In vitro study on signal transduction in mice spiral ganglion cell stimulated by multi-wavelength laser based on calcium imaging / 中华耳鼻咽喉头颈外科杂志

Objective@#To research the auditory nerve transduction effects under multi-wavelength pulsed laser stimulations within a safe and acceptable signal range.@*Methods@#The real-time detection of intracellular calcium concentration was adopted by specific fluorescent indicator staining based on calcium imager. The spiral ganglion cells of mice were cultured in vitro. After fluorescent indicating, morphologic observation under optical microscope, Fura-2 calcium ion fluorescence excitation, intact morphology cells selection, fixing the optical fiber, the spiral ganglion cells were irradiated by different wavelength laser, including visible light (450 nm) and near infrared light (808 nm,1 065 nm). The intracellular calcium concentration was monitored by calcium ion imaging.@*Results@#When 450 nm laser stimulated spiral ganglion cells, the intracellular calcium concentration was strongly increased, however, for other wavelength laser stimulation, there was no obvious relative response. And the sensitivity expression of the nerve cells under laser was related with the location of laser fiber. Cells closer to the fiber produced more obvious changes in calcium ion concentration, while for cells farther away from the fiber, the change amplitudes were weaker although the number of changes in calcium ion concentration was consistent.@*Conclusion@#The spiral ganglion cells of mice can induce a signal transduction response under the action of laser, and the response has laser wavelength selectivity.

Evaluation of the electrode position by CBCT following cochlear implantation / 中华耳鼻咽喉头颈外科杂志

Objective@#To observe the position of the electrode in the cochlea following cochlear implantation by cone beam computed tomography (CBCT).@*Methods@#Twenty-five children who received cochlear implantation and CBCT examinations in the Department of Otorhinolaryngology Head and Neck Surgery from the Second Hospital of Shandong University between January 2016 and December 2017 were selected. There were 15 males (17 ears) and 10 females (10 ears). The age ranged from 0.5 to 7.0 years old, with a median age of 1.6 years. 23 patients with unilateral implantation and two patients with bilateral implantation. The implants were all Med-El standard 12-electrode contact arrays. The CBCT was used to determine the position of the electrode in the cochlea, the distance between the electrode contacts and modiolus, and intracochlear insertion length of the electrode arrays. SPSS Statistics, version 22.0 was used for data processing and statistical analysis.@*Results@#CBCT images could clearly demonstrate the structure of round window, oval window, modiolus, osseous cochlear duct, osseous spiral lamina, and electrodes. The electrode arrays of all the children were fully implanted into the cochlea. 26 of the electrode arrays were located in the scala tympani and one of them was inserted into the scala vestibular. The mean intracochlear insertion length of the electrode arrays was 30.23 (95%CI, 30.04-30.71) mm. The distance between the electrode contacts and modiolus gradually increased at the 1-4th electrode contacts and reached the maximum at the 4th electrode contacts with an average of 1.10 mm (95%CI, 1.02 to 1.18 mm), and then gradually decreased from the 5th electrode contacts.@*Conclusions@#CBCT can clearly show cochlear fine structures and therefore accurately assess the electrode position following cochlear implantation.

Cochlear implantation in bilateral traumatic severe to profound sensorineural deafness / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the audiologic results of cochlear implantation in bilateral severe to profound sensorineural hearing loss following head trauma.</p><p><b>METHODS</b>A retrospective study of our cochlear implantation cases in bilateral severe to profound sensorineural hearing loss following head trauma (with or without temporal bone fractures). Four patients in second hospital of Shandong university were analyzed in this study.</p><p><b>RESULTS</b>All the patients received unilateral cochlear implantation and gained open-set speech perception ranging from 92% to 100%. The aided hearing threshold ranged from 30 dBHL to 35 dBHL. None of them experienced a decrease in the hearing performance in the follow-up (1-2 years).</p><p><b>CONCLUSION</b>With sufficient preoperative assessment, cochlear implantation is an effective management for hearing rehabilitation in bilateral severe to profound sensorineural hearing loss following head trauma.</p>

Sensorineural hearing impairment resulted from radiochemotherapy in patients with nasopharyngeal carcinom / 中华放射肿瘤学杂志

Objective To compare the severity of sensorineural hearing impairment resulted from radiotherapy (RT) and radiochemotberapy (CRT) in patients with nasopharyngeal carcinoma (NPC). Methods Between March 2002 and May 2007, 100 initially diagnosed NPC patients in Shandong Tumor Hospital and Qi Lu Hospital were randomized to RT group and CRT group. All patients underwent intensity modulated radiation therapy. In CRT group, concurrent and adjuvant CDDP were administered (CDDP 25 mg/m2/d for 3 days to 4 cycles). Pure tone auditory threshold examination was performed 1 week ,6 months, 1 year and 2 years after the completion of radiotherapy. Statistical analyses were performed using Mann-Whit-ney U test,chi-square test and Fisber's exact probability test. Results The high-frequency threshold was significantly increased in CRT group comparing with RT group at 1- and 2-year after the treatment. In RT group, the hearing threshold was impaired immediately after the treatment, partially recovered within the first year but impaired again after 2 years. In CRT group, hearing threshold was impaired at the same time and kept getting worse until 1 year after radiotherapy, which could not be recovered. Conclusions Patients with NPC treated with radiotherapy and concurrent/adjuvant chemotherapy have more severe sensorineural hearing impairment comparing with those with radiotherapy alone, especially to the high frequency sound in the speech range. Inner ear tissue tolerance should be redefined for patients receiving radiochemotherapy.

The diagnostic value of multi-planar reconstruction in semicircular canals disease by HRCT / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the diagnostic value of high-resolution computed tomography (HRCT) and multiplanar reconstruction (MPR) in assessment of semicircular canals disease.@*METHOD@#Eighty-three patients were scanned with HRCT and the original data were processed with MPR. The semicircular canals full length was respectively observed in one image of MPR in the normal ears. The abnormal location of the canal were observed.@*RESULT@#In one image the full length of the horizontal, superior and posterior semicircular canal can be respectively displayed in one image of MPR in normal ears. By this way ,1 superior semicircular canal dehiscence (SSCD)was found in precaution group, 1 superior and 2 horizontal semicircular canal blocked, 1 vestibular aqueduct (VA) joined into superior semicircular canal and 2 VAs joined into posterior semicircular canal and abnormity of the three semicircular canals were found in SNHL.@*CONCLUSION@#MPR canould display the three canals full length in one picture and have a high specificity in the diagnosis of the semicircular canal abnormity.

Expression and significance of nuclear factor-kappa B ligand and correlation factor in the tissue of otitis media with cholesteatoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expressions of nuclear factor-kappa B ligand (RANKL), receptor activator of nuclear factor-kappa B(RANK)and osteoprotegerin (OPG) and the relation of RANKL with bone- erosion in human cholesteatoma tissue.@*METHOD@#Thirty cholesteatoma and twenty normal auditory canal skin specimens were investigated. The expressions of RANKL, RANK and OPG were examined by immunohistochemistry.@*RESULT@#The overexpressions of the cytokine RANKL and RANK were found in infiltrated lymphocytes in the cholesteatoma tissue comparing with normal external meatal skin( t = 7. 758,6. 482, P <0. 05); While, the expression of OPG was significantly higher in cholesteatoma tissue comparing with normal external meatal skin. the OPG/ RANKL was decreased in cholesteatoma tissue comparing with normal external meatal skin( t = 8. 183, P < 0. 05).@*CONCLUSION@#This study revealed that the expressions level of RANKL and RANK were markedly increased in the perimatrix of cholesteatoma, which is closely related to the bone- erosion induced by cholesteatoma.

Diagnostic value of high-resolution computed tomography imaging in congenital inner ear malformations / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the inner ear structure with volume rendering (VR) reconstruction and to evaluate the role of high-resolution computed tomography (HRCT) in congenital inner ear malformations.@*METHOD@#HRCT scanning was performed in 10 patients (20 ears) without ear disease (control group) and 7 patients (11 ears) with inner ear malformations (IEM group) and the original data was processed with VR reconstruction. The inner ear osseous labyrinth structure in the images generated by these techniques was observed respectively in the normal ears and malformation ears.@*RESULT@#The inner ear osseous labyrinth structure and the relationship was displayed clearly in VR imaging in the control group,meanwhile, characters and degree of malformed structure were also displayed clearly in the IEA group. Of seven patients (11 ears) with congenital inner ear malformations, the axial, MPR and VR images can display the site and degree in 9 ears. VR images were superior to the axial images in displaying the malformations in 2 ears with the small lateral semicircular canal malformations. The malformations included Mondini deformity (7 ears), vestibular and semicircular canal malformations (3 ears), vestibular aqueduct dilate (7 ears, of which 6 ears accompanied by other malformations) , the internal auditory canal malformation (2 ears, all accompanied by other malformations).@*CONCLUSION@#HRCT can display the normal structure of bone inner ear through high quality VR reconstructions. VR images can also display the site and degree of the malformations three-dimensionally and intuitively. HRCT is valuable in diagnosing the inner ear malformation.

Surgical approaches of anterior skull base tumors / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Study for surgical approaches on anterior skull base tumors.@*METHOD@#All 37 cases with anterior skull base tumors were surgically treated. Twenty-one cases were treated with anterior craniofacial approaches: Frontal subcranial combined with total maxillectomy in 8 cases or/with orbital exenteration in 5 cases, combined with lateral rhinotomy in 1 cases, combined with naso translocation with medial maxillectomy in 7 cases. Partial or total maxillary swing combined with naso pyramid translocation in 13 cases. Frontonasal, fronto-orbital and midface degloving in one case respectively.@*RESULT@#Of the 27 malignant cases the 3 and 5-year survival rates were 81.9% (22/27) and 62.9% (17/27) respectively, and one tumor free case living well more than 9 years. There were no recurrence in 10 cases with benign tumor.@*CONCLUSIONS@#Various craniofacial approaches except lateral rhinotomy provide directly satisfactory tumor exposure and facilitate enbloc resection of the naso paranasal sinus tumor with intracranial extension. Partial or total maxillary swing combined with naso pyramid translocation is good for tumor involving the skull base without intracranial invasion. The fronto-nasal pyramid translocation is good for removal of the upper part of nasal tumor with intracranial extension on well developed frontal sinus. The fronto orbital approach is proper for removal of fronto-sphenoid tumor and midface degloving may be used in selected cases.