Patients with obstructive sleep apnea are at great risk of flavor disorders: a 15-year population-based cohort study.

OBJECTIVE: Obstructive sleep apnea (OSA) results from upper airway remodeling, which has been suggested to alter sensory and motor neuron function due to hypoxia or snore vibration. This study investigated whether OSA was associated with the risk of flavor disorder (FD). MATERIALS AND METHODS: Seven thousand and eight hundred sixty-five patients with OSA and 7865 propensity score-matched controls without OSA were enrolled between 1999 and 2013 through a nationwide cohort study. The propensity score matching was based on age, sex, comorbidities including hypertension, hyperlipidemia, chronic obstructive pulmonary disease (COPD), asthma, ankylosing spondylitis, and Charlson comorbidity index, and co-medications during the study period, including statins and angiotensin-converting enzyme (ACE) inhibitors. The adjusted hazard ratio (aHR) of incident FD following OSA was derived using a Cox proportional hazard model. A log-rank test was used to evaluate the time-dependent effect of OSA on FD. Age, sex, comorbidities, and co-medications were stratified to identify subgroups susceptible to OSA-associated FD. RESULTS: Patients with OSA were at a significantly great risk of FD (aHR = 1.91, 95% CI = 1.08-3.38), which was time-dependent (log-rank test p = 0.013). Likewise, patients with hyperlipidemia were at a significant great risk of FD (aHR = 2.99, 95% CI = 1.33-6.69). Subgroup analysis revealed that female patients with OSA were at higher risks of FD (aHR = 2.39, 95%CI = 1.05-5.47). CONCLUSIONS: Patients with OSA were at significantly great risk of incident FD during the 15-year follow-up period, especially in female patients with OSA. CLINICAL RELEVANCE: Timely interventions for OSA may prevent OSA-associated FD.

Mitophagy protects SH-SY5Y neuroblastoma cells against the TNFα-induced inflammatory injury: Involvement of microRNA-145 and Bnip3.

Inflammatory response is involved in the development of facial neuritis. The aim of our study is to explore the role of mitophagy in facial nerve damage induced by tumor necrosis factor α (TNFα). Our results indicated that TNFα induced SH-SY5Y cell apoptosis in a dose-dependent manner. Besides, TNFα treatment also suppressed mitophagy by reducing the expression of BCL2 interacting protein 3 (Bnip3). Overexpression of Bnip3 under sustained SH-SY5Y cell viability in the setting of TNFα-mediated inflammation injury. At the molecular levels, Bnip3 overexpression maintained mitochondrial function via preserving mitochondrial membrane potential, reducing cytochrome-c leakage and inhibiting mitochondrial permeability transition pore opening. Functional studies have suggested that microRNA-145 (miR-145) was an upstream regulator of Bnip3-dependent mitophagy. MiR-145 inhibited Bnip3 transcription and expression, leading to mitophagy inhibition. In contrast, inhibition of miR-145 reversed mitophagy activity and subsequently promoted SH-SY5Y cell survival in the context of TNFα-mediated inflammation injury. Altogether, our data identified Bnip3-dependent mitophagy as one of the defensive mechanisms to sustain mitochondrial homeostasis and SH-SY5Y cell survival. Besides, miR-145/Bnip3/mitophagy axis may be considered as a potential target for the treatment of facial neuritis in clinical practice.

Effect of chitosan combined with hyaluronate on promoting the recovery of postoperative facial nerve regeneration and function in rabbits.

To determine better solutions for postoperative nerve functional recovery, the effects of chitosan and hyaluronate on perineural scar formation and neural function recovery were investigated in 40 rabbits. Rabbits were randomized into 4 groups: A (chitosan), B (chitosan + hyaluronate), C (hyaluronate) and D (control). The rabbits underwent the same parotidectomy surgery, but different materials were used to cover the operated nerves. By evaluating specific indicators, including vibrissae motion tests, neural electrophysiological examinations and extraneural examinations, it was revealed that the amplitude of vibrissae motion of all groups had increased 6 weeks after surgery. The recovery of Group B was superior compared with all other groups at 4 and 12 weeks post-surgery; however no significant differences were detected. Group B exhibited a great number of nerve fibers, thicker myelin sheath and greater nerve conduction velocity. In summary, the use of a chitosan conduit combined with sodium hyaluronate gel may prevent perineural scar formation in facial nerves and promote nerve functional recovery.

Chitosan conduit combined with hyaluronic acid prevent sciatic nerve scar in a rat model of peripheral nerve crush injury.

In the present study, the effects of hyaluronic acid (HA) combined with chitosan conduit on peripheral nerve scarring and regeneration were investigated in a rat model of peripheral nerve crush injury. A total of 60 Sprague-Dawley rats were randomly distributed into four groups (15 rats in each group), in which the nerve was either not treated (control group) or treated with chitosan conduit, hyaluronic acid, or chitosan conduit coupled with hyaluronic acid following clamp injury to the sciatic nerve. The surgical sites were evaluated by assessing the sciatic functional index, the degree of scar adhesions, the numbers of myelinated nerve fibers, the average diameter of myelinated nerve fibers and the myelin sheath thickness. Larger epineurial scar thickness was observed in the control groups compared with the treatment groups at 4, 8 and 12 weeks following surgery. There was no significant difference in scar adhesion among the four groups at 4 weeks following surgery. However, animals receiving chitosan coupled with HA demonstrated better neural recovery, as measured by reduced nerve adherence to surrounding tissues, less scar adhesion, increased number of axons, nerve fiber diameter and myelin thickness. In conclusion, the application of chitosan conduit combined with HA, to a certain extent, inhibited sciatic nerve extraneural scaring and adhesion, and promoted neural regeneration and recovery.

[Measurement of temporomandibular joint space of patients with obstructive sleep apnea hypopnea syndrome].

PURPOSE: This research evaluated the morphological differences of temporomandibular joint (TMJ) between patients with obstructive sleep apnea hypopnea Syndrome (OSAHS) and normal population using magnetic resonance imaging (MRI). METHODS: Eighteen OSAHS patients were admitted from January 2014 to May 2016 and 18 healthy adults were chosen as control. OSAHS patients were divided into three sub-groups (n=6), i.e. the mild group, the moderate group and the severe group, according to apnea and hypopnea index (AHI). All subjects underwent TMJ MRI for measurement of joint space. Statistical analysis was performed using SPSS 17.0 software package. RESULTS: There was no significant difference between the two groups in age, gender, superior joint space and displacement of condyle. The left anterior joint space [(2.63±0.18)mm vs (2.48±0.17)mm, P<0.05] and right anterior joint space [(2.63±0.18) mm vs (2.48±0.17) mm, P<0.05] of the TMJ of OSAHS patients was bigger than that of healthy people. The left posterior joint space [(2.43±0.20) mm vs (2.51±0.19) mm, P<0.05] and right posterior joint space [(2.44±0.20) mm vs (2.60±0.13) mm, P<0.05] of the TMJ of OSAHS patients was smaller than that of healthy people. The left anterior joint space [(2.53±0.26) mm vs (2.73±0.07) mm, P<0.05] and right anterior joint space [(2.54±0.11) mm vs (2.74±0.14) mm, P<0.05] of the TMJ of OSAHS patients in the mild sub-group was smaller than that of the OSAHS patients in the severe sub-group; the left posterior joint space [(2.56±0.29) mm vs ( 2.29±0.09) mm, P<0.05] and right posterior joint space of OSAHS patients in the mild sub-group was bigger than that of the OSAHS patients in the severe sub-group. CONCLUSIONS: The condyle of OSAHS patients is at the posterior position of glenoid compared with heath people. The tendency of posterior position of condyle at glenoid is related to the severity of OSAHS.

Recurrent Pleomorphic Adenoma of the Parotid Gland: Intraoperative Facial Nerve Monitoring during Parotidectomy.

OBJECTIVE: To determine the benefit to postoperative facial function of intraoperative facial nerve monitoring (IFNM) during recurrent pleomorphic adenoma (RPA) parotid surgery. STUDY DESIGN: Cohort study with planned data collection. SETTING: Chinese PLA General Hospital. SUBJECTS AND METHODS: Fifty-eight RPA parotidectomies were performed between 2004 and 2012. Recurrence was confirmed by histopathologic examination. None of the patients had preoperative facial palsy. Electromyography-based IFNM was used in 28 patients; 30 patients were unmonitored. The durations of surgery and the severity of postoperative facial nerve palsy were compared between the 2 groups. RESULTS: There were no significant differences between the 2 groups in the incidence of immediate or permanent facial paralysis after RPA parotidectomy (P = .95 and P = .36, respectively). However, the differences in the average duration of surgery and the severity of postoperative facial nerve palsy after total parotidectomy or wide resection were significant (P < .01 and P = .01, respectively). In contrast, these differences were not significant after superficial parotidectomies (P = .43 and P = .49, respectively). The average recovery time of temporary facial nerve paralysis was significantly shorter in the monitored group compared with the unmonitored group, independent of surgical technique (P < .01). CONCLUSION: The use of IFNM during total or wide resection RPA parotidectomy reduced the duration of surgery and the incidence of postoperative facial paralysis and enhanced recovery. However, there was little impact on facial nerve outcomes when IFNM was used during superficial RPA parotidectomy.

A retrospective study on craniofacial fibrous dysplasia: preoperative serum alkaline phosphatase as a prognostic marker?

BACKGROUND: Craniofacial fibrous dysplasia (CFD) often requires surgery to correct facial deformity and prevent functional impairment. However, recurrence is common, and there is no reliable prognostic biomarker. The aim of this paper is to evaluate the possibility of using preoperative alkaline phosphatase (ALP) as a prognostic marker for CFD. MATERIAL AND METHODS: Forty-nine patients with CFD who underwent surgery from 2000 to 2011 were selected. The relationship between preoperative ALP and age, gender, lesion type and prognosis was investigated. RESULTS: The recurrence rate was 31.8% in patients who received conservative bone contouring. Patients with recurrence did not show significantly higher levels and abnormal rates of ALP than patients without recurrence. Young patients and those with polyostotic CFD showed higher ALP levels than adults and those with monostotic CPD (P < 0.05). Although CFD patients showed higher levels and abnormal rates of ALP than the control group, significant levels were not reached (P > 0.05). No correlation between age, gender, type, ALP and recurrence could be established using the logistic regression model. CONCLUSION: Preoperative ALP may not be a reliable prognostic marker of CFD based on the findings in this study. Close follow-up is recommended after conservative bone contouring.

Chitosan conduits combined with nerve growth factor microspheres repair facial nerve defects.

Microspheres containing nerve growth factor for sustained release were prepared by a compound method, and implanted into chitosan conduits to repair 10-mm defects on the right buccal branches of the facial nerve in rabbits. In addition, chitosan conduits combined with nerve growth factor or normal saline, as well as autologous nerve, were used as controls. At 90 days post-surgery, the muscular atrophy on the right upper lip was more evident in the nerve growth factor and normal sa-line groups than in the nerve growth factor-microspheres and autologous nerve groups. physiological analysis revealed that the nerve conduction velocity and amplitude were significantly higher in the nerve growth factor-microspheres and autologous nerve groups than in the nerve growth factor and normal saline groups. Moreover, histological observation illustrated that the di-ameter, number, alignment and myelin sheath thickness of myelinated nerves derived from rabbits were higher in the nerve growth factor-microspheres and autologous nerve groups than in the nerve growth factor and normal saline groups. These findings indicate that chitosan nerve conduits bined with microspheres for sustained release of nerve growth factor can significantly improve facial nerve defect repair in rabbits.

[Clinical manifestation and diagnosis of non-Hodgkin's lymphoma (NHL) in head and neck : analysis of 138 cases].

PURPOSE: To analyze the clinical features, pathological classification, causes of misdiagnosis, treatment and prognosis of non-Hodgkin's lymphoma (NHL) originated in head and neck and to afford experience in early diagnosis and treatment. METHODS: The clinical manifestation , treatment and prognosis of 138 cases of primary head and neck NHL were studied retrospectively. RESULTS: The incidence in male was higher than that in female (male:female=1.26:1). Among non-Hodgkin's lymphomas, 86.2% were neoplasms originating from B lymphocytes,which was remarkably higher than those originating from T lymphocyte(13.8%). The early symptom was mainly painless mass(71.7%). The primary location was in the following order: cervical region, submandibular region , parotid gland, skin of face, maxilla and mandible, tongue and palate. The main treatment was multimodal therapy(chemotherapy and operations).The five- year survival rate was 59.4%. CONCLUSIONS: The clinical manifestation of head and neck NHL is not specific and has a high misdiagnosis rate,so we must pay more attention to improve the early diagnosis and treatment of NHL.

[Comparison of therapeutic efficacy between surgical and non-surgical treatment on mandibular condylar fractures].

PURPOSE: To compare the therapeutic efficacy between surgical and non-surgical treatment on mandibular condylar fractures. METHODS: Patients with mandibular condylar fractures who were treated in our department with complete record from January, 1987 to June, 2009 were collected in this study. We conducted a retrospective analysis on the pathogenic factor, type, treatments and therapeutic efficacy of mandibular condylar fractures to compare the therapeutic efficacy between surgical and non-surgical treatment. RESULTS: A total of 228 patients were included in this study,among which 130 patients were treated by surgical procedure and the other 98 patients were treated by non-surgical treatment. All the patients were followed up for 1.5 years at average. Postoperative opening wide in the midline, occlusal relation and radiographs were examined to evaluate the therapeutic efficacy. Both surgical and non-surgical treatment showed good result. CONCLUSIONS: Surgical and non-surgical treatment for mandibular condylar fracture can achieve good results, when indication is selected appropriately. Non-surgical treatment is acceptable for young children or preschool children, whose mandibular condylar can accommodate well because of their vigorous growth and development and reconstruction function.

Effect of chondroitin sulfate modification on rhBMP-2 release kinetics from collagen delivery system.

Protein delivery systems focus on protecting the protein that directly affects release kinetics. This study was carried out to determine the effect of surface polar group and fiber structure in a recombinant human bone morphogenetic protein-2 (rhBMP-2) protecting system based on a collagen matrix on its pharmacokinetics (PK) and osteoinductive activity In this study, two types of collagen carriers were made for rhBMP-2 protecting system. The PKs of rhBMPs within collagen (Col) and collagen-chondroitin sulfate (Col-CS) carriers were determined using (125)I-labeled proteins in rat ectopic assay. The two carriers were characterized with surface energy and hydrophilicity. We observed that the osteoinductivity of these two scaffolds seemed to depend on two parameters: the nature of the carrier material and the release kinetics of the carriers. Results indicated that with CS modification, the initial burst release of rhBMP-2 from Col-CS scaffold was much higher than collagen scaffold. The subsequent PKs at longer times were not strongly dependent on the carriers. These differences were expected to affect the osteoinductive activity of the implants. It was concluded that surface energy played a significant role in the release PK of implanted rhBMP and higher initial burst is favorable to bone regeneration near the matrix.

[Changes of the ultrastructures of temporomandibular joint after removal of emotional stress factors in rats].

OBJECTIVE: To examine the changes of the ultrastructures of temporomandibular joint after removal of the emotional stress factors in rats. METHODS: Thirty-two 12-week-old male Wistar rats were divided into two groups randomly, experimental group and control group. Each group was divided into two subgroups according to execution time, 9-week subgroup and 12-week subgroup with eight rats in each subgroup. Chronic unpredictable stress animal model were firstly established in experimental group in the first 6 weeks, then all the stimulation factors removed and breed normally. After 9 weeks, rats in 9-week subgroup were killed. After 12 weeks, rats in 12-week subgroup were killed. All condyles and articular discs were dissected and observed by scanning electron microscope. RESULTS: There was some recovery in condyles and articular discs in experimental group under scanning electron microscope. The gelatum on the surface of condyles increased, collagen fibrils became regular and deep layer collagen fibrils less exposed. There were no such obvious changes on the surface of condyles and articular discs in control group. CONCLUSIONS: The ultrastructure injures of temporomandibular joint in rats induced by emotional stress could be reversed if the stress factors were removed.

[Bone density and biomechanics study of alveolar ridge augmentation with titanium nickel shape memory alloy distractor and acellular dermal matrix].

OBJECTIVE: To observe the dynamic changes of bone density and bone strength after alveolar ridge augmentation with Titanium Nickel shake memory alloy (TiNi-SMA) distractor and acellular dermal matrix (ADM). METHODS: Twelve adult healthy male dogs were selected. After the animal model of alveolar atrophy was set up, on one side of mandible, two S-shaped distractors were placed. The diameter of S-shaped distractor was 1 mm and the rebound temperature was 33 degrees C. The ADM was placed on the distraction gap and fixed by the feet of distractors. The other side was placed only with distractors, serving as control side. Six dogs' mandibles were harvested after 1 and 3 months respectively. Dual energy X-ray absorptiometry (DEXA) was used to scan bone density around the distraction gap. Mechanical machine was used to test compression strength and elastic modulus. RESULTS: Months after distraction, the bone density of upper distraction gap, distraction gap and low distraction gap were respectively (0.714 +/- 0.238) g/cm2, (0.512 +/- 0.435) g/cm2 and (0.615 +/- 0.043) g/cm2 on experimental side. The compression strength and elastic modulus were (36.54 +/- 7.32) MPa and (1674.10 +/- 256.43) MPa. All of above were higher than those of control side. CONCLUSIONS: ADM can improve the bone quality, increase bone density and intensity and is an ideal guided bone regeneration(GBR) membrane for alveolar ridge augmentation with TiNi-SMA distractor.

Synthesis and characterization of collagen-chitosan-hydroxyapatite artificial bone matrix.

In this study, a new artificial bone matrix was constructed with collagen and Ca(5)(PO(4))(3)OH (hydroxyapatite/HA) which are the main components of natural bone. To improve the property of the artificial bone matrix, chitosan (CS), a kind of positive charged polysaccharide, was crosslinked into the scaffolds. Solid-liquid phase separation method was used to shape 3D porous structure benefited for cells growing into. The artificial bone matrix was investigated by transmission electron microscopy, scanning electron microscopy, and electron spectroscopy for chemical analysis, etc. for structures and characteristics. And its ability of bone repair was investigated by orthotope bone defect reparation in vivo. The results showed that the artificial bone matrix was a porousscaffold with three-dimension interconnected fiber microstructure. HA particles were dispersed evenly among collagen fiber and CS was modified on the surface of collagen fiber. It was indicated that this artificial bone matrix could be used as a bone substitute with outstanding properties.