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Objective: To analyze the effect and safety of treatment in patients with airway stenosis caused by tracheotomy for mechanical ventilation. Method: We treated the patients with airway stenosis caused by granulation tissue. The patients with grade Ⅰ,Ⅱ airway stenosis were treated with adjustable flange tracheostomy tube, and the holmium laser under a fibro-laryngoscope were applied for the patients with grade Ⅲ airway stenosis.Two hundred and sixteen patients were enrolled in this study. Forty-four patients had been found tracheal stenosis caused by granulomatous hyperplasia, accounting for 20.4% of all patients, including 12 cases of gradeⅠ, 18 cases of grade Ⅱ, and 14 cases of grade Ⅲ. Result: Thirty patients with grade Ⅰ and Ⅱ were replaced with adjustable flange tracheostomy cannula. Fourteen cases of grade Ⅲ airway stenosis were treated with Ho:YAG laser under a fibro laryngoscope. All cases were completed operation successfully. None of cases bleeding, perforated and asphyxia during operation. The clinical symptoms disappeared after operation, and endoscopy showed that airways of patients were smooth. No recurrence were found after operation. Conclusion: Replacement of adjustable flange tracheostomy tube and Ho:YAG laser can safely and effectively treat airway obstruction caused by tracheal granulation tissue hyperplasia after tracheotomy., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To ascertain the effects of a new method of photochemical reaction in vestibular function in guinea pigs. Method: Local photochemical reaction was initiated by systemic injection of rose bengal(20mg), photoillumination of the vestibule through medial wall of epitympanum for 30 minutes was started immediately after the injection of rose bengal, with a optic fiber connected to a xenon light (wavelength, 540nm; photointense, 500-600 mW/cm ²). There were 20 guinea pigs divided random equally into 2 groups. Group 1 was injected with rose bengal. Group 2 was control, injected with physiological saline solution. The ice caloric tests were performed on the second day. Result: The test group (7 ears) and the control group (6 ears) with test nystagmus showed mean frequencies were（2.0±0.33）times/s and（3.7±0.33）times/s,the mean amplitude were (3.1±0.39)mm and (3.5±0.54)mm,and the mean duration were (44.7±17.22)s and (62.0±7.22)s respectively.The nystagmus frequency difference was statistically significant, but the amplitude and the duration of the nystagmus were not significantly different. There was no obvious spontaneous nystagmus in the two groups, and there were negative results of ice water test (3 ears in the test group and 4 ears in the control group). Conclusion: Photochemical reaction can induce the ischemic state of the vestibule system in guinea pig, and produce an acute vestibular dysfunction, and ice water test shows that the frequency of nystagmus is reduced., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: The research aimed to study the relationship between endolymphatic imaging and clinical manifestations(duration of last attack period to MRI scan) of Meniere's patients. Method: Twenty-six Meniere's patients and 29 affected ears were enrolled in this research. According to clinical manifestations, when performing MRI scan, patients who were not in attack period and the duration of last attach period to MRI scan was longer than 14 days were divided to Group A; and patients who were in attack period or the duration of last attach period to MRI scan was shorter than or equal to 14 days were divided to Group B. Administrate gadolinium to mid-ear affected by MD via non-invasive method through Eustachian tube, and then perform 3D-FLAIR MRI scan the next day. After measurement and calculation, compare RV and RC (area of endolymphatic space divided by total lymphatic space in vestibule and cochlea, respectively) of the two groups. Result: Twenty-nine affected ears of 26 patients were administrated successfully.The endolymphatic spaces were distinct from perilymphatic spaces in vestibule and cochlea in 26 ears. In the images of B6, B12, B14, the cochlea and semicircular canals were enhanced, but the vestibules were not enhanced. For Group A ,the average of RV was 0.37±0.06; the average of RC was 0.15±0.04. As to Group B ,the average of RV was 0.52±0.26; the average of RC was 0.18±0.06. According to ANOVA test,RV of the two groups had significant difference（ P <0.05）, RC had no significant difference（ P >0.05）. The positive RC and RV in Group A were 7.1% and 42.9% respectively. The positive RC and RV in Group B were 13.3% and 66.7%, respectively. As to 4 patients who were during attack period in Group B, the positive RC and RV were 50% and 100%, respectively. The positive RV of Group B was higher than that of Group A. Conclusion: The clinical manifestations(duration of last attack period to MRI scan) of Meniere's patients had relationship with positive rate of MRI scan. The possibility of positive RV was higher when the duration of attack period to MRI scan was shorter., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: The purpose of this study was to observe the clinical characteristics of two types of geotropic direction-changing positional nystagmus, the transient(nystagmus time <1 min) and the persistent(nystagmus time > 1 min), and to evaluate the efficacy of the barbecue roll maneuver. Methods: A total of 105 cases diagnosed by supine roll test were studied, which including 35 males and 70 females and the average age was (56.9±14.6)years. There were 70 transient geotropic DCPN and 35 persistent geotropic DCPN. The clinical characteristics and the immediate and one-week efficacy of the barbecue roll maneuver were discussed. Results: The nystagmus disappeared at the null-point position and the nystagmus in supine position were opposite to the bowing (90° nose-down) position in persistent geotropic DCPN cases. While to the transient geotropic DCPN cases, there were no NP and no nystagmus in prone position. The ratio of the first onset of the two groups was 28.6% (persistent) and 72.9% (transient) respectively, and the difference was statistically significant ( P <0.05). The immediate and one-week efficacy after barbecue roll maneuver were 91.4% and 80.0% in transient geotropic DCPN cases, and 0% and 42.9% in persistent geotropic DCPN cases, which were statistically significant different( P <0.05). Conclusions: The light cupula hypothesis can mainly explain the clinical features of persistent geotropic DCPN cases; the barbecue roll maneuver is invalid to persistent geotropic DCPN cases which can be self-healing.

Objective: To investigate the main factors affecting the source of snoring sound of snoring patients. Method: Seventy-three patients with either simple snoring or obstructive sleep apnea-hypopnea syndrom(AHI≤40) underwent routine ENT examination,CT scanning(in awake condition) and drug-induced sleep endoscopy.The sources of snoring sound were observed.The neck circumference,body mass index and CT data were measured. Result: The sources of snoring sound of the 73 cases were divided into three types in general: palatal fluttering based group(Group Ⅰ),lateral wall vibration based group(Group Ⅱ) and palatal fluttering together with vibration of lateral wall based group(Group Ⅲ).The minimum lateral caliber of retropalatal region and retroglossal region,the ratio of minimum anteroposterior/ lateral caliber of the two regions,the thickness of pharyngeal lateral wall had statistical differences.The main influencing factors on the source of snoring sound between Group Ⅱ and Group Ⅰ were the ratio of minimum anteroposterior/lateral caliber of retropalatal region and the mean thickness of pharyngeal lateral wall.The influencing factor between Group Ⅲ and Group Ⅰ was the mean thickness of pharyngeal lateral wall. Conclusion: The ratio of minimum anteroposterior/lateral caliber of retropalatal region and the mean thickness of pharyngeal lateral wall are the main factors affecting the source of snoring sound of snoring patients., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: This study was designed to observe the dizziness handicap inventory (DHI) scores in patients with BPPV (benign paroxysmal positional vertigo) before and after maneuver repositioning and aimed to discuss the values of DHI scores in the diagnosing and treatment of BPPV. Method: Charts of 72 patients with BPPV diagnosed by positioning test were reviewed. Four DHI scores were used including the total score (DHIT), the functional score (DHIF), the emotional score (DHIE), and the physical score (DHIP). We compared the pre-repositioning DHI scores and post-repositioning scores of patients, and also compared the DHI scores of patients with and without residual dizziness. Result: All of the 72 patients were underwent maneuver repositioning and recorded the DHI scores. The mean post-repositioning scores were dramatically decreased compared with pre-repositioning scores, and the difference was significant ( P <0.01). The differences of the DHIP scores between the residual dizziness group and the non-residual dizziness group was not significant, while the DHIF scores, the DHIE scores and the DHIT scores between the two groups were statistically different. Conclusion: After maneuver repositioning the dizziness handicap of BPPV patients could be significantly improved. The next treatment program for residual dizziness patients after successful repositioning could be aimed at the functional and emotional dizziness., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To explore the efficacies of nasal cavity enlarging surgery in obstructive sleep apnea hypopnea syndrome (OSAHS) patients with nasal obstruction., Methods: From April 2011 to October 2012, a total of 22 OSAHS patient with nasal obstruction underwent nasal cavity enlargement. Natural overnight snoring was digitally recorded, polysomnography (PSG) performed simultaneously and nasal resistance measured at pre- and post-operation. Body mass index (BMI), Epworth sleepiness scale (ESS), apnea-hypopnea index (AHI), minimum oxygen saturation SaO2, total nasal resistance, peak frequency, maximal frequency, mean frequency, central frequency and power ratio 800 Hz of snores were recorded and compared., Results: BMI and SaO2 rose while AHI and ESS declined post-operatively. No statistical difference existed between pre-operation and post-operation. The total nasal resistance was (0.39 ± 0.15) and (0.29 ± 0.11) Pa·cm(-3)·s(-1) at pre- and post-operation. And there was significant statistical difference (P < 0.01) . The snores at pre- and post-operation exhibited different patterns in time and power spectrum distribution domains. And fmax, fpeak and fmean declined while fc and PR800 rose at post-operation. Significant statistical differences existed in the change of fpeak and PR800 at pre- and post-operation (P < 0.01) ., Conclusion: Nasal cavity enlargement can lessen nasal resistance and change the acoustic characteristics of snoring in OSAHS patients. The postoperative snoring focus of lower frequency suggests that acoustic parameters of snores may be used to evaluate the efficacy of OSAHS surgery.

Objective: To investigate the characteristics of gastroesophageal reflux disease (GERD) with chronic cough by the results of combined multichannel intraluminal impedance and high-resolution manometry (MII-HRM) procedure and 24-hour multichannel intraluminal impedance combined pH (MII-pH) monitoring., Methods: From March 2010 to November 2010, consecutive patients of GERD with chronic cough (more than 8 weeks) admitted to Beijing Chaoyang Hospital of Capital Medical University underwent 24-hour MII-pH monitoring and MII-HRM procedure with symptom association probability (SAP) over 95%. Data of lower esophageal sphincter (LES) pressure, LES relaxation, LES residual pressure, esophageal body peristalsis function and swallow bolus transit (liquid/viscous) was collected and the result of 24-hour MII-pH monitoring was analysed by the computer software containing reflux episode activity (acid/nonacid, upright/recumbent), proximal extent, acid exposure and mean acid/bolus clearance time. Seventeen patients of GERD with typical reflux symptom were selected as the control group., Results: Comparing with patients of GERD with typical reflux symptom, patients of GERD with chronic cough showed decreased upper esophageal sphincter pressure (UESP) [(122.55 ± 60.48) mm Hg vs (86.37 ± 41.35) mm Hg, P < 0.05, 1 mm Hg = 0.133 kPa], higher percentage of abnormality peristalsis [(9.47 ± 15.63)% vs (22.16 ± 17.45)%, P < 0.05], degraded esophagus transmittability of liquid substance [(88.82 ± 12.23)% vs (71.68 ± 23.06)%, P < 0.05], more reflux episode activity (acid/nonacid) in supine position and proximal reflux episode (nonacid) in supine position (P < 0.05) and longer mean bolus clearance time (P < 0.05)., Conclusion: Decrease of the UESP, increase of the reflux episode activity (acid/nonacid) in supine position and proximal reflux episode (nonacid) in supine position, lengthened mean bolus clearance time in supine position and the degraded esophagus clearance ability may all correlated with the pathogenesy of GERD with chronic cough.

Objective: To observe the distribution of Gd-DTPA in the inner ear of guinea pig by MRI at different time points after intratympanic administration, explore the optical time for observing the whole inner ear. To study the pharmacokinetic feature of Gd-DTPA in the inner ear, and find out whether discrimination of endolymph and perilymph can be obtained under current conditions., Methods: Sixty-five guinea pigs were randomly divided into 13 groups, after diluted Gd-DTPA intratympanic injection, each group of guinea pigs were scanned through MRI (3D-T1 FSE sequence) at different time points (0 h, 0.5 h, 1 h, 2 h, 4 h, 6 h, 8 h, 10 h, 12 h, 24 h, 48 h, 72 h, 96 h). Pixel intensity values of some locations in the inner ear were analyzed using e-Film software, then pixel intensity was converted into concentration using the results of previous in-vitro study. ABR thresholds of bilateral ears before, 1 d and 7 d after intratympanic injection were compared., Results: Six hours after transtympanic Gd-DTPA injection was the time point when contrast agent was distributed all over the inner ear, and reached a high concentration: 589.29, 552.54, 570.17, 255.08, 107.09 and 139.18 µmol/L in the vestibule, scala vestibuli and scala tympani of basal turn, the 2(nd), the 3(rd) and the apical turn individually, that was also the optimal time for observing the whole inner ear by MRI. Perilymph appeared to be preferentially enhanced relative to the endolymph, resulting in a distinction between the scales of the inner ear. There was no significant difference between the experimental ear (diluted GD-DTPA injected ear) and contrast ear (physiological saline injected ear) on 1 d and 7 d., Conclusions: The best time getting MRI imaging after intratympanic diluted GD-DTPA injection is 6 h. After diluted agent injection perilymph can be enhanced so as to be differentiated with endolymph by MRI, diluted agent have no obvious effect on the ABR threshold. The pharmacokinetic feature of Gd-DTPA in the inner can be studied using MRI.

Objective: To determine the prevalence of gastroesophageal reflux disease (GERD) in patients with idiopathic pulmonary interstitial fibrosis (IPIF)., Methods: From December 2006 to January 2008, 24 consecutive patients with IPIF admitted to Beijing Chaoyang Hospital underwent 24-hour esophageal pH monitoring and esophageal manometry. Meanwhile, 23 patients with diffuse parenchymal lung disease (DPLD) (excluding IPIF) admitted to the hospital in the same period served as a control group. Comparison of the prevalence of pathologic esophageal acid exposure GERD symptoms, and ineffective esophageal motility (IEM) between the two groups was made. In this study, nocturnal acid exposure is defined as acid reflux episodes occurring from 10pm to 6am., Results: (1) 16 out of the 24 (66.7%) patients with IPIF were demonstrated to have pathologic esophageal acid exposure; the prevalence of GERD in IPIF patients was significantly higher than that in other DPLD patients, whose prevalence was 26.1% (P < 0.05) ; (2) 87.5% patients with IPIF and GERD (GERD-IPIF) had nocturnal acid exposure episodes; (3) only 37.5% of the GERD-IPIF patients was found to have typical GERD symptoms such as heartburn and regurgitation; (4) The prevalence of IEM was similar in IPIF and other DPLD patients, being 42.9% and 39.1% respectively (P > 0.05)., Conclusions: IPIF patients have higher prevalence of GERD and most of them usually do not show typical reflux symptoms. It is hereby suggested that IPIF patients should be screened with pH monitoring for GERD.

Objective: To visualize the endolymph in Meniere's disease by applying for non-invasive intratympanic gadolinium through eustachian tube and three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI)., Methods: With a 3 Tesla magnetic resonance imaging (MRI) unit, 3D-FLAIR imaging was performed 24 h after intratympanic gadolinium through eustachian tube in seven patients with Meniere's disease. Pure tone test was performed 24 h before and after administered gadolinium. Tympanometry was performed 24 h before, 24 h and 3 months after administered gadolinium., Results: In five patients, the gadolinium could appear in parts of the perilymph inside the inner ear but not in the middle ear and mastoid, moreover, the border between the perilymph and endolymph was visible so that endolymphatic space was clearly shown on 3D-FLAIR imaging. In two patients with endolymphatic hydrops, the perilymphatic space surrounding endolymph was small or disappeared. In two patients, the gadolinium could appear in parts of the middle ear and mastoid but not in the inner ear. No significant changes in pure tone test and tympanometry were noted., Conclusions: 3D-FLAIR MRI with intratympanic gadolinium through eustachian tube could clearly reveal the visualization of endolymphatic space in Meniere's disease.

Objective: To describe a series of patients with multiple canal involvement in benign paroxysmal positional vertigo (BPPV), with respect to diagnosis and management., Methods: Ninety-five individuals with symptoms of BPPV and positional nystagmus were included in this study. The diagnosis was based on a history of brief episodes of vertigo and the presence of multiple positional nystagmus as confirmed by video-oculographic examination. Patients were treated by means of different particle repositioning manoeuvres according to the affected canal., Results: Ninety-five patients showed multiple positional nystagmus during the examination corresponding to simultaneous multi-canal BPPV. Fourteen patients (14.7%) had bilateral canal BPPV. Six patients had bilateral posterior canal. Six patients had bilateral horizontal canal, and two patients had bilateral anterior canal. Fifty-three patients (55.8%) had torsional, up-beating nystagmus with down-beating nystagmus, which suggested possible affected both of posterior and anterior canals. Twenty patients (21.1%) had torsional up-beating nystagmus and horizontal direction nystagmus, which suggested possible affected both of posterior and horizontal canals. Five patients had down-beating nystagmus with horizontal nystagmus, which suggested affected both of anterior and horizontal canals. Three patients had torsional up-beating with down-beating and horizontal nystagmus, which suggested possible affected multiple canals. Treatment given to the patients varied according to the canal affected, started with the canal that elicited a strong positional nystagmus and vertigo, and 93.7% (89/95) of patients were symptom free or improved., Conclusions: It has been found that multi-canal BPPV is not a rate observation in clinic, and most of them affected posterior and anterior canals. Treatment of multi-canal BPPV can be effective using repositioning maneuver.

Objective: To explore the normal values of vestibular autorotation test (VAT) in young people., Methods: VAT was performed in 31 young people aged 20-30 years. The measured value were analyzed and compared with the reference normal value., Results: The measured values of VAT in healthy young people are almost within the normal range of the general population. Compared with the reference normal values, the horizontal gains at 2.0, 2.3, 2.7, 5.5, and 5.9 Hz, the vertical gains at 2.0 and 5.9 Hz, and the vertical phases at 2.0, 2.3, 2.7, 3.1, 3.5, and 3.9 Hz were significantly different (P < 0. 05). No significant difference was shown in the horizontal phases and asymmetry., Conclusions: The normal values of VAT in young people is within the reference normal range of the general population. The vestibular function of young people may be more sensitive in lower frequency range (2-3Hz).

Objective: To attempt to visualize the endolymph in patients with Meniere's disease by applying non-invasive intratympanic gadolinium through eustachian tube and three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI)., Methods: With a 3 Tesla magnetic resonance imaging (MRI) unit, 3D-FLAIR imaging was performed 24 hours after intratympanic gadolinium through eustachian tube in two patients with medically active and intractable Meniere's disease. Pure tone test and tympanometry were performed 24 hours before and after the administration of gadolinium., Results: The gadolinium appeared in almost all parts of the perilymph inside the inner ear; moreover, the border between the perilymph and the endolymph was visible so endolymphatic space was clearly shown on 3D-FLAIR. No change in pure tone test and tympanometry was noted., Conclusions: 3D-FLAIR MRI with intratympanic gadolinium through eustachian tube can clearly reveal the visualization of endolymph in patients with Meniere's disease. Intratympanic gadolinium therapy through eustachian tube is a safe and effective.

Objective: To evaluate the pathological status of the vestibular system associated with noise-induced inner ear impairment., Methods: Totally 68 patients with noise-induced hearing loss (NIHL) who presented with vestibular symptoms including vertigo, dizziness, and chronic disequilibrium were screened. All patients underwent a series of conventional vestibular function tests and vestibular autorotation test and the results were retrospectively reviewed and evaluated., Results: Sixty-eight (14.5%) patients with NIHL were identified among 469 patients with vertigo, dizziness, or imbalance. A pure tone hearing threshold of patients with vertigo and NIHL at 4000 Hz were between 30 dB HL and 80 dB HL with an average threshold of (46.7 +/- 17.6) dB HL in left ear and (37.3 +/- 16.7) dB HL in right ear. Patients with symmetrical hearing loss at 4000 Hz accounted for 41.7% and those with asymmetrical loss accounted for 58.3%. Vestibular pathologies included benign positional paroxysmal vertigo (45.7%), unilateral decreased caloric responses (20.0%), bilateral decreased caloric responses (26.7%), abnormal vestibulo-spinal reflex function (28.6%), vestibular function response hyperactivity (3.0%), and abnormal vestibulo-ocular reflex presentation at high frequencies (97.0%)., Conclusions: Loud acoustic stimulation not only damages the cochlea but also causes clear functional impairment to the vestibular end organs. Although the vestibular pathology is not correlated with the severity of the hearing loss, it correlates with the subjective symptoms of the vestibular system.

With pot experiment, this paper studied the effects of cadmium stress on the leaf chlorophyll content, photosynthetic rate, stomatal conductance, transpiration rate, and intercellular CO2 concentration of strawberry. The results showed that cadmium reduced the chlorophyll content, and changed the chlorophyll a/b ratio. Cadmium reduced the photosynthetic rate and stomatal conductance, though they were increased by low concentration cadmium at the initial stage of cadmium stress. Cadmium also reduced the transpiration rate and intercellular CO2 concentration, but the decrement of intercellular CO2 concentration was relatively less.

Objective: To analyse the video-oculographic findings of positional tests and evaluate the efficacy of canalith repositioning procedure (CRP) in patients with paroxysmal positional vertigo ( BPPV) of the anterior semicircular canal (ASC)., Methods: A retrospective study of 31 patients with ASC BPPV. Then the CRP was performed., Results: Twenty-two individuals (70.97%) presented a unilateral positional nystagmus during the Dix-Hallpike test, in 17 individuals had torsional nystagmus component, 5 individuals only had pure positional down beat nystagmus. Nine patients presented bilateral positional nystagmus, 7 individuals had torsional component positional nystagmus, in 2 patients the direction of the torsional component were the same during right and left Dix-Hallpike test, in 4 patients the torsional component were concurrent with positional down beat nystagmus but the direction could not be ascertained clinically, in 2 patients had pure positional down beat nystagmus. Nineteen patients (61.29%) had unilateral lesion, 11 patients had the left ASC BPPV, 8 patients had right ASC BPPV. Eleven patients had with both ASC and PSC BPPV in the ipsilateral. Twenty-one patients (67.74%) were cured, 29 patients (93.55%) were improved, 2 (6.45%) patients were inefficacy. CRP effectively resolved the nystagmus and vertigo in 14 patients (45.16%) when applied only once, The average number of CRP was 1.7 times, there were 5 patients recurrence during the follow-up., Conclusions: ASC BPPV was not a common condition. The torsional nystagmus component of ASC BPPV might be weak during the Dix-Hallpike test. The positional nystagmus of ASC BPPV was triggered bilaterally. Based on these findings, CRP could be one of the most effective treatment methods for ASC BPPV.

Objective: To investigate the short-term efficacy and safety of transtympanic pressure treatment in the management of recalcitrant vertigo in Meniere disease in order to lead to the further long-term treatment., Methods: Using cross-sectional case study, eighteen patients with medically intractable and active Meniere disease were opted to manage with Meniett pulse generator. A standard ventilation tube was inserted in the affected ear and the treatment period with Meniett pulse generator was 8 weeks. Patients indicated on the symptom report card and six-point functional scale the maximum level of vertigo, activity and stress. Hearing was assessed by pure tone average thresholds (PTA), moreover, electrocochleogram and vestibular caloric were performed., Results: Of eighteen patients, the changes of vertigo severity, vertigo frequency, sick day and six-point functional scale between after and before treatment with Meniett were statistically significant (P < 0.05), moreover, the changes of--SP/AP between after and before treatment with Meniett were statistically significant (P < 0.05). No change in vestibular function was noted. Two of 18 patients showed a significant PTA increase of 10dB or more and hearing was stable in the remainder of patients 4 weeks after treatment with Meniett. Twelve of 18 patients showed a significant PTA increase of 10dB or more and hearing was stable in the remainder of patients 8 weeks after treatment with Meniett. There were no complications during 6-month follow-up with Meniett., Conclusions: Meniett seemed to be a safe, effective and non-destructive level of therapy, which could reduce vertiginous symptoms and functional handicap and showed an improvement of hearing in patients with medically intractable Meniere disease. This method was recommended before attempting any surgical or chemical vestibular ablation procedure.

Objective: To study human vestibular cerebral representations by combining right-sided ice-water stimulation at 0 degree C with blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI) and to evaluate the value of this method in the functional localization of human vestibular cortex., Methods: Twenty right-handed volunteers (12 men and 8 women) received unilateral irrigation of the right external auditory meatu for 15 s with 15 ml of water at 0 degrees C during fMRI in complete darkness. The functional imaging of brain cortex was acquired with a 1.5-T MRI scanner (Signa Infinity Twin + Excite; General Electric Co., USA). The successive functional images from each subject were analyzed as a group with statistical parametric mapping software (SPM 99)., Results: Ultimately, data obtained from 17 subjects were analyzed (3 subjects were eliminated from data because of head movement exceeding 2 mm). The group analysis showed bilateral (particularly left-sided) cortical activation, associated with caloric stimulus involving in temporoparietal junction extending into the posterior insula, supramarginal gyrus in the inferior parietal lobe, precuneus, supplementary motor area (SMA), the ventrolateral portion of the occipital lobe, cuneus and lingual gyrus, superior temporal gyrus and cingular cortex., Conclusions: Ice-water stimulation at 0 degree C in fMRI reveals a widespread cortical network involved in vestibular signal processing in human. As the functional localization of vestibular cortex could be determined precisely, ice-water stimulation at 0 degree C in fMRI would hold great promise as a sensitive and reproducible tool for the research in human vestibular cortex.

Objective: To understand the various factors causing vertigo and balance disorders in the elderly., Methods: 118 elderly patients (aged equal or older than 60 years of age) with vertigo or balance disorders were retrospectively analyzed through clinical symptoms, audio-vestibular function tests, X-ray, CT scan or MRI in cervical vertebras, brain and inner ears, ultrasonography, transcranial doppler (TCD) or magnetic resonance angiography (MRA) in blood vessels on head and neck., Results: Of 118 patients, 70 (23%) of them suffered perip heral vestibular disorders while 29 (58%) having cerebral vertigo or dizzness, leaving 19 cases (16%) as unclassified., Conclusion: For elderly patients, vertigo and balance disorders were commonly caused by many kinds of peripheral and cerebral vestibular pathological disfunctions while the functional weakness of vestibular organs and systems affected by the physiological process of ageing and different concommitant diseases as well as environmental, psychogenic factors should also be considered.

Objective: To investigate whether apoptosis is one of the mechanism for cell death in spiral ganglion(SG) and organ of Corti of Mongolian gerbils cochlea induced by cisplatin., Methods: Mongolian gerbils were administered 4 mg.kg-1.d-1 cisplatin consecutively for 4 to 7 days. The apoptotic cell death in spiral ganglion and organ of Corti of cochlea basal turn was detected via transmission electron microscopy and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) method., Results: The observation of electron microscopy shown special morphological change consistent with the feature of cell apoptosis in some spiral ganglion cells and outer hair cells after 5-7 days' cisplatin treatment. The apoptotic labeling by TUNEL in spiral ganglion and organ of Corti was detected after 5 days' treatment and increased after 6 and 7 days' treatment whereas almost negative result were obtained in the normal control animals., Conclusion: Apoptosis is one of the important mechanisms for cell injury of spiral ganglion and organ of Corti induced by cisplatin.

Objective: To measure the voice samples of the normal aged in order to systemically study the features of the voice changes., Method: To collect and analyze 146 voice samples of the normal aged with sonogram., Result: The fundamental frequency of the voice of the aged decreases and rises in the male more than 80 years older. The low frequency harmonics are regulation and the intensity is strong in the formant of the aged. The difference reduces in voice between male and female. The harmonics to noise ratio tends downwards and the amplitude perturbation quotient tends upwards along with the growth of age in the aged male. The changes of the above-mentioned parameters are not significant in the aged female., Conclusion: The voice changes are normal physiological ones in the normal aged. The changes of the parameters are used to evaluate normal aged voice and abnormal one. The changes show that the function in the aged phonation tends to decline to a certain extent and it must be protected and be trained.