, the sensitivity, specificity and consistency test Kappa value were 76.7%, 74.7% and 0.449, respectively. CONCLUSION: The nonacid reflux events account for the highest proportion of laryngopharyngeal reflux events, and the consistency of the results of RSI and or RFS with all reflux events is higher than that with only acid reflux events, that indicates nonacid reflux may play an important role in LPRD.

[Prognostic factors of sudden sensorineural hearing loss in children].

OBJECTIVE: The aim of this retrospective study was to analyze the recovery rate of sudden sensorineural hearing loss in children, and explore the prognostic factors in order to guide the clinical diagnosis and treatment. METHOD: A retrospective review was conducted for the prognosis of children with sudden sensorineural hearing loss during the past 5 years (from November 2010 to May 2015) in Chinese PLA General Hospital. This paper have a complete clinical data of 101 patients (113 ears)with sudden hearing loss, ranging from 0 to 18 years old Patients were divided into four groups according to hearing recovery and eight putative prognostic factors were analyzed. RESULT: Among 101 patients (113 ears), the ratio of male and female was 60:53. Treatment was initiated from 1 to 183 days after disease onset, with an average of (18.5 ± 22.1) d. Bilateral and unilateral hearing loss were 24 ears and 89 ears, respectively. The proportion of mild hearing loss, moderate hearing loss, severe hearing loss and profound hearing loss were 7.1%, 6.2%, 23.9% and 62.8%, respectively. Vertigo and tinnitus occurred in 54.9% and 77.9% of the patients, respectively. After the treatment, the complete recovery rate was 9.7% and the overall recovery rate was 36.3%. The degree of hearing loss, earlier treatment onset, sex and bilateral involvement were significantly associated with hearing recovery (P < 0.05). CONCLUSION: Sudden sensorineural hearing loss in children was generally identified as severe and profound hearing loss, but after positive and timely treatment, it can be improved or even cured. The mild hearing loss, earlier treatment onset, unilateral hearing loss and female were positive prognostic factors. The concurrence of tinnitus or vertigo, the results of ABR and DPOAE had no significant influence on prognosis.